鞍山市大气污染对儿童呼吸系统健康的影响

目的探讨空气污染对儿童呼吸系统健康的危害.方法于2002年4月,在鞍山市轻、中、重污染区随机抽取小学和幼儿园各1所,学校内的所有学生作为调查对象(共1951人),调查不同污染区的儿童健康状况及室内外环境.结果鞍山市儿童持续咳嗽、持续咯痰、哮喘、哮喘现患、喘鸣及喘鸣样症状的发生率分别为9.48%,4.82%,1.33%,0.92%,6.30%,4.97%.幼儿哮喘、哮喘现患,喘鸣、喘鸣样症状发生率均高于学龄儿童;性别间差异无统计学意义.重污染区儿童持续咳嗽和持续咯痰的发生率高于轻污染区儿童的发生率(P＜0.05).随着住房与交通干线距离的接近,儿童呼吸系统疾病的发生率也呈增高趋势.易感因素与室外空气污染的联合作用较强,呼吸系统各种疾病的发生率均以受大气污染影响的易感儿童为高,无大气污染影响的非易感儿童发生率为低.结论室外空气污染是儿童呼吸系统健康的影响因素.     

室外空气污染对学龄儿童呼吸系统健康影响的研究

[目的]探讨沈阳市室外空气污染对学龄儿童呼吸系统健康的影响,筛选敏感效应指标。[方法]根据该市环保局大气污染监测资料,采取整群抽样的方法在轻、重污染区选取1、6年级学龄儿童各3000名,男女各半,进行呼吸系统健康问卷调查。并在此基上在轻、重污染区各抽取150名学龄儿童,男女各半,进行血清IgE测定。[结果]重污染区儿童咳嗽、咳痰、持续咳嗽、咳嗽咳痰、持续性咳嗽咳痰的阳性率均高于轻污染区儿童,差异有统计学意义﹙P﹤0.01﹚;重污染区肺炎和哮喘的发病率与轻污染区比较差异有统计学意义﹙P﹤0.05﹚,经非条件Logistic回归分析,居住在重污染区的学龄儿童呼吸系统疾病的危险度明显高于轻污染区的儿童,OR值﹥1。在控制其他因素后,学龄儿童呼吸系统健康与父母亲呼吸系统疾病史也呈正相关;血清IgE浓度比较,重污染区明显高于轻污染区﹙P﹤0.01﹚,且一年级血清IgE浓度更高,与空气污染程度一致。[结论]室外空气污染能引起学龄儿童呼吸系统健康的损害,父母亲呼吸系统疾病史也是危险因素之一。血清IgE可作为引起过敏反应的早期敏感效应指标。     

本溪市儿童呼吸系统健康状况及其影响因素

目的 调查工业城市——本溪市大气污染对儿童呼吸系统健康的影响,筛选可能产生呼吸系统损害的各种因素,以提出防治措施,保护易感人群。方法 根据环保部门提供的大气污染数据,选择轻、重2个污染区,并分别选取1、6年级学龄儿童各3000名,男、女各半,以发放调查表的方式进行呼吸系统健康状况调查。结果 轻、重污染区TSP浓度分别为0.59 mg/m3和1.02 mg/m3,差异有显著性(P<0.05);SO2分别为0.17 mg/m3和0.19 mg/m3。重污染区儿童的咳嗽、咯痰、咳嗽咯痰、持续咳嗽咯痰等症状的阳性率均高于轻污染区儿童(P<0.05)。重污染区儿童的支气管炎、哮喘性支气管炎、肺炎的患病率也高于轻污染区儿童(P<0.05)。用非条件logistic回归模型计算了几种呼吸系统症状和疾病的OR值及95%,可信区间,通过调整大气污染区、年龄、性别、家庭用煤、父母吸烟、通风设施、父母亲呼吸系疾病史等因素,在控制了其他因素后,重污染区儿童患呼吸系统疾病和症状的危险性显著高于轻污染区(P<0.05或P<0.01)。父母亲呼吸系疾病史、家庭成员吸烟也是危险因素之一。结论 大气污染能够引起儿童呼吸系统健康的损害。     

