Childhood respiratory symptoms, hospital admissions, and long-term exposure to airborne particulate matter

The effects of long-term exposure to air pollution on respiratory symptoms and respiratory hospitalization (for asthma, bronchitis or pneumonia) were assessed in a cross-sectional study of children (ages 7-11 years, N=667) li ving in a moderately industrialized city in Central Slovakia. Individual he alth, residence and family history data obtained through the CESAR study we re coupled, using Geographic Information System (GIS) technologies, with to tal suspended particulate (TSP) exposure estimates derived from dispersion modeling of almost all local stationary sources. These data were used to as sess, at the intra-city level and child-specific level, the potential for T SP as a risk factor for respiratory disease in children. TSP, PM10, and PM2 .5 monitored ambient concentrations are highly correlated in the study loca tion. Modeled TSP concentrations resulting from local source emissions are dominated by a large wood processing facility, suggesting variation in expo sures among children. The prevalence of respiratory non-asthmatic symptoms and hospitalizations was associated with increased TSP. No association betw een long-term exposure to TSP and asthma diagnosis or wheeze symptoms was f ound. Logistic regression modeling indicated a significant increase in hosp ital admissions for asthma, bronchitis or pneumonia associated with increas ing air pollution (OR 2.16, CI, 1.01-4.60), doctor-diagnosed bronchitis (OR 1.53, CI, 1.02-2.30), and parent-reported chronic phlegm (OR 3.43, CI, 1.6 4-7.16), expressed as odds for a 15 mug/m(3) increase in estimated TSP expo sure, and these increases are not due to differences in socio-economic, hea lth care or other identified factors.