Respiratory Disorders In Children Research Articles

Sleep bruxism and sleep respiratory disorders in children and adolescents: A systematic review

AbstractObjectiveSleep bruxism (SB) is a repetitive rhythmic and nonrhythmic activity. It can be a comorbid condition for other disorders, such as sleep breathing disorders (SBD). However, a clear causal link between these factors is yet to be established. Moreover, this relationship is even more unknown in children. Thus, this systematic review aimed to determine the relationship between SB and SBD in children and teenagers and consolidate the current knowledge about the possible association between both phenomena at the pediatric age.Materials and MethodsAdvanced searches were performed in five electronic databases with the last search updated on February 1, 2023. The methodological quality of the selected studies was analyzed using the quality assessment tool for experimental bruxism studies.ResultsTwenty‐nine of 6378 articles were selected for detailed analyses. Most articles found a comorbid relationship between SB and SBD, though no study analyzed a temporary relationship. Due to the heterogeneity of the studies, a meta‐analysis could not be performed.ConclusionDespite the limitations of this systematic review, it can be concluded that there is an association between SB and SBD in children. However, the level of evidence is low.

The Role of Parents in Fulfilling Nutrition and Respiratory Health for Children in Agricultural Area: Literature Review

Parents have a very important role in fulfilling the nutritional status of children. Lack of nutritional knowledge, especially in agricultural areas, influences food processing behavior so that nutritional problems in children tend to increase. This literature review aims to describe mother's knowledge, family support and risk factors for infectious diseases with nutritional status and respiratory problems in children in agricultural areas. Methods: This research uses the literature review study method with 4 databases, namely Google Scholar, PubMed, Scient Direct, and Springer with a range of 2019-2023. Result: The role of parents is related to nutritional status and health conditions in children. Parental education, inadequate environmental conditions, and potential risk factors can also affect the nutritional status and respiratory problems in children under five in agricultural areas. Babies born to mothers with low levels of education have a higher risk of experiencing health problems than babies born to mothers with higher education. The occurrence of ISPA in agricultural areas is caused by various environmental factors such as exposure to smoke and inadequate physical conditions of houses which can worsen indoor air quality. Potential risk factors that can cause STH infection are parental education and occupation, how to play on the ground, use of the toilet and how to wash hands. Nurses must provide support and education to people in agricultural areas related to providing nutritional intake, quality of living environment, and patterns of daily life in order to reduce problems with nutritional status and respiratory disorders in children.

Altered intestinal microbiota enhances adenoid hypertrophy by disrupting the immune balance.

Adenoid hypertrophy (AH) is a common upper respiratory disorder in children. Disturbances of gut microbiota have been implicated in AH. However, the interplay of alteration of gut microbiome and enlarged adenoids remains elusive. 119 AH children and 100 healthy controls were recruited, and microbiome profiling of fecal samples in participants was performed using 16S rRNA gene sequencing. Fecal microbiome transplantation (FMT) was conducted to verify the effects of gut microbiota on immune response in mice. In AH individuals, only a slight decrease of diversity in bacterial community was found, while significant changes of microbial composition were observed between these two groups. Compared with HCs, decreased abundances of Akkermansia, Oscillospiraceae and Eubacterium coprostanoligenes genera and increased abundances of Bacteroides, Faecalibacterium, Ruminococcus gnavus genera were revealed in AH patients. The abundance of Bacteroides remained stable with age in AH children. Notably, a microbial marker panel of 8 OTUs were identified, which discriminated AH from HC individuals with an area under the curve (AUC) of 0.9851 in the discovery set, and verified in the geographically different validation set, achieving an AUC of 0.9782. Furthermore, transfer of mice with fecal microbiota from AH patients dramatically reduced the proportion of Treg subsets within peripheral blood and nasal-associated lymphoid tissue (NALT) and promoted the expansion of Th2 cells in NALT. These findings highlight the effect of the altered gut microbiota in the AH pathogenesis.