家养皮毛宠物与儿童哮喘关系

目的 了解家养皮毛宠物与儿童哮喘的关系.方法 采用整群抽样方法,在沈阳市5个行政区内随机选取10所幼儿园和5所小学,采用国际统一标准问卷ATS调查表对所有学生进行呼吸系统疾病及症状调查.结果 沈阳市儿童持续咳嗽、持续咳痰、哮喘、哮喘现患、喘鸣现患和过敏性鼻炎的患病率分别为9.53％、4.49％、6.23％、2.42％、5.61％和5.27％,其中男生哮喘、喘鸣现患及过敏性鼻炎的患病率明显高于女生(P＜0.05);家养宠物对儿童哮喘无明显影响,但与宠物同室睡会增加儿童患哮喘的危险(P＜0.05);logistic回归分析显示,与无家族易感史且未饲养宠物的儿童相比,具有家族易感史的儿童患哮喘的危险增加了229％(95％ CI=2.55～4.25),而同时暴露家族易感史和宠物的儿童患哮喘的危险增加了101％(95％CI=1.17 ～3.43),家族易感史与家养宠物的交互效应差异无统计学意义(P＞0.05).结论 家族易感史是儿童患哮喘及哮喘样症状的危险因素,家养皮毛宠物对儿童哮喘的影响与儿童跟宠物接触的密切程度有关.     

百色市室内环境污染对儿童哮喘及哮喘样症状影响的流行病学调查

目的 探讨室内环境污染对儿童哮喘及哮喘样症状的影响效应.方法 采用整群随机抽样方法,于2010年4月在百色市随机抽取6所小学,采用国际统一的标准问卷ATS调查表对所选学校的所有学生的室内环境和呼吸系统疾病及症状进行流行病学调查.结果 百色市儿童的持续咳嗽、持续咳痰、哮喘、哮喘现患、喘鸣现患和过敏性鼻炎的患病率分别是11.52％、6.68％、7.63％ 、2.04％、4.15％、5.90％.男性儿童哮喘和哮喘现患患病率显著高于女性儿童患病水平(P＜0.05).多因素非条件logistic回归分析结果显示,暴露室内装修可显著的增高儿童患有哮喘的风险性(OR=1.88,95％ CI=1.46 ～2.42),暴露被动吸烟的儿童患有哮喘的风险性是非暴露儿童的1.76倍(95％ CI=1.37 ～2.26),同时在调整了其他混杂因素的效应后,家养宠物(OR=1.68,95％CI=1.26～2.24)、室内发霉或霉斑(OR=1.87,95％CI=1.17～2.98)及蟑螂(OR=1.96,95％ CI=1.51～2.54)等均为儿童患有哮喘的危险因素;而冬季经常开窗换气和使用抽油烟机可降低儿童患有哮喘及哮喘样症状的危险性.结论 室内装修、被动吸烟暴露、室内烹饪油烟、饲养宠物、霉菌、蟑螂是儿童患有哮喘及哮喘样症状的危险因素;而开窗换气和使用抽油烟机可降低儿童患有哮喘的危险性.     

青岛地区儿童哮喘影响因素病例对照研究

目的探讨儿童哮喘的影响因素。方法应用1：1配对的病例一对照研究方法，采用问卷调查方式，调查300对病例和对照儿童，并分析有关的暴露因素。结果单因素Logistic回归分析结果显示，有17个因素与儿童哮喘有关联，包括父亲呼吸系统疾病史、母亲呼吸系统疾病史、家庭收入情况、特应性体质、急性呼吸道感染史、食肉习惯、海产品摄入量、是否有泡沫制品、是否装修过、厨房排烟方式、排烟效果、是否饲养宠物、家族哮喘病史、家族过敏性鼻炎史、父母食物过敏史、父母粉尘过敏史、首次发病后是否经过系统治疗。多因素Logistic回归分析显示，7个因素进入主效应模型，其中父亲有呼吸系统疾病史（OR=3．771，95％CI：1．533～9．278）、家庭低收入（OR=I．503，95％CI：1．258～1．795）、特应性体质（OR=3．788，95％CI：2．368～6．058）、喜食肥肉（OR=2．042，95％CI：1．481～2．815）、家族哮喘病史（OR=I．710，95％CI：0．988～2．958）、家族过敏性鼻炎史（OR=I．991，95％CI：1．234～3.211）是儿童哮喘的危险因素，饲养宠物（OR=0．443，95％CI：0．265～0．739）是保护因素；回归系数分别为1．327，0．407，1．332，0．714，0．536，0．689，-0．814。结论儿童哮喘是遗传和环境双重因素共同作用导致的一种复杂疾病。     

