Prevalence Of Bronchitis Research Articles

Ambient Air Pollution and Chronic Bronchitis in a Cohort of U.S. Women.

Background:Limited evidence links air pollution exposure to chronic cough and sputum production. Few reports have investigated the association between long-term exposure to air pollution and classically defined chronic bronchitis.Objectives:Our objective was to estimate the association between long-term exposure to particulate matter (diameter , ; , ), nitrogen dioxide , and both incident and prevalent chronic bronchitis.Methods:We estimated annual average , , and concentrations using a national land-use regression model with spatial smoothing at home addresses of participants in a prospective nationwide U.S. cohort study of sisters of women with breast cancer. Incident chronic bronchitis and prevalent chronic bronchitis, cough and phlegm, were assessed by questionnaires.Results:Among 47,357 individuals with complete data, 1,383 had prevalent chronic bronchitis at baseline, and 647 incident cases occurred over 5.7-y average follow-up. No associations with incident chronic bronchitis were observed. Prevalent chronic bronchitis was associated with [adjusted odds ratio (aOR) per interquartile range (IQR) difference ; 95% confidence interval (CI): 1.01, 1.13]. In never-smokers, was associated with prevalent chronic bronchitis ( per IQR difference; 95% CI: 1.04, 1.34), and was associated with prevalent chronic bronchitis (; ), cough (; 95% CI: 1.05, 1.16), and phlegm (; 95% CI: 1.01, 1.14); interaction p-values (nonsmokers vs. smokers) .Conclusions: exposure was related to chronic bronchitis prevalence. Among never-smokers, and exposure was associated with chronic bronchitis and component symptoms. Results may have policy ramifications for regulation by providing evidence for respiratory health effects related to long-term exposure. https://doi.org/10.1289/EHP2199

Bronchitis and Its Associated Risk Factors in First Nations Children.

Respiratory diseases, such as bronchitis and pneumonia, are common in First Nations children in Canada. The objectives are to determine prevalence and associated risk factors of bronchitis in children 6–17 years old residing in two reserve communities. The cross-sectional study was conducted in 2013 and children from two First Nations reserve communities participated. The outcome was ever presence/absence of bronchitis. Logistic regression analysis was conducted to examine the relationship between bronchitis and the individual and environmental factors. A total of 351 First Nations children participated in the study. The prevalence of bronchitis was 17.9%. While 86.6% had at least one parent who smoked, smoking inside home was 43.9%. Signs of mold and mildew in homes were high. Prevalence of houses with any damage caused by dampness was 42.2%, with 44.2% of homes showing signs of mold or mildew. Significant predictors of increased risk of bronchitis were: being obese; having respiratory allergies; exposed to parental cigarette smoking; and signs of mold and mildew in the home. There are several modifiable risk factors that should be considered when examining preventive interventions for bronchitis including obesity, smoking exposure, and home mold or dampness.

Prevalence of chronic respiratory diseases from a rural area in Kerala, southern India

BackgroundChronic lung diseases are one of the leading causes of morbidity in developing countries. A community based survey was undertaken with an objective to estimate the prevalence of chronic respiratory diseases and to describe the profile of people with CRDs in the rural area Nilamel health block in Kollam district, Kerala, southern India. MethodsA household information sheet and a translated respiratory symptom questionnaire based on International Union against Tuberculosis and Lung Disease (IUATLD) bronchial symptoms questionnaire was administered to 12,556 people above 15 years, selected randomly from Nilamel health block. ResultsPrevalence of self reported asthma was 2.82% (95% CI 2.52–3.12) and that of chronic bronchitis was 6.19% (95% CI 5.76–6.62) while other CRDs which did not fit to either constitute 1.89%. Prevalence of asthma among males was 2.44% (95% CI 2.05–2.85) while that of females was 3.14% (95% CI 2.71–3.57). Chronic bronchitis prevalence was 6.73% and 5.67% among males and females respectively. ConclusionAlthough India has devised a programme to combat cancer, diabetes, cardio vascular disease and stroke, none have been devised for chronic respiratory illness till date. Considering high prevalence and its contributions to morbidity and mortality, a comprehensive programme to tackle chronic respiratory diseases is needed.

