The role of intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and regulated on activation, normal T-cell expressed and secreted (RANTES) in the relationship between air pollution and asthma among children

To evaluate the role of adhesion molecules and chemokines in the relationship between air pollution and asthma, the authors determined the following in 230 children who lived in 4 communities in Japan that had different levels of air pollution: serum concentrations of soluble intercellular adhesion molecule-1 (sICAM-1); soluble vascular cell adhesion molecule-1 (sVCAM-1); regulated on activation, normal T-cell expressed and secreted (RANTES); and total immunoglobulin E (IgE). Children with asthma or who exhibited wheezing (n = 115) and nonasthmatic children (n = 115) were studied. Serum concentrations of sICAM-1, sVCAM-1, and RANTES were increased significantly in asthmatic children, compared with nonasthmatic children. Nonasthmatic children with serum IgE levels that were greater than or equal to 250 IU/ml had significantly lower concentrations of sICAM-1 and sVCAM-1 than the other children. The geometric means of sICAM-1 increased as air pollution increased. The results of this study suggest that adhesion molecules or chemokines are associated with asthma and that ICAM-1 may play an important role in the relationship between air pollution and the occurrence of asthma.     

The Role of Intercellular Adhesion Molecule-1 (ICAM-1), Vascular Cell Adhesion Molecule-1 (VCAM-1), and Regulated on Activation,Normal T-Cell Expressed and Secreted (RANTES) in the Relationship between Air Pollution and Asthma among Children

To evaluate the role of adhesion molecules and chemokines in the relationship between air pollution and asthma, the authors determined the following in 230 children who lived in 4 communities in Japan that had different levels of air pollution: serum concentrations of soluble intercellular adhesion molecule-1 (sICAM-1); soluble vascular cell adhesion molecule-1 (sVCAM-1); regulated on activation, normal T-cell expressed and secreted (RANTES); and total immunoglobulin E (IgE). Children with asthma or who exhibited wheezing (n = 115) and nonasthmatic children (n = 115) were studied. Serum concentrations of sICAM-1, sVCAM-1, and RANTES were increased significantly in asthmatic children, compared with nonasthmatic children. Nonasthmatic children with serum IgE levels that were greater than or equal to 250 IU/ml had significantly lower concentrations of sICAM-1 and sVCAM-1 than the other children. The geometric means of sICAM-1 increased as air pollution increased. The results of this study suggest that adhesion molecules or chemokines are associated with asthma and that ICAM-1 may play an important role in the relationship between air pollution and the occurrence of asthma.     

Traffic-related air pollution and respiratory symptoms in children living along trunk roads in Chiba Prefecture,Japan

Automobile exhaust is considered to be a potential risk factor for respiratory diseases. To investigate the effects of traffic-related air pollution on respiratory symptoms among children who lived near trunk roads, we conducted a cohort study on 2,506 schoolchildren in eight different communities in Japan. Over that four-year period, the prevalence of asthma was higher among girls who lived less than 50 m from trunk roads (roadside areas) than among girls in the other areas studied. Testing for trends showed that the prevalence of asthma among girls increased significantly with increases in the concentration of air pollution in each area. Among boys, the prevalence of asthma did not differ in relation to the distance from roads, although the rate was higher in urban areas than in rural areas. The incidence of asthma during the follow-up period significantly increased among boys living in roadside areas relative to rural areas (odds ratio = 3.75; 95% confidence interval: 1.00-14.06). Among girls, the incidence of asthma also increased (odds ratio = 4.06; 95% confidence interval:0.91-18.10), although the risk was not significant. These findings suggest that traffic-related air pollution may be of particular importance in the development of asthma among children living near major trunk roads with heavy traffic.     

