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      Chronic effects of ambient air pollution on respiratory morbidities among Chinese children: a cross-sectional study in Hong Kong

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          Abstract

          Background

          The chronic health effects from exposure to ambient air pollution are still unclear. This study primarily aims to examine the relationship between long-term exposure to ambient air pollution and respiratory morbidities in Chinese children.

          Methods

          A cross-sectional study was conducted among 2,203 school children aged 8–10 in three districts with different air pollution levels in Hong Kong. Annual means for ambient PM 10, SO 2, NO 2 and O 3 in each district were used to estimate participants’ individual exposure. Two questionnaires were used to collect children’s respiratory morbidities and other potential risk factors. Multivariable logistic regression was fitted to estimate the risks of air pollution for respiratory morbidities.

          Results

          Compared to those in the low-pollution district (LPD), girls in the high-pollution district (HPD) were at significantly higher risk for cough at night (OR adj. = 1.81, 95% CI: 1.71-2.78) and phlegm without colds (OR adj. = 3.84, 95% CI: 1.74-8.47). In addition, marginal significance was reached for elevated risks for asthma, wheezing symptoms, and phlegm without colds among boys in HPD (adjusted ORs: 1.71-2.82), as well as chronic cough among girls in HPD (OR adj. = 2.03, 95% CI: 0.88-4.70).

          Conclusions

          Results have confirmed certain adverse effects on children’s respiratory health from long-term exposure to ambient air pollution. PM 10 may be the most relevant pollutant with adverse effects on wheezing and phlegm in boys. Both PM 10 and NO 2 may be contributing to cough and phlegm in girls.

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          Most cited references19

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          Epidemiology Standardization Project (American Thoracic Society).

          B G Ferris (1978)
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            Living near a main road and the risk of wheezing illness in children.

            The effect of road vehicle traffic pollution on asthma is still not clearly understood. However, any effect is likely to be most marked among those who live within 150 m of a main road, because this is the distance within which concentrations of primary vehicle traffic pollutants are raised above ambient background levels. We have investigated the relation between proximity of the family home to the nearest main road, estimated objectively using geographical information system software, and the risk of wheeze in the past year in a case-control sample of 6,147 primary schoolchildren (age 4 to 11 yr) and a random cross-sectional sample of 3,709 secondary schoolchildren (age 11 to 16 yr) in Nottingham, United Kingdom. Among children living within 150 m of a main road, the risk of wheeze increased with increasing proximity by an odds ratio (OR) of 1.08 (95% confidence interval [CI] 1.00 to 1.16) per 30-m increment in primary schoolchildren, and 1.16 (1.02 to 1.32) in secondary schoolchildren. Most of the increased risk was localized to within 90 m of the roadside. Among primary schoolchildren, effects were stronger in girls than boys (p(interaction) = 0.02). Living within approximately 90 m of a main road is associated with a proximity-related increase in the risk of wheezing illness in children.
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              Road traffic and adverse effects on respiratory health in children.

              To examine whether road traffic in a big city has a direct effect on pulmonary function and respiratory symptoms in children. Cross sectional study. Of all 7445 fourth grade children (aged 9-11 years) in Munich, 6537 were examined. Of the children with German nationality and the same residence during the past five years and known exposure data, 4678 questionnaires and 4320 pulmonary function tests could be analysed. Variables of pulmonary function by forced expiration and respiratory symptoms reported in a questionnaire; census data on car traffic collected in the school district. Density of car traffic ranged from 7000 to 125,000 cars per 24 hours. Multiple regression analysis of peak expiratory flow showed a significant decrease of 0.71% (95% confidence interval 1.08% to 0.33%) per increase of 25,000 cars daily passing through the school district on the main road. Maximum expiratory flow when 25% vital capacity had been expired was decreased by 0.68% (1.11% to 0.25%). In contrast, response to cold air challenge was not increased. The adjusted odds ratio for the cumulative prevalence of recurrent wheezing with the same exposure was 1.08 (1.01 to 1.16). Cumulative prevalence of recurrent dyspnoea was increased, with an odds ratio of 1.10 (1.00 to 1.20). Lifetime prevalence of asthma (odds ratio 1.04; 0.89 to 1.21) and recurrent bronchitis (1.05; 0.98 to 1.12) were not significantly increased. High rates of road traffic diminish forced expiratory flow and increase respiratory symptoms in children.
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                Author and article information

                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central
                1471-2458
                2014
                3 February 2014
                : 14
                : 105
                Affiliations
                [1 ]Department of Physical Education, Hong Kong Baptist University, Hong Kong, China
                [2 ]School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
                [3 ]Injury Prevention Research Center, Medical College of Shantou University, Shantou, China
                Article
                1471-2458-14-105
                10.1186/1471-2458-14-105
                3914361
                24484614
                c88eee68-1d51-4635-956b-dfdc77deea31
                Copyright © 2014 Gao et al.; licensee BioMed Central Ltd.

                This is an open access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 29 August 2013
                : 26 January 2014
                Categories
                Research Article

                Public health
                urban,china,pm10,child,no2,respiratory morbidity,air pollution
                Public health
                urban, china, pm10, child, no2, respiratory morbidity, air pollution

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