title: Urban air pollutants are significant risk factors for asthma and pneumonia in children: the influence of location on the measurement of pollutants.
abstract: BACKGROUND
  Air pollution is associated with a substantial burden on human health; however, the most important pollutants may vary with location. Proper monitoring is necessary to determine the effect of these pollutants on respiratory health.
  
  
  OBJECTIVE
  This study was designed to evaluate the role of outdoor, indoor and personal exposure to combustion-related pollutants NO(2) and O(3) on respiratory health of children in a non-affluent urban area of São Paulo, Brazil.
  
  
  METHODS
  Levels of NO(2) and O(3) were continuously measured in outdoor and indoor air, as well as personal exposure, for 30 days using passive measurement monitors. Respiratory health was assessed with a Brazilian version of the ISAAC questionnaire.
  
  
  RESULTS
  Complete data were available from 64 children, aged 6-10 years. Respiratory morbidity was high, with 43 (67.2%) reporting having had wheezing at any time, 27 (42.2%) wheezing in the last month, 17 (26.6%) asthma at any time and 21 (32.8%) pneumonia at any time. Correlations between levels of NO(2) and O(3) measured in the three locations evaluated were poor. Levels of NO(2) in indoor air and personal exposure to O(3) were independently associated with asthma (both cases P=.02), pneumonia (O(3), P=.02) and wheezing at any time (both cases P<.01). No associations were seen between outdoor NO(2) and O(3) and respiratory health.
  
  
  CONCLUSIONS
  Exposure to higher levels of NO(2) and O(3) was associated with increased risk for asthma and pneumonia in children. Nonetheless, the place where the pollutants are measured influences the results. The measurements taken in indoor and personal exposure were the most accurate.
authors: Department of Pediatrics, School of Medicine, Universidade de São Paulo, São Paulo, Brazil. sandra@hu.usp.br
authors: Sandra Elisabete
authors: SE
authors: Vieira
authors: Renato Tetelbom
authors: RT
authors: Stein
authors: Alexandre Archanjo
authors: AA
authors: Ferraro
authors: Luciana Duzolina
authors: LD
authors: Pastro
authors: Sibelli Silva Cosme
authors: SS
authors: Pedro
authors: Miriam
authors: M
authors: Lemos
authors: Emerson Rodrigues
authors: ER
authors: da Silva
authors: Peter David
authors: PD
authors: Sly
authors: Paulo Hilario
authors: PH
authors: Saldiva
mesh_terms: D000393:Air Pollutants / Q000009:adverse effects* / Q000032:analysis; D016902:Air Pollution, Indoor / Q000009:adverse effects; D001249:Asthma / Q000453:epidemiology / Q000209:etiology*; D001938:Brazil / Q000453:epidemiology; D002648:Child; D004781:Environmental Exposure / Q000009:adverse effects; D004784:Environmental Monitoring / Q000295:instrumentation / Q000379:methods; D005260:Female; D005374:Filtration; D006798:Housing; D006801:Humans; D008297:Male; D009585:Nitrogen Dioxide / Q000009:adverse effects* / Q000032:analysis; D010126:Ozone / Q000009:adverse effects* / Q000032:analysis; D011014:Pneumonia / Q000453:epidemiology / Q000209:etiology*; D011204:Poverty Areas; D012135:Respiratory Sounds / Q000209:etiology; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000009:adverse effects; D014504:Urban Health; D001335:Vehicle Emissions / Q000633:toxicity
chemical_list: D000393:Air Pollutants; D014028:Tobacco Smoke Pollution; D001335:Vehicle Emissions; D010126:Ozone; D009585:Nitrogen Dioxide