Respiratory problems associated with exposure to airborne particles in the community.

During the spring of 1995, schoolchildren aged 7-13 y who lived in a rural area in Israel were studied. These children lived in two communities: in one community, the population was exposed to pollution from a cement factory and quarries; the population of the second community was not exposed to pollution from these sources. The children from participating schools performed forced vital capacity, forced expiratory volume in 1 s, peak expiratory flow, forced expiratory flow at 50%, and forced expiratory flow at 25%. Parents completed an American Thoracic Society-National Heart and Lung Institute health questionnaire, which included information about respiratory symptoms and diseases of the children and information about background variables. A trend of higher prevalence of most respiratory symptoms occurred in 638 children who were growing up in the community that bordered the industrial zone, compared with 338 children from the unexposed community. Cough without cold, sputum without cold, and cough accompanied by sputum were the most prevalent symptoms. Asthma diagnosed by a physician was reported more frequently for children who lived near the polluting sources. No consistent trend of reduced pulmonary function tests was observed among children who lived in the polluted community; however, peak expiratory flow was significantly lower among these children. Odds ratio values, calculated from logistic regressions in which we controlled for respiratory problems among parents, mothers who smoked, crowding index, education of mothers, and residential heating, were 3.6 (p value for model = .244) for cough without cold, 4.0 (p value for model = .333) for asthma, and 2.2 (p value for model = .753) for asthma and/or bronchitis in the polluted area, compared with 1.0 in the low-pollution community. Total suspended particulate matter and levels of airborne particles less than 10 microns, measured in the community bordering the industrial zone, very often violated the relevant 24-h Israeli standards of 200 microg/m3 and 150 microg/m3, respectively.     

Respiratory symptoms and pulmonary function in chicken catchers in poultry confinement units

To evaluate the respiratory consequences of working in poultry confinement units, we completed a cross-sectional epidemiologic study of respiratory symptoms and pulmonary function in 59 chicken catchers. The results were compared to a published reference standard of nonexposed blue-collar workers. Chicken catchers reported a high rate of acute symptoms associated with work in poultry houses. They also reported statistically significant higher rates for chronic phlegm (39.0%) and chronic wheezing (27.1%) than nonexposed blue-collar workers. Chicken catchers had significant decrements over a work shift in forced vital capacity (-2.2%) and forced expiratory volume in 1 sec (-3.4%), and there was suggestive evidence that they had decreased preshift pulmonary function compared with nonexposed blue-collar workers. These results indicate that chicken catchers are at risk for respiratory dysfunction and emphasize the need to develop measures to minimize their exposure to respiratory toxicants in poultry confinement units.     

Residential outdoor air pollution and lung function in schoolchildren

BACKGROUND: Long-term exposure to outdoor air pollution has typically been estimated on the aggregate level, and more individual measures of exposure are needed. We investigated the associations with lung function of residential outdoor air pollution in early life, total lifetime, and days before lung function test. METHODS: In 2001-2002, spirometry was performed in 2307 9- and 10-year-old children who had lived in Oslo, Norway, since birth. Outdoor air pollution exposure for each child was assessed by the EPISODE dispersion model, calculating hourly concentrations of nitrogen dioxide (NO2), particulate matter (PM) with aerodynamic diameter less than 10 microm (PM10) and 2.5 microm (PM2.5). We applied linear regression analysis stratified by sex. RESULTS: Early and lifetime exposures to outdoor air pollution were associated with reduced peak expiratory flow and reduced forced expiratory flow at 25% and 50% of forced vital capacity, especially in girls. One interquartile increase of lifetime exposure to NO2, PM10, and PM2.5 was associated with change in adjusted peak respiratory flow of, respectively, -79 mL/s (95% confidence interval = -128 to -31), -66 mL/s (-110 to -23), and -58 mL/s (-94 to -21). We also found short-term effects of NO2 that became stronger with increasing time lags, but no short-term effects of PM. When we included short- and long-term NO2 exposures simultaneously, only the long-term effect remained. We found no effect on forced volumes. Adjusting for a contextual socioeconomic factor diminished the associations. CONCLUSIONS: Short- and long-term residential exposures to traffic-related pollutants in Oslo were associated with reduced peak expiratory flow and forced expiratory flow at 25% and 50% in 9- to 10-year-old children, especially in girls, with weaker associations after adjusting for a contextual socioeconomic factor.     

