GD Thurston, M Lippmann, MB Scott and JM Fine
Nelson Institute of Environmental Medicine, New York University School of Medicine, Tuxedo 10987, USA.

In order to investigate associations between summertime haze air pollution and asthma at an individual level, 52, 58, and 56 children (ages 7 to 13) attending a summer "asthma camp" were followed during the last week of June in 1991, 1992, and 1993, respectively. Most of the subjects had moderate to severe asthma. Daily records were kept of the environmental conditions, as well as of subject medication use, lung function, and medical symptoms. Air pollution was found to be significantly and consistently correlated with acute asthma exacerbations, chest symptoms, and lung function decrements. The pollutant most consistently associated with adverse health consequences was ozone (O3), although associations with sulfates and hydrogen ion suggest a possible role by fine particles as well. Effects were found to be roughly monotonic as a function of O3 concentration. Regression of morning (8:00 A.M.) to afternoon (5:00 P.M.) peak flow change on O3 indicated pulmonary function reductions similar to those previously reported for more active children without asthma. Moreover, analyses also indicated an increased risk of an asthma exacerbation and of experiencing chest symptoms of approximately 40% on the highest pollution day, relative to the mean. Based on these relative risk estimates, a rise in the 1-h daily maximal O3 from 84 ppb to 160 ppb was associated in this group with an increase from 20 to 28 (+/- 2) in the expected number of unscheduled medications administered/day, and from 29 to 41 (+/- 3) in the expected total number of chest symptoms/day. Thus, air pollution can be a major contributor to the respiratory problems experienced by children with asthma during the summer months.

This article has been cited by other articles:

				J. S. Schildcrout, L. Sheppard, T. Lumley, J. C. Slaughter, J. Q. Koenig, and G. G. Shapiro Ambient Air Pollution and Asthma Exacerbations in Children: An Eight-City Analysis Am. J. Epidemiol., September 15, 2006; 164(6): 505 - 517. [Abstract] [Full Text] [PDF]

				Committee on Environmental Health Ambient Air Pollution: Health Hazards to Children Pediatrics, December 1, 2004; 114(6): 1699 - 1707. [Abstract] [Full Text] [PDF]

				J. F. Gent, E. W. Triche, T. R. Holford, K. Belanger, M. B. Bracken, W. S. Beckett, and B. P. Leaderer Association of Low-Level Ozone and Fine Particles With Respiratory Symptoms in Children With Asthma JAMA, October 8, 2003; 290(14): 1859 - 1867. [Abstract] [Full Text] [PDF]

				G. D. Thurston and D. V. Bates Air Pollution as an Underappreciated Cause of Asthma Symptoms JAMA, October 8, 2003; 290(14): 1915 - 1917. [Full Text] [PDF]

				J. Just, C. Segala, F. Sahraoui, G. Priol, A. Grimfeld, and F. Neukirch Short-term health effects of particulate and photochemical air pollution in asthmatic children Eur. Respir. J., October 1, 2002; 20(4): 899 - 906. [Abstract] [Full Text] [PDF]

				J Douwes, P Gibson, J Pekkanen, and N Pearce Non-eosinophilic asthma: importance and possible mechanisms Thorax, July 1, 2002; 57(7): 643 - 648. [Abstract] [Full Text] [PDF]

				K.M. Mortimer, L.M. Neas, D.W. Dockery, S. Redline, and I.B. Tager The effect of air pollution on inner-city children with asthma Eur. Respir. J., April 1, 2002; 19(4): 699 - 705. [Abstract] [Full Text] [PDF]

				L. Michalec, B. K. Choudhury, E. Postlethwait, J. S. Wild, R. Alam, M. Lett-Brown, and S. Sur CCL7 and CXCL10 Orchestrate Oxidative Stress-Induced Neutrophilic Lung Inflammation J. Immunol., January 15, 2002; 168(2): 846 - 852. [Abstract] [Full Text] [PDF]

				M. S. Friedman, K. E. Powell, L. Hutwagner, L. M. Graham, and W. G. Teague Impact of Changes in Transportation and Commuting Behaviors During the 1996 Summer Olympic Games in Atlanta on Air Quality and Childhood Asthma JAMA, February 21, 2001; 285(7): 897 - 905. [Abstract] [Full Text] [PDF]

				S. R. Kleeberger, S. P. M. Reddy, L.-Y. Zhang, H.-Y. Cho, and A. E. Jedlicka Toll-like receptor 4 mediates ozone-induced murine lung hyperpermeability via inducible nitric oxide synthase Am J Physiol Lung Cell Mol Physiol, February 1, 2001; 280(2): L326 - L333. [Abstract] [Full Text] [PDF]

				Y. Ohtsuka, K. J. Brunson, A. E. Jedlicka, W. Mitzner, R. W. Clarke, L.-Y. Zhang, S. M. Eleff, and S. R. Kleeberger Genetic Linkage Analysis of Susceptibility to Particle Exposure in Mice Am. J. Respir. Cell Mol. Biol., May 1, 2000; 22(5): 574 - 581. [Abstract] [Full Text]

				S. R. Kleeberger, S. Reddy, L.-Y. Zhang, and A. E. Jedlicka Genetic Susceptibility to Ozone-Induced Lung Hyperpermeability . Role of Toll-Like Receptor 4 Am. J. Respir. Cell Mol. Biol., May 1, 2000; 22(5): 620 - 627. [Abstract] [Full Text]

				A. Venn, S. Lewis, M. Cooper, R. Hubbard, I. Hill, R. Boddy, M. Bell, and J. Britton Local road traffic activity and the prevalence, severity, and persistence of wheeze in school children: combined cross sectional and longitudinal study Occup. Environ. Med., March 1, 2000; 57(3): 152 - 158. [Abstract] [Full Text]

				L. P. NAEHER, T. R. HOLFORD, W. S. BECKETT, K. BELANGER, E. W. TRICHE, M. B. BRACKEN, and B. P. LEADERER Healthy Women's PEF Variations with Ambient Summer Concentrations of PM10, PM2.5, SO42-, H+, and O3 Am. J. Respir. Crit. Care Med., July 1, 1999; 160(1): 117 - 125. [Abstract] [Full Text]

				C. CASSINO, K. ITO, I. BADER, C. CIOTOLI, G. THURSTON, and J. REIBMAN Cigarette Smoking and Ozone-Associated Emergency Department Use for Asthma by Adults in New York City Am. J. Respir. Crit. Care Med., June 1, 1999; 159(6): 1773 - 1779. [Abstract] [Full Text]

				G. T. Wolff A REANALYSIS OF THE OZONE/ ASTHMA RELATIONSHIP Am. J. Respir. Crit. Care Med., July 1, 1998; 158(1): 341 - 342. [Full Text] [PDF]