EFFECTS OF ENVIRONMENT ON ATOPIC STATUS AND RESPIRATORY DISORDERS IN CHILDREN

Background: We investigated whether living in areas with higher air po llution levels increases the prevalence of positive skin reactivity in children and the possible synergic effect of air pollution exposure a nd atopy on respiratory disorders. Methods: This cross-sectional study was conducted in an urban area, in an industrialized area, and in a r ural control area in the Latium region of Italy. A total of 2226 subje cts, aged 7 to 11 years, were studied Results: The prevalence of child ren with positive skin test results did not vary significantly over th e areas (urban area = 21.0%, industrialized area = 22.0%, rural area = 20.2%). Children living in polluted areas experienced significantly m ore cough and phlegm (odds ratio [OR] = 1.5), rhinitis (OR = 1.7), pne umonia (OR = 1.7), and early respiratory infections (OR = 1.4) than co ntrol subjects. The pattern of the odds ratios for atopy and air pollu tion suggested that the two factors were probably additive in affectin g asthma and early respiratory infections (synergy index [SI] = 1.04 a nd 1.27, respectively), whereas they seemed to act synergically in reg ard to cough and phlegm (SI = 1.59), rhinitis (SI = 3.01), and pneumon ia (SI = 2.75). Conclusion: Environmental air pollution seems not to i ncrease the prevalence of atopic status; it seems, however, to enhance the development of clinical symptoms among already sensitized subject s.