Abstract
Background: An association between wheeze (a symptom of asthma) and environmental tobacco smoke (ETS), types of fuel used for residential heating or cooking and the frequency of trucks passing near homes, has been reported mainly in developed countries. Little is known about the strength of such associations in developing countries. This study was conducted in residential areas situated in Ekurhuleni Metropolitan Municipality, namely Tembisa and Kempton Park, which form part of the Highveld region, a priority area in terms of air pollution in South Africa. Methods: From 3764 eligible school children, aged between 13 and 14 years, from 16 selected high schools in the study area, 3468 completed a modified questionnaire based on the International Study of Asthma and Allergies in Childhood (ISAAC). Data were analysed using multiple logistic regression models. Results: The results are based on data from 3424 children. In the adjusted models, exposure to ETS at school was associated with wheeze ever (OR 1.22 95% CI: 1.03 − 1.45) and current wheeze (OR 1.33 95% CI: 1.08 − 1.64). When gas was most frequently used for residential heating the likelihood of wheeze ever increased by 47% (OR 1.47 95% CI: 1.15 − 1.88). Trucks passing near homes for almost the whole day during weekdays, increased the likelihood of wheeze ever (OR 1.32 95% CI: 1.01 − 1.73), current wheeze (OR 1.61 95% CI: 1.15 − 2.24) and current severe wheeze (OR 2.22 95% CI: 1.28 − 3.77). When data were stratified according to residential area, for children living in Tembisa, ETS exposure at home was associated with current wheeze (OR 1.36 95% CI: 1.06 − 1.77); gas most frequently used for residential heating was associated with wheeze ever (OR 1.68 95% CI: 1.23 − 2.28) and current wheeze (OR 1.61 95% CI: 1.08 − 2.39); paraffin most frequently used for residential heating was associated with current severe wheeze (OR 1.85 95% CI: 1.04 − 3.28). Conclusion: It was concluded that children living in one of the air pollution priority areas of South Africa, have an increased risk of wheezing due to exposure to both indoor and outdoor air pollution sources.
Highlights
An association between wheeze and environmental tobacco smoke (ETS), types of fuel used for residential heating or cooking and the frequency of trucks passing near homes, has been reported mainly in developed countries
The aim of our study was to investigate the association of wheeze, a symptom of asthma with indoor and outdoor air pollution sources, ETS, the types of fuel most frequently used for residential cooking or heating, transportation to school and the frequency of trucks passing near homes in urban areas of Tembisa and Kempton Park
When the data were stratified by location of schools in Tembisa and Kempton Park, ETS exposure at home was associated with current wheeze for children residing in Tembisa
Summary
An association between wheeze (a symptom of asthma) and environmental tobacco smoke (ETS), types of fuel used for residential heating or cooking and the frequency of trucks passing near homes, has been reported mainly in developed countries. There is growing evidence linking respiratory symptoms in children to air pollution [1]. Children are more vulnerable as their immune system and lungs are not fully developed when air pollution exposure begins [3]. Personal exposure of children to air pollutants occurs mainly in three microenvironments, home, school and during transport, which Ashmore and Dimitroulopoulou discuss in detail [3]. Environmental tobacco smoke (ETS), combustion of fuels for residential cooking/heating and the frequency of trucks passing near homes have all been associated with respiratory diseases in children [4,5]
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