The effect of elevated ozone levels in the ambient air on lung function of children engaged in sports

In the summer of 1989, ozone levels in the ambient air were regularly found to be increased in The Netherlands. The question was studied whether this affected pulmonary function of children aged 7 to 12 years practising sports in the open air. Before and after sessions of training in the open air, the peak expiratory flow rate was determined using peak flow meters (mini-Wright). This was done on 37 different days with varying ozone concentrations. Measurements were carried out on four or more days in a total of 65 children. No correlation between ozone concentration during training and differences between pre- and post-training peak flows was found. No correlation was found either between the maximal ozone concentration on a given day and the peak flow at the end of training on that day. However, a negative correlation was found between the maximal ozone concentration on the day preceding the pulmonary function tests and the peak flow after the training.     

Indoor air pollution and pulmonary function growth in preadolescent children

Results are reported from a study of the association between exposure to sidestream cigarette smoke or gas stove emissions and pulmonary function level and growth rate of 7,834 children seen at 2-5 annual visits between the ages of 6-10 years. Children whose mothers smoked one pack of cigarettes per day had levels of forced expiratory volume in one second (FEV1) at age eight that were 0.81% lower than children of nonsmoking mothers (p less than 0.0001), and FEV1 growth rates approximately 0.17% per year lower (p = 0.05). For a child of age eight with an FEV1 of 1.62 liters, this corresponds to a deficit in rate of change of FEV1 of approximately 3 ml/annum and a deficit of 13 ml at age eight. Children whose mothers smoked one pack per day had levels of forced vital capacity (FVC) at age eight that were 0.33% higher than children of nonsmokers (p = 0.12); however, their growth rates of FVC were 0.17% per year lower (p = 0.04). Because few mothers changed their smoking habits during the course of the study, it was not possible to determine whether the difference in rate of growth was due to current exposure or to an effect of prenatal and early childhood exposure on the course of development. The magnitude of the effect on FEV1 is consistent with deficits in FEV1 of up to 3% in early adult life due to childhood exposure to sidestream cigarette smoke. The importance of this relatively small effect will be evaluated further through follow-up of these children as they are exposed to other risk factors such as personal active smoking. The data provide some evidence for an association between gas stove exposure and pulmonary function level, especially at younger ages, but no evidence for an effect of gas stove exposure on growth rate.     

Body growth rate in preadolescent children and outdoor air quality

STUDY OBJECTIVE: The main purpose of this paper was to assess the impact of the outdoor and indoor air quality on the growth rate of preadolescent children after accounting for parental height and potential confounders. The data were collected from a cohort prospective epidemiological study on the effect of air pollution on respiratory diseases in children in Krakow. PARTICIPANTS: Of the 1044 children covered by the study, the records were complete for 958 children. Characteristics of the outdoor air pollution level in the residence area was based on the communal air pollutants, such as SPM (suspended particulate matter) and SO(2). In the city center (highly polluted area) the mean level of SPM over a 5-year period for the winter season was 103.5 microg/m(3) and that of SO(2) was 86.9 microg/m(3); the corresponding values in the summer season were 32.3 microg/m(3) and 41.8 microg/m(3). The body growth rates of children were assessed by their height changes over a 2-year period. MAIN RESULTS: The body growth rates over the 2-year period in children from the highly polluted area was lower by 1.5 cm than those from the control area. Of the total growth rate variability explained by the multivariate model over the follow-up, about 3.1% has been explained by air pollution in the residence area. The compromising effect of higher air pollution in the residence area on height gain was about the same in shorter and taller children. CONCLUSIONS: The results of our study suggest that a child's growth rate is related to the post- natal air pollution level in the residence area. The results may have important implications for epidemiological studies on lung function in children related to environmental exposures. As the height gain is lower in exposed subjects and this does produce a height deficit, the estimates of adjusted lung function to body size may be biased.     