Air Pollution and Potential Health Risk in Ostrava Region - a Review.

The aim of this review was to collect all available data about air pollution in Ostrava, which is one of the most polluted area in central Europe and to make a concise assessment of health risks resulting from historical exposures of air pollutants since the beginning of the monitoring, i.e. since 1970 to the present time. All available information sources (the Czech Hydrometeorological Institute, the Institute of Public Health in Ostrava or publications) were used. To evaluate the exposures both short-term (hourly and daily) data and long term (yearly) data during 45 years were analysed. For health risk assessment the relationship between exposure and biological effects of pollutants published by the WHO and the US EPA were employed. During the studied period annual average concentrations of PM10 ranged from 25 to 96 µg/m3; PM2.5 from 24 to 45 µg/m3; SO2 from 3.4 to 101.5 µg/m3; NO2 from 17.76 to 51.17 µg/m3; benzene from 0.24 to 9.2 µg/m3; benzo[a]pyrene from 2.1 to 14 ng/m3; arsenic from 1.2 to 9.5 ng/m3. Since the turn of the 80s and 90s of the 20th century trend of air pollutant concentrations has been decreasing until the turn of millennium, when it stopped, and it has been constant until present time. However, presented results demonstrate that the citizens of Ostrava have been exposed to relatively high concentrations of pollutants in comparison to other similar cities. The most significant pollutants contributing to health risks are airborne dust (PM10, PM2.5), benzene and benzo[a]pyrene. The long-term average health risk of PM10 has increased in case of postneonatal infant mortality up to 30%; prevalence of bronchitis in children up to 61%; and incidence of chronic bronchitis in adults up to 89%. The long-term average health risk of PM2.5 increased for all-cause mortality in persons aged 30+ years up to 22%; cardiopulmonary related mortality up to 25%; and lung cancer related mortality up to 39%. The highest carcinogenic risk is observed in benzo[a]pyrene, when the range of individual lifetime carcinogenic risk is up to 1.25*10-3. This assessment is valid according to the strict carcinogenic risk by the WHO, while the maximum carcinogenic risk according the US EPA is 7.2*10-5. A significant reduction of the pollutants' concentrations in Ostrava in the nineties of the last century does not mean a required improvement of outdoor air quality to the desired level. Persisting episodes with a very strong short-term increase of the concentration of PM10 and PM2.5, as well as long-term load of these substances on the population is very high. Health risks from such burdens are likely to lead to a higher mortality and morbidity especially from specific diseases.

Infectious diseases are associated with carotid intima media thickness in adolescence

ObjectiveInflammatory risk factors in childhood, e.g. obesity, impact on carotid artery intima media thickness (CIMT), an early indicator of atherosclerosis. Little is known on potential infectious origins in childhood. We investigated the association between number of reported different childhood infectious diseases and CIMT in adolescence. Study design288 SAPALDIA offspring (8–21years) underwent a clinical examination in 2010–2011: anthropometry, blood pressure, CIMT, blood draw (cardiovascular biomarkers, cotinine). Offspring and parents gave information on individuals' and family health, child's vaccination status, infectious diseases and other early life factors. Life-time prevalence of bronchitis, pneumonia, tonsillitis, otitis, mononucleosis, meningitis, appendicitis, and scarlet fever were investigated, separately, and as cumulative infectious disease score. Multilevel adjusted linear regression analysis on the association between subjects' CIMT average and infectious diseases score was performed, stratifying by sex. ResultsYouth (mean age 14.8 yrs; 53% female) reported on average 1.3 of the listed infectious diseases; 22% boys and 15% girls reported ≥3 infectious diseases (p = 0.136). Two-thirds were vaccinated according to recommendations (boys 56%, girls 61.5%, p = 0.567). Sex-stratified analyses yielded significantly increased CIMT in boys with ≥3 infectious diseases vs. none (0.046 mm, 95%CI 0.024; 0.068). In girls, the effect was of same direction but statistically non-significant (0.011 mm, 95%CI −0.015; 0.036). ConclusionThe SAPALDIA Youth study complements current evidence on infectious origins of atherosclerosis in adults. The larger effects observed in boys may relate to a higher vulnerability of the vasculature and/or to infectious pathogens. Our data are suggestive of an early impact of childhood infectious diseases on vascular health.