空气污染对儿童部分免疫及肺通气功能的多因素分析

目的：探讨空气污染儿童健康影响，方法：根据1988－1998年大气污染物[SO2,NOx,总悬浮颗粒（TSP），CO]监测资料，选择唐山市工业区（污染区）和相对清洁区（对照组）7－15岁学龄儿童656人和712人进行局部非特异免疫功能[唾液溶菌酶和分泌型免疫球蛋白A（SIgA)]和肺功能（肺活性（VC），用力肺活量（FVC），1s用力呼气容积（FEV），25％，50％和75％用力肺活量呼气流速（V25,V50和V75)最大通气量（MVV）进行检测并开展问卷调查，结果：污染区大气SO2，NOx和TSP均显著高于对照区（P＜0．05或P＜0．01），多因素分析显示，除SIgA外其他指标均与生理因素有关，其中主要与年龄呈正相关（t=5.130-9.698,P=0.0001)，唾液溶菌酶、SIgA,VC,FVC,MVV,V25,V50和V75，主要与空气NOx可SO2浓度显负相关（P＝0．0005－0．0086），结论：空气污染尤其室外空气污染可导致儿童局部非特异免疫功能及肺通气功能降低。     

Short-term effect of ozone on the pulmonary function of children in primary school.

The objective of this study was to evaluate the short-term effect of ambient air pollution on the pulmonary function of schoolchildren. We sampled 941 children in primary school in three communities in Taiwan (Sanchun, Taihsi, and Linyuan). The nearby stations of the Taiwan air quality monitoring network provided the hourly ambient concentrations of sulfur dioxide, carbon monoxide, ozone, particulate matter < or = to 10 microm in aerodynamic diameter, and nitrogen dioxide. Spirometry was performed once for each sampled child. We also obtained the status of indoor air pollution and chronic respiratory disease history by using a structured questionnaire. Multivariate linear model analysis was used to evaluate pulmonary function effects of each pollutant in addition to determinants of indoor air pollution and meteorologic conditions. We found a significantly negative association of peak O(3) concentration on the day before spirometry with individual forced vital capacity and forced expiratory volume in 1 sec. The decrease in children's lung function can occur at peak hourly O(3) concentrations < 80 ppb. The slope of lung function decrease for Taiwanese children is approximately 1 mL/ppb for peak hourly O(3) exposure.     

Acute effect of sulphur dioxide from a power plant on pulmonary function of children, Thailand

BACKGROUND: Epidemiological studies have shown reversible declines of lung function in response to air pollution, but research on the independent effect of short-term exposure to ambient sulphur dioxide (SO2) on pulmonary function is limited. This study evaluated the association of short-term exposure to increased ambient SO2 and daily pulmonary function changes among children with and without asthma. METHODS: The associations of daily exposure to SO2 and particulate matter 10 microm in diameter (PM10) with pulmonary function were examined in 175 asthmatic and non-asthmatic children aged 6-14 years who resided near a coal-fired power plant in Thailand. Each child performed daily pulmonary function tests during the 61-day study period. General linear mixed models were used to estimate the association of air pollution and pulmonary function controlling for time, temperature, co-pollutants, and autocorrelation. RESULTS: In the asthmatic children, a daily increase in SO2 was associated with negligible declines in pulmonary function, but a small negative association was found between PM10 and pulmonary function. A 10-microg/m(3) increment was associated with changes in the highest forced vital capacity (FVC) (-6.3 ml, 95% CI: -9.8, -2.8), forced expiratory volume at 1 second (FEV(1)) (-6.0 ml, 95% CI: -9.2, 2.7), peak expiratory flow rate (PEFR) (-18.9 ml.sec(-1), 95% CI: -28.5, -9.3) and forced expiratory flow 25 to 75% of the FVC (FEF(25-75%)) (-3.7 ml.sec(-1), 95% CI: -10.9, 3.5). No consistent associations between air pollution and pulmonary function were found for non-asthmatic children. CONCLUSION: Declines in pulmonary function among asthmatic children were associated with increases in particulate air pollution, rather than with increases in SO2.     

