Improved Air Quality in Reunified Germany and Decreases in Respiratory Symptoms

Abstract

The decreasing prevalence of nonallergic respiratory symptoms, along with improvements in ambient particle mass and sulfur dioxide (but not in nucleation-mode particles), indicates the reversibility of adverse health effects in children. This adds further evidence of a causal association between combustion-related air pollutants and childhood respiratory symptoms.

Nonallergic respiratory morbidity improved along with a decline of traditional air pollution levels: a review

“…The annual mean TSP decreased from 1991 to 1998. The crude prevalence of bronchitis in the three respective areas decreased by 15%, 12%, and 11% between 1992 and 1995 [14]; prevalence of nonallergic respiratory symptoms also decreased for an extended follow-up until 1999, indicating the reversibility of adverse health effects [14,15]. This adds further evidence to a causal association between combustion-related air pollutants and childhood respiratory symptoms.…”

“…One of these studies reported effect estimates stratified for children with and without indoor exposures such as those derived from parental tobacco smoke, emissions from gas stoves, mouldy or damp homes or from cats. Children without these indoor exposure revealed higher effect sizes and had a greater benefit from the improvement of air hygiene levels than children who were exposed to at least one of these indoor pollutants [15]. The effect size estimates for FVC were also higher in children not exposed to these indoor factors [47].…”

“…Examinations of w14,000 school beginners in each single school year 1991-1995 in four regions of Sachsen and Sachsen-Anhalt found a temporal decrease of prevalence of infectious airway diseases (bronchitis, tonsillitis, frequent colds, frequent cough) along with the strong decline in an annual mean of SO 2 ) and TSP (56 versus 29%) [15]. The design of two of these three studies allowed the contribution of ambient air pollution to the temporal changes of prevalence of respiratory illness to be modelled [15,43]. In table 2 the effect estimates are given for SO 2 and TSP on 1991, 1992, 1993, 1994, 1995 1992-1993, 1995-1996, 1998-1999 1991-1992, 1995 : repeated lung function measurements were performed only in sixth graders.…”

Metal composition of ambient PM2.5 influences severity of allergic airways disease in mice.

“…Despite the closure of several industries in Hettstedt and the convergence of particle mass levels during the 1990s, regional differences in PM elemental composition persist (Heinrich et al 2002a), perhaps as a result of the reopening of industries in Hettstedt, persisting industrial emissions, resuspension of contaminated dust from slagheap, and geographical characteristics of the region, as Hettstedt is in a valley surrounded by hills, whereas Zerbst is located in a fairly level county (Heinrich et al 1999(Heinrich et al , 2002a. Although Zerbst has a predominant agricultural economy, endotoxin levels present in both Zerbst and Hettstedt PM 2.5 samples were very low, indicating that endotoxin was not responsible for the observed enhancement of allergic airway responses.…”

“…These results suggested that exposure to air pollutants, including PM 2.5 (PM < 2.5 µm aerodynamic diameter), could promote sensitization to common aeroallergens and promote the development or exacerbation of allergic and respiratory diseases. After German reunification, levels of total PM and sulfur dioxide in eastern Germany decreased throughout the 1990s, and regional differences in the prevalence of bronchitis, sinusitis, and frequent colds declined (Heinrich et al 2000(Heinrich et al , 2002a. However, the difference in the prevalence of allergies between the two cities continued, despite the convergence of ambient PM concentrations (Heinrich et al 2002b), suggesting that the composition of Hettstedt PM may also contribute to the higher prevalence of allergies in that area.…”