In-home particle concentrations and childhood asthma morbidity.
BACKGROUND
Although outdoor particulate matter (PM) has been linked to mortality and asthma morbidity, the impact of indoor PM on asthma has not been well established.


OBJECTIVE
This study was designed to investigate the effect of in-home PM on asthma morbidity.


METHODS
For a cohort of 150 asthmatic children (2-6 years of age) from Baltimore, Maryland, a technician deployed environmental monitoring equipment in the children's bedrooms for 3-day intervals at baseline and at 3 and 6 months. Caregivers completed questionnaires and daily diaries during air sampling. Longitudinal data analyses included regression models with generalized estimating equations.


RESULTS
Children were primarily African Americans (91%) from lower socioeconomic backgrounds and spent most of their time in the home. Mean (+/- SD) indoor PM(2.5-10) (PM with aerodynamic diameter 2.5-10 microm) and PM(2.5) (aerodynamic diameter < 2.5 microm) concentrations were 17.4 +/- 21.0 and 40.3 +/- 35.4 microg/m(3). In adjusted models, 10-microg/m(3) increases in indoor PM(2.5-10) and PM(2.5) were associated with increased incidences of asthma symptoms: 6% [95% confidence interval (CI), 1 to 12%] and 3% (95% CI, -1 to 7%), respectively; symptoms causing children to slow down: 8% (95% CI, 2 to 14%) and 4% (95% CI, 0 to 9%), respectively; nocturnal symptoms: 8% (95% CI, 1 to 14%) and 6% (95% CI, 1 to 10%), respectively; wheezing that limited speech: 11% (95% CI, 3 to 19%) and 7% (95% CI, 0 to 14%), respectively; and use of rescue medication: 6% (95% CI, 1 to 10%) and 4% (95% CI, 1 to 8%), respectively. Increases of 10 microg/m(3) in indoor and ambient PM(2.5) were associated with 7% (95% CI, 2 to 11%) and 26% (95% CI, 1 to 52%) increases in exercise-related symptoms, respectively.


CONCLUSIONS
Among preschool asthmatic children in Baltimore, increases in in-home PM(2.5-10) and PM(2.5) were associated with respiratory symptoms and rescue medication use. Increases in in-home and ambient PM(2.5) were associated with exercise-related symptoms. Although reducing PM outdoors may decrease asthma morbidity, reducing PM indoors, especially in homes of inner-city children, may lead to improved asthma health.
McCormack
Meredith C
MC
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205 , USA.
Breysse
Patrick N
PN
Matsui
Elizabeth C
EC
Hansel
Nadia N
NN
Williams
D'Ann
D
Curtin-Brosnan
Jean
J
Eggleston
Peyton
P
Diette
Gregory B
GB
D016902:Air Pollution, Indoor / Q000009:adverse effects*; D001249:Asthma / Q000453:epidemiology* / Q000473:pathology; D015142:Baltimore; D002648:Child; D002675:Child, Preschool; D004784:Environmental Monitoring; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D008297:Male; D008396:Maryland; D052638:Particulate Matter / Q000009:adverse effects*; D011795:Surveys and Questionnaires
D052638:Particulate Matter