Sleep Respiratory Disorders in Children and Adolescents with Cystic Fibrosis and Primary Ciliary Dyskinesia.

Cystic fibrosis (CF) and primary ciliary dyskinesia (PCD) are genetic respiratory diseases featured by chronic upper and lower airway inflammation and infection, mainly due to impaired mucociliary clearance due to genetic mutations. Sleep is crucial to healthy children's normal physical and psychological development and has an important value in chronic respiratory diseases. Impaired sleep quality, such as sleep deprivation or insufficient sleep during the night, and sleep respiratory disorders (SRDs) are common in 5% to 30% of the general population. Sleep disruption leads to attention deficits, daytime sleepiness, fatigue and mood disorders and correlates to a worsened quality of life. Furthermore, sleep respiratory disorders (SRSs) are under-recognized comorbidities in CF and PCD patients. SRSs include a spectrum of symptoms ranging from primary snoring through upper airway resistance to obstructive sleep apnea (OSA), nocturnal hypoventilation and hypoxemia occurring in people with moderate to severe lung disease and damaging the disease-related outcomes and quality of life. Effective screening during sleep with polysomnography is very important for the timely initiation of efficacious treatments and to prevent worsened respiratory, metabolic and cardiovascular outcomes. However, the impact of SRDs on health and quality of life is still underinvestigated.

Health Impact of School Built Environment on Children

School-built environment impacts mental health, physical health, obesity, bullying, learning disorder, and respiratory disorders in children. The built environments of schools have a direct implication on the health of children. Indoor air quality in school buildings will play a role in children's exposure to pollution. One of the most consistently reported factors associated with children's active travel rates to school is the distance to school, with children more likely to walk or cycle to school the closer they live to the school. An evidence base regarding the built environment factors that shape decision-making and behavior related to active modes of travel in adults is emerging for policymakers. Functional aspects of the built environment include the distance between places; street design and geometry; street connectivity; path infrastructure, aesthetic qualities; safety; the mix of land uses; and the proximity and quality of destinations. Regarding architecture, the primary goal should be to create a space that maximizes natural light, airflow, and captivating aesthetics. Students spend their most important and developing years on school campuses; it is essential to consider their mental and physical health to create an environment where they can learn and develop their personalities in comfort. This paper discusses the health impacts that school-built environments have on children from a public health professional's perspective as well as an architect's viewpoint, as both institutions are crucial for children and adolescents to grow up in environments that encourage more active, safe, and sustainable lifestyles.

Five Decades of Research Progress in Air Pollution, Children's Respiratory Health, and Emergency Department Visits: A Bibliometric Analysis.

Air pollution is a global environmental health concern. Our study aims to examine the collective scientific impact of air pollution, children's respiratory health, and emergency department visits during the last five decades. Original articles, review papers, and conference proceedings in the English language published from 1972 to 2022 were obtained after a comprehensive search of the Scopus database using the terms air pollution, children, respiratory health, and emergency department visit. The Biblioshiny web application of the R software (R Foundation for Statistical Computing, Vienna, Austria) was used to analyse the publication trend and identify the top authors and journals of the subject. The countries' collaborative network was mapped, and the authors' trending keywords were tracked using a thematic map. In total, 1,309 publications authored by 6,342 authors from 483 sources were retrieved. Three distinctive collaborative network clusters were observed, with the United States as the connecting central node. Among the 39 trending keywords identified, particulate matter had constantly been a motor theme with an emerging interest in individual pollutants, specific diseases, and time series analysis. In conclusion, political will is a strong driver for research on air pollution, children's respiratory health, and emergency department visits, which is further enhanced by technological advancement that increases the availability and accessibility of air pollution and patient data. The trend for future studies is time series analysis and research on the impact of individual air pollutants on specific respiratory disorders in children.

Clinical-functional characteristics of children with asthma and obstructive sleep apnea overlap associated with attention deficit hyperactivity disorder: A cross-sectional study.