Rural Dwelling and Temporal Trends in Relation to Childhood Asthma and Related Conditions in Belarus: A Repeated Cross-sectional Survey

ABSTRACTThere is a lack of asthma research in Belarus, with no investigation of temporal trends. The purpose of the study was to determine the prevalence of asthma and related conditions comparing urban and rural children while investigating temporal changes in the region of Grodno, Belarus. A repeated cross-sectional survey design was used. Parents completed surveys on behalf of the child. Data collection was based on the International Study of Asthma and Allergies in Children (ISAAC) survey and included 5020 urban and rural children aged 7–15 years in 2009–2010 and 4953 children in 2014 from the Grodno Region. Asthma prevalence in 2009 was 1.4% compared with 1.8% in 2014, whereas spastic bronchitis prevalence was higher (2009: 6.8%; 2014: 8.5%). After adjustment for confounders, rural dwelling showed a statistically significant inverse association with each of the allergic conditions or symptoms. However, asthma (odds ratio [OR] = 1.01, 95% confidence interval [CI] = 0.69–1.50) was not associated with rural dwelling. A diagnosis of asthma was more likely in 2014 compared with 2009 (OR = 1.57, 95% CI = 1.05–2.33), as was spastic bronchitis (OR = 1.26, 95% CI = 1.06–1.51). Maternal smoking was associated with the presence of respiratory symptoms. The data showed that the prevalence of diagnosed asthma was comparable between urban and rural areas but lower than other regions, there was generally an increase in the prevalence of asthma and related conditions, and that temporal changes did not vary by urban-rural status. The prevalence of spastic bronchitis was over 3 times higher than that of asthma. These findings also suggest that the presence of undiagnosed asthma in children is occurring in the Grodno Region.

Gümüşhane il merkezinde yaşayan erişkinlerde kronik bronşit prevalansı

Chronic bronchitis and emphysema are major components of chronic obstructive pulmonary diseases (COPD). The aim of this study was to determine the prevalence of chronic bronchitis 20 years and over living in the center of Gumushane and to analyze the risk factors. The study is targeted to reach 373 people who represent the center of Gumushane, 368 (98.6%) people have been reached. Participants were filled modified version of the questionnaire created by the Medical Research Council by face-to-face interview technique. The prevalence of chronic bronchitis was 14.1%. The average age was in the chronic bronchitis group and non-chronic bronchitis group was respectively 43.2 ± 12.9, 39.3 ± 11.6, and the differance was statistically significant (p< 0.05). Considering the relationship between cigarette smoking with chronic bronchitis, it was more frequent in smokers than non-smokers (p< 0.001, OR 4.74, 95% CI 2.47-9.17). Chronic bronchitis was observed in passive smokers than in non-smokers (p= 0.004, OR 2.86, 95% CI 1.36-6.03). Occupational exposure to dust, fumes and history of childhood pulmonary diseases were increased chronic bronchitis prevalence (respectively, p< 0.001, OR 9.53, 95% CI 4.56-19.94; p< 0.001, OR 12.14, 95% CI 5.87-25.12). Male gender, low income level and to warm up with stove were found statistically significant by univariate logistic regression analysis but these risk factors were not statistically significant in the multivariate analysis. Educational level was not found statistically significant in both analysis (p> 0.05). The prevalence of chronic bronchitis was 14.1% in 20 years and older adults living in the center of Gumushane. Old age (especially over the age of 50), active or passive smoking, occupational history of dust, fumes and history of childhood pulmonary diseases were found to be risk factors for chronic bronchitis.