Effects of time since diagnosis on the association between parent and child distress in families with pediatric cancer

Although parental distress and child distress have been linked in families of children with cancer, how these associations change over time is unknown. The present study examined how the amount of time elapsed since the child’s diagnosis moderates the associations between self-reported parent and child symptoms of depression, anxiety, and post-traumatic stress in 255 parent-child dyads. Time since diagnosis moderated the associations between parental symptoms and child-reported anxiety and post-traumatic stress. Dyads farther out from diagnosis exhibited stronger associations between parental and child symptoms. Findings suggest the importance of monitoring the psychological adjustment of parents and children over time.     

Acute effects of urban air pollution on respiratory health of children with and without chronic respiratory symptoms

OBJECTIVES: To investigate to what extent different components of air pollution are associated with acute respiratory health effects in children with and without chronic respiratory symptoms. METHODS: During three consecutive winters starting in 1992-3, peak expiratory flow (PEF) and respiratory symptoms were registered daily in panels of children of 7-11 years old with and without symptoms, living in urban areas with high traffic intensity in The Netherlands. Simultaneously, panels of children living in non-urban areas were studied. Daily measurements of particles with aerodynamic diameter < 10 microns (PM10), black smoke (BS), sulphate, SO2, and NO2 were performed in both areas. RESULTS: The contrast in particle concentrations (PM10, BS, and sulphate) between urban and non-urban areas was small, but there was more contrast in the concentrations of SO2 and NO2. In children with symptoms from both areas, significant associations were found between PM10, BS, and sulphate concentrations and the prevalence of symptoms of the lower respiratory tract (LRS) and decrements in PEF. Particle concentrations were also associated with use of bronchodilators in the urban areas, but not in the non-urban areas. After stratification by use of medication, stronger associations were found in children who used medication than in children who did not use medication. The magnitude of the estimated effects was in the order of a twofold increase in the use of bronchodilators, a 50% increase in LRS, and an 80% increase in decrements in PEF for a 100 micrograms/m3 increase in the 5 day mean PM10 concentration. In children without symptoms, significant associations were found between concentrations of PM10 and BS and decrements in PEF in both areas, but these associations were smaller than those for children with symptoms. No associations with respiratory symptoms were found. CONCLUSIONS: The results suggest that children with symptoms are more susceptible to the effects of particulate air pollution than children without symptoms, and that use of medication for asthma does not prevent the adverse effects of particulate air pollution in children with symptoms.

 

     

Cross-sectional and longitudinal changes in pulmonary function associated with automobile pollution among bridge and tunnel officers

This study investigated the effects of emissions from the internal combustion engine on pulmonary function and respiratory symptoms in men collecting tolls and directing traffic in areas with high levels of air pollution. Bridge and tunnel officers (BTOs) were administered pulmonary function tests and respiratory questionnaires for up to 11 consecutive years (n = 944). Carboxyhemoglobin levels were also measured. Regression coefficients on year tested were calculated on 466 individuals (49% of all BTOs) tested at least 3 years. The tunnel workers had significantly lower FEV1S (forced expiratory volume at one second) and FVCs (forced vital capacity), respiratory symptoms, and higher carboxyhemoglobin levels than the bridge workers. BTOs working over 20 years had the lowest mean pulmonary function values, the steepest slopes, and the most respiratory symptoms. We believe that the data show an association between working as a bridge and tunnel officer and decreased pulmonary function and increased respiratory symptoms, but it was not readily evident whether the effects were of clinical importance.     

Do You See What I See? Parent and Child Reports of Parental Monitoring of Media

Research on parental monitoring of children's media use suggests parents can reduce the negative effects of media exposure on children, although this research is rarely conducted with elementary school children and leaves open questions about whether parents or children are better reporters. Participants were 1,323 children, their parents, and teachers. Parents and children reported on four aspects of monitoring for TV and video games: co‐using, limit setting on amount, limit setting on content, and active mediation. Parents gave much higher estimates than did children. Monitoring was moderated by child age, child sex, parent marital status, parent education, and parent income. Although parent‐ and child‐reported monitoring correlated rather poorly, both types were almost equally good predictors of children's screen time, media violence exposure, and teacher reports of school performance. When there were differences, the child reports tended to be slightly better predictors, demonstrating the validity of child reports of parental monitoring.     

