title: Early childhood lower respiratory illness and air pollution.
abstract: 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.
authors.affiliation: Department of Public Health Sciences, University of California, Davis, California 95616, USA. ihp@ucdavis.edu
authors.forename: Irva
authors.initials: I
authors.lastname: Hertz-Picciotto
authors.forename: Rebecca James
authors.initials: RJ
authors.lastname: Baker
authors.forename: Poh-Sin
authors.initials: PS
authors.lastname: Yap
authors.forename: Miroslav
authors.initials: M
authors.lastname: Dostál
authors.forename: Jesse P
authors.initials: JP
authors.lastname: Joad
authors.forename: Michael
authors.initials: M
authors.lastname: Lipsett
authors.forename: Teri
authors.initials: T
authors.lastname: Greenfield
authors.forename: Caroline E W
authors.initials: CE
authors.lastname: Herr
authors.forename: Ivan
authors.initials: I
authors.lastname: Benes
authors.forename: Robert H
authors.initials: RH
authors.lastname: Shumway
authors.forename: Kent E
authors.initials: KE
authors.lastname: Pinkerton
authors.forename: Radim
authors.initials: R
authors.lastname: Srám
mesh_terms: 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
chemical_list: D000393:Air Pollutants; D011084:Polycyclic Aromatic Hydrocarbons