title: Air pollution, aeroallergens, and emergency room visits for acute respiratory diseases and gastroenteric disorders among young children in six Italian cities.
abstract: BACKGROUND
  Past studies reported evidence of associations between air pollution and respiratory symptoms and morbidity for children. Few studies examined associations between air pollution and emergency room (ER) visits for wheezing, and even fewer for gastroenteric illness. We conducted a multicity analysis of the relationship between air pollution and ER visits for wheezing and gastroenteric disorder in children 0-2 years of age.
  
  
  METHODS
  We obtained ER visit records for wheezing and gastroenteric disorder from six Italian cities. A city-specific case-crossover analysis was applied to estimate effects of particulate matter (PM), nitrogen dioxide, sulfur dioxide, ozone, and carbon monoxide, adjusting for immediate and delayed effects of temperature. Lagged effects of air pollutants up to 6 prior days were examined. The city-specific results were combined using a random-effect meta-analysis.
  
  
  RESULTS
  CO and SO(2) were most strongly associated with wheezing, with a 2.7% increase [95% confidence interval (CI), 0.5-4.9] for a 1.04-microg/m(3) increase in 7-day average CO and a 3.4% (95% CI, 1.5-5.3) increase for an 8.0-microg/m(3) increase in SO(2). Positive associations were also found for PM with aerodynamic diameter < or = 10 microg and NO(2). We found a significant association between the 3-day moving average CO and gastroenteric disorders [3.8% increase (95% CI, 1.0-6.8)]. When data were stratified by season, the associations were stronger in summer for wheezing and in winter for gastroenteric disorders.
  
  
  CONCLUSIONS
  Air pollution is associated with triggering of wheezing and gastroenteric disorders in children 0-2 years of age; more work is needed to understand the mechanisms to help prevent wheezing in children.
authors.affiliation: Pediatric Emergency Room, Santobono's Hospital, Naples, Italy.
authors.forename: Flavia
authors.initials: F
authors.lastname: Orazzo
authors.forename: Luigi
authors.initials: L
authors.lastname: Nespoli
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Ito
authors.forename: Davide
authors.initials: D
authors.lastname: Tassinari
authors.forename: Daniela
authors.initials: D
authors.lastname: Giardina
authors.forename: Maurizio
authors.initials: M
authors.lastname: Funis
authors.forename: Alessandra
authors.initials: A
authors.lastname: Cecchi
authors.forename: Chiara
authors.initials: C
authors.lastname: Trapani
authors.forename: Gisella
authors.initials: G
authors.lastname: Forgeschi
authors.forename: Massimo
authors.initials: M
authors.lastname: Vignini
authors.forename: Luana
authors.initials: L
authors.lastname: Nosetti
authors.forename: Sabrina
authors.initials: S
authors.lastname: Pigna
authors.forename: Antonella
authors.initials: A
authors.lastname: Zanobetti
mesh_terms: D000208:Acute Disease; D000393:Air Pollutants / Q000032:analysis / Q000633:toxicity*; D000397:Air Pollution / Q000009:adverse effects* / Q000032:analysis; D000485:Allergens / Q000276:immunology; D002248:Carbon Monoxide / Q000032:analysis / Q000633:toxicity; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005767:Gastrointestinal Diseases / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D052638:Particulate Matter / Q000032:analysis / Q000633:toxicity; D012135:Respiratory Sounds / Q000209:etiology; D012140:Respiratory Tract Diseases / Q000453:epidemiology / Q000209:etiology*; D013458:Sulfur Dioxide / Q000032:analysis / Q000633:toxicity
chemical_list: D000393:Air Pollutants; D000485:Allergens; D052638:Particulate Matter; D013458:Sulfur Dioxide; D002248:Carbon Monoxide