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Published ahead of print on July 31, 2003, doi:10.1164/rccm.200304-466OC

Am. J. Respir. Crit. Care Med., Volume 168, Number 7, October 2003, 790-797

A more recent version of this article appeared on October 1, 2003
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Submitted on April 9, 2003
Accepted on July 29, 2003

PROSPECTIVE STUDY OF AIR POLLUTION AND BRONCHITIC SYMPTOMS IN CHILDREN WITH ASTHMA

Rob McConnell1*, Kiros Berhane1, Frank Gilliland1, Jassy Molitor1, Duncan Thomas1, Fred Lurmann2, Edward Avol1, W. James Gauderman1, and John M Peters1

1 Preventive Medicine, University of Southern California, Los Angeles, CA, USA, 2 Sonoma Technology, Inc., Petaluma, CA, USA

* To whom correspondence should be addressed. E-mail: rmcconne{at}usc.edu.

The relationship of bronchitic symptoms to ambient particulate matter and to particulate elemental and organic carbon (OC), nitrogen dioxide (NO2) and other gaseous pollutants was examined in a cohort of asthmatic children in 12 Southern California communities. Symptoms, assessed yearly by questionnaire from 1996-1999, were associated with the yearly variability of particulate matter with aerodynamic diameter less than 2.5 µ (odds ratio (O.R.) 1.09/µg/m3; 95% confidence interval (C.I.) 1.01-1.17), OC(O.R. 1.41/µg/m3; 95% C.I. 1.12-1.78), NO2 (O.R. 1.07/part per billion (ppb); 95% C.I. 1.02-1.13) and ozone (O.R. 1.06/ppb; 95% C.I. 1.00-1.12). The odds ratios associated with yearly within-community variability in air pollution were larger than the effect of the between-community four-year average concentrations. In two pollutant models, the effects of yearly variation in OC and NO2 were only modestly reduced by adjusting for other pollutants, except in a model containing both OC and NO2; the effects of all other pollutants were reduced after adjusting for OC or NO2. We conclude that OC and NO2 deserve greater attention as potential causes of the chronic symptoms of bronchitis in asthmatic children and that previous cross-sectional studies may have underestimated the risks associated with air pollution.
Key words: asthma; epidemiology; air pollution; child




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