title: Asthma prevalence and risk factors among children and adolescents living around an industrial area: a cross-sectional study.
abstract: BACKGROUND
  The exposure to air pollution has negative effects on human health, increasing the risk of respiratory diseases, such as asthma. Few data are yet available on the epidemiology of childhood asthma in some areas of Italy. The aim of the study was to estimate asthma prevalence and related risk factors in children and adolescents residents around the industrial area of Termoli, Molise region, Central-South Italy.
  
  
  METHODS
  Prevalence was assessed through the administration of modified ISAAC questionnaires filled out by parents of 89 children and adolescents for the identification of confirmed and probable cases, and by analyzing pediatricians' databases on drug prescriptions for symptoms control and treatment of assisted population in the study area (n = 1,004), compared to a control area (n = 920) with lower industrialization. The association of asthma with risk factors was evaluated by univariate (Chi-square or Fisher's Exact test) and regression logistic analysis.
  
  
  RESULTS
  A total of 22 (24.7%) asthmatics were identified, including both confirmed (n = 7; 7.9%) and probable cases (n = 15; 16.8%), most of them (n = 17; 77.3%) resident of Termoli town. All asthma cases were georeferenced based on the residence, however clusters were not found. Using drug prescriptions analysis, a higher prevalence (n = 138; 13.7%) of diagnosed cases was found. Lifetime history of both atopic dermatitis and bronchitis were significantly relateds to asthma cases, as well as an elevated body mass index, whose association is consistent with prevalence data of overweight/obese children living in the study area. Moreover, being resident of the town of Termoli was associated to the occurrence of cases.
  
  
  CONCLUSIONS
  Although our data indicated a prevalence concordance with previous national studies in pediatric population, a definitive correlation with environmental industrial factors present in the study area was not established. However, asthma outcome was significantly associated to individuals living in the town of Termoli that, despite the industrial/manufacturing activities, is also subjected to a higher environmental pressure due to the presence of toll road, state highway, railroad, and seaport which may cause air pollution from motor vehicle traffic and increase asthma induction. This study provides hitherto unavailable data on asthma in childhood population living in an industrialized area which was never investigated before, could be part of a systematic review or meta-analysis procedure, might suggest significant findings for larger observational studies, and contribute to complete the frame of disease epidemiology in Italy.
authors.affiliation: Chair of Hygiene, Department of Medicine and of Health Sciences, University of Molise, Via De Sanctis, Campobasso, 86100, Italy. ripab@unimol.it.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Ripabelli
authors.forename: Manuela
authors.initials: M
authors.lastname: Tamburro
authors.forename: Michela Lucia
authors.initials: ML
authors.lastname: Sammarco
authors.forename: Guglielmo
authors.initials: G
authors.lastname: de Laurentiis
authors.forename: Andrea
authors.initials: A
authors.lastname: Bianco
mesh_terms: D000293:Adolescent; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D001991:Bronchitis / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003876:Dermatitis, Atopic / Q000453:epidemiology; D004781:Environmental Exposure / Q000009:adverse effects; D005260:Female; D006801:Humans; D007221:Industry / Q000706:statistics & numerical data*; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D018927:Anti-Asthmatic Agents