Inner city air pollution and respiratory health and atopy in children

Abstract

The impact of inner city air pollution on the development of respiratory and atopic diseases in childhood is still unclear.In a cross sectional study in Dresden, Germany, 5,421 children in two age groups (5±7 yrs and 9±11 yrs) were studied according to the International Study of Asthma and Allergies in Childhood (ISAAC) phase II protocol. The prevalences of wheezing and cough as well as doctor diagnosed asthma and bronchitis were assessed by parental questionnaires. Children also underwent skin-prick testing, venipuncture for the measurement of serum immunoglobulin (Ig)E, lung function testing and a bronchial challenge test (4.5% saline) to assess airway hyperresponsiveness. Exposure was assessed on an individual basis by relating mean annual air pollution levels (SO 2 , NO 2 , CO, benzene, and O 3 ) which had been measured on a 1 km 2 grid, to the home and school address of each study subject.After adjusting for potential confounding factors an increase in the exposure to benzene of 1 mg . m 3 air was associated with an increased prevalence of morning cough (adjusted odds ratio (aOR)): 1.15; 1.04±1.27) and bronchitis (aOR: 1.11; 1.03±1.19). Similar associations were observed for NO 2 and CO. In turn, the prevalences of atopic sensitization, symptoms of atopic diseases and bronchial hyperresponsiveness were not positively associated with exposure to any of these pollutants.It is concluded that in this study a moderate increase in exposure to traffic-related air pollution was associated with an increased prevalence of cough and bronchitis, but not with atopic conditions in children. Eur Respir J 1999; 14: 669±677. [3,4,6] and the occurrence of respiratory tract illnesses. Not all reports attempted to discriminate between the different phenotypes of these conditions. Reports that provide detailed information suggest an effect on the prevalence of cough and bronchitis, but not on asthma and atopy [2,7,8].Other epidemiological studies found an association between automobile [9,10] or truck traffic frequency [11± 13] and wheeze. Higher exposure to truck traffic and black smoke was also associated with impaired forced expiratory volume in one second (FEV1) [14]. Some studies also reported an association between truck traffic frequency [12,13] or black smoke exposure [11] and symptoms of allergic rhinitis. A large Italian study on 39,275 children [15] found a significant association between truck traffic exposure and wheeze, but the associations with other respiratory symptoms (cough and phlegm) were more pronounced. No positive associations were seen between traffic exposure and doctor-diagnosed asthma [9, 11], atopy [11] or bronchial hyperrespon-siveness (BHR) [9]. In contrast to these findings data from in vitro studies and laboratory experiments suggest that particles from diesel exhaust, one of the major contributors to particulate matter pollution in urban areas, specifically promote allergic reactions and BHR [16].Limitations of study design and exposure assessment have hampered the interpretation ...

Expressing urine from a gel disposable diaper for biomonitoring using phthalates as an example

“…Ozone may cause a small increase in reported respiratory symptoms of cough and bronchitis at peak levels greater than 160 μg/m 3 (Braun-Fahrlander et al, 1997). Diesel exhaust emissions have been associated with increased reporting of cough and nonspecific respiratory symptoms in children (Nakatsuka et al, 1991;Nitta et al, 1993;Wjst et al, 1993;Oosterlee et al, 1996;Hirsch et al, 1999). Children living in close proximity to major freeways with high truck density experience increased cough, wheeze, and rhinitis , and children less than two years of age may be the most vulnerable (Gehring et al, 2002).…”

Particulate Air Pollutants and Airway Inflammation

“…Air pollution is convincingly associated with many signs of asthma aggravation, including pulmonary function decrements, increased AHR, visits to emergency departments, hospital admissions, increased medication use, and reported symptoms; it is also associated with inflammatory changes, interactions between air pollution and allergen challenges, and immune symptom changes. 33 A significant association between trafficrelated air pollution and wheeze has also been reported in children, 34,35 and exposure to diesel exhaust particles may reduce lung function in children living near motorways. Long-term exposure to ambient ozone has been associated with the development of asthma in adult males.…”

Use of an index to reflect the aggregate burden of long-term exposure to criteria air pollutants in the United States.

“…Hirsch et al (65) recently found an association between CO and other pollutants and respiratory symptoms in children. Ritz and Yu (70) found an association between 3-month average maternal exposures to CO and low birth weight.…”

“…Researchers have found increased morbidity to be associated with long-term exposure to NO 2 , for decreased lung function (38,58,65,66), increased respiratory symptoms or illness (41,46,65,(67)(68)(69), and increased symptoms in children with asthma (47).…”

“…Researchers have found decreased lung function (38,58) and increased respiratory symptoms or illness (39,65) to be associated with long-term exposure to SO 2 .…”