title: School environmental factors are predictive for exercise-induced symptoms in children.
abstract: BACKGROUND
  Environmental factors in schools have a significant effect on the exercise-induced bronchoconstriction and symptoms in a general paediatric population.
  
  
  OBJECTIVE
  To determine the environmental factors such as atmospheric conditions and the presence of allergens in gymnasiums, that could be predictive of the presence of exercise-induced symptoms/bronchospasm in children during physical education (PE).
  
  
  METHODS
  1370 schoolchildren were enrolled. Children attended 45 min PE lesson with similar exercise intensity. Pulmonary function tests were performed before and after PE lesson. Air temperature, humidity and pressure, samples of dust for allergen exposure in the gymnasiums were taken. Children who reported symptoms induced during PE lesson were invited to the clinic for ETC (exercise treadmill challenge) and atopy measurement.
  
  
  RESULTS
  1033 participants were included into the analysis. Sixty seven(6.5%) children reported dyspnea/cough, and in 94(9.4%) children bronchoconstriction induced during PE lesson was documented. There is a correlation between the results of the ETC and bronchoconstriction after PE (OR: 2.55; 95%CI: 1.07-6.05; p = 0.034). Exposure to higher air pressure and higher humidity independently increase the risk of clinical symptoms reported during or after PE lesson. Exposure to cat's allergens increase the risk of bronchoconstriction (independently from atopy status). We showed significant interaction between presence of asthma and current ICS therapy as a risk of physical inactivity at school (OR: 4; 95%CI: 1.3-12; p < 0.001).
  
  
  CONCLUSIONS
  This study showed an effect of cat allergen and environmental factors (humidity, air pressure) on the appearance of exercise related cough/bronchoconstriction during activity class in a natural environment at school in a large urban population of schoolchildren.
authors: Department of Pediatrics and Allergy, Medical University of Lodz, Copernicus Memorial Hospital, Lodz, Poland. Electronic address: alergol@kopernik.lodz.pl.
authors: Iwona
authors: I
authors: Stelmach
authors: Department of Pediatrics and Allergy, Medical University of Lodz, Copernicus Memorial Hospital, Lodz, Poland.
authors: Łukasz
authors: Ł
authors: Cichalewski
authors: Department of Pediatrics and Allergy, Medical University of Lodz, Copernicus Memorial Hospital, Lodz, Poland.
authors: Paweł
authors: P
authors: Majak
authors: Department of Pediatrics and Allergy, Medical University of Lodz, Copernicus Memorial Hospital, Lodz, Poland.
authors: Katarzyna
authors: K
authors: Smejda
authors: Department of Pediatrics and Allergy, Medical University of Lodz, Copernicus Memorial Hospital, Lodz, Poland.
authors: Daniela
authors: D
authors: Podlecka
authors: Department of Pediatrics and Allergy, Medical University of Lodz, Copernicus Memorial Hospital, Lodz, Poland.
authors: Joanna
authors: J
authors: Jerzyńska
authors: Department of Social and Preventive Medicine, Medical University of Lodz, Lodz, Poland.
authors: Włodzimierz
authors: W
authors: Stelmach
mesh_terms: D000293:Adolescent; D000485:Allergens / Q000276:immunology; D000528:Alternaria / Q000276:immunology; D000818:Animals; D039741:Antigens, Dermatophagoides; D001250:Asthma, Exercise-Induced / Q000453:epidemiology* / Q000503:physiopathology; D001274:Atmospheric Pressure; D002415:Cats; D003058:Cockroaches / Q000276:immunology; D003371:Cough / Q000453:epidemiology*; D004417:Dyspnea / Q000453:epidemiology*; D004777:Environment; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D005080:Exercise Test; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D006813:Humidity; D006969:Hypersensitivity, Immediate / Q000453:epidemiology*; D008297:Male; D051379:Mice; D010806:Physical Education and Training; D011044:Poland / Q000453:epidemiology; D039981:Pyroglyphidae / Q000276:immunology; D012129:Respiratory Function Tests; D012574:Schools; D014505:Urban Population / Q000706:statistics & numerical data
chemical_list: D000485:Allergens; D039741:Antigens, Dermatophagoides; C518791:Mus m 1 allergen, Mus musculus
keywords: Exercise-induced bronchospasm; Exercise-induced cough; PE classes'; Schoolchildren