Are the respiratory health effects found in manufacturers of ceramic fibres due to the dust rather than the exposure to fibres?

OBJECTIVES--To determine whether the respiratory symptoms and decrements in lung function found in manufacturers of ceramic fibres are related to exposure to the respirable fibre or inspirable mass constituents of the air in the working environment. METHODS--Cross sectional survey of all current European primary producers of ceramic fibre was carried out, with measurement of exposure to respiratory fibres by personal samplers that measured inspirable and total mass, together with a health survey with an expanded respiratory questionnaire and standardised measurement of lung function. Odds ratios were calculated for symptoms and current exposure by multiple logistic regression, and multiple linear regression coefficients for lung function related to cumulative exposures controlled for the effects of respirable fibre and inspirable mass separately and together. RESULTS--Significant effects of current exposure to both inspirable dust and respirable fibres were related to dry cough, stuffy nose, eye and skin irritation and breathlessness. The decrements found in smokers and to some extent in ex-smokers in forced expiratory volume in one second and forced expiratory flow from 25% to 75% of expiratory volume, seem to be related to the respirable fibres rather than the inspirable mass constituents of the environment. CONCLUSIONS--Current symptoms were related to both current exposure to inspirable dust and respirable fibre. The decrements in lung function were related to the fibre constituent of the exposure.     

Respiratory effects of exposure of shipyard workers to epoxy paints

Epoxy resin systems have been associated with occupational asthma in several case reports, but medical publications contain little on the potential adverse respiratory effects of these chemicals in exposed worker populations. To further evaluate the association of workplace exposure to epoxy paints and respiratory dysfunction, the cross workshift changes in pulmonary function and symptoms of 32 shipyard painters exposed to epoxy paints were compared with 28 shipyard painters not exposed to epoxy paints. The prevalence of lower respiratory tract symptoms was significantly higher among painters exposed to epoxy paints compared with controls. Among exposed painters the mean cross workshift change in forced expiratory volume in one second (FEV1) (-3.4%) was greater than the decrement in the non-exposed group (-1.4%). A significant linear relation was seen between % decrement in FEV1 and hours of exposure to epoxy paints. This study suggests that epoxy resin coatings as used by shipyard painters are associated with increased lower respiratory tract symptoms and acute decrements in FEV1. Adequate respiratory protection and medical surveillance programmes should be established in workplaces where exposure to epoxy resin systems occurs.     

Respiratory effects of exposure of shipyard workers to epoxy paints.

Epoxy resin systems have been associated with occupational asthma in several case reports, but medical publications contain little on the potential adverse respiratory effects of these chemicals in exposed worker populations. To further evaluate the association of workplace exposure to epoxy paints and respiratory dysfunction, the cross workshift changes in pulmonary function and symptoms of 32 shipyard painters exposed to epoxy paints were compared with 28 shipyard painters not exposed to epoxy paints. The prevalence of lower respiratory tract symptoms was significantly higher among painters exposed to epoxy paints compared with controls. Among exposed painters the mean cross workshift change in forced expiratory volume in one second (FEV1) (-3.4%) was greater than the decrement in the non-exposed group (-1.4%). A significant linear relation was seen between % decrement in FEV1 and hours of exposure to epoxy paints. This study suggests that epoxy resin coatings as used by shipyard painters are associated with increased lower respiratory tract symptoms and acute decrements in FEV1. Adequate respiratory protection and medical surveillance programmes should be established in workplaces where exposure to epoxy resin systems occurs.     

南宁市空气污染水平不同的两区儿童肺功能及其影响因素的研究

目的 比较南宁市不同空气污染水平地区儿童肺功能的差异,探讨肺功能的影响相关因素。方法 按整群抽样方法,在南宁市青秀区和西乡塘区各选1所小学（A校和B校）3～4年级的儿童共537人作为研究对象,进行肺功能测试和问卷调查。结果 两区大气首要污染物都为PM2.5和PM10,青秀区A校周围大气中PM2.5、PM10、SO2、NO2年均浓度低于西乡塘区B校（P＜0.05）;控制年龄、身高、体重等因素后,青秀区A校女生FVC、FEV1.0、PEF、FEF25%～75%、FEF25%和FEF50%实测值均高于西乡塘区B校,A校男生FEV1.0实测值也高于B校,差异具有统计学意义（P＜0.05）;学校所在地区、房屋1年内购置大件家具、房屋3年内装修、房屋内饲养宠物和使用空气净化器是影响儿童肺功能的主要因素（P＜0.05）。结论 南宁市空气污染与儿童肺功能下降有关,且女生较男生对空气污染物更敏感;室内空气质量也是影响儿童肺功能的重要因素,空气净化器的使用对儿童肺功能有保护作用。     