大气污染对学龄儿童呼吸系统健康的影响(一)

目的：探讨现有水平大气污染对儿童呼吸系统健康的影响程度，为控制大气污染的损害。保护人类健康提供依据。方法：在辽宁省大气污染程度不同的三个城市，采用整群抽样的方法每个城市大气轻，重污染区抽取6000名小学1，6年级的学龄儿童，进行儿童呼吸系统健康状况的调查。结果：本溪，沈阳两个重工业城市中，重污染区儿童的咳嗽，咳痰，持续性咳嗽咳痰的阳性率及既往呼吸系统疾病如肺炎，支气管炎的患病率显著高于轻污染区的儿童，而大连轻，重污染区的儿童呼吸系统健康状况差异无显著性。结论：大气污染可引起儿童呼吸系统疾病和症状的阳性率增高，是导致儿童呼吸系统健康损害的危险因素。     

大气污染对儿童上呼吸道微生态影响的分析

目的：探讨大气污染对儿童上呼吸道微生态的影响。为微生态防治提供依据。方法：采用整群抽样的方法，分别于2000年、2002年对沈阳市大气污染、轻重不同两个地区的儿童进行了上呼吸道菌群检测。需氧菌用血琼脂和伊红美兰琼脂培养，按常规方法鉴定；厌氧菌用厌氧分离培养基培养，按KA21－109微机处理系统检索。结果：轻重污染区儿童口咽部菌群分布出现不同，轻污染区儿童口咽部的优势菌依次为奈瑟氏菌（85．6％）、消化链球菌（54．4％）、甲型链球菌（42．2％），重污染区依次为奈瑟氏菌（90．1％）、肺炎链球菌（50．6％）、韦荣球菌（48．1％），其中两地区儿童口咽部肺炎链球菌和甲型链球菌比较有显性差异（P＜0．01），重污染区儿童甲型链球菌减少。重污染区检出的细菌种类数为24，离于轻污染区（17种），并有非正常菌群。对不同污染区儿童咽部菌群密度分析，重污染区儿童口咽部需氧菌和厌氧菌密度均高于轻污染区（P＜0．01）。此外重污染区儿童咽部菌群密度分析，重污染区儿童口咽部需氧菌和厌氧菌密度均高于轻污染区（P＜0．01）。此外重污染区儿童条件致病菌检出率高于轻污染区（P＜0．01）。结论：大气污染可使儿童上呼吸道菌群平衡发生改变，特别是甲型链球菌的减少，可导致其它异常菌群的增多，使呼吸系统疾病易感性增强。     

大气环境质量对学龄儿童呼吸健康的影响

目的研究大气环境质量对学龄儿童呼吸健康的影响。方法根据南宁市环境监测站的常规监测资料,选择分别位于南宁市重污染区、中污染区和轻污染区的3所小学的全体学生为研究对象。空气质量采用上海大气质量指数进行评价;疾病资料通过流行病学调查和问卷调查收集。结果重污染区学生支气管炎、肺炎、哮喘、鼻炎、扁桃体炎的患病率高于轻污染区(P<0.05)。用非条件Logistic回归模型计算了以上几种呼吸系统疾病的OR值和95%的可信区间,通过调整性别、年龄、家庭用煤、家庭成员吸烟、父母亲呼吸系统病史、大气污染等因素,在控制了其他因素后,大气重污染区学龄儿童患呼吸系统疾病的危险性显著高于轻污染区(P<0.05或P<0.01)。父母亲呼吸系统疾病史、家庭成员吸烟、家庭燃煤也是危险因素。结论大气污染能引起学龄儿童的呼吸系统健康的损害。     

