Asthmatic disease among urban preschoolers: an observational study.
Asthma is of increasing concern especially in industrialized countries. This cross-sectional study was to assess the influence of spatial and temporal variations in the urban air pollution profile on asthmatic disease. The prevalences presented are based on physician-diagnosed asthmatic and allergic disease data, collected between 1993 and 1995. Seven hundred and thirty-six preschool children (age 2 to 7, mean 5.7 years) of 37 daycare centres in the City of Leipzig participated in the study. Variations were observed in the lifetime prevalences of asthma and allergy with differences in a residential area's ambient pollution profile. Depending on the level of traffic (high or low), children residing in areas with a dominant coal-heating emission profile had more frequently a diagnosis of asthma, 17.5% and 8.8% (95% confidence intervals [CI]: 10.8...23.5 and 5.8...11.6, respectively), as compared to those, living in centrally heated areas 13.4% and 5.8% (CI: 6.6...19.3 and 1.2...9.6, respectively). Allergic disorders occurred more often in areas with a predominantly traffic-associated pollution profile, 14.3% and 9.6% vs. 5.8% and 3.7% (CI: 7.4...20.3 and 6.4...12.5; 1.2...9.6 and 0.2...6.5, respectively). Interestingly, asthmatic disease was not necessarily associated with a clinical history of allergies. Of the children with physician-diagnosed asthma, 83.7% were not reported to have a concurrent diagnosis of allergies nor to show clinical symptoms. This suggests that environmental exposures (i.e., complex pollution mixtures associated with residential coal-heating and/or traffic) may have differentially influenced the phenotypic expression of asthma. A qualitative discussion is presented on the occurrence of "asthma without reported allergies" in Leipzig.
Fritz
Gisela J
GJ
Medical Faculty, University of Leipzig, Leipzig, Germany. gisela.fritz@ufz.de
Herbarth
Olf
O
D000393:Air Pollutants / Q000009:adverse effects*; D001249:Asthma / Q000150:complications / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D002656:Child Day Care Centers; D002675:Child, Preschool; D003031:Coal; D003430:Cross-Sectional Studies; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology*; D017745:Incineration; D008297:Male; D010641:Phenotype; D015995:Prevalence; D014505:Urban Population; D001335:Vehicle Emissions
D000393:Air Pollutants; D003031:Coal; D001335:Vehicle Emissions