title: Childhood morbidity and air pollution in the Teplice program.
abstract: BACKGROUND
  A study of morbidity of children aged 0 to 3 years was conducted in two districts in the Czech Republic. Comparisons were made between children living in Teplice district, known for its high air pollution, and children living in Practice, a district with consistently lower particulate and SO2 exposures.
  
  
  RESULTS
  The children were selected for the follow up based on deliveries from May 1994 to December 1966. Childhood morbidity during the first three years of life of 452 children was extracted from their pediatric records. Diagnoses were coded using the International Classification of Diseases--10th edition, and categorized into broad groupings. Children born in Teplice experienced a significantly higher rate of otitis media and otalgia, gastrointestinal infections, upper respiratory infections, and pneumonia, but did not differ in their risk for bronchitis or for viral infections such as varicella. These findings remained after multiple linear regression models adjusted for education, maternal age, maternal smoking, and other smokers in the household, breastfeeding, and attendance at day care.
  
  
  CONCLUSIONS
  Air pollution may alter early childhood susceptibility to infection, but other differences between the districts must be considered: systematic diagnostic differences for several health outcomes comparing pediatricians in Teplice vs. Practice, differences in health-care seeking behavior by the parents, and inadequate control for confounding.
authors.affiliation: Institute of Exp. Medicine, Academy of Sciences, Prague, Czech Republic. dostal@biomed.cas.cz
authors.forename: M
authors.initials: M
authors.lastname: Dostál
authors.forename: I
authors.initials: I
authors.lastname: Hertz-Picciotto
authors.forename: R
authors.initials: R
authors.lastname: James
authors.forename: J
authors.initials: J
authors.lastname: Keller
authors.forename: J
authors.initials: J
authors.lastname: Dejmek
authors.forename: S
authors.initials: S
authors.lastname: Selevan
authors.forename: F
authors.initials: F
authors.lastname: Kotĕsovec
authors.forename: J
authors.initials: J
authors.lastname: Nozicka
authors.forename: A
authors.initials: A
authors.lastname: Gomez-Caminero
authors.forename: G
authors.initials: G
authors.lastname: Wegienka
authors.forename: R
authors.initials: R
authors.lastname: Srám
mesh_terms: D000397:Air Pollution / Q000009:adverse effects; D002675:Child, Preschool; D018153:Czech Republic / Q000453:epidemiology; D005767:Gastrointestinal Diseases / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007239:Infections / Q000453:epidemiology*; D010033:Otitis Media / Q000453:epidemiology; D011014:Pneumonia / Q000453:epidemiology; D012141:Respiratory Tract Infections / Q000453:epidemiology; D014777:Virus Diseases / Q000453:epidemiology