Effect of air pollution on prevalence of chronic bronchitis symptoms-a cross-sectional analysis of 5 cohort studies

Background and Aims: Chronic bronchitis symptoms are associated with increased risk of COPD and, in some studies, overall as well as COPD mortality. This study aims to assess effects of outdoor air pollution exposures on chronic bronchitis prevalence in five cohort studies participating in the European Study of Cohorts for Air Pollution Effects (ESCAPE) project. Methods: Annual average air pollution exposures of particulate matter (PM) metrics PM2.5, PM10, PMcoarse, PM2.5absorbance, NO2, NOx derived from Land Use Regression models for 2008-2011 and road traffic measures, were assigned to home address of five European cohorts (E3N, ECRHS,NSHD,SALIA,SAPALDIA) at follow-up periods in 2000-2011. Chronic bronchitis was defined as questionnaire-reported chronic cough and phlegm production for ³3 months for 2 or more years. Cross-sectional multivariable logistic regression analyses were conducted in each cohort, adjusting for a confounder set common to all studies (age, sex, smoking status, interview season, education) followed by random-effect meta-analysis. Results: 13,758 and 8,784 participants respectively were included in NO2 and PM analyses at follow-up. Prevalence of chronic bronchitis ranged from 1.5% in E3N (non-asthmatic females) to 6.8% in SALIA (elderly females). No consistent associations were observed between any air pollution measure and prevalence of chronic bronchitis. Meta-analysis combined ORs were: for NO2 OR: 0.96 (95%CI: 0.89-1.04) per 10ug/m3; for PM10 OR 0.85 (95%CI: 0.53-1.39) per 10ug/m3. Results were suggestive of possible effects in asthmatics and never-smokers in some cohorts but this was not consistent across all studies. Conclusions:In contrast to some previously published European studies, this study did not find consistent effects of current air pollution exposures level on chronic bronchitis symptoms. Further investigations including use of back-extrapolated air pollution values to actual year of questionnaire are needed.

Comparison of total suspended particulate concentration–response relationships for respiratory symptoms between Chinese children with a different susceptibility status

Few studies have explored concentration–response (C–R) relationships between levels of particulate matter (PM) and respiratory morbidity in terms of the susceptibility of children to respiratory diseases. We sought to determine whether the shapes of C–R curves for comparing total suspended particle (TSP) concentration versus the adjusted prevalence of bronchitis (persistent cough or phlegm) and asthma (current wheeze or asthma) symptoms between children with a different susceptibility status. We used the restricted cubic spline (RCS) function to characterize the C–R relationships between TSP and the adjusted prevalence rates of four respiratory symptoms, after controlling for possible confounding by SO2 and NO2 levels, in 11,860 children selected from 18 districts of six cities in Liaoning province. Susceptible children exhibited a 2- to 3-fold elevation in the prevalence of all four respiratory symptoms across the entire TSP range (188–689μg/m3). Significant differences in the shapes of C–R curves were evident in children with symptoms of bronchitis (ballistic “S”-shaped curves) and asthma (flattened “U”-shaped curves), as well as between the low and high TSP ranges of such curves, when children were grouped by susceptibility status. A significant linear association between TSP levels and current asthma prevalence was found only among susceptible children exposed to high levels of TSP. The shapes and properties of the TSP-morbidity C–R curves differed significantly by type of respiratory symptom, susceptibility status, and TSP range. More work is required to characterize CR relationships in terms of susceptibility status in countries with different PM levels.

