Chronic effects of ambient air pollution on respiratory morbidities among Chinese children: a cross-sectional study in Hong Kong

BMC Public Health

Tze Wai Wong³  Patrick WC Lau¹  Liping Li²  Emily YY Chan³  Yang Gao¹ 

[1] Department of Physical Education, Hong Kong Baptist University, Hong Kong, China;Injury Prevention Research Center, Medical College of Shantou University, Shantou, China;School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China

关键词: Urban;    China;    Respiratory morbidity;    Child;    NO₂;    PM₁₀;    Air pollution;   

Others  :  1161279
DOI  :  10.1186/1471-2458-14-105

 received in 2013-08-29, accepted in 2014-01-26,  发布年份 2014

【 摘 要 】

Background

The chronic health effects from exposure to ambient air pollution are still unclear. This study primarily aims to examine the relationship between long-term exposure to ambient air pollution and respiratory morbidities in Chinese children.

Methods

A cross-sectional study was conducted among 2,203 school children aged 8–10 in three districts with different air pollution levels in Hong Kong. Annual means for ambient PM₁₀, SO₂, NO₂ and O₃ in each district were used to estimate participants’ individual exposure. Two questionnaires were used to collect children’s respiratory morbidities and other potential risk factors. Multivariable logistic regression was fitted to estimate the risks of air pollution for respiratory morbidities.

Results

Compared to those in the low-pollution district (LPD), girls in the high-pollution district (HPD) were at significantly higher risk for cough at night (OR_adj. = 1.81, 95% CI: 1.71-2.78) and phlegm without colds (OR_adj. = 3.84, 95% CI: 1.74-8.47). In addition, marginal significance was reached for elevated risks for asthma, wheezing symptoms, and phlegm without colds among boys in HPD (adjusted ORs: 1.71-2.82), as well as chronic cough among girls in HPD (OR_adj. = 2.03, 95% CI: 0.88-4.70).

Conclusions

Results have confirmed certain adverse effects on children’s respiratory health from long-term exposure to ambient air pollution. PM₁₀ may be the most relevant pollutant with adverse effects on wheezing and phlegm in boys. Both PM₁₀ and NO₂ may be contributing to cough and phlegm in girls.