Asthma and obstructive sleep apnea (OSA) are common chronic respiratory disorders in children. The relationship between asthma and OSA is bidirectional; these conditions share multiple epidemiological risk factors. Untreated OSA may cause attention deficit hyperactivity disorder (ADHD) symptoms. This study aimed to assess the prevalence of ADHD in asthmatic children with OSA and the link between asthma control and lung function of children with asthma and OSA. A total of 96 children aged 6-15 years diagnosed with asthma, according to the Global Initiative for Asthma (GINA) 2020, were enrolled in this study. All demographic data, including age, gender, body mass index, asthma control status, therapy, the Vanderbilt ADHD Diagnostic Parent Rating Scale, lung function, and exhaled nitric oxide, were collected. In addition, home respiratory polygraphy was used to identify OSA in study subjects. A total of 96 patients (8.4 ± 2.4 years) were included in the present study. OSA was identified in 60.4% of asthmatic children with a mean apnea-hypopnea index (AHI) of 3.5 ± 3.0 event/h. The inattentive ADHD subtype was significantly lower in the non-OSA asthmatic group than in the OSA asthmatic group (7.9 vs. 34.5%, p < 0.05). ADHD had a higher probability of presence (OR: 3.355; 95% CI: 1.271-8.859; p < 0.05) in the OSA group (AHI >1 event/h). Children with poorly controlled asthma had a significantly high risk of OSA (83.0 vs. 17.0%, p < 0.001) than children with well-controlled asthma. Allergic rhinitis increased the odds of having OSA in patients with asthma [OR: 8.217 (95% CI: 3.216-20.996); p < 0.05]. The prevalence of OSA is increased among poorly controlled asthma. ADHD may have a higher prevalence in children with OSA. Therefore, prompt diagnosis of OSA will lead to an accurate asthma control strategy in patients with asthma.

The Challenging Diagnosis of Interstitial Lung Disease in Children-One Case Report and Literature Review.

Childhood interstitial lung disease (chILD) includes a heterogeneous spectrum of rare respiratory disorders in children associated with substantial morbi-mortality. Interstitial tissue, and other pulmonary structures, epithelium, blood vessels, or pleura are involved, resulting in a restrictive lung disfunction. Respiratory symptoms set in progressively and are often subtle, making thorough clinical history and physical examination fundamental. The etiology often is obscure. The clinical presentation mimics pneumonia or asthma, leading to a diagnostic delay. Challenging diagnosis may require genetic tests, bronchoalveolar lavage, or lung biopsy. Alongside general supportive therapeutic measures, anti-inflammatory, immunosuppressive or antifibrotic agents may be used, based on data derived from adult studies. However, if accurate diagnosis and treatment are delayed, irreversible chronic respiratory failure may ensue, impacting prognosis. The most frequent chILD is hypersensitivity pneumonitis (HP), although it is rare in children. HP is associated with exposure to an environmental antigen, resulting in inflammation of the airways. Detailed antigen exposure history and identification of the inciting trigger are the cornerstones of diagnostic. This article provides the current state of chILD, revealing specific features of HP, based on a clinical case report of a patient admitted in our clinic, requiring extensive investigations for diagnosis, with a favorable long-term outcome.

When Stridor is Not Croup: A Case Report

BackgroundCroup is one of the most common causes of acute respiratory disorder in children. It presents as acute laryngeal symptoms in the context of viral infection. Treatment consists of systemic steroids and aerosolized adrenaline, after which the symptoms must resolve rapidly. There are many differential diagnoses, including neurological causes. In these cases, clinical presentation is atypical and the outcome can be less favorable. Case ReportWe present the cases of three children who presented with stridor, which was initially treated as croup but eventually turned out to have a neurological origin. Why Should an Emergency Physician Be Aware of This?Clinicians need to be aware of the differential diagnoses of croup. We suggest a few key points to help emergency physicians manage these patients, including adequate use of monitoring and nasofibroscopy. Early identification is a key element in the effective management of certain rapidly progressive neurological diseases.