Association between gaseous ambient air pollutants and adverse pregnancy outcomes in Vancouver, Canada

The association between ambient air pollution and adverse health effects, such as emergency room visits, hospitalizations, and mortality from respiratory and cardiovascular diseases, has been studied extensively in many countries, including Canada. Recently, studies conducted in China, the Czech Republic, and the United States have related ambient air pollution to adverse pregnancy outcomes. In this study, we examined association between preterm birth, low birth weight, and intrauterine growth retardation (IUGR) among singleton live births and ambient concentrations of sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone in Vancouver, Canada, for 1985-1998. Multiple logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for such effects. Low birth weight was associated with exposure to SO2 during the first month of pregnancy (OR = 1.11, 95% CI, 1.01-1.22, for a 5.0 ppb increase). Preterm birth was associated with exposure to SO2 (OR = 1.09, 95% CI, 1.01-1.19, for a 5.0 ppb increase) and to CO (OR = 1.08, 95% CI, 1.01-1.15, for a 1.0 ppm increase) during the last month of pregnancy. IUGR was associated with exposure to SO2 (OR = 1.07, 95% CI, 1.01-1.13, for a 5.0 ppb increase), to NO2 (OR = 1.05, 95% CI, 1.01-1.10, for a 10.0 ppb increase), and to CO (OR = 1.06, 95% CI, 1.01-1.10, for a 1.0 ppm increase) during the first month of pregnancy. In conclusion, relatively low concentrations of gaseous air pollutants are associated with adverse effects on birth outcomes in populations experiencing diverse air pollution profiles.     

Personal and ambient air pollution exposures and lung function decrements in children with asthma

BACKGROUND: Epidemiologic studies have shown associations between asthma outcomes and outdoor air pollutants such as nitrogen dioxide and particulate matter mass < 2.5 mum in diameter (PM(2.5)). Independent effects of specific pollutants have been difficult to detect because most studies have relied on highly correlated central-site measurements. OBJECTIVES: This study was designed to evaluate the relationship of daily changes in percent-predicted forced expiratory volume in 1 sec (FEV(1)) with personal and ambient air pollutant exposures. METHODS: For 10 days each, we followed 53 subjects with asthma who were 9-18 years of age and living in the Los Angeles, California, air basin. Subjects self-administered home spirometry in themorning, afternoon, and evening. We measured personal hourly PM(2.5) mass, 24-hr PM(2.5) elemental and organic carbon (EC-OC), and 24-hr NO(2), and the same 24-hr average outdoor central-site(ambient) exposures. We analyzed data with transitional mixed models controlling for personal temperature and humidity, and as-needed beta(2)-agonist inhaler use. RESULTS: FEV(1) decrements were significantly associated with increasing hourly peak and daily average personal PM(2.5), but not ambient PM(2.5). Personal NO(2) was also inversely associated with FEV(1). Ambient NO(2) was more weakly associated. We found stronger associations among 37 subjects not taking controller bronchodilators as follows: Personal EC-OC was inversely associated with morning FEV(1); for an interquartile increase of 71 mug/m(3) 1-hr maximum personal PM(2.5), overall percent-predicted FEV(1) decreased by 1.32% [95% confidence interval (CI), -2.00 to -0.65%]; and for an interquartile increase of 16.8 ppb 2-day average personal NO(2), overall percent-predicted FEV(1) decreased by 2.45% (95% CI, -3.57 to -1.33%). Associations of both personal PM(2.5) and NO(2) with FEV(1) remained when co-regressed, and both confounded ambient NO(2). CONCLUSIONS: Independent pollutant associations with lung function might be missed using ambient data alone. Different sets of causal components are suggested by independence of FEV(1) associations with personal PM(2.5) mass from associations with personal NO(2).     