C3c concentrations in sera of persons living in areas with different levels of air pollution in Northrhine-Westphalia (Federal Republic of Germany)

A number of air pollutants is known to affect the immune system resulting in alterations of the complement activity in serum. We determined the levels of C3c, one of the activation products of the component C3, in serum samples obtained from various population groups living in areas with different levels of air pollution in Northrhine-Westphalia (FRG). The results show that the serum C3c levels tend to be increased in subjects living in areas with elevated levels of air pollution. By applying a linear regression model it can be demonstrated that a significant part of the variance of the C3c concentrations is explained by the residence area factor after making allowance for the effect of various confounders. The increase of the serum C3c concentrations appears to result from an increased activation of the complement component C3. The underlying mechanisms as well as the pathophysiological significance of these findings are unknown.     

Effect of air pollution and environmental tobacco smoke on serum hyaluronate concentrations in school children

Objectives: To evaluate serum hyaluronate concentrations relative to air pollution, environmental tobacco smoke (ETS), and respiratory health in Japanese school children.

Methods: Respiratory symptoms and serum IgE concentrations were examined in 1037 school children living in four communities in Japan with differing levels of air pollution. Serum hyaluronate concentrations were assayed in 230 children, consisting of all the children who had symptoms of either asthma or wheeze (65 and 50 subjects, respectively) and normal controls adjusted for sex, school grade, and school without these symptoms (115 subjects).

Results: Although serum hyaluronate concentrations did not differ for either asthma or wheeze, the concentrations were significantly higher in children living in communities with higher levels of air pollution. Children with asthma or wheeze and those with serum IgE concentrations of 250 IU/ml or above showed differences in hyaluronate concentrations that related to the degree of air pollution in the communities. In children with higher serum IgE concentrations, the hyaluronate concentrations among subjects exposed to ETS were significantly higher than among those without exposure to ETS.

Conclusions: The present results suggest that serum hyaluronate concentration is related to the degree of air pollution and exposure to ETS. Children with asthma or wheeze and children with higher IgE concentrations are considered to be more susceptible to environmental factors.

     

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。     

Air pollution and serum C-reactive protein concentration in children

BACKGROUND: Few biological markers that allow evaluation of the effects of air pollution on human health have been identified. This study evaluated the association of serum C-reactive protein (CRP) concentration in children with their respiratory symptoms and air pollution. METHODS: Respiratory symptoms and serum concentrations of CRP were examined in 2,094 school children living in 3 communities with different concentrations of air pollutants in Chiba Prefecture, Japan in 2001. The relationships between serum CRP concentration and sex, age, respiratory symptoms, and various environmental factors were analyzed. RESULTS: Serum CRP concentration decreased with age, and was significantly higher both in children who were bottle-fed in infancy and whose mothers smoked. Children with wheeze had significantly higher serum CRP concentration than those without wheeze. After adjustment for potential confounding factors, increased serum CRP concentrations of the 90th percentile (1.4 mg/L) or above were significantly associated with atmospheric concentration of suspended particulate matter (SPM) (odds ratio [OR] =1.49 for the range of observed concentrations, 95% confidence interval [CI]: 1.07-2.06) and sulfur dioxide (SO(2)) (OR =1.45, 95% CI: 1.04-2.03). In a two-pollutant model including SPM and nitrogen dioxide (NO(2)) concentrations, increased serum CRP concentrations were also associated with SPM (OR =1.94, 95% CI: 1.08-3.50), but no such association was found with NO(2) (OR =0.62, 95% CI: 0.26-1.48). CONCLUSION: Serum CRP concentration is related to wheezing and the degree of air pollution. Because the concentrations of air pollutants are highly correlated, it is difficult to elaborate on which pollutant has a stronger effect on serum CRP concentrations.     

Height-specific serum cholesterol levels in pubertal children: data from population-based Japanese school screening

Background

Inverse associations between height and serum lipid levels in pubertal children have been reported. To develop criteria for normal serum lipid levels stratified by height in pubertal children, we examined height-specific cholesterol levels, using data from a population-based school screening.

Methods

Serum levels of total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C) were investigated in 10 151 children (98.9% of the target population) aged 10 and 14 years who attended public schools in Iwata City from 2002 through 2007.

