Air Pollution and Recent Symptoms of Asthma, Allergic Rhinitis, and Atopic Eczema in Schoolchildren Aged Between 6 and 7 Years

Arnedo-Pena, Alberto; García-Marcos, Luis; Urueña, Ignacio Carvajal; Monge, Rosa Busquets; Suárez-Varela, María Morales; Canflanca, Izaskun Miner; Garrido, José Batlles; Quirós, Alfredo Blanco; López-Silvarrey Varela, Ángel; Hernández, Gloria García; Ontoso, Inés Aguinaga; Díaz, Carlos González

doi:10.1016/S1579-2129(09)72152-4

Archivos de Bronconeumología

ISSN: 0300-2896

Archivos de Bronconeumologia is an international journal that publishes original studies whose content is based upon results of research initiatives dealing with several aspects of respiratory medicine including epidemiology, respiratory physiology, pathophysiology of respiratory diseases, clinical management, thoracic surgery, pediatric lung diseases, respiratory critical care, respiratory allergy and basic research. Other types of articles such as editorials, reviews, and different types of letters are also published in the journal. Additionally, the journal expresses the voice of the following scientific societies: the Spanish Respiratory Society of Pneumology and Thoracic Surgery (SEPAR; https://www.separ.es/), the Latin American Thoracic Society (ALAT; https://alatorax.org/), and the Iberian American Association of Thoracic Surgery (AIACT; http://www.aiatorax.com/).

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Vol. 45. Issue 5.

Pages 224-229 (May 2009)

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Pages 224-229 (May 2009)

Original article

DOI: 10.1016/S1579-2129(09)72152-4

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Air Pollution and Recent Symptoms of Asthma, Allergic Rhinitis, and Atopic Eczema in Schoolchildren Aged Between 6 and 7 Years

Contaminación del aire y síntomas recientes de asma, rinitis alérgica y eccema atópico en escolares de 6 y 7 años

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Alberto Arnedo-Penaa,

Corresponding author

arnedo_alb@gva.es

Corresponding author.

, Luis García-Marcosb, Ignacio Carvajal Urueñac, Rosa Busquets Monged, María Morales Suárez-Varelae, Izaskun Miner Canflancaf, José Batlles Garridog, Alfredo Blanco Quirósh, Ángel López-Silvarrey Varelai, Gloria García Hernándezj, Inés Aguinaga Ontosok, Carlos González Díazl

a Sección de Epidemiología, Centro de Salud Pública, Castellón, Spain

b Unidades de Neumología y de Alergia Pediátrica, Hospital Infantil Universitario Virgen de la Arrixaca, CIBER Epidemiología y Salud Pública (CIBERESP), Murcia, Spain

c Centro de Salud La Ería, Servicio de Salud del Principado de Asturias, Oviedo, Asturias, Spain

d Departamento de Pediatría, Hospital del Mar, Barcelona, Spain

e Unidad de Salud Pública y Medio Ambiente, Departamento de Medicina Preventiva, Universidad de Valencia, CIBER CB06/02/0045, CIBER Actions-Epidemiología y Salud Pública, Fundación para la Investigación, Grupo de investigación, Hospital Universitario Dr. Peset, Valencia, Spain

f Departamento de Pediatría, Hospital Donostia, San Sebastián, Guipúzcoa, Spain

g Unidad de Neumología Infantil, Servicio de Pediatría, Hospital Torrecárdenas, Almería, Spain

h Departamento de Pediatría, Universidad de Valladolid, Valladolid, Spain

i Fundación María José Jove, La Coruña, Spain

j Unidad de Neumología y Alergia Pediátrica, Hospital Infantil 12 de Octubre, Madrid, Spain

k Departamento de Epidemiología, Ayuntamiento de Pamplona, Pamplona, Navarra, Spain

l Departamento de Pediatría, Hospital de Basurto, Bilbao, Vizcaya, Spain

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Abstract

Objective

The objective of the study was to analyze the relationship between air pollutants and the prevalence of recent symptoms of asthma, allergic rhinitis, and atopic eczema in schoolchildren aged between 6 and 7 years.