Respiratory symptoms and pulmonary function in welders of mild steel: A cross-sectional study

Pulmonary function measurements, respiratory symptoms, smoking history, and occupational history were obtained from 91 male welders of mild steel, with mean welding exposure of 108 months, and 80 male factory controls. Nonsmoking welders compared to nonsmoking controls reported higher frequencies of respiratory symptoms and the differences were statistically significant for two symptoms: phlegm, and episodes of cough and phlegm. In comparisons of smoking welders and smoking controls, no significant differences were found in the prevalence of respiratory symptoms. Nonsmoking welders and smoking welders, compared to respective controls, did not have significantly decreased mean values of forced vital capacity or forced expired volume in 1 sec. Mean mid-expiratory flow rates and forced expiratory flow rates at 75% of forced vital capacity were lower, but not significantly different, for welders, compared to controls. These decrements in peripheral flow rates could be trivial or they could represent the initial stages of chronic obstructive pulmonary disease. Long-term follow-up, provided by a large prospective study, is needed to make this distinction.     

Effects of environment and passive smoking on the respiratory health of children.

A cross-sectional survey was conducted to evaluate the possible effects of outdoor air pollution and of parental smoking on the respiratory health of children. A total of 3092 primary schoolchildren living in two polluted areas (an industrial town, Civitavecchia, and the city of Rome) and in a rural area, were chosen. A self-administered questionnaire was filled in by the parents of 2929 children (94.2%). A broad spectrum of respiratory symptoms and illnesses were taken as outcome variables. The frequency of most outcome variables was higher among children from the polluted areas than among those growing up in the non-polluted area (e.g. asthma: odds ratio (OR) = 1.4 for Civitavecchia, OR = 1.3 for Rome). Exposure to any passive smoking increased OR of having night cough (OR = 1.8), snoring (OR = 1.4), and respiratory infections during the first 2 years of life (OR = 1.3). A further increase in risk was observed in children whose mothers smoked or if both parents were smokers (asthma, OR = 1.5). When the separate and joint effects of the two exposures were studied, the patterns of OR did not suggest synergism between the two factors. The study indicates that both air pollution and passive smoking cause an increase in respiratory symptoms in children, although there would seem to be no additional effects of the two exposures together.     

本溪市大气污染与急慢性呼吸系统疾病的关系

目的 灯一溪市大气污染治理。方法 于１９９４年和１９９５年连续二年调查室外大气污染对呼呼统健康的影响,经对市内５个衡区２５岁以上成中呼吸系统症状生咳 、气短、突发性喘息）三种疾病（慢性支气管炎,慢性阻塞性疾患及上呼吸道感染）以内外多种暴露的流行病学调查,用多因素Ｌｏｇｉｓｔｉｃ回归分析,调整了年龄、性别、文化程度、职业、室内煤及吸烟状况后,得出室外大气污染和一呼吸系统疾病的联系。结果 ６种呼吸系统     

Study on the relationship of air pollution to respiratory disease in schoolchildren.

Respiratory symptoms and ventilatory functions were measured in fourth and fifth grade school children living in two areas that differ in air pollution but are comparable with respect to social and demographic factors.Children living in the high polluted area showed a higher prevalence of cough during the day or at night, which is assumed to be due to the difference in pollution level.Mean ventilatory function in the children from both areas did not differ. In both areas mean PEFR (peak expiratory flow rate) and mean FEV (forced expiratory volume) of children with symptoms were lower than in children without.Depending on the criteria used prevalence figures for chronic respiratory disease ranged between 5,3–12,7% in the high polluted and 3,3–9,8% in the low polluted area.     