湘潭某工厂子弟中学学生受虐待的多因素分析

目的探讨儿童受虐待的危险因素，以便为保护儿童身心健康提供依据。方法抽取湘潭某工厂子弟学校初中二年级学生282名，采用一般资料问卷、儿童受虐筛查表、父母养育方式评价量表及艾森克个性问卷(儿童版)进行调查。将父母养育方式评价量表及艾森克个性问卷(儿童)共计15个因子作为自变量进行Logistic回归分析。结果近1a内遭受过虐待的儿童有86名，儿童遭受虐待行为的危险因素有父亲惩罚、严厉(B=0．073，OR=1．076，P=0．012，95％CI为1．016—1．140)，母亲拒绝、否认(B=0．115，OR=1．121，P=0．002，95％CI为1．042～1．207)，儿童性格古怪、孤僻、易找麻烦(B=-0．026，OR=0．974，P=0．099，95％CI为0．944—1．005)以及儿重个性的掩饰维度(B=-0．035，OR=0．966，P=0．041，95％CI为0．934-0．999)进入Logistie回归方程。结论父亲应减少对儿童的惩罚、严厉，母亲应减少对儿童的拒绝、否认。同时，着力塑造儿童健全的人格，有望减少儿童受虐的发生。     

Asthmatic symptoms among pupils in relation to winter indoor and outdoor air pollution in schools in Taiyuan, China

BACKGROUND: There are few studies on associations between children's respiratory heath and air pollution in schools in China. The industrial development and increased traffic may affect the indoor exposure to air pollutants in school environment. Moreover, there is a need to study respiratory effects of environmental tobacco smoke (ETS) and emissions from new building materials in homes in China. OBJECTIVES: We studied the associations between pupils' asthmatic symptoms and indoor and outdoor air pollution in schools, as well as selected home exposures, in a coal-burning city in north China. METHODS: A questionnaire survey was administered to pupils (11-15 years of age) in 10 schools in urban Taiyuan, collecting data on respiratory health and selected home environmental factors. Indoor and outdoor school air pollutants and climate factors were measured in winter. RESULTS: A total of 1,993 pupils (90.2%) participated; 1.8% had cumulative asthma, 8.4% wheezing, 29.8% had daytime attacks of breathlessness. The indoor average concentrations of sulfur dioxide, nitrogen dioxide, ozone, and formaldehyde by class were 264.8, 39.4, 10.1, and 2.3 microg/m3, respectively. Outdoor levels were two to three times higher. Controlling for possible confounders, either wheeze or daytime or nocturnal attacks of breathlessness were positively associated with SO2, NO2, or formaldehyde. In addition, ETS and new furniture at home were risk factors for wheeze, daytime breathlessness, and respiratory infections. CONCLUSIONS: Indoor chemical air pollutants of mainly outdoor origin could be risk factors for pupils' respiratory symptoms at school, and home exposure to ETS and chemical emissions from new furniture could affect pupils' respiratory health.     

Acute effects of urban ambient air pollution on respiratory symptoms, asthma medication use, and doctor visits for asthma in a cohort of Australian children

We enrolled a cohort of primary school children with a history of wheeze (n=148) in an 11-month longitudinal study to examine the relationship between ambient air pollution and respiratory morbidity. We obtained daily air pollution (ozone, particulate matter less than 10 microm, and nitrogen dioxide), meteorological, and pollen data. One hundred twenty-five children remained in the final analysis. We used logistic regression models to determine associations between air pollution and respiratory symptoms, asthma medication use, and doctor visits for asthma. There were no associations between ambient ozone concentrations and respiratory symptoms, asthma medication use, and doctor visits for asthma. There was, however, an association between PM(10) concentrations and doctor visits for asthma (RR=1.11, 95% CI=1.04-1.19) and between NO(2) concentration and wet cough (RR=1.05, 95% CI=1.003-1.10) in single-pollutant models. The associations remained significant in multipollutant models. There was no consistent evidence that children with wheeze, positive histamine challenge, and doctor diagnosis of asthma reacted differently to air pollution from children with wheeze and doctor diagnosis of asthma and children with wheeze only. There were significant associations between PM(10) levels and doctor visits for asthma and an association between NO(2) levels and the prevalence of wet cough. We were, however, unable to demonstrate that current levels of ambient air pollution in western Sydney have a coherent range of adverse health effects on children with a history of wheezing.     