上海市大气污染对小学生肺功能小气道指标的急性效应研究

目的 分析上海市复合型大气污染对儿童肺功能小气道指标的急性影响。方法 在上海市内环、中环和外环各选择一所小学（A、B和C）,每所学校各随机抽取3~5年级一个班级学生为研究对象（共233人）;A、B两校于2013年12月和C校于2014年12月测试肺功能3次,各校分别于次年5-6月测试第4次肺功能。同时收集同期三校就近环境空气质量监测点大气细颗粒物（PM_2.5）、可吸入颗粒物（PM₁₀）、二氧化硫（SO₂）和二氧化氮（NO₂）污染物数据和气象监测数据;采用线性混合效应模型分析大气污染对肺功能小气道指标的影响。结果 控制气象因素和个体因素后,PM_2.5、PM₁₀滞后2 d和累计滞后2 d、SO₂累计滞后2 d和NO₂检测当日浓度每增加一个四分位间距（IQR）,儿童25%肺活量最大呼吸流速（MEF_25%）、50%肺活量最大呼吸流速（MEF_50%）、75%肺活量最大呼吸流速（MEF_75%）和用力呼气中段流速（FEF_25%~75%）均有不同程度的降低（P<0.05或P<0.01）;双污染物模型分析显示SO₂和NO₂分别叠加PM_2.5和PM₁₀污染时,滞后效应值大于SO₂和NO₂单独存在时（P<0.05）。结论 上海市大气污染物短期暴露与儿童肺功能小气道指标变化呈负相关,并存在滞后效应及累计滞后效应。     

Association of lung function with declining ambient air pollution

Recent studies have found a declining prevalence of respiratory infections in East German children, along with a tremendous improvement of air pollution since 1990. The present study evaluates the effects of improved air quality on lung function. Three consecutive cross-sectional surveys of schoolchildren ages 11-14 years from three communities in East Germany were performed in 1992-1993, 1995-1996, and 1998-1999. Lung function tests were available from 2,493 children. The annual mean of total suspended particulates (TSP) declined from 79 to 25 micro g/m(3), whereas levels for sulfur dioxide declined from 113 to 6 micro g/m(3). Mean forced vital capacity (FVC) and forced expiratory volume in 1 sec (FEV(1)) of the children increased from 1992-1993 to 1998-1999. The adjusted percent change of the geometric mean of FVC was 4.7% for a 50 micro g/m(3) decrease of TSP (p = 0.043) and 4.9% for a decrement of 100 micro g/m(3) SO(2) (p = 0.029). Effects on FEV(1) were smaller and not statistically significant. Our study indicates that a reduction of air pollution in a short time period may improve children's lung function.     

环境空气污染物对女性生育力影响的研究进展

近年来,环境空气污染物对健康的影响已经不容小觑。随着社会工业化的进步及不可避免的冬季供暖,空气质量愈加恶化,雾霾天气时常出现。已有越来越多的研究表明,可吸入颗粒物(particulate matter,PM)、二氧化氮(NO2)、二氧化硫(SO2)、多环芳烃(polycyclic aromatic hydrocarbons,PAHs)、苯并芘(benzapyrene,BaP)作为环境空气污染物的主要成分,影响女性生殖内分泌水平,对女性生育力造成破坏,造成妊娠失败。     

Long-term effects of ambient air pollution on lung function: a review

Lung function is an important measure of respiratory health and a predictor of cardiorespiratory morbidity and mortality. Over the past 2 decades, more than 50 publications have investigated long-term effects of ambient air pollution on lung function with most finding adverse effects. Several studies have also suggested effects from traffic-related air pollution. There is strong support for air pollution effects on the development of lung function in children and adolescents. It remains unclear whether subjects with slower development of lung function compensate by prolonging the growth phase, or whether they end their development at a lower plateau, thus entering the decline phase with a reduced lung function. In adults, the evidence for long-term air pollution effects is mostly based on cross-sectional comparisons. One recent longitudinal study observed that decreasing pollution attenuated the decline of lung function in adults. Earlier inconclusive cohort studies were based on limited data. There is great diversity in study designs, markers of air pollution, approaches to the measurement of exposure, and choices in lung function measures. These limit the comparability of studies and impede quantitative summaries. New studies should use individual-level exposure assessment to clarify the role of traffic and to preclude potential community-level confounding. Further research is needed on the relevance of specific pollution sources, particularly with regard to susceptible populations and relevant exposure periods throughout life.     