【 授权许可】

   
2014 Gao et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]World Health Organization: WHO Air quality guidelines for particulate matter, ozone, nitrogen dioxide and sulfur dioxide - Global update 2005 - Summary of risk assessment. Geneva: WHO Press; 2006.
• [2]World Health Organization Regional Office for Europe: Air quality guidelines for Europe, second edition, 2000. Copenhagen: WHO Regional Office for Europe; 2000. [WHO Regional Publications, European Series, No. 91]
• [3]Ware JH, Ferris BG Jr, Dockery DW, Spengler JD, Stram DO, Speizer FE, et al.: Effects of ambient sulfur oxides and suspended particles on respiratory health of preadolescent children. Am Rev Respir Dis 1986, 133:834-842.
• [4]Dockery DW, Cunningham J, Damokosh AI, Neas LM, Spengler JD, Koutrakis P, et al.: Health effects of acid aerosols on north American children: respiratory symptoms. Environ Health Perspect 1996, 104:500-5005.
• [5]Peters JM, Avol E, Navidi W, London SJ, Gauderman WJ, Lurmann F, et al.: A study of twelve southern California communities with differing levels and types of air pollution. I. Prevalence of respiratory morbidity. Am J Respir Crit Care Med 1999, 159:760-767.
• [6]Wjst M, Reitmeir P, Dold S, Wulff A, Nicolai T, von Loeffelholz-Colberg EF, et al.: Road traffic and adverse effects on respiratory health in children. BMJ 1993, 307:596-600.
• [7]Edwards J, Walters S, Griffiths RK: Hospital admissions for asthma in preschool children: relationship to major roads in Birmingham, United Kingdom. Arch Environ Health 1994, 49:223-227.
• [8]Shima M, Adachi M: Effect of outdoor and indoor nitrogen dioxide on respiratory symptoms in schoolchildren. Int J Epidemiol 2000, 29:862-870.
• [9]Hwang BF, Lee YL, Jaakkola JJK, Guo YL: Traffic related air pollution as a determinant of asthma among Taiwanese school children. Thorax 2005, 60:467-473.
• [10]Anderson HR, Ruggles R, Pandey KD, Kapetanakis V, Brunekreef B, Lai CKW, et al.: Ambient particulate pollution and the world-wide prevalence of asthma, rhinoconjunctivitis and eczema in children: phase one of the International Study of Asthma and Allergies in Childhood (ISAAC). Occup Environ Med 2010, 67:293-300.
• [11]Environmental Protection Department of Hong Kong: Air quality annual report. data is available on http://www.aqhi.gov.hk/en/download/air-quality-reportse469.html?showall=&start=1 webcite on 27 June, 2012
• [12]Yu TS, Wong TW, Wang XR, Song H, Wong SL, Tang JL: Adverse effects of low-level air pollution on the respiratory health of schoolchildren in Hong Kong. J Occup Environ Med 2001, 43:310-316.
• [13]Wong CM, Lam TH, Peters J, Hedley AJ, Ong SG, Tam AY, et al.: Comparison between two districts of the effects of an air pollution intervention on bronchial responsiveness in primary school children in Hong Kong. J Epidemiol Community Health 1998, 52:571-578.
• [14]Zhang JJ, Hu W, Wei F, Wu G, Korn LR, Chapman RS: Children’s respiratory morbidity prevalence in relation to air pollution in four Chinese cities. Environ Health Perspect 2002, 110:961-967.
• [15]Gao Y, Chan EYY, Zhu YJ, Wong TW: Adverse effect of outdoor air pollution on cardiorespiratory fitness in Chinese children. Atmos Environ 2013, 64:10-17.
• [16]Gao Y, Chan EYY, Li LP, Wong TW: Chronic effects of ambient air pollution on lung function among Chinese children. Arch Dis Child 2013, 98:128-135.
• [17]Ferris BG: Epidemiology standardization project (American Thoracic Society). Am Rev Respir Dis 1978, 118:1-120.
• [18]Leung R, Wong G, Lau J, Ho A, Chan JK, Choy D, et al.: Prevalence of asthma and allergy in Hong Kong schoolchildren: an ISAAC study. Eur Respir J 1997, 10:354-360.
• [19]Katz MH: Multivariable analysis: a practical guide for clinicians. Cambridge: Cambridge University Press; 1999.
• [20]Wang SL, Guo XB, Zhang JL: Study on the effect of ambient air pollution on respiratory disease and symptoms among school-age children in Beijing [in Chinese]. J Environ Health 2004, 21:41-44.
• [21]Ye LJ, Sun WJ, Yu W: Study on the influence of air pollution inside door or outside door on the health of the school children [in Chinese]. Mod Prev Med 2007, 34:4686-4687.
• [22]Tian QX, Zhou LZ, Wang R, Tian ZM: The study about influences of the air pollution on the respiratory system health of the children and their parents in Lanzihou [in Chinese]. Environ Monit China 2001, 17:48-51.
• [23]Kong LL, He QC, Xu F, Xu KY, Guo H: Study on the effects of indoor and outdoor air pollution on the respiratory system of school-age children [in Chinese]. Environ Monit China 2001, 17:43-48.
• [24]Wu J, He Q, Du L: Cross-sectional study on the relationship of outdoor air pollution with children’s respiratory health in Guangzhou City [in Chinese]. South China J Prev Med 2012, 38:1-5.
• [25]Wu Y, Zhang J, Zhao X: Relationship between ambient air pollution and Children’s respiratory health in China. J Environ Health 2009, 26:471-477.
• [26]Pan GW, Zhang SJ, Feng YP, Takahashi K, Kagawa J, Yu LZ: Air pollution and children’s respiratory symptoms in six cities of Northern China. Respir Med 2010, 104:1903-1911.
• [27]Aunan K, Pan XC: Exposure-response functions for health effects of ambient air pollution applicable for China - A meta-analysis. Sci Total Environ 2004, 329:3-16.
• [28]Braun-Fahrlander C, Vuille JC, Sennhauser FH, Neu U, Kunzle T, Grize L: Respiratory health and long-term exposure to air pollutants in Swiss schoolchildren. SCARPOL Team: Swiss Study on Childhood Allergy and Respiratory Symptoms with Respect to Air Pollution, Climate and Pollen. Am J Respir Crit Care Med 1997, 155:1042-1049.
• [29]Pershagen G, Rylander E, Norberg S, Eriksson M, Nordvall SL: Air pollution involving nitrogen dioxide exposure and wheezing bronchitis in children. Int J Epidemiol 1995, 24:1147-1153.
• [30]Kramer U, Koch T, Ranft U, Ring J, Behrendt H: Traffic-related air pollution is associated with atopy in children living in urban areas. Epidemiology 2000, 11:64-70.
• [31]Venn AJ, Lewis SA, Cooper M, Hubbard R, Britton J: Living near a main road and the risk of wheezing illness in children. Am J Respir Crit Care Med 2001, 164:2177-2180.
• [32]HEI Accountability Working Group: Assessing Health Impact of Air Quality Regulations: Concepts and Methods for Accountability Research, Communication 11. Boston MA: Health Effects Institute; 2003.