Traffic-related outdoor air pollution and respiratory symptoms in children: the impact of adjustment for exposure measurement error

BACKGROUND: Outdoor concentrations of soot and nitrogen dioxide (NO2) outside of schools have been associated with children's respiratory and eye symptoms. We assessed how adjustments for measurement error affect these associations. METHODS: Concentrations of air pollutants outside children's schools were validated by personal measurements of exposure to traffic-related air pollution. We estimated prevalence ratios of 4 health outcomes (current wheeze, conjunctivitis, phlegm, and elevated total serum immunoglobulin E) using school outdoor measurements, and then adjusted for measurement error using the personal exposure data and applying a regression calibration method. The analysis adjusting for measurement error was carried out using a main study/external validation design. RESULTS: Adjusting for measurement error produced effect estimates related to soot and NO2 that were 2 to 3 times higher than in the original study. The adjusted prevalence ratio for current phlegm was 5.3 (95% confidence interval = 1.2-23) for a 9.3 microg/m3 increase in soot, and 3.8 (1.0-14), for a 17.6 microg/m3 increase in NO2, compared with the original results of 2.2 (1.3-3.9) and 1.8 (1.1-2.8), respectively. Corrections were of similar magnitude for the prevalence of current wheeze, current conjunctivitis, and total elevated total immunoglobulin E. CONCLUSIONS: The estimated effects of outdoor air pollution on respiratory and other health effects in children may be substantially attenuated when based on exposure measurements outside schools instead of personal exposure.     

Air pollution and bronchitic symptoms in Southern California children with asthma.

The association of air pollution with the prevalence of chronic lower respiratory tract symptoms among children with a history of asthma or related symptoms was examined in a cross-sectional study. Parents of a total of 3,676 fourth, seventh, and tenth graders from classrooms in 12 communities in Southern California completed questionnaires that characterized the children's histories of respiratory illness and associated risk factors. The prevalences of bronchitis, chronic phlegm, and chronic cough were investigated among children with a history of asthma, wheeze without diagnosed asthma, and neither wheeze nor asthma. Average ambient annual exposure to ozone, particulate matter (PM(10) and PM(2.5); [less than/equal to] 10 microm and < 2.5 microm in aerodynamic diameter, respectively), acid vapor, and nitrogen dioxide (NO(2)) was estimated from monitoring stations in each community. Positive associations between air pollution and bronchitis and phlegm were observed only among children with asthma. As PM(10) increased across communities, there was a corresponding increase in the risk per interquartile range of bronchitis [odds ratio (OR) 1.4/19 microg/m(3); 95% confidence interval (CI), 1.1-1.8). Increased prevalence of phlegm was significantly associated with increasing exposure to all ambient pollutants except ozone. The strongest association was for NO(2), based on relative risk per interquartile range in the 12 communities (OR 2.7/24 ppb; CI, 1.4-5.3). The results suggest that children with a prior diagnosis of asthma are more likely to develop persistent lower respiratory tract symptoms when exposed to air pollution in Southern California.     

Factor analysis of household factors: are they associated with respiratory conditions in Chinese children?

BACKGROUND: We explored methods to develop uncorrelated variables for epidemiological analysis models. They were used to examine associations between respiratory health outcomes and multiple household risk factors. METHODS: We analysed data collected in the Four Chinese Cities Study (FCCS) to examine health effects on prevalence rates of respiratory symptoms and illnesses in 7058 school children living in the four Chinese cities: Lanzhou, Chongqing, Wuhan, and Guangzhou. We used factor analysis approaches to reduce the number of the children's lifestyle/household variables and to develop new uncorrelated 'factor' variables. We used unconditional logistic regression models to examine associations between the factor variables and the respiratory health outcomes, while controlling for other covariates. RESULTS: Five factor variables were derived from 21 original variables: heating coal smoke, cooking coal smoke, socioeconomic status, ventilation, and environmental tobacco smoke (ETS) and parental asthma. We found that higher exposure to heating coal smoke was associated with higher reporting of cough with phlegm, wheeze, and asthma. Cooking coal smoke was not associated with any of the outcomes. Lower socioeconomic status was associated with lower reporting of persistent cough and bronchitis. Higher household ventilation was associated with lower reporting of persistent cough, persistent phlegm, cough with phlegm, bronchitis, and wheeze. Higher exposure to ETS and the presence of parental asthma were associated with higher reporting of persistent cough, persistent phlegm, cough with phlegm, bronchitis, wheeze, and asthma. CONCLUSIONS: Our study suggests that independent respiratory effects of exposure to indoor air pollution, heating coal smoke, and ETS may exist for the studied children.     