Asthma symptoms in Hispanic children and daily ambient exposures to toxic and criteria air pollutants

Although acute adverse effects on asthma have been frequently found for the U.S. Environmental Protection Agency's principal criteria air pollutants, there is little epidemiologic information on specific hydrocarbons from toxic emission sources. We conducted a panel study of 22 Hispanic children with asthma who were 10-16 years old and living in a Los Angeles community with high traffic density. Subjects filled out symptom diaries daily for up to 3 months (November 1999 through January 2000). Pollutants included ambient hourly values of ozone, nitrogen dioxide, sulfur dioxide, and carbon monoxide and 24-hr values of volatile organic compounds (VOCs), particulate matter with aerodynamic diameter < 10 microm (PM10, and elemental carbon (EC) and organic carbon (OC) PM10 fractions. Asthma symptom severity was regressed on pollutants using generalized estimating equations, and peak expiratory flow (PEF) was regressed on pollutants using mixed models. We found positive associations of symptoms with criteria air pollutants (O3, NO2, SO2, PM10), EC-OC, and VOCs (benzene, ethylbenzene, formaldehyde, acetaldehyde, acetone, 1,3-butadiene, tetrachloroethylene, toluene, m,p-xylene, and o-xylene). Selected adjusted odds ratios for bothersome or more severe asthma symptoms from interquartile range increases in pollutants were, for 1.4 ppb 8-hr NO2, 1.27 [95% confidence interval (CI), 1.05-1.54]; 1.00 ppb benzene, 1.23 (95% CI, 1.02-1.48); 3.16 ppb formaldehyde, 1.37 (95% CI, 1.04-1.80); 37 microg/m3 PM10, 1.45 (95% CI, 1.11-1.90); 2.91 microg/m3 EC, 1.85 (95% CI, 1.11-3.08); and 4.64 microg/m3 OC, 1.88 (95% CI, 1.12-3.17). Two-pollutant models of EC or OC with PM10 showed little change in odds ratios for EC (to 1.83) or OC (to 1.89), but PM10 decreased from 1.45 to 1.0. There were no significant associations with PEF. Findings support the view that air toxins in the pollutant mix from traffic and industrial sources may have adverse effects on asthma in children.     

The effects of ambient ozone on lung function in children: a reanalysis of six summer camp studies.

Studies of children attending summer camps often have observed relationships between daily outdoor ozone (O3) concentrations and decreased lung function that are qualitatively similar to results seen in human chamber studies. The former studies, focusing on the pulmonary effects of O3 and associated pollutants on children under natural conditions of exposure, are potentially of great importance to understanding the public health impact of ambient O3. However, a thorough assessment of the results of these studies has been hampered by differences in the analysis and reporting of data across the various studies. We obtained data sets from six summer camp studies carried out by three separate investigative groups, including two New Jersey studies performed by New York University, two studies in Ontario carried out by Health and Welfare Canada, and two studies in southern California. The data consisted of sequential, daily measurements of forced expiratory volume in 1 sec (FEV1), peak expiratory flow rate (PEFR), and 1-hr O3 concentration in the hour preceding lung function measurements for each child. We analyzed the relationships between lung function and O3 using linear regression models that fit subject-specific intercepts and a single, pooled O3 slope. These models were fit for each of the six studies separately and for all studies combined. All of the study-specific slopes of FEV1 on O3 were negative (i.e., increased O3 associated with decreased FEV1); five of six were statistically significant. Analysis of the combined six-study data set yielded a slope of -0.50 ml FEV1/ppb O3 (p<0.0001). Addition of time-trend variables to the combined-data analysis diminished, but did not eliminate, the FEV1-O3 relationship. Study-specific slopes for PEFR on O3 were more variable. Combined over studies, no significant relationship was observed between PEFR and O3. However, this negative finding appeared to be partially confounded by time trends in PEFR. The results of this reanalysis provide strong evidence that children exposed to O3 under natural conditions experience decreases in FEV1 of the kind demonstrated in laboratory studies, and raise concern that other acute respiratory effects observed in those studies (e.g., pulmonary inflammation) may also occur in young people exposed to ambient O3.     

