Abstract
BackgroundThe exposure to air pollution has negative effects on human health, increasing the risk of respiratory diseases, such as asthma. Few data are yet available on the epidemiology of childhood asthma in some areas of Italy. The aim of the study was to estimate asthma prevalence and related risk factors in children and adolescents residents around the industrial area of Termoli, Molise region, Central-South Italy.MethodsPrevalence was assessed through the administration of modified ISAAC questionnaires filled out by parents of 89 children and adolescents for the identification of confirmed and probable cases, and by analyzing pediatricians’ databases on drug prescriptions for symptoms control and treatment of assisted population in the study area (n = 1,004), compared to a control area (n = 920) with lower industrialization. The association of asthma with risk factors was evaluated by univariate (Chi-square or Fisher’s Exact test) and regression logistic analysis.ResultsA total of 22 (24.7%) asthmatics were identified, including both confirmed (n = 7; 7.9%) and probable cases (n = 15; 16.8%), most of them (n = 17; 77.3%) resident of Termoli town. All asthma cases were georeferenced based on the residence, however clusters were not found. Using drug prescriptions analysis, a higher prevalence (n = 138; 13.7%) of diagnosed cases was found. Lifetime history of both atopic dermatitis and bronchitis were significantly relateds to asthma cases, as well as an elevated body mass index, whose association is consistent with prevalence data of overweight/obese children living in the study area. Moreover, being resident of the town of Termoli was associated to the occurrence of cases.ConclusionsAlthough our data indicated a prevalence concordance with previous national studies in pediatric population, a definitive correlation with environmental industrial factors present in the study area was not established. However, asthma outcome was significantly associated to individuals living in the town of Termoli that, despite the industrial/manufacturing activities, is also subjected to a higher environmental pressure due to the presence of toll road, state highway, railroad, and seaport which may cause air pollution from motor vehicle traffic and increase asthma induction. This study provides hitherto unavailable data on asthma in childhood population living in an industrialized area which was never investigated before, could be part of a systematic review or meta-analysis procedure, might suggest significant findings for larger observational studies, and contribute to complete the frame of disease epidemiology in Italy.
Highlights
The exposure to air pollution has negative effects on human health, increasing the risk of respiratory diseases, such as asthma
A lower representativeness of other municipalities was present, with San Martino in Pensilis accounting for 6.7% (n = 6), followed by Portocannone (5.6%, n = 5), San Giacomo degli Schiavoni (3.4%, n = 3) and Guglionesi (1.1%, n = 1)
In this study, by using ISAAC questionnaires methodology, including only “confirmed cases”, a prevalence of 7.9% was found which is almost in agreement with previous Italian SIDRIA studies [13], where asthma occurred in the 9.1-9.5% and 9.1-10.4% of children (6–7 years) and adolescents (13–14 years), respectively over 1994–95 and 2002
Summary
The exposure to air pollution has negative effects on human health, increasing the risk of respiratory diseases, such as asthma. The aim of the study was to estimate asthma prevalence and related risk factors in children and adolescents residents around the industrial area of Termoli, Molise region, Central-South Italy. Asthma is a chronic respiratory disease, characterized by episodes or attacks of impaired breathing, affecting up to 10% of adults and 30% of children [1,2]. In the framework of the International Study of Asthma and Allergies in Childhood (ISAAC) Project [10], the first SIDRIA (Italian Studies of Respiratory Diseases in Childhood and the Environment) survey in children and adolescents (6–7 and 13–14 years old) was carried out in 10 areas of northern and central Italy [11,12], reporting a lifetime prevalence of 9.1%. Few data are available on the prevalence of asthma symptoms in some areas of Italy among the childhood population
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