title: Association between exhaled nitric oxide, ambient air pollution and respiratory health in school children.
abstract: OBJECTIVE
  The aim of the study was to investigate whether the level of exhaled nitric oxide (eNO) provides a more sensitive measure to assess adverse pulmonary effects of air pollution than conventional lung function indices.
  
  
  METHODS
  The non-selected cohort studied consisted of 68 children (aged 10-11 years) living in an urban environment. For 7 weeks respiratory complaints were reported daily by these children in a diary, and lung function measures and eNO levels were determined in the children once a week on days with various level of air pollution.
  
  
  RESULTS
  During the study the increase in the levels of the various air pollutants was positively associated with eNO (6% to 31% increase; P<0.05) but not with lung function measures. In contrast to the lung function measures, the prevalence of respiratory symptoms such as "sore throat", "runny nose", "having a cold", and "sick at home" were positively associated with the level of eNO measured in the following week.
  
  
  CONCLUSIONS
  Though clinically very meaningful, functional pulmonary measures appear to be too course to detect relatively mild clinical symptoms in response to exposure to air pollution. In an epidemiological setting the increase in eNO may represent a more suitable measure to assess such adverse effects.
authors: Laboratory of Exposure Assessment and Environmental Epidemiology, National Institute of Public Health and the Environment, Bilthoven, The Netherlands.
authors: P H
authors: PH
authors: Fischer
authors: P A
authors: PA
authors: Steerenberg
authors: J D
authors: JD
authors: Snelder
authors: H
authors: H
authors: van Loveren
authors: J G C
authors: JG
authors: van Amsterdam
mesh_terms: D000397:Air Pollution / Q000009:adverse effects / Q000032:analysis*; D015415:Biomarkers; D001944:Breath Tests; D002648:Child; D004781:Environmental Exposure / Q000032:analysis*; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D009569:Nitric Oxide / Q000032:analysis*; D012120:Respiration Disorders / Q000453:epidemiology / Q000209:etiology; D012129:Respiratory Function Tests; D013147:Spirometry; D011795:Surveys and Questionnaires; D014504:Urban Health
chemical_list: D015415:Biomarkers; D009569:Nitric Oxide