Air pollution and health in urban areas

In this paper, recent reviews of the World Health Organization, other review papers, and more recent literature on the human health effects of current air pollution trends in urban areas are reviewed and summarized as follows: Sulphur dioxide. Some studies, but not others, found associations between sulphur dioxide (SO2) exposure and daily mortality and morbidity. Single-pollutant correlations sometimes disappeared when other pollutants, especially suspended particulate matter (SPM), were included. Cross-sectional studies with asthmatics revealed significant, non-threshold relations between SO2 and decrements of the forced expiratory volume in 1 second (FEV1). Nitrogen dioxide. Weak associations between short-term nitrogen dioxide (NO2) exposure from gas cooking and respiratory symptoms and a decrement in lung function parameters were found in children, but not consistently in exposed women. With long-term exposure, children, but not adults, exhibit increased respiratory symptoms, decreased lung function, and increased incidences of chronic cough, bronchitis, and conjunctivitis. A causal relationship between NO2 exposure and adverse health effects has not yet been established. Carbon monoxide. Binding of CO in the lungs with hemoglobin in the blood forms carboxyhemoglobin (COHb), which impairs the transport of oxygen. The health effects of CO include hypoxia, neurological deficits and neurobehavioral changes, and increases in daily mortality and hospital admissions for cardiovascular diseases. The latter persists even at very low CO levels, indicating no threshold for the onset of these effects. Whether the relation between daily mortality and exposure to CO are causal or whether CO might act as a proxy for SPM is still an open question. Ambient CO may have even more serious health consequences than does COHb formation and at lower levels than that mediated through elevated COHb levels. Ozone. Short-term acute effects of O3 include pulmonary function decrements, increased airway responsiveness and airway inflammation, aggravation of pre-existing respiratory diseases like asthma, increases in daily hospital admissions and emergency department visits for respiratory causes, and excess mortality. Exposure-response relations are non-linear for the respective associations between O3 and FEV1, inflammatory changes, and changes in hospital admissions, whereas the relation between percent change in symptom exacerbation among adults and asthmatics is linear. Single-pollutant associations between O3 exposure and daily mortality and hospital admissions for respiratory diseases is statistically significant, even in multi-pollutant models. Suspended particulate matter. Associations between SPM concentrations and mortality and morbidity rates are significant. The acute health effects of SPM, even at short-term low levels of exposure, include increased daily mortality and hospital admission rates for exacerbation of respiratory disease, fluctuations in the prevalence of bronchodilator use, and cough and peak flow reductions, as well as long-term effects with respect to mortality and respiratory morbidity. Such effects depend on particle size and concentration and can fluctuate with daily fluctuations in PM10 or PM2.5 levels. The relation between PM10 or PM2.5 exposure and acute health effects is linear at concentrations below 100 micrograms/m3. Currently no threshold has been reported below which no effects occur. The influence of co-polluting gaseous pollutants could explain part of the observed variance in short-term health effects and reduce the contribution of SPM. Lead. The biological effects of lead can be related to blood lead levels, the best indicator of internal exposure. The potential effects of lead in adults and children include encephalopathic signs and symptoms, central nervous system symptoms, cognitive effects, increased blood pressure, and reduced measures of child intelligence. (ABSTRACT TRUNCATED)     

Inhomogeneity in response to air pollution in European children (PEACE project)

OBJECTIVES: The PEACE study is a multicentre panel study of the acute effects of particles with a 50% cut off aerodynamic diameter of 10 microns (PM10), black smoke (BS), sulphur dioxide (SO2), and nitrogen dioxide (NO2) on respiratory health of children with chronic respiratory symptoms. In the complete panels no consistent association between air pollution and respiratory health was found. The study evaluated whether potentially more sensitive subgroups in the panels did show effects of air pollution. METHODS: To evaluate heterogeneity in response to air pollution, effect estimates of air pollution on peak expiratory flow (PEF) and respiratory symptoms were calculated in subgroups based on presence of chronic respiratory symptoms, use of respiratory medication, atopy, sex, and baseline lung function. RESULTS: The association between PEF and air pollution was positive in asthmatic children who used respiratory medication whereas the associations tended to be negative in children who did not use respiratory medication selected only on cough. No consistent association was found among asthmatic children who did not use medication. The association between daily prevalence of symptoms and concentrations of air pollution was not different between these subgroups. CONCLUSION: None of the predefined potentially more sensitive subgroups showed a consistent association between air pollution, PEF, and respiratory symptoms.