Effect of outdoor and indoor nitrogen dioxide on respiratory symptoms in schoolchildren

BACKGROUND: Nitrogen dioxide (NO(2)), an oxidant gas that contaminates both outdoor and indoor air, is considered to be a potential risk factor for asthma. We investigated concurrently the effects of outdoor and indoor NO(2) on the prevalence and incidence of respiratory symptoms among children. METHODS: A cohort study was carried out over 3 years on 842 schoolchildren living in seven different communities in Japan. Indoor NO(2) concentrations over 24 hours were measured in both winter and summer in the homes of the subjects, and a 3-year average of the outdoor NO(2) concentration was determined for each community. Respiratory symptoms were evaluated every year from responses to questionnaires. RESULTS: The prevalence of bronchitis, wheeze, and asthma significantly increased with increases of indoor NO(2) concentrations among girls, but not among boys. In neither boys nor girls were there significant differences in the prevalence of respiratory symptoms among urban, suburban, and rural districts. The incidence of asthma increased among children living in areas with high concentrations of outdoor NO(2). Multiple logistic regression analysis showed that a 10 parts per billion (ppb) increase of outdoor NO(2) concentration was associated with an increased incidence of wheeze and asthma (odds ratios [OR] = 1.76, 95% CI : 1.04-3.23 and OR = 2.10, 95% CI : 1.10-4.75, respectively), but that no such associations were found with indoor NO(2) concentration (OR = 0.73, 95% CI : 0.45-1.14 and OR = 0.87, 95% CI : 0.51-1.43, respectively). CONCLUSIONS: These findings suggest that outdoor NO(2) air pollution may be particularly important for the development of wheeze and asthma among children. Indoor NO(2) concentrations were associated with the prevalence of respiratory symptoms only among girls. Girls may be more susceptible to indoor air pollution than boys.     

Children's respiratory morbidity prevalence in relation to air pollution in four Chinese cities

We examined respiratory health effects of long-term exposure to ambient air pollution in 7,621 schoolchildren residing in eight districts of four Chinese cities. The four cities exhibited wide between-city and within-city gradients in ambient levels of four size fractions of particulate matter [less than or equal to 2.5 micro m in aerodynamic diameter (PM(2.5)), between 2.5 and 10 micro m (PM(10-2.5)), less than or equal to 10 micro m (PM(10)), and total suspended particulates (TSP)] and two gaseous pollutants (SO(2) and NO(x)). Informed consent and written responses to questionnaires about children's personal, residential, and family information, as well as their health histories and status, were obtained with the help of the parents and the school personnel. We used a two-stage regression approach in data analyses. In the first-stage logistic regressions, we obtained logits of district-specific prevalence of wheeze, asthma, bronchitis, hospitalization for respiratory diseases, persistent cough, and persistent phlegm, adjusted for covariates representing personal, household, and family parameters. Some of these covariates were found to be risk factors of children's respiratory health, including being younger in the study group, being male, having been breast-fed, sharing bedrooms, sharing beds, room being smoky during cooking, eye irritation during cooking, parental smoking, and a history of parental asthma. In several of the second-stage variance-weighted linear regressions, we examined associations between district-specific adjusted prevalence rates and district-specific ambient levels of each pollutant. We found positive associations between morbidity prevalence and outdoor levels of PM of all size fractions, but the association appeared to be stronger for coarse particles (PM(10-2.5)). The results also present some evidence that ambient levels of NO(x) and SO(2) were positively associated with children's respiratory symptoms, but the evidence for these two gaseous pollutants appeared to be weaker than that for the PM.     