Results

The 95th percentiles of TC in the lowest and highest quintiles of height were 221 and 219 mg/dL, respectively, in 10-year-old boys, 215 and 203 mg/dL in 14-year-old boys, 220 and 204 mg/dL in 10-year-old girls, and 226 and 214 mg/dL in 14-year-old girls. The fifth percentiles of HDL-C in the lowest and highest quintiles of height were 45 and 43 mg/dL in 10-year-old boys, 43 and 40 mg/dL in 14-year-old boys, 46 and 42 mg/dL in 10-year-old girls, and 47 and 44 mg/dL in 14-year-old girls.

Conclusions

This study provided height-specific levels of serum lipids in 10-year-old and 14-year-old children. Height should be considered when evaluating cholesterol levels in pubertal children.Key words: child, diagnosis, growth, cholesterol     

不同年龄段小儿血清骨碱性磷酸酶水平的测定

目的:测定不同年龄段骨碱性磷酸酶的水平,并探讨其变化规律。方法:在儿科门诊查体或因某些感染性疾病如上呼吸道感染、心肌炎、肺炎等原因住院的166例患儿和高中、初中健康检体的学生154例作为研究对象。按照传统分组分别将男女研究对象分为6组,采用ELISA法测定骨碱性磷酸酶及总碱性磷酸酶。结果:在生长发育过程的不同阶段,男孩血清骨碱性磷酸酶的水平不同,6个年龄段分组的血清骨碱性磷酸酶水平有差别(F=6.722,P<0.01)。女孩6个年龄段分组之间的血清骨碱性磷酸酶水平无差别(F=2.089,P=0.071>0.05)。结论:小儿血清骨碱性磷酸酶的浓度变化与年龄有关,监测血清骨碱性磷酸酶的水平变化可以准确地判断小儿各阶段生长发育状况。     

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。     

Serum leptin levels in healthy adolescents: Effects of gender and growth

Objectives The purposes of this paper were to evaluate the serum leptin levels in healthy adolescents and to establish standard age variation curves. Methods Nine hundred six (414 boys and 492 girls) healthy adolescents were investigated. The maximum increment age in height (MIA) was identified in 124 boys and 130 girls. The menarcheal age (MA) was obtained for 130 girls. Fasting leptin levels were measured by enzyme immunoassay. The MIA was calculated by proportional allotment of yearly height increments. Results Serum leptin levels did not change in boys and girls from the ages of 9 to 11. They decreased after the age of 11 in boys, while they increased in girls. Stepwise multiple regression analysis revealed that serum leptin levels were closely related to pubertal stage. The levels decreased remarkably after MIA in boys and increased remarkably after MA in girls. We drew standard age variation curves of serum leptin levels by calculating the 25th, 50th and 75th percentiles for each age in both boys and girls. The percentile curves for boys were divided into pre-MIA and post-MIA curves. Those for girls were divided into pre-MA and post-MA curves. Conclusion We have devised a potentially useful method for evaluating serum leptin levels in adolescents considering the effects of gender and growth.     

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.     

青岛市6～18岁女性双生子血清硫酸脱氢表雄酮水平的研究

目的探讨青春期女性血清硫酸脱氢表雄酮(DHEAS)的变化趋势,估计遗传与环境因素的相对效应。方法以学校登记为基础募集青岛市6~18岁女性双生子180对,其中同卵双生子(MZ)132对,异卵双生子(DZ)48对,按Tanner标准进行青春发育分期,放免法测定空腹血清DHEAS浓度。结果青春期女生血清DHEAS浓度随年龄增长和青春期进程而增高,Tanner IV期达高峰,Tanner V期略有下降;遗传效应分析显示血清DHEAS浓度偶内平均差、偶内方差为MZDZ;遗传度为0.65,分期估计遗传度分别为乳房未发育组0.92,乳房发育未来潮组0.73,已潮组0.67。结论青春期女性血清DHEAS受遗传因素的控制较强,尤其乳房发育前肾上腺功能初现期。提示在与肾上腺功能初现有关的内分泌失调性疾病的发病中遗传因素可能起重要的作用。     

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.     

