Early childhood lower respiratory illness and air pollution.
BACKGROUND
Few studies of air pollutants address morbidity in preschool children. In this study we evaluated bronchitis in children from two Czech districts: Teplice, with high ambient air pollution, and Prachatice, characterized by lower exposures.


OBJECTIVE
Our goal was to examine rates of lower respiratory illnesses in preschool children in relation to ambient particles and hydrocarbons.


METHODS
Air monitoring for particulate matter < 2.5 microm in diameter (PM(2.5)) and polycyclic aromatic hydrocarbons (PAHs) was conducted daily, every third day, or every sixth day. Children born May 1994 through December 1998 were followed to 3 or 4.5 years of age to ascertain illness diagnoses. Mothers completed questionnaires at birth and at follow-up regarding demographic, lifestyle, reproductive, and home environmental factors. Longitudinal multivariate repeated-measures analysis was used to quantify rate ratios for bronchitis and for total lower respiratory illnesses in 1,133 children.


RESULTS
After adjustment for season, temperature, and other covariates, bronchitis rates increased with rising pollutant concentrations. Below 2 years of age, increments in 30-day averages of 100 ng/m(3) PAHs and of 25 microg/m(3) PM(2.5) resulted in rate ratios (RRs) for bronchitis of 1.29 [95 % confidence interval (CI), 1.07-1.54] and 1.30 (95% CI, 1.08-1.58), respectively; from 2 to 4.5 years of age, these RRs were 1.56 (95% CI, 1.22-2.00) and 1.23 (95% CI, 0.94-1.62), respectively.


CONCLUSIONS
Ambient PAHs and fine particles were associated with early-life susceptibility to bronchitis. Associations were stronger for longer pollutant-averaging periods and, among children > 2 years of age, for PAHs compared with fine particles. Preschool-age children may be particularly vulnerable to air pollution-induced illnesses.
Hertz-Picciotto
Irva
I
Department of Public Health Sciences, University of California, Davis, California 95616, USA. ihp@ucdavis.edu
Baker
Rebecca James
RJ
Yap
Poh-Sin
PS
Dostál
Miroslav
M
Joad
Jesse P
JP
Lipsett
Michael
M
Greenfield
Teri
T
Herr
Caroline E W
CE
Benes
Ivan
I
Shumway
Robert H
RH
Pinkerton
Kent E
KE
Srám
Radim
R
D000393:Air Pollutants / Q000633:toxicity*; D001988:Bronchiolitis / Q000453:epidemiology*; D001991:Bronchitis / Q000453:epidemiology*; D002675:Child, Preschool; D015331:Cohort Studies; D018153:Czech Republic / Q000453:epidemiology; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011014:Pneumonia / Q000453:epidemiology*; D011084:Polycyclic Aromatic Hydrocarbons / Q000633:toxicity*; D012189:Retrospective Studies; D012306:Risk; D012621:Seasons
D000393:Air Pollutants; D011084:Polycyclic Aromatic Hydrocarbons