Pediatric Asthma Epidemiology: 529 Prevalence of Bronchitis and Revealing of the Risk Factors in the Children's Population

BackgroundIt is well known that with change oc climatic conditions cases of various diseases increase and especially, with cold climate, the frequency of acute respiratory diseases, especially, the influenza, rhinites, bronchitis, etc. grows.ObjectiveTo study of prevalence of bronchitis and its risk factors in children's population.MethodsStudy was conducted in the selected pediatric clinics of Tbilisi and involved 698 children from 6 months to 5 years age, based on the random and representative groups. Epidemiological study was conducted by cross-section method. Questioning was provided based on the questionnaire specially developed for this purpose. Study of the factors of the cause significance was provided on the basis of anamnesis data. Obtained results were processed by means of special software package SPSS/V11.5.ResultsAccording to the questioning, acute bronchitis was indicated 3 times, in 56.2% of the children's population, of which 47.4% were boys and 52.6% - girls. 43.8% of the population suffered complications in a form of pneumonia. In 21.9% of cases bronchitis was diagnosed for the first time. Wheezing was regarded as a risk factor (78.5%), serous nasal discharge (87.3%), cough, regarding its nature (68.3%) (short cough, wet cough productive cough), in part of the respondents lacrimation was indicated (35.6%), there was also indicated in children the immunodeficiency, sex, socioeconomic status, heredity factor, overcrowded homes. Prevalence of the symptoms of bronchitis was quite higher (P < 0.05) among girls, compared with the boys. 98.9% of the respondents with the symptoms of bronchitis stated that the disease was of seasonal nature, mostly from early October to end of March (P < 0.01).ConclusionsThus, single-stage epidemiological study showed that frequency of bronchitis in children's population is quite high, with prevalence among girls (59.9%).

Increase in asthma and a high prevalence of bronchitis: Results from a population study among adults in urban and rural Vietnam

While a large amount of data about the epidemiology of asthma, COPD, chronic bronchitis and respiratory symptoms are available from developed countries, the information about these diseases in developing countries in south-east Asia are scarce. Assess the prevalence of respiratory diseases and symptoms and their relation with demographic data including smoking habits among adults in rural and urban Vietnam. A random sample of subjects aged 21-70 years were invited; 3008 subjects living in an inner city area of Hanoi and 4000 in a rural area of Bavi in northern Vietnam. An internationally used questionnaire was delivered by field workers to the study subjects. The questionnaire was completed by the subjects, or when necessary, by the field workers after reading the questions for the study participants. The response rate was 92% in Bavi and 70% in Hanoi. Of men in Bavi 67.8% (Hanoi 49.7%; p < 0.001) were smokers, while of women 4.2% were smokers in Hanoi (Bavi 1.2%; p < 0.001). The prevalence of ever asthma was in Hanoi 5.6% (Bavi 3.9%; p = 0.003) with no major gender difference. The most common symptom was longstanding cough (Hanoi 18.1%, Bavi 12.0%; p < 0.001) followed by sputum production, while the prevalence of symptoms common in asthma was considerably lower. Although the large difference in smoking habits, respiratory symptoms tended to be only slightly more common in men than women. Family history of asthma and chronic bronchitis, respectively, were strongly associated with both diseases. The prevalence of asthma in adults may have increased in both urban and rural Vietnam, as the few previous estimates have found 2% of adults having asthma. Half of men in Hanoi and two-thirds in Bavi were smokers versus a few percent of women in both areas. Bronchitic symptoms were common in both men and women.

Identification and Initial Characterization of Prominent Air Pollution Sources and Respiratory Health at Secondary Schools in Ibadan, Nigeria