空气污染对儿童血清免疫球蛋白水平的影响

目的：探讨空气污染对儿童免疫功能的影响。方法：随机选择不同大气污染区以及不同生活居住条件下6－8岁儿童共87名作为研究对象，采用酶联免疫法检测其血清免疫球蛋白含量。结果：儿童血清免疫球蛋白含量与性别无关，不同污染区儿童血清IgA,IgM,IgG含量差异显著。结论：通过对大气污染和家庭所用燃料两因素进行比较分析，发现大气污染是影响免疫球蛋白水平的最主要因素。     

Serum albumin and clinical outcome in pediatric cardiac surgery

OBJECTIVE: We evaluated the behavior of serum albumin concentrations in response to metabolic stress that is associated with cardiac surgery and the role of this protein as a predictor of clinical outcome in children at high surgical risk who undergo operative correction of congenital heart defects. METHODS: Serum albumin concentrations were measured in 30 children who had heart disease and were at high surgical risk. Analyses were performed before surgery, on the second postoperative day, and on discharge from the intensive care unit. Preoperative serum concentrations of albumin were compared with those of a control group that consisted of 20 healthy and well-nourished children. RESULTS: Preoperative albumin concentrations of patients were lower than those of the control group (3.4+/-0.25 g/dL versus 4.0+/-0.18 g/dL, P<0.05). Serum levels decreased on the second postoperative day and at discharge from the intensive care unit (3.1+/-0.65 g/dL and 3.2+/-0.44 g/dL, P<0.05) compared with preoperative concentrations. Preoperative concentrations lower than 3.0 g/dL were associated with increased postsurgical infection (P=0.0026) and with increased mortality (P=0.0138). Patients whose postoperative levels were lower than 3.0 g/dL had longer hospital stays compared with those whose concentrations were higher than 3.0 g/dL (14.5+/-1.3 d versus 10+/-2.2 d, P<0.05). CONCLUSION: The results suggest that hypoalbuminemia is common among children who have heart disease and are at high surgical risk, and serum albumin concentrations lower than 3 g/dL may be related to outcome in the period after cardiac surgery.     

天津市城市地区3～6岁儿童血尿酸水平及正常参考值范围探讨分析

目的了解天津市城市地区3~6岁儿童血尿酸水平及分布特征,探讨其正常参考值范围。方法随机抽取天津市城市地区26所幼儿园4 083名3~6岁儿童,采集末梢血,检测血浆尿酸水平。结果 1)血尿酸水平为(243.0±52.8)μmol/L,男童尿酸水平高于女童(t=5.423,P0.001);5~6岁组高于3~4岁组(t=-2.245,P=0.025);肥胖组儿童血尿酸水平高于超重组及体型正常组(F=58.641,P0.001)。2)选择体型正常和超重儿童为"健康人群",根据不同年龄、性别分别计算尿酸正常值,3~4岁组男童(240.8±101.1)μmol/L,女童(235.2±105.8)μmol/L,5~6岁组男童(244.1±101.4)μmol/L,女童(236.5±98.6)μmol/L。结论性别、年龄、体型是影响城市地区3~6岁儿童尿酸水平的重要因素。根据不同性别及年龄建立的城市地区3~6岁儿童血尿酸水平弥补了当前缺乏相应标准的不足。     

Serum immunoglobulin E (IgE) levels and dietary intake of Korean infants and young children with atopic dermatitis