Outdoor sulphur dioxide and respiratory symptoms in Czech and Polish school children: a small-area study (SAVIAH)

OBJECTIVES: Air pollution has been linked to respiratory outcomes but controversy persists about its long-term effects. We used a novel technique to estimate the outdoor concentrations of sulphur dioxide (SO2) at small-area level to study the long-term effects on respiratory symptoms and disease in children. METHODS: As part of the international SAVIAH study, parents of 8,013 children aged 7-10 studied in Prague (Czech Republic) and Poznan (Poland) completed a questionnaire covering respiratory health, demographic and socio-economic factors and health behaviours (response rate 91%). This report is based on 6,959 children with complete data. Outdoor SO2 was measured by passive samplers at 80 sites in Poznan and 50 sites in Prague during 2-week campaigns. Concentrations of SO2 at each point (location) in the study areas were estimated from these data by modelling in a geographical information system. The mean of the estimated SO2 concentrations at children's homes and schools was used as an indicator of exposure to outdoor SO2. RESULTS: The prevalence of respiratory outcomes was similar in both cities. In the pooled data, 12% of children had experienced wheezing/whistling in the past 12 months; 28% had a lifetime prevalence of wheezing/whistling; 14% had a dry cough at night; and 3% had had asthma diagnosed by a doctor. The estimated mean exposure to outdoor SO2 was 80 (range 44-140) microg/m3 in Poznan and 84 (66-97) microg/m3 in Prague. After socio-economic characteristics and other covariates were controlled for, SO2 was associated with wheezing/whistling in the past 12 months (adjusted OR per 50 microg/m3 1.32, 95% CI 1.10-1.57), lifetime prevalence of wheezing/whistling (OR 1.13, 95% CI 0.99-1.30), and lifetime prevalence of asthma diagnosed by a doctor (OR 1.39, 95% CI 1.01-1.92). The association with dry cough at night did not reach statistical significance. CONCLUSIONS: In these two Central European cities with relatively high levels of air pollution, small-area based indicators of long-term outdoor winter concentrations of SO2 were associated with wheezing/whistling and with asthma diagnosed by a doctor.     

Traffic density and stationary sources of air pollution associated with wheeze, asthma, and immunoglobulin E from birth to age 5 years among New York City children

Exposures to ambient air traffic-related pollutants and their sources have been associated with respiratory and asthma morbidity in children. However, longitudinal investigation of the effects of traffic-related exposures during early childhood is limited. We examined associations of residential proximity and density of traffic and stationary sources of air pollution with wheeze, asthma, and immunoglobulin (Ig) E among New York City children between birth and age 5 years.Subjects included 593 Dominican and African American participants from the Columbia Center for Children's Environmental Health cohort. Prenatally, through age 5 years, residential and respiratory health data were collected every 3–6 months. At ages 2, 3, and 5 years, serum IgE was measured. Spatial data on the proximity and density of roadways and built environment were collected for a 250 m buffer around subjects' homes. Associations of wheeze, asthma, total IgE, and allergen-specific IgE with prenatal, earlier childhood, and concurrent exposures to air pollution sources were analyzed using generalized estimating equations or logistic regression.In repeated measures analyses, concurrent residential density of four-way intersections was associated significantly with wheeze (odds ratio: 1.26; 95% confidence interval [CI]: 1.01, 1.57). Age 1 exposures also were associated with wheeze at subsequent ages. Concurrent proximity to highway was associated more strongly with total IgE (ratio of the geometric mean levels: 1.25; 95% CI: 1.09, 1.42) than were prenatal or earlier childhood exposures. Positive associations also were observed between percent commercial building area and asthma, wheeze, and IgE and between proximity to stationary sources of air pollution and asthma.Longitudinal investigation suggests that among Dominican and African American children living in Northern Manhattan and South Bronx during ages 0–5 years, residence in neighborhoods with high density of traffic and industrial facilities may contribute to chronic respiratory morbidity, and concurrent, prenatal, and earlier childhood exposures may be important. These findings may have broad implications for other urban populations that commonly have high asthma prevalence and exposure to a high density of traffic and stationary air pollution sources.