Abstract
Background: Alterations in allergic susceptibility are a central feature of several chronic respiratory diseases. This study was conducted to determine whether variation in individual allergic susceptibility alters the air pollution effects on attacks of pediatric asthma. Methods: Daily records of personal asthma emergency department visits among children in school-age and ambient air pollutant concentration were obtained from 2000 to 2008 in Taipei basin, Taiwan. Subjects who had ever had a clinical visit in the departments of otolaryngology and pediatrics or a visit to the emergency department due to allergic rhinitis before their first asthma-related emergency department visit were defined as having allergic rhinitis co-morbidities. A time-stratified approach for the case-crossover technique and a conditional logistic regression were used to examine whether allergic comorbidity modified air pollution-induced asthma attacks. Results: Particulate matter with an aerodynamic diameter of 2.5 μm or less (PM2.5) was found to be associated with asthma-related emergency department visits on the day of exposure among children with allergic rhinitis co-morbidity (2 nd quartile OR = 1.19; 3 rd quartile OR = 1.37; 4 th quartile OR = 1.38). High ozone levels were associated with emergency room visits for asthma on a 1-day lag assumption among children with allergic rhinitis co-morbidity (4 th quartile OR = 1.38). Conclusion: The negative effects of air pollution were observed for subjects who had an allergic co-morbidity. The variation in allergic co-morbidity was associated with differences in susceptibility to the adverse effects of air pollutants on respiratory disease.
Highlights
Asthma is a disease with high prevalence that affects 1.6% to 36.8% of children worldwide (Beasley et al, 1998)
The negative effects of air pollution were observed for subjects who had an allergic co-morbidity
The variation in allergic co-morbidity was associated with differences in susceptibility to the adverse effects of air pollutants on respiratory disease
Summary
Asthma is a disease with high prevalence that affects 1.6% to 36.8% of children worldwide (Beasley et al, 1998). In Taiwan, the asthma prevalence in children is approximately 5.2% (Guo et al, 1999). Several populationbased epidemiological studies demonstrate that the prevalence of childhood asthma has been increasing over time (Pearce et al, 2000; Isolauri et al, 2004; Asher et al, 2006). Asthma is not limited to physical symptoms of the target organ. It provokes disturbances in the general wellbeing of the affected subjects. Alterations in allergic susceptibility are a central feature of several chronic respiratory diseases. This study was conducted to determine whether variation in individual allergic susceptibility alters the air pollution effects on attacks of pediatric asthma
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