Atopic dermatitis (AD) has become a serious epidemic in Korean children. We aimed to investigate the association between vitamin C, E and other nutrients, and serum total IgE/specific IgE levels in children with AD. A total of 119 children (0-24 mo) diagnosed with AD were recruited for this cross-sectional study from a medical center in Seoul. A 24 h recall was used to assess dietary intakes. Serum total and six food-allergen specific IgE levels were measured by CAP-FEIA. Serum vitamin E was also measured but only in 25 out of the total 119 participants. Multiple linear regression analysis was performed to estimate the coefficients between serum IgE levels and dietary intake as well as serum vitamin E. Serum vitamin E levels showed a significantly inverse association with serum total IgE and all specific IgE levels (P < 0.05). Fat intake was inversely related with specific-IgEs for egg whites, milk, buck wheat, soy, and peanuts (P < 0.05). Positive associations were found between carbohydrate (CHO) intake and total IgE and specific IgEs to egg whites, milk, soy, and peanuts (P < 0.05). Vitamin C, E and n-3/n-6 fatty acids were not related with serum total IgE and specific IgE levels except for the association between buck wheat and vitamin E. In addition, there were no significant differences between males and females in dietary intake and serum IgE levels by student''s t-test. Although dietary vitamin E showed no association with serum IgE levels, serum vitamin E drew a significant inverse relationship with serum IgE levels. The evidence seems to suggest that vitamin E may possibly lower total and specific-IgEs in children with AD, and that it is important to maintain a relatively high serum vitamin E level in children with AD.     

Role of risk factors in the development of chronic digestive system diseases in children

The spread, patterns, and risk factors of alimentary diseases were examined in children residing in areas of petroleum-refining, petrochemical, and chemical industries. A total of 4816 children aged 3 to 14 years who lived in Ufa areas differing in the level and nature of ambient air pollution were examined. Those living in the poorer ecological areas (high total pollution and levels of chlorinated hydrocarbons, formaldehyde, and phenol) had more commonly gastroenterological diseases with prevailing hepatobiliary disorders in the pattern of diseases. The specific features of the diseases in these children are earlier onset, more frequent recurrences, more prolonged exacerbations involving other organs and systems than in those living in more favourable areas.     

The adverse effect of low levels of ambient air pollutants on lung function growth in preadolescent children.

The main purpose of our study was to assess the effect of low concentrations of ambient air pollution on lung function growth in preadolescent children. We accounted for height velocity over the follow-up period and also for other possible confounders such as baseline anthropometric and physiologic characteristics of children. In addition to outdoor air pollution, we considered the possible effects of social class and exposure to indoor pollutants such as gas stove fumes or environmental tobacco smoke. The cohort prospective study was carried out in 1,001 preadolescent children from two areas of Krakow, Poland, that differed in ambient air pollutants. In the city center (higher pollution area), the mean annual level [+/- standard deviation (SD)] of suspended particulate matter was 52.6 +/- 53.98 microg/m(3) and that of SO(2) was 43.87 +/- 32.69 microg/m(3); the corresponding values in the control area were 33.23 +/- 35.99 microg/m(3) and 31.77 +/- 21.93 microg/m(3). Mean lung function growth rate adjusted to height velocity and lung function level at the study entry was significantly lower in boys and girls living in the more polluted areas. Also, the proportion of children with the slower lung function growth (SLFG) was higher in the children from the more polluted area of the city. The analysis completed in the group of children after the exclusion of asthmatic subjects and those with asthmalike symptoms confirmed that, in boys, odds ratios (ORs) for SLFG [forced vital capacity (FVC)] and air pollution after adjustment to baseline FVC, height, and growth rate was significant [OR = 2.15; 95% confidence interval (CI), 1.25-3. 69)]. The analysis also confirmed that for SLFG(FEV(1)) the OR was 1. 90 (CI, 1.12-3.25). The corresponding OR values in girls were insignificant (OR = 1.50; CI, 0.84-2.68 and OR = 1.39; CI, 0.78-2. 44). The association between ambient pollutants and poorer gain of pulmonary volumes in children living in more polluted areas suggests that air pollution in the residence area may be a part of the causal chain of reactions leading to retardation in pulmonary function growth during the preadolescent years.