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Acute effects of winter air pollution on respiratory function in schoolchildren in southern England

¹ Department of Public Health Sciences, St George’s Hospital Medical School, London SW17 0RE, UK
² Environmental Health Department, Medway Council, Civic Centre, Rochester, Kent ME2 4AW, UK
³ School of Earth and Environmental Sciences, University of Greenwich, Chatham Maritime, Kent ME4 4TB, UK

Correspondence to:
Correspondence to:
Dr J L Peacock, Senior Lecturer in Medical Statistics, Department of Public Health Sciences, St George’s Hospital Medical School, London SW17 0RE, UK;
j.peacock{at}sghms.ac.uk

Aim: To investigate the acute health effects of winter outdoor air pollution (nitrogen dioxide (NO₂), ozone (O₃), sulphur dioxide (SO₂), sulphate (SO₄^2-) ,and particles (PM₁₀)) on schoolchildren in an area of southern England where levels of SO₂ had been reported to be high.

Methods: A total of 179 children, aged 7–13, from three schools (two urban and one rural location), were included. Peak expiratory flow rate (PEFR) and presence or absence of upper respiratory infections were recorded on 63 school days from 1 November 1996 to 14 February 1997. Air pollution and meteorological data were taken from monitors at each school site. The analysis regressed daily PEFR on pollutant level adjusting for confounders and serial correlation and calculated a weighted pooled estimate of effect overall for each pollutant. In addition, large decrements in PEFR were analysed as a binary outcome. Same day, lag 1, lag 2, and a five day average of pollutant levels were used.

Results: There were no clear effects of any pollutant on mean PEFR. In addition, we analysed large PEFR decrements (a binary outcome), observing consistent negative associations with NO₂, SO₄^2-, and PM₁₀, although few lag/pollutant combinations were significant: odds ratios (95% CI) for five day average effect: NO₂ 24 h average 1.043 (1.000 to 1.089), SO₄^2- 1.090 (0.898 to 1.322), PM₁₀ 1.037 (0.992 to 1.084). The observed effects of PM₁₀ (only) were stronger in wheezy children (1.114 (1.057 to 1.174)). There were no consistent negative associations between large decrements and ozone or SO₂ .

Conclusions: There is no strong evidence for acute effects of winter outdoor air pollution on mean PEFR overall in this area, but there is evidence for negative effects on large PEFR decrements.

Keywords: air pollution; children; panel study; peak expiratory flow; PM10

Abbreviations: FEV, forced expiratory volume; FVC, forced vital capacity; PEFR, peak expiratory flow rate; PM, particulate matter; TEOM, tapered element oscillating microbalance

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