Objective. Research on air quality in and around schools, and the associated vulnerability of school-age children, is limited in less developed countries (LDCs), particularly Africa. The main objective of this study was to conduct an initial assessment of sources of air pollution in and around schools as a surrogate for air quality and report adverse health effects among students at selected secondary schools in urban Ibadan, Nigeria. Methods. The study was a descriptive cross-sectional survey involving eight secondary schools selected purposively, defined with eight acronyms (listed alphabetically): ABHS, AGS, BOHS, CDSS, IGS, LC, MGS, and OAHS. We used pre-tested, self-administered questionnaires, observational checklists to assess certain environmental health indicators, and interviews. The questionnaire was divided into five sections including environmental and health conditions. A total of 400 students from senior secondary classes, 50 from each school, were selected through stratified random sampling. Results. The school's location, especially if close to high traffic roadways, contributed to reported perceived poor air quality of school environments. The majority of students believed air pollution sources in the school environment were mainly refuse burning and car emissions from nearby roadways. Cough and asthma were the most frequently reported adverse health outcomes. The highest prevalence of reported recent asthma episodes (symptoms) were recorded at BOHS (84%) and at CDSS (62%); furthermore, at ABHS it was nearly 1-in-2 students and at OAHS about 1-in-5 students. BOHS and OAHS each reported over 10% for prevalence of bronchitis. Conclusions. Proximity of study schools to certain sources and activities such as refuse burning and major roadways seemed to present substantial risk factors for reported respiratory morbidity among secondary students in urban Ibadan, Nigeria. Future research should quantify source emissions and exposure and further characterize frequency and severity of respiratory symptoms, among other parameters, at schools in Nigeria and other sprawling urban areas of Africa.

Quantification of Teratological Effects of Infectious Bronchitis Virus Isolated from Commercial Poultry in Pakistan

2 Abstract: In continuation of our studies with the Infectious Bronchitis prevalence in Pakistan, the current study was conducted to determine the teratological effects of the Infectious Bronchitis Virus (IBV) on developing chicken embryo. The tissues collected (Trachea and Lungs) from clinically positive IB chickens were tested with the indirect immunofluorescence assay against M-41 IBV strain (reported previously). The positive samples were further tested with the RT-PCR against the IBV primers (reported previously). The tissue homogenates from 43 such RT-PCR-positive samples were serially passaged through 11 days old embryos and the effects on the embryonic development in terms of dwarfing, curling, stunting and urates deposits were recorded. The data showed that the passaging sequentially increased the IBV teratological effects. Only 13 out of 43 samples exhibited IBV-associated teratological effects over various passages. These effects were effectively neutralizes by using IBV variant specific antisera in a viral neutralization test. These studies imply that IBV variants isolated from Pakistan are no different in producing teratological effects considered representative of the IBV.

Chronic Bronchitis in Women Using Solid Biomass Fuel in Rural Peshawar, Pakistan

Biomass smoke has been associated with many diseases. The aim of this study was to evaluate the relationship between biomass smoke and chronic bronchitis in women in the rural setting of Peshawar, Pakistan. Three villages in rural Peshawar were randomly selected as "test villages" where biomass fuel was used. The women responsible for cooking in these villages were interviewed for the prevalence of bronchitis, and data were compared to those obtained from three matching "control villages" where liquid petroleum gas was used as fuel. Crude odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a statistical software package (EPI Info, version 6.0 [public domain software]; Centers for Disease Control and Prevention; Atlanta, GA). This study was carried out in 1,426 female test patients and 1,131 female control subjects. Chronic bronchitis was found in 100 women (7.01%) in the test group and 33 women (2.92%) in the control group. The OR was 2.51 (95% CI, 1.65 to 3.83). A strong association was found between bronchitis and the use of wood (OR, 2.38; 95% CI, 2.12 to 3.01), dung cake (OR, 2.01; 95% CI, 1.72 to 2.42), rice straws (OR, 3.32; 95% CI, 1.11 to 9.88), and kai grass (OR, 1.96; 95% CI, 1.75 to 2.45). Cooking in the living room and bronchitis were highly associated (OR, 2.5; 95% CI, 1.94 to 3.66). An association between the presence of a kitchen and bronchitis was established with an OR of 2.65 (95% CI, 2.10 to 3.42). In the test group, 75% of kitchens were ventilated; in the control group, 82% were ventilated. The difference between the two groups was nonsignificant (p>0.6; chi2=0.39; OR, 0.83; 95% CI, 0.5 to 1.4). Biomass fuel exposure is strongly associated with chronic bronchitis in women who are involved in cooking in rural Peshawar.

Pesticide use and chronic bronchitis among farmers in the Agricultural Health Study.

