title: Geographical information system and environmental epidemiology: a cross-sectional spatial analysis of the effects of traffic-related air pollution on population respiratory health.
abstract: BACKGROUND
  Traffic-related air pollution is a potential risk factor for human respiratory health. A Geographical Information System (GIS) approach was used to examine whether distance from a main road (the Tosco-Romagnola road) affected respiratory health status.
  
  
  METHODS
  We used data collected during an epidemiological survey performed in the Pisa-Cascina area (central Italy) in the period 1991-93. A total of 2841 subjects participated in the survey and filled out a standardized questionnaire on health status, socio-demographic information, and personal habits. A variable proportion of subjects performed lung function and allergy tests. Highly exposed subjects were defined as those living within 100 m of the main road, moderately exposed as those living between 100 and 250 m from the road, and unexposed as those living between 250 and 800 m from the road. Statistical analyses were conducted to compare the risks for respiratory symptoms and diseases between exposed and unexposed. All analyses were stratified by gender.
  
  
  RESULTS
  The study comprised 2062 subjects: mean age was 45.9 years for men and 48.9 years for women. Compared to subjects living between 250 m and 800 m from the main road, subjects living within 100 m of the main road had increased adjusted risks for persistent wheeze (OR = 1.76, 95% CI = 1.08-2.87), COPD diagnosis (OR = 1.80, 95% CI = 1.03-3.08), and reduced FEV1/FVC ratio (OR = 2.07, 95% CI = 1.11-3.87) among males, and for dyspnea (OR = 1.61, 95% CI = 1.13-2.27), positivity to skin prick test (OR = 1.83, 95% CI = 1.11-3.00), asthma diagnosis (OR = 1.68, 95% CI = 0.97-2.88) and attacks of shortness of breath with wheeze (OR = 1.67, 95% CI = 0.98-2.84) among females.
  
  
  CONCLUSIONS
  This study points out the potential effects of traffic-related air pollution on respiratory health status, including lung function impairment. It also highlights the added value of GIS in environmental health research.
authors.affiliation: Epidemiology Unit, Regional Agency of Public Health of Tuscany (ARS), Via Pietro Dazzi 1, I-50141 Florence, Italy. daniela.nuvolone@asf.toscana.it
authors.forename: Daniela
authors.initials: D
authors.lastname: Nuvolone
authors.forename: Roberto
authors.initials: R
authors.lastname: Della Maggiore
authors.forename: Sara
authors.initials: S
authors.lastname: Maio
authors.forename: Roberto
authors.initials: R
authors.lastname: Fresco
authors.forename: Sandra
authors.initials: S
authors.lastname: Baldacci
authors.forename: Laura
authors.initials: L
authors.lastname: Carrozzi
authors.forename: Francesco
authors.initials: F
authors.lastname: Pistelli
authors.forename: Giovanni
authors.initials: G
authors.lastname: Viegi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000393:Air Pollutants / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004782:Environmental Health; D005260:Female; D040362:Geographic Information Systems; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D018986:Motor Vehicles / Q000706:statistics & numerical data; D052638:Particulate Matter / Q000009:adverse effects; D012129:Respiratory Function Tests; D012140:Respiratory Tract Diseases / Q000453:epidemiology*; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter