Road traYc and adverse respiratory eVects in children

1998 
Objectives—To investigate the relation between traYc indicators in the area of residence and the occurrence of chronic respiratory disorders in children. Methods—A population based survey was conducted in 10 areas of northern and central Italy (autumn 1994 to winter 1995) in two age groups (6‐7 and 13‐14 years). Information on several respiratory disorders and on traYc near residences was collected with a questionnaire given to children and to their parents. The sample analysed included 39 275 subjects (response rate 94.4%). Outcomes were: (a) early (first 2 years of life) respiratory diseases, and (b) current respiratory disorders (asthma, wheeze, cough, or phlegm in the past year). Odds ratios (ORs) and 95% confidence intervals (95% CIs), adjusted for several potential confounders, were estimated from logistic regression models. Main results were stratified by level of urbanisation (metropolitan areas, other centres). Results—In the metropolitan areas, high frequency of lorry traYc in the street of residence was associated with significantly increased risks for many adverse respiratory outcomes. Among early respiratory diseases, the strongest associations were found for recurrent bronchitis (OR 1.69, 95% CI 1.24 to 2.30), bronchiolitis (1.74, 1.09 to 2.77) and pneumonia (1.84, 1.27 to 2.65), although no association was detected for episodes of wheezing bronchitis. All the current respiratory disorders were positively and consistently associated with frequency of lorry traYc, particularly the most severe bronchitic and wheezing symptoms: persistent phlegm for >2 months (1.68; 1.14 to 2.48), and severe wheeze limiting speech (1.86; 1.26 to 2.73). No or weaker associations with heavy vehicular traYc were detected in urban and rural areas and no increased risks were found in the whole sample with the reported traYc density in the zone of residence. After extensive evaluations, the potential of reporting bias seems unlikely. Conclusion—Exposure to exhausts from heavy vehicular traYc may have several adverse eVects on respiratory health of children living in metropolitan areas, increasing the occurrence of lower respiratory tract infections early in life and of wheezing and bronchitic symptoms at school age. (Occup Environ Med 1998;55:771‐778)
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