Assessment of the Feasibility of a Future Integrated Larger-Scale Epidemiological Study to Evaluate Health Risks of Air Pollution Episodes in Children.

Air pollution exposure can lead to exacerbation of respiratory disorders in children. Using sensitive biomarkers helps to assess the impact of air pollution on children’s respiratory health and combining protein, genetic and epigenetic biomarkers gives insights on their interrelatedness. Most studies do not contain such an integrated approach and investigate these biomarkers individually in blood, although its collection in children is challenging. Our study aimed at assessing the feasibility of conducting future integrated larger-scale studies evaluating respiratory health risks of air pollution episodes in children, based on a qualitative analysis of the technical and logistic aspects of a small-scale field study involving 42 children. This included the preparation, collection and storage of non-invasive samples (urine, saliva), the measurement of general and respiratory health parameters and the measurement of specific biomarkers (genetic, protein, epigenetic) of respiratory health and air pollution exposure. Bottlenecks were identified and modifications were proposed to expand this integrated study to a higher number of children, time points and locations. This would allow for non-invasive assessment of the impact of air pollution exposure on the respiratory health of children in future larger-scale studies, which is critical for the development of policies or measures at the population level.

Risk Factors of Chronic Cough and Wheezing in Outpatient and Hospitalized Children

Background: Wheezing and chronic cough are the most common respiratory disorders in children. They, as a multifactorial disorder, have different respiratory-associated illnesses and occur because of different etiologies. Objectives: In this study, we investigated correlation between wheezing and cough conditions and different probable risk factors. Methods: This is a cross-sectional and hospital-based study conducted on 485 children with wheezing and chronic cough in hospitalized and outpatients. The pediatrician confirmed these disorders after evaluating children’s respiratory systems. Interns filled out the related standardized questionnaires for evaluating the risk factors. Results: In total, 485 children were evaluated, 268 children (55.3%) were male, and 217 children (44.7%) were female. Smoke and steam were recorded as the most common etiologies and risk factors of chronic cough and wheezing. Other factors evaluated in this study included 14% dust, 9% flowers, and plants, 10.9% cold air, 5.8% sporting, 4.5% spicy, and 35.7% other stimulants foods, and out of these factors had other stimulating factors (P = 0.0001). Conclusions: Based on these findings, lifestyle, diet, location, contact with triggers, treatment, and control of underlying disease, environmental hygiene, and type of fuel consumption may be effective in reducing the symptoms.

Obstructive sleep apnea in pediatric patients

Obstructive sleep apnea is a highly prevalent disorder in children manifested as an obstruction of the upper airway during sleep. Objective: To analyze in the literature the etiology, diagnosis, risk factors and treatment of the systemic illness. Methodology: Articles found at PubMed, SCOPUS and Google scholar were analyzed, with an emphasis on the last 5 years. Articles were evaluated with the PRISMA and AMSTAR guidelines. The search was carried out using the words “sleep apnea” related with “tonsillar hypertrophy”, “sleep”, “upper airway”, “obstruction”. Results: Etiology: It’s a multifactorial disease, mainly caused by an obstacle in upper airway due to tonsillar hypertrophy. Diagnosis: Performed with clinical or instrumental examinations, overnight polysomnography is the gold standard for the diagnosis of this disorder. Risk factors: Tonsillar hypertrophy, iron deficiency, disturbances in craniofacial growth and childhood obesity. Treatment: It can be performed surgically or non-surgically and can be supported by orthodontic treatments. Conclusion: Obstructive sleep apnea is a common respiratory disorder in children, usually caused by tonsillar hypertrophy, it can be diagnosed by clinical or instrumental examinations. It is related to risk factors such as childhood obesity, and the treatment can be surgical or non-surgical.

