title: Effects of ambient pollen concentrations on frequency and severity of asthma symptoms among asthmatic children.
abstract: BACKGROUND
  Previous studies on the associations between ambient pollen exposures and daily respiratory symptoms have produced inconsistent results. We investigated these relationships in a cohort of asthmatic children using pollen exposure models to estimate individual ambient exposures.
  
  
  METHODS
  Daily symptoms of wheeze, night symptoms, shortness of breath, chest tightness, persistent cough, and rescue medication use were recorded in a cohort of 430 children with asthma (age 4-12 years) in Connecticut, Massachusetts, and New York. Daily ambient exposures to tree, grass, weed, and total pollen were estimated using mixed-effects models. We stratified analyses by use of asthma maintenance medication and sensitization to grass or weed pollens. Separate logistic regression analyses using generalized estimating equations were performed for each symptom outcome and pollen type. We adjusted analyses for maximum daily temperature, maximum 8-hour average ozone, fine particles (PM2.5), season, and antibiotic use.
  
  
  RESULTS
  Associations were observed among children sensitized to specific pollens; these associations varied by use of asthma maintenance medication. Exposures to even relatively low levels of weed pollen (6-9 grains/m(3)) were associated with increased shortness of breath, chest tightness, rescue medication use, wheeze, and persistent cough, compared with lower exposure among sensitized children on maintenance medication. Grass pollen exposures ≥ 2 grains/m(3) were associated with wheeze, night symptoms, shortness of breath, and persistent cough compared with lower exposure among sensitized children who did not take maintenance medication.
  
  
  CONCLUSIONS
  Even low-level pollen exposure was associated with daily asthmatic symptoms.
authors.affiliation: School of Forestry and Environmental Studies, Yale University, New Haven, CT 06511, USA. curt.dellavalle@gmail.com
authors.forename: Curt T
authors.initials: CT
authors.lastname: DellaValle
authors.forename: Elizabeth W
authors.initials: EW
authors.lastname: Triche
authors.forename: Brian P
authors.initials: BP
authors.lastname: Leaderer
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Bell
mesh_terms: D001249:Asthma / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D003237:Connecticut / Q000453:epidemiology; D004781:Environmental Exposure / Q000009:adverse effects; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D009518:New York / Q000453:epidemiology; D011058:Pollen / Q000009:adverse effects*; D011446:Prospective Studies; D012621:Seasons; D012720:Severity of Illness Index; D014887:Weather
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