Patients and Methods

The prevalence of recent (previous 12 months) symptoms of allergic diseases was obtained by means of the questionnaire of the International Study of Asthma and Allergies in Childhood (ISAAC), Spain, with the participation of 7 centers (Asturias, Barcelona, Bilbao, Cartagena, La Coruña, Madrid, and Valencia) and 20 455 schoolchildren aged between 6 and 7 years, from 2002 to 2003. The pollutant detection systems of the aforementioned centers provided the mean annual concentrations of sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and total suspended particulate matter.

Results

The annual average concentration of SO2 showed a significant association with a higher prevalence of recent severe asthma (adjusted odds ratio [aOR] between level-1 and level-3 pollution, 1.32; 95% confidence interval [CI], 1.01–1.73), rhinitis (aOR, 1.56; 95% CI, 1.39–1.75), and rhinoconjunctivitis (aOR, 1.70; 95% CI, 1.45–2.00). The annual average concentration of CO was associated with a higher prevalence of rhinitis (aOR, 1.65; 95% CI, 1.34-2.04), rhinoconjunctivitis (aOR, 1.76; 95% CI, 1.31–2.37), and eczema (aOR, 1.55; 95% CI, 1.17–2.04). The annual average concentration for NO2 and total suspended particulate matter showed inverse associations with the prevalence of nocturnal dry cough.

Conclusions

Findings suggest that air pollutants such as SO2 and CO increase the risk of recent symptoms of asthma and allergic rhinitis in schoolchildren aged between 6 and 7 years in Spain.

Keywords:

Asthma

Air pollution

Sulfur dioxide

Nitrogen dioxide

Atopic eczema

Schoolchildren

Allergic rhinitis

Resumen

Introducción

El objetivo del estudio ha sido analizar la relación entre contaminantes del aire y la prevalencia de síntomas recientes de asma, rinitis alérgica y eccema atópico, en escolares de 6 y 7 años.

Pacientes y métodos

La prevalencia de síntomas de enfermedades alérgicas recientes (últimos 12 meses) se obtuvo mediante el cuestionario del estudio ISAAC (International Study of Asthma and Allergies in Childhood) España, con la participación de 7 centros (Asturias, Barcelona, Bilbao, Cartagena, La Coruña, Madrid y Valencia) y 20.455 escolares de 6 y 7 años, durante 2002–2003. De los sistemas de detección de contaminantes de los centros citados se obtuvieron datos de las concentraciones anuales medias de dióxido de azufre (SO2), dióxido de nitrógeno (NO2), monóxido de carbono (CO) y total de partículas en suspensión.

Resultados

La concentración media anual (CMA) de SO2 se asoció significativamente con una mayor prevalencia de asma grave reciente (odds ratio ajustada [ORa], nivel 3 sobre nivel 1 de contaminación=1,32; intervalo de confianza [IC] del 95%, 1,01–1,73), rinitis (ORa = 1,56; IC del 95%, 1,39–1,75) y rinoconjuntivitis (ORa = 1,70; IC del 95%, 1,45–2,00). La CMA de CO se asoció con una prevalencia más alta de rinitis (ORa = 1,65; IC del 95%, 1,34-2,04), rinoconjuntivitis (ORa = 1,76; IC del 95%, 1,31–2,37) y eccema atópico (ORa = 1,55; IC del 95%, 1,17–2,04). Las CMA de NO2 y de total de partículas en suspensión presentaron asociaciones inversas con la prevalencia de tos seca nocturna.

Conclusiones

Se indica qué contaminantes del aire, como SO2 y CO, incrementan el riesgo de síntomas recientes de asma y rinitis alérgica en escolares de 6 y 7 años de nuestro medio.

Palabras clave:

Asma

Contaminación atmosférica

Dióxido de azufre

Dióxido de nitrógeno

Atopic eczema

Escolares

Rinitis alérgica

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References

[1.]

R.J. Davies, C. Rusznak, J.L. Devalia.

Why allergy increasing? Environmental factors.

Clin Exp Allergy, 28 (1998), pp. 8-14

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