Decline of ambient air pollution levels and improved respiratory health in Swiss children

The causality of observed associations between air pollution and respiratory health in children is still subject to debate. If reduced air pollution exposure resulted in improved respiratory health of children, this would argue in favor of a causal relation. We investigated whether a rather moderate decline of air pollution levels in the 1990s in Switzerland was associated with a reduction in respiratory symptoms and diseases in school children. In nine Swiss communities, 9,591 children participated in cross-sectional health assessments between 1992 and 2001. Their parents completed identical questionnaires on health status and covariates. We assigned to each child an estimate of regional particles with an aerodynamic diameter < 10 microg/m3 (PM10) and determined change in PM10 since the first survey. Adjusted for socioeconomic, health-related, and indoor factors, declining PM10 was associated in logistic regression models with declining prevalence of chronic cough [odds ratio (OR) per 10-microg/m3 decline = 0.65, 95% confidence interval (CI), 0.54-0.79], bronchitis (OR = 0.66; 95% CI, 0.55-0.80), common cold (OR = 0.78; 95% CI, 0.68-0.89), nocturnal dry cough (OR = 0.70; 95% CI, 0.60-0.83), and conjunctivitis symptoms (OR = 0.81; 95% CI, 0.70-0.95). Changes in prevalence of sneezing during pollen season, asthma, and hay fever were not associated with the PM10 reduction. Our findings show that the reduction of air pollution exposures contributes to improved respiratory health in children. No threshold of adverse effects of PM10 was apparent because we observed the beneficial effects for relatively small changes of rather moderate air pollution levels. Current air pollution levels in Switzerland still exceed limit values of the Swiss Clean Air Act; thus, children's health can be improved further.     

大气污染对变应性疾病及花粉症就诊人次的影响

目的 研究大气污染物浓度对医院变应性疾病和花粉症日就诊人次的影响.方法 收集2004年4-9月北京市8个国家监测点大气污染物[SO2、NO2、可吸入颗粒物(PM10)]浓度、4个观测点花粉日监测数据、气象资料及北京世纪坛医院变态反应科同时段变应性疾病和花粉症日就诊人次资料,应用时间序列分析的广义相加泊松回归模型进行定量分析,并考虑滞后效应和多种空气污染物的影响.结果 研究期间大气SO2、NO2、PM10日均浓度分别为(20.9±12.9)、(58.6±13.6)、(126.8 ±64.1)μg/m3,花粉日均浓度为(163.8±209.0)粒/1000 mm2,变应性疾病日就诊(16.3±5.3)人次,花粉症日就诊(3.5±5.0)人次.时间序列分析显示,花粉浓度每升高100粒/1000 mm2,第2天的变应性疾病日就诊人次增加2.44%(95%CI:0.75%～4.13%),当天的花粉症日就诊人次增加6.58%(95%CI:3.82%～9.34%).而大气污染物(NO2、SO2和PM10)对变应性疾病和花粉症日就诊人次的影响呈现明显的滞后效应:NO2每升高10 μg/m3,滞后6 d的变应性疾病日就诊人次增加3.14%(95%CI:0.42%～5.85%);S02滞后1 d、NO2滞后6 d、PM10滞后3 d对花粉症日就诊人次影响较大,但差异均无统计学意义[RR值(95%CI值)分别为1.0460(0.9640～1.1280)、1.0325(0.9633～1.1017)、1.0079(0.9942～1.0217)].将4种大气污染物同时引入模型分析时,其效应稍微增强:花粉浓度每升高100粒/1000 mm2,变应性疾病日就诊人次增加2.56%(95%CI:0.80%～4.31%),花粉症日就诊人次增加6.81%(95%CI:3.91%～9.71%).结论 影响变应性疾病和花粉症日就诊人次的环境因素主要为空气花粉浓度,大气污染物的作用不大.     