Farmers have increased risk for chronic bronchitis. Few investigators have considered pesticides. We evaluated pesticides as risk factors for chronic bronchitis using the Agricultural Health Study enrollment data on lifetime pesticide use and history of doctor-diagnosed chronic bronchitis from 20,908 private pesticide applicators, primarily farmers. A total of 654 farmers (3%) reported chronic bronchitis diagnosed after age 19. After adjustment for correlated pesticides as well as confounders, 11 pesticides were significantly associated with chronic bronchitis. Heptachlor use had the highest odds ratio (OR=1.50, 95% Confidence Interval (CI)=1.19, 1.89). Increased prevalence for chronic bronchitis was also seen for individuals who had a history of a high pesticide exposure event (OR=1.85, 95% CI=1.51, 2.25) and for those who also applied pesticides in off-farm jobs (OR=1.40, 95% CI=1.04, 1.88). Co-morbid asthma and current farm activities did not explain these results. These results provide preliminary evidence that pesticide use may increase chronic bronchitis prevalence.

NO2 and children’s respiratory symptoms in the PATY study

Objectives: NO2 is a major urban air pollutant. Previously reported associations between ambient NO2 and children’s respiratory health have been inconsistent, and independent effects of correlated pollutants hard to assess....

Different Labelling of Obstructive Airway Diseases in Estonia, Finland, and Sweden

Large differences in prevalence of asthma have been reported between westernised countries and the former Eastern European countries, and still no consensus about the reasons for the differences exists. The aim of this study was to assess diagnostic labelling of obstructive airway diseases, comparing subjects with respiratory symptoms and the diagnoses obtained in Estonia, Finland, and Sweden. A postal questionnaire was sent to population-based random samples, and 44,483 (76%) answers were obtained from the 58,661 invited in 1996. Among men, current smoking was most common in Estonia, 60%, followed by Finland, 39%, and Sweden, 28%. In all three countries, 30% of women were current smokers. Most respiratory symptoms including wheezing were most common in Estonia, also among non-smokers. The prevalence of asthma was 2.0% and chronic bronchitis 10.7% in Estonia, while the opposite was found in Sweden with an asthma prevalence of 7.8% and a chronic bronchitis prevalence of 3.1%. The pattern in Finland was similar to that of Sweden. The same differences between the three countries were found also among young subjects. The total proportion of diagnosed obstructive lung diseases in subjects with respiratory symptoms was similar, but the diagnosis of asthma was considerably more common in Finland and Sweden. Chronic bronchitis was favoured in Estonia, also among young adults irrespectively of what symptoms were present. In a multivariate model with correction for confounders, the risk (OR) for having a diagnosis of asthma was 5.65 (95% CI: 4.86-6.56) when living in Sweden, and 3.51 (95% CI: 3.00-4.12) in Finland, whereas risk for chronic bronchitis was 0.28 (0.25-0.31) and 0.22 (0.19-0.25), respectively, compared to Estonia. The study indicates differences in diagnostic practices of obstructive lung diseases between the three countries.

CAR AND TRUCK TRAFFIC AND ADVERSE EFFECTS ON RESPIRATORY HEALTH IN CHILDHOOD. THE RESULTS OF A LARGE ITALIAN MULTICENTER SURVEY (SIDRIA 2)

