Pollution effects on asthmatic children in Europe, the PEACE study

Roemer,; Hoek,; Brunekreef, None

doi:10.1046/j.1365-2222.2000.00851.x

Cited by 47 publications

(46 citation statements)

References 35 publications

(27 reference statements)

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“…An association with elevated PM10 concentrations was observed in symptomatic children [4,5,28,31]. In other recent studies, however, PM10 showed no effect on lower respiratory symptoms in adults [32] and children [9,33,35] (PEACE study). In the PEACE study, the short follow-up period made it difficult to control for seasonal or other time trends.…”

Section: Wheezingmentioning

confidence: 72%

“…Small but consistent increases in respiratory symptoms and decreases in lung function were observed in asthmatic adults and children in most of the studies [3][4][5][6][7][8]. In contrast, a large European multicentre study (Pollution Effects on Asthmatic Children in Europe (PEACE)) has shown negative findings [9]. Asthma medication use has been reported to increase in association with particulate air pollution [5,[10][11][12].…”

mentioning

confidence: 98%

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Increased asthma medication use in association with ambient fine and ultrafine particles

Klot¹,

Wölke²,

Tuch³

et al. 2002

European Respiratory Journal

236

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The association between particulate air pollution and asthma medication use and symptoms was assessed in a panel study of 53 adult asthmatics in Erfurt, Germany in winter 1996/1997.Number concentrations of ultrafine particles, 0.01-0.1 mm in diameter (NC0.01-0.1), mean 17,300?cm -3 , and mass concentrations of fine particles 0.01-2.5 mm in diameter (MC0.01-2.5), mean 30.3 mg?m -3 , were measured concurrently. They were not highly correlated (r=0.45). The associations between ambient particle concentrations and the prevalence of inhaled b 2 -agonist, corticosteroid use and asthma symptoms, were analysed separately with logistic regression models, adjusting for trend, temperature, weekend, holidays, and first order autocorrelation of the error.Cumulative exposures over 14 days of ultrafine and fine particles were associated with corticosteroid use. b 2 -agonist use was associated with 5-day mean NC0.01-0.1 and MC0.01-2.5. The prevalence of asthma symptoms was associated with ambient particle concentrations. The results suggest that reported asthma medication use and symptoms increase in association with particulate air pollution and gaseous pollutants such as nitrogen dioxide. Eur Respir J 2002; 20: 691-702.

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Section: Wheezingmentioning

confidence: 72%

mentioning

confidence: 98%

Increased asthma medication use in association with ambient fine and ultrafine particles

Klot¹,

Wölke²,

Tuch³

et al. 2002

European Respiratory Journal

236

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“…Other studies have also reported larger estimates from moving day average exposures than those based on single-day exposures [18,19,20]. The Pollution Effects on Asthmatic Children in Europe (PEACE) study [21] did not see an effect of winter pollutants and presented data based on shorter lags. These differences, as well as possible differences in population characteristics that modify the response to pollution may account for the contradictory results [10].…”

