title: Air pollution and seasonal asthma during the pollen season. A cohort study in Puertollano and Ciudad Real (Spain).
abstract: BACKGROUND
  Many studies have demonstrated a positive association between air pollutants and emergency visits for asthma. However, few studies have included pollen when analysing this relationship in mild-moderate asthmatic patients.
  
  
  OBJECTIVE
  To determine the importance of the pollutants such as ozone (O(3)), particles (PM(10)), nitrogen dioxide (NO(2)) and sulphur dioxide (SO(2)) in the clinical course of mild-moderate pollen-allergic asthmatic patients from two Spanish towns in La Mancha: Puertollano (high pollution levels) and Ciudad Real (low pollution levels).
  
  
  METHODS
  We used a Poisson regression model to study a cohort of 137 patients from Puertollano and Ciudad Real during two pollen seasons (2000-2001) and analysed the relationship between air pollutant and pollen levels and daily symptoms, the medication used and peak-flow measurements.
  
  
  RESULTS
  The number of asthma symptoms and the mean values of the PM(10), SO(2) and NO(2) levels were higher in Puertollano than in Ciudad Real. In Puertollano, the risk of asthma increased by 6% with a 3-day lag for PM(10), by 8% with a 3-day lag for O(3), by 4% with a 1-day lag for SO(2) and by 15% with a 3-day lag for O(3) when its values exceeded the health threshold (P < 0.05).
  
  
  CONCLUSIONS
  The air pollution levels in Puertollano were associated with an increased risk of asthma symptoms in pollen-allergic asthmatic patients com pared with a similar group from Ciudad Real.
authors.affiliation: Allergy Section, General Hospital, Ciudad Real, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Feo Brito
authors.forename: P
authors.initials: P
authors.lastname: Mur Gimeno
authors.forename: C
authors.initials: C
authors.lastname: Martínez
authors.forename: A
authors.initials: A
authors.lastname: Tobías
authors.forename: L
authors.initials: L
authors.lastname: Suárez
authors.forename: F
authors.initials: F
authors.lastname: Guerra
authors.forename: J M
authors.initials: JM
authors.lastname: Borja
authors.forename: A M
authors.initials: AM
authors.lastname: Alonso
mesh_terms: D000328:Adult; D000393:Air Pollutants / Q000032:analysis*; D000397:Air Pollution / Q000032:analysis; D000485:Allergens / Q000032:analysis; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage; D001249:Asthma / Q000188:drug therapy / Q000453:epidemiology*; D015984:Causality; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009585:Nitrogen Dioxide / Q000032:analysis; D010126:Ozone / Q000032:analysis; D016012:Poisson Distribution; D011058:Pollen; D012424:Rural Population; D012621:Seasons; D012720:Severity of Illness Index; D013030:Spain; D013458:Sulfur Dioxide / Q000032:analysis; D014505:Urban Population
chemical_list: D000393:Air Pollutants; D000485:Allergens; D018927:Anti-Asthmatic Agents; D013458:Sulfur Dioxide; D010126:Ozone; D009585:Nitrogen Dioxide