Oc. Yu et al., Effects of ambient air pollution on symptoms of asthma in Seattle-area children enrolled in the CAMP study, ENVIR H PER, 108(12), 2000, pp. 1209-1214
We observed a panel of 133 children (5-13 years of age) with asthma residin
g in the greater Seattle, Washington, area for an average of 58 days (range
28-112 days) during screening for enrollment in the Childhood Asthma Manag
ement Program (CAMP) study. Daily self-reports of asthma symp toms were obt
ained from study diaries and compared with ambient air pollution levels in
marginal repeated measures logistic regression models. We defined days with
asthma symptoms as any day a child reported at least one mild asthma episo
de. All analyses were controlled for subject-specific variables [age, race,
sex, baseline height, and FEV1 PC20 concentration (methacholine provocativ
e concentration required to produce a 20% decrease in forced expiratory vol
ume in 1 sec)] and potential rime-dependent confounders (day of week, seaso
n, and temperature). Because of variable observation periods for participan
ts, we estimated both between- and within-subject air pollutant effects. Ou
r primary interest was in the within-subject effects: the effect of air pol
lutant excursions from typical levels in each child's observation period on
the odds of asthma symptoms. In single-pollutant models, the population av
erage estimates indicated a 30% [95% confidence interval (CI), 11-52%] incr
ease for a 1-ppm increment in carbon monoxide lagged I day, an 18% (95% CI,
5-33%) increase for a 10-mug/m(3) increment in same-day particulate matter
< 1.0 <mu>m (PM1.0), and an 11% (95% CI, 3-20%) increase for a 10-mug/m(3)
increment in particulate matter < 10 <mu>m (PM10) lagged 1 day. Conditiona
l on the previous day's asthma symptoms, we estimated 25% (95% CI, 10-42%),
14% (95% CI, 4-26%), and 10% (95% CI, 3-16%) increases in the odds of asth
ma symptoms associated with increases in CO, PM1.0, and PM10, respectively.
We did not find any association between sulfur dioxide (SO2) and the odds
of asthma symptoms. In multipollutant models, the separate pollutant effect
s were smaller. The overall effect of an increase in both CO and PM1.0 was
a 31% (95% CI, 11-55%) increase in the odds of symptoms of asthma. We concl
ude that there is an association between change in shea-term air pollution
levels, as indexed by PM and CO, and the occurrence of asthma symptoms amon
g children in Seattle. Although PM effects on asthma have been found in oth
er studies, it is likely that CO is a marker for vehicle exhaust and other
combustion by-products that aggravate asthma.