Anamnestic and biochemical predictors of obstetric and perinatal complications in intrahepatic cholestasis of pregnancy

Objective. To determine the anamnestic and biochemical predictors of obstetric and perinatal complications in women with intrahepatic cholestasis of pregnancy (ICP).Materials and methods. 59 women with ICP and 30 pregnant women included into the comparison group were examined. The characteristics of the reproductive history, anamnesis of the disease, complaints, biochemical parameters of liver function (syndromes of cholestasis and hepatocyte cytolysis, function of protein synthesis), features of the course and treatment of ICP were studied.Results. The main predictors of preterm birth in the women with ICP were: age (P(U)=0.027), multiple pregnancy (OR=17.5, p=0.033); alkaline phosphatase (ALP) blood level &gt; 499 U/l (AUC=0.801; p=0.008); De Ritis Ratio value ≤ 0.49 (AUC=0.757; p=0.005). The main prognostic markers for meconium staining of amniotic fluid (MSAF) in the patients with ICP were: ICP in previous pregnancies (OR=7.1; p=0.029); serum bile acid concentration &gt; 14 μmol/l (AUC=0.718; p=0.043); total bilirubin blood level &gt; 13 μmol/l (AUC=0.773; p=0.007); ALP activity &gt; 484 U/l (AUC=0.728; p=0.033); blood creatinine concentration ≤ 60 μmol/l (AUC=0.930; p=0.0001) in asymptomatic course. The development of respiratory disorders in children born to women with asymptomatic ICP was associated with a total protein concentration in the blood of 78 g/l or less (AUC=0.852; p=0.0001).Conclusion. The anamnesis of the disease and the determination of the levels of the biochemical parameters of liver function allows predicting obstetric and perinatal complications in ICP.

The potential of impulse oscillometry in lung function assessment in children after allogeneic hematopoietic stem cell transplantation

The article analyzes the potential of using impulse oscillometry in the diagnosis of respiratory disorders in children with oncological and hematological diseases after allogeneic hematopoietic stem cell transplantation (HSCT). The study was approved by the Independent Ethics Committee and the Scientific Council of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation. A comparative analysis of parameters of impulse oscillometry and spirometry before and on Days 30, 90, 180 and 360 after HSCT was carried out. It was revealed that pulmonary ventilation function impairments are quite common in this group of patients, worsening significantly by month 3 of follow-up. An increase in reactance at a frequency of 5 Hz is one of the earliest signs of impaired respiratory function, which can be used for timely diagnosis of pulmonary complications after allogeneic HSCT.

Association between greenspace and lung function in Italian children-adolescents.

Few studies have examined the impact of urban greenspace exposure on lung function in children-adolescents, and the available evidence is still inconsistent. The aim of the current study was to verify the hypothesis that the effects of greenspace exposure vary with differing levels of lung function of children-adolescents. Between November 2005 and May 2006, 2150 children-adolescents (age-range: 10-15 years) living in the city of Palermo were enrolled in a cross-sectional survey. Parents were interviewed through a modified version of the Italian Studies on Respiratory Disorders in Children and the Environment (SIDRIA) questionnaire. All children-adolescents performed spirometry and were tested for allergic sensitization. Exposures to greenspace and grey space at the home addresses were measured using the CORINE land-cover classes. Parametric quantile regression models were applied for assessing the association between greenspace exposure and spirometry parameters, accounting for possible confounders and effect modifiers. A p-value lower than 0.05 was considered statistically significant. From the 1st to the 21st percentile, children-adolescents living within greenspace had higher FEV1 than those living within grey space. In particular, the estimated effects were: 1st (β=0.238L, p=0.01), 5th (β=0.140L, p=0.01), 10th (β=0.097L, p=0.015), and 15th (β=0.073L, p=0.025). Similarly, from the 1st to the 29th percentile, children-adolescents living within greenspace had higher FVC than those living within grey space. In particular, the estimated effects were: 1st (β=0.367L, p=0.0003), 5th (β=0.215L, p=0.0003), 10th (β=0.150L, p=0.0004), and 15th (β=0.112L, p=0.001). No significant associations were found for FEV1/FVC, FEF25-75 and FEF25-75/FVC. Quantile regression techniques may provide new insights into the evaluation of the association between greenspace exposure and lung function in children-adolescents, showing substantially heterogeneous effects from lower to higher quantiles of spirometry parameters. These results may help implementing policies for planning sustainable housing and surrounding greenspaces.

