Abstract
Abstract: Exposure to outdoor air pollution has been shown to increase asthma symptoms. We assessed the potential role of particulate matter with aerodynamic diameter <2.5 μm (PM2.5) on respiratory condition in schoolchildren in the south Mediterranean area. A total of 2400 children aged 11–14 years were recruited, and data on their symptoms were collected through an ISAAC (International Study of Asthma and Allergies in Childhood)-based questionnaire. Outdoor PM2.5 was collected for 48 consecutive hours in the schoolyards of their schools and selected residential outdoor areas. The levels of PM2.5 were measured, along with its elemental composition. The incidence of an acute respiratory illness within the first 2 years of life was higher amongst Sicilian children when compared to Maltese children (29.7% vs. 13.5% respectively, p < 0.0001). Malta had a significantly higher prevalence of doctor‐diagnosed asthma, when compared to Sicily (18.0% Malta vs. 7.5% Sicily, p <0.0001). Similarly, current asthma (7.8% vs. 2.9%, p < 0.0001) and use of asthma medication in the last 12 months (12.1% vs. 4.9%, p < 0.0001) were more frequent amongst Maltese children. Total median PM2.5 was 12.9 μg/m3 in Sicily and 17.9 μg/m3 in Malta. PM2.5 levels were highest in the Maltese urban town of Hamrun (23.6 μg/m3), while lowest in the rural Sicilian town of Niscemi (10.9 μg/m3, p < 0.0001). Hamrun also exhibited the highest levels of nickel, vanadium, lead, zinc, antimony, and manganese, whilst the Sicilian city of Gela had the highest levels of cadmium, and the highest level of PM2.5 when compared to rural Sicily. Elevated levels of PM2.5 were positively associated with the prevalence of doctor diagnosed asthma (odds ratio (OR) 1.05), current asthma (OR 1.06), and use of asthma medication (OR 1.06). All elements in PM2.5 showed increased OR for doctor diagnosed asthma, while higher concentrations of Cd and Mn were associated with higher prevalence of rhinitis.
Highlights
Asthma is a worldwide health problem and its prevalence has been increasing in many countries, especially in young children [1]
In a logistic regression analysis model performed to assess the relationships between prevalent respiratory symptoms/diseases and identified PM2.5 elements, adjusting for confounders/effect modifiers, we found that significant odds ratio (OR) for doctor-diagnosed asthma were observed for PM2.5 and V, Ni, Pb, Mn, Sb, and Zn
We found significant differences in the concentration of PM2.5 and its elemental composition (V, Ni, Cd, Pb, Mn, Sb, and Zn) among Mediterranean communities with different site characteristics
Summary
Asthma is a worldwide health problem and its prevalence has been increasing in many countries, especially in young children [1]. Asthma prevalence is high in industrialized countries, even though a change in trend was noticed in the most recent years [2]. Multiple genetic factors increase the risk of developing asthma, whilst environmental conditions play a fundamental role in the expression of its symptoms [3]. The avoidance of air pollution has been suggested as a nonpharmacological intervention for the prevention of asthma exacerbations in the latest Global. Initiative for Asthma (GINA) Guidelines [1]. Exposure to outdoor air pollution increases asthma symptoms, and asthmatic children are at increased risk of adverse effects from poor air quality [4,5].
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