Section: Discussionmentioning

confidence: 99%

The effect of air pollution on inner-city children with asthma

Mortimer¹,

Neas²,

Dockery³

et al. 2002

Eur Respir J

199

117

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The effect of daily ambient air pollution was examined within a cohort of 846 asthmatic children residing in eight urban areas of the USA, using data from the National Cooperative Inner-City Asthma Study.Daily air pollution concentrations were extracted from the Aerometric Information Retrieval System database from the Environment Protection Agency in the USA. Mixed linear models and generalized estimating equation models were used to evaluate the effects of several air pollutants (ozone, sulphur dioxide (SO 2 ), nitrogen dioxide (NO 2 ) and particles with a 50% cut-off aerodynamic diameter of 10 mm (PM10) on peak expiratory flow rate (PEFR) and symptoms in 846 children with a history of asthma (ages 4-9 yrs).None of the pollutants were associated with evening PEFR or symptom reports. Only ozone was associated with declines in morning % PEFR (0.59% decline (95% confidence interval (CI) 0.13-1.05%) per interquartile range (IQR) increase in 5-day average ozone). In single pollutant models, each pollutant was associated with an increased incidence of morning symptoms: (odds ratio (OR)=1.16 (95% CI 1.02-1.30) per IQR increase in 4-day average ozone, OR=1.32 (95% CI 1.03-1.70) per IQR increase in 2-day average SO 2 , OR=1.48 (95% CI 1.02-2.16) per IQR increase in 6-day average NO 2 and OR=1.26 (95% CI 1.0-1.59) per IQR increase in 2-day average PM10.This longitudinal analysis supports previous time-series findings that at levels below current USA air-quality standards, summer-air pollution is significantly related to symptoms and decreased pulmonary function among children with asthma. Much of the evidence for the effect of air pollution on respiratory health [1-8] is based on time-series analyses of repeated measurements in closed cohorts, which create a daily summary of responses across all study individuals. Fluctuations in this summary measure are evaluated relative to daily fluctuations in air pollution. Therefore, these approaches are not well suited to investigations of individual-level factors related to heterogeneity of response. Time-series analyses require that the distribution of individuallevel factors in the study population remain stable over time [9] or that data on changes in these characteristics are included in the model. This limits their usefulness in studying populations which do not remain fixed during the study period.Longitudinal analysis techniques such as mixed linear models and generalized estimating equations provide a more statistically powerful alternative by incorporating individual level outcomes and covariates.They permit estimation of individual mean effects and individual change over time as well as population mean effects over the entire study period. These methods require no assumptions about stability of population characteristics over time and subjects with incomplete data can be included in the analysis [10]. Therefore these methods are well-suited for epidemiological studies.These methods were used to evaluate air pollutionrelated health effects in a large cohort of...

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“…Exposure misclassification from using central regional PM data is expected to diminish the accuracy of exposure-response estimates, possibly leading to null findings. Despite this expectation, with few exceptions (Roemer et al 1999(Roemer et al , 2000, recent panel studies of asthmatic children are largely consistent in showing positive associations between acute increases in asthma morbidity and ambient PM (Delfino et al 1998(Delfino et al , 2002(Delfino et al , 2003Gielen et al 1997;Just et al 2002;Koenig et al 2003;Mortimer et al 2000Mortimer et al , 2002Ostro et al 2001;Pekkanen et al 1997;Peters et al 1997aPeters et al , 1997bRomieu et al 1996;Segala et al 1998;Slaughter et al 2003;Thurston et al 1997;Timonen and Pekkanen 1997;Vedal et al 1998;Yu et al 2000).…”

mentioning

confidence: 99%

Association of FEV1 in asthmatic children with personal and microenvironmental exposure to airborne particulate matter.

Delfino

Quintana²,

Floro³

et al. 2004

Environ Health Perspect

193

143

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Exposure to particulate matter (PM) air pollution has been shown to exacerbate children's asthma, but the exposure sources and temporal characteristics are still under study. Children's exposure to PM is likely to involve both combustion-related ambient PM and PM related to a child's activity in various indoor and outdoor microenvironments. Among 19 children with asthma, 9-17 years of age, we examined the relationship of temporal changes in percent predicted forced expiratory volume in 1 sec (FEV 1 ) to personal continuous PM exposure and to 24-hr average gravimetric PM mass measured at home and central sites. Subjects were followed for 2 weeks during either the fall of 1999 or the spring of 2000, in a southern California region affected by transported air pollution. FEV 1 was measured by subjects in the morning, afternoon, and evening. Exposure measurements included continuous PM using a passive nephelometer carried by subjects; indoor, outdoor home, and central-site 24-hr gravimetric PM 2.5 (PM of aerodynamic diameter < 2.5 µm) and PM 10 ; and central-site hourly PM 10 , nitrogen dioxide, and ozone. Data were analyzed with linear mixed models controlling for within-subject autocorrelation, FEV 1 maneuver time, and exposure period. We found inverse associations of FEV 1 with increasing PM exposure during the 24 hr before the FEV 1 maneuver and with increasing multiday PM averages. Deficits in percent predicted FEV 1 (95% confidence interval) for given PM interquartile ranges measured during the preceding 24-hr were as follows: 128 µg/m 3 1-hr maximum personal PM, -6.0% (

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Pollution effects on asthmatic children in Europe, the PEACE study

Cited by 47 publications

References 35 publications

Increased asthma medication use in association with ambient fine and ultrafine particles

Increased asthma medication use in association with ambient fine and ultrafine particles

The effect of air pollution on inner-city children with asthma

Association of FEV1 in asthmatic children with personal and microenvironmental exposure to airborne particulate matter.

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