Chinese expert consensus on immunoprophylaxis of common respiratory pathogens in children (2021 edition).

Respiratory tract infections are infectious diseases involving the respiratory tract (such as the sinuses, throat, airways or lungs), which are the common respiratory disorders in children. With the development of society and the improvement of economic conditions, great progress has been made in China in the prevention of common respiratory pathogens in children. As a result, the incidence and mortality of respiratory tract infections in children have dropped sharply in the past decades. However, there is still a certain gap compared with the international leading levels, which can be partly attribute to insufficient public awareness of vaccination, uneven vaccination services of vaccinators, and so on. On the basis of comprehensive analysis of the clinical evidence of immunoprophylaxis of common respiratory pathogens among children in China and abroad, combined with the clinical situation and the experience of experts, the consensus focuses on the characteristics of transmission, clinical manifestations and immunoprophylaxis of common respiratory pathogens in children, so as to provide reference for clinical practice. This consensus document applies to all Centers for Disease Control and Prevention (CDC) staff levels engaged in the prevention and control of related pathogens, vaccinators at vaccination sites, and medical staff in pediatric, respiratory, and infectious diseases departments at all levels in medical institutions.

Evaluating Technical Knowledge of Using Inhalation Devices Amongst Medical Students and Pediatrics Residents in Iran

Background: Asthma is a common chronic respiratory disorder in children and adults worldwide. Inhalers are vital medications that are prescribed to control the disease and reduce its mortality and morbidity. Objectives: This study aimed to assess the knowledge and skills of Medical Students (MSs) and pediatric residents (PRs) in using different inhaler devices (IDs). Methods: This cross-sectional study included 243 MSs and PRs at Shiraz University of Medical Sciences, Iran, from March 2018 to March 2019. The MSs were divided into the senior medical students (SMSs) and junior medical students (JMSs). Data regarding participants’ knowledge on metered dose inhalers (MDIs), dry powder inhalers (DPIs), and nebulizers (NBs) were gathered using questionnaires and a face-to-face interview. Results: Of the 243 participants in the study, 113 (46.5%) were SMSs, 87 (35.8%) were JMSs, and 43 (17.7%) were PRs. The mean age of the participants was 26/20 ± 4/25 years. There was no significant difference between studied groups regarding recognition of MDI device (P = 0.072). PRs were more familiar with the DPIs than MSs (P &lt; 0.001). They also could recognize the NBs better than the MSs (P &lt; 0.001). In terms of using DPIs correctly, PRs executed all the steps better than MSs (P &lt; 0.001) except for the third step which all the participants had the same knowledge (P = 0.13). Regarding correct use of NBs, PRs had better performance compared to MSs (P &lt; 0.001). Conclusions: According to our results, there was an educational vacancy in training MSs regarding using IDs correctly, which can lead to poor compliance in asthmatic patients and deteriorating their lifestyle. The current research supports the need to redesign the educational curriculum of MSs and PRs in Iran to teach them sufficient knowledge and skills about how to use different types of inhalers properly.

Evaluation of sleep-disordered breathing in children and adolescents referred to the sleep ward of Qazvin children's hospital during 2014-2019