ISEE-379 Introduction: A number of epidemiological studies have provided evidence that exposure to vehicular traffic increases the prevalence of bronchitis, cough and lung function deficit, and exacerbates pre-existing asthma. A specific role of diesel exhaust from heavy traffic has been suggested. The aim of this study was to evaluate separate and combined effects of cars and trucks traffic on the respiratory health of children. Methods: A survey (SIDRIA-2, Italian Studies on respiratory disorders in childhood and environment) was conducted in Winter-Spring 2002. Standardised, self administered questionnaires were used to collect information on several health outcomes and potential risk factors. A questionnaire filled in by parents was available for 33,632 subjects (response rate: 86.7%). Car and truck traffic in the street of residence was assessed with parental questionnaires. Results: Both traffic indicators (frequency of truck transit in the street of residence, frequency of car traffic in the street of residence) were weakly associated with current asthmatic symptoms. Exposure to continuous car passage and to continuous truck transit was significantly associated with persistent cough or phlegm (OR=1.36 95%CI=1.15–1.61; OR=1.82, 95%CI=1.54–2.16 respectively). Children exposed to both, continuous car traffic and frequent or continuous truck traffic, showed the highest risk of persistent cough or phlegm (OR= 1.59, 95%CI=1.39–1.82); children with only car traffic exposure showed an OR=1.34 (95%CI=1.01–1.77), while children exposed to truck traffic only showed an OR= 1.39 (95%CI=0.93–2.08). Conclusion: These analyses on the risk of persistent cough or phlegm confirm stronger associations with heavy traffic pollution, but show also an independent effect of car traffic. Funding: The SIDRIA-2 phase study was partially funded by the Italian Ministry of Health.

Gesundheitliche Wirkungen von Feinstaub: Epidemiologie der Langzeiteffekte

Health Impact of Exposure to Suspended Particulate Matter. Epidemiology of Long-Term Effects Chronic effects of ambient air pollutants are studied by cross- sectional and cohort designs including adjustment for confounder on an individual basis. This review summarizes the state of the art about chronic effects of ambient particulate air pollutants. A majority of regional cross-sectional studies show a higher risk for non-allergic, infectious respiratory diseases such as bronchitis in children who grew up in highly polluted areas. Impaired lung function was only shown in few of these studies, whereas in adults impairments were homogeneously seen in cross-sectional studies. A 10 µg/m 3 TSP or PM10 increase in annual means in- creases the prevalence of bronchitis in children by 20 - 40%. According to North-American cohort studies total mortality can be estimated to increase by 24 - 50% for PM10 (per 50 µg/m3 increase), 17 - 25% for PM 2.5 (per 25 µg/m3 increase), and 10 - 50% for sulfates (per 15 µg/m3 increase). Prevalence of bronchitis and infectious respiratory health in East German children de- creased along with the improvement of air quality. Further studies on chronic effects including an improved expo- sure assessment are needed to quantify health effects more pre- cisely. These future studies should include a higher number of areas with different air pollution levels. They should help to set up more evidence-based regulations for the control of air pollu- tants and to improve the evaluation of clean air acts.

Changing prevalence of asthma in Turin school children between 1994 and 1999

Asthma is a widespread chronic disorder in children and its prevalence has been on the increase in Europe. Only few studies have described the prevalence variation in respiratory symptoms in Italian regions. The aim of this study, conducted in Turin during the 1998/1999 school year, is to investigate the distribution of respiratory symptoms in a sample of Turin school children and to compare the obtained results with the findings of the SIDRIA study performed in 1994-95. The sample in study is composed of all the children attending to three elementary schools in Turin. All of the selected schools had already participated in the 94-95 ISAAC-SIDRIA study. A total of 448 pupils aged 6-10 years received a standardised questionnaire to be filled by parents. Response rate is higher than 97% in all the studies. In 1999 we found that the prevalence of wheezing in the past 12 months was 7.3%. The 13.3% of children had asthma at least once in life and the 5.3% reported an attack in the last year. The comparison of our study results with the ISAAC-SIDRIA (1994-95) shows that the prevalence of asthma and asthma-like symptoms is rather stable among children, while the prevalence of bronchitis reveals a reduction of about 5.5%, but not statistically significant (p=0.094; 95%CI:-11.9;0.9). A considerable reduction in exposure to parents' passive smoke is shown: deltaP%=-4.7 (95%CI: -9.4;-0.1) for maternal smoking in pregnancy, deltaP%=-8.2 and -15.2, respectively for maternal and paternal smoking in the first two years of life. The results indicate a stable prevalence rate in asthma symptoms in children. A possible explanation of slight variation in asthma prevalence may be due to a reduced exposure to outdoor and indoor risk factors as reported in the questionnaires.