空气污染物对胎儿生长发育影响的研究进展

胎儿生长发育迟缓与围产期、儿童时期及成年后的多种疾病相关,是重要的公共卫生问题。随着空气污染物长期暴露测量技术的进步,近年来陆续有流行病学研究观察了孕期空气污染物暴露水平对胎儿生长发育的影响。笔者通过查阅Medline、Web of Science数据库,对近年来空气污染物与胎儿生长发育关系的研究进展做综述。     

煤烟型大气污染对儿童肺功能的影响

为观察煤烟型大气污染对儿童健康的影响 ,选择了太原市 3个污染程度不同地区的 45 0名儿童进行肺功能测试和问卷调查。研究结果显示 ,儿童呼吸功能表现为重度污染区 <中度污染区 <相对清洁区 ;肺通气功能阻塞性异常率表现为重度污染区 >中度污染区 >相对清洁区 ;Logistic回归分析发现肺通气功能阻塞性异常率与小学生家庭的取暖方式、厨房和卧室是否分开以及污染物的水平有关 ;多元线性回归分析显示重度污染区儿童的FVC、FEF5 0与相对清洁区相比分别减少了 65 80ml、119 2 7ml,中度污染区儿童的FVC、FEF5 0与相对清洁区相比分别减少了 5 7 2 8ml和 114 2 9ml;Ln(SO2 )每升高一个单位 ,FVC和FEF5 0分别减少69 10ml和 119 79ml,Ln(PM1 0 )每升高一个单位 ,FVC、FEF5 0等分别减少了 193 5 0ml和 171 69ml。结果提示 ,太原市煤烟型大气污染对儿童呼吸系统产生了危害。     

No association between serum cholesterol and growth in preadolescent American children.

To determine the relation between serum cholesterol level (SCL) and growth in preadolescent children (2-12 years of age) in the United States, we examined the association of SCL and three measures of growth in a national sample of American children from 1971 to 1974. We investigated three parameters: sitting height, standing height, and weight and undertook separate analyses for sex and race. We found no consistent statistically significant associations with any of these three measures of growth. This result did not change when we adjusted the data for age alone or for age, poverty index, serum protein level, and hematocrit. We conclude that growth in this population group is not dependent on SCL.     

大气混合污染物致大鼠肺氧化损伤作用

目的探讨大气混合污染物对大鼠肺损伤的作用。方法48只Wistar大鼠随机分为4组,即对照组和实验组(实际、中、高剂量组),进行可吸入颗粒物(PM10)及混合气体(SO₂、NO₂、CO)染毒。染尘采用一次性气管注入法,混合气体染毒采用静式吸入法,每天2 h,连续30 d。测定血清及支气管肺泡灌洗液(BALF)中相关生化酶的活性和脂质过氧化指标水平。结果实验组BALF中的乳酸脱氢酶(LDH)活性(4.03,2.98,3.63 U/ml)及总蛋白水平(1.14,0.71,0.98 g/L)均显著高于对照组(1.91 U/ml,0.37 g/L),差异有统计学意义。高剂量丙二醛(MDA)平均水平(2.10 mmol/ml)明显高于对照组(0.95 mmol/ml,P<0.05);实验组超氧化物歧化酶(SOD)活性(18.32,25.72,16.82 U/ml)均明显低于对照组(40.88 U/ml,P<0.01);血清中各指标水平变化不明显。结论大气混合污染物可引起肺的氧化损伤,并导致大鼠肺细胞膜的通透性增强。     

主要大气污染物与出生缺陷相关性研究进展

出生缺陷的原因包括遗传、环境、食品、药物病毒感染等,环境因素中的大气污染一直被证实与出生缺陷相关。从上世纪60年代的反应停药害事件,到本世纪大气污染物对胎儿早期生长发育、与母体营养物质、氧气交换等研究也相继表明了大气污染是胎儿生长发育的危险因素。近年来研究表明,孕妇在孕期暴露于大气污染物与胎儿心血管疾病的发生有相关性。本研究就出生缺陷与大气污染中的主要成份二氧化硫、氮化物和二氧化氮、可吸入颗粒物的关系分别进行阐述。