Background: Polysomnography is a gold standard method for examination of information obtained from physiological changes in the body related to sleep. The aim of this study was to diagnose respiratory disorders in children and adolescents with sleep disorders using polysomnography. Methods: In this cross-sectional retrospective study, the complete data of 112 children and adolescents aged 0-18 years that were referred to the sleep ward of Qazvin children's hospital due to sleep disorders were collected. The results of polysomnography and severity of obstructive sleep apnea (OSA) were determined. SPSS 21 software and frequency table were used to determine the prevalence of the variables. Results: The most common sleep disorder was restless sleep (68; 60.71%). One hundred and four (92.85%) patients had sleep apnea. Also, 66 (58.92%) patients with severe OSA, 19 (16.96%) patients with moderate OSA, 14 (12.5%) patients with mild OSA and 5 (4.46%) patients with central sleep apnea were observed. Eighty eight (78.57%) children had less than normal sleep efficiency (less than 90%) and 34 (30.35%) had normal and desirable sleep efficiency. Total adenotonsilectomy, medical therapy for OSA and non-invasive ventilation (NIV) were recommended for 46 (41.7%), 27 (24.10%) and 20 (17.85%) patients, respectively. Conclusion: Respiratory disorders symptoms during sleep were seen in our results, especially in children with a history of adenotonsillectomy. Based on the severity of symptoms, medication was prescribed for children. Referral of children suspected to sleep disorders to a physician by parents is essential for control and treatment of this disease.

The relationship between particulate matter and childhood respiratory complaints and peak expiratory flows in Harran agricultural area.

In recent years, many studies have evaluated the increasing incidence of asthma and chronic respiratory diseases among children living close to rural areas with pesticide application. Pesticide exposure in 266 children (126 girls and 140 boys) in Şanlıurfa, a cotton-producing province in Turkey, was explored in this work. Four different villages spread over 40 km2 were included. Measurements of peak expiratory flow (PEF) in 266 children were conducted in late June, before intensive pesticide applications in the cotton-producing fields. The measurements were repeated for 72 of 266 children after pesticide application in late August. PEF, particulate matter with diameter less than 2.5 μm (PM < sub > 2.5 < /sub > ), particulate matter with diameter less than 10 μm (PM < sub > 10 < /sub > ), temperature, humidity, and wind speed were measured. After pesticide application, mean PM < sub > 2.5 < /sub > and PM < sub > 10 < /sub > values were significantly increased compared to before pesticide application (p < 0.001 for both parameters). After pesticide exposure, nasal discharge, sneezing, burning and itching in the eyes, cough, sputum production, wheezing, shortness of breath and chest tightness were significantly increased (p < 0.001). The mean PEF value was demonstrated to decrease significantly after pesticide application (p < 0.001). Moreover, significant negative correlations were noted between PEF and PM < sub > 10 < /sub > and between PEF and PM < sub > 2.5 < /sub > (p < 0.001). Intensive pesticide application causes respiratory dysfunction and increased respiratory complaints in children living near the affected agricultural areas, and impacts quality of life adversely. The results of this work can be used to develop an early warning system and methods to prevent respiratory disorders in children residing in the study area.

Prevalence of Asthma Symptoms in 13-14-Year-Old Adolescents in Karaj.

Asthma is the most common chronic inflammatory respiratory disorder in children. This study was designed to assess the prevalence of asthma in 13-14-year-old adolescents in Karaj, Alborz province in Iran, using the international study of asthma and allergies in childhood (ISAAC) questionnaire.Totally 950 adolescents attending 40 schools located in 4 regions of Karaj city were enrolled in the survey. The Persian version of the ISAAC questionnaire was filled by 13-14-year-old students. Multi-stage clustered random sampling was used to divide the city of Karaj into four educational districts. Ever wheezing was reported in 22% of the individuals; 10.52% claimed to have wheeze in the last 12 months and 22.73% had during or after exercise. The experience of wheezing in the last 12 months was more prevalent among males (11.73% vs. 9.38%; p<0.05). However, having a history of asthma was higher among males (7.55% vs. 3.47%; p<0.05). History of hospitalization (60.8%), family history of asthma (49.4%), and history of food allergy (42.3%) were found to be the most frequent characteristics significantly associated with" ever wheezing" (p<0.05). The prevalence of wheezing in the last 12 months, as a major index of current asthma, was 10% which was close to the national average. However, nocturnal cough and exercise-induced wheezing were higher in Karaj compared to other cities of Iran; which could be related to the high level of air pollution in this industrial area.