Skip to main content
PMC home page
Environmental Health Perspectives logoLink to Environmental Health Perspectives
. 2002 Sep;110(9):961–967. doi: 10.1289/ehp.02110961

Children's respiratory morbidity prevalence in relation to air pollution in four Chinese cities.

Junfeng Jim Zhang 1, Wei Hu 1, Fusheng Wei 1, Guoping Wu 1, Leo R Korn 1, Robert S Chapman 1
PMCID: PMC1240998  PMID: 12204833

Abstract

We examined respiratory health effects of long-term exposure to ambient air pollution in 7,621 schoolchildren residing in eight districts of four Chinese cities. The four cities exhibited wide between-city and within-city gradients in ambient levels of four size fractions of particulate matter [less than or equal to 2.5 micro m in aerodynamic diameter (PM(2.5)), between 2.5 and 10 micro m (PM(10-2.5)), less than or equal to 10 micro m (PM(10)), and total suspended particulates (TSP)] and two gaseous pollutants (SO(2) and NO(x)). Informed consent and written responses to questionnaires about children's personal, residential, and family information, as well as their health histories and status, were obtained with the help of the parents and the school personnel. We used a two-stage regression approach in data analyses. In the first-stage logistic regressions, we obtained logits of district-specific prevalence of wheeze, asthma, bronchitis, hospitalization for respiratory diseases, persistent cough, and persistent phlegm, adjusted for covariates representing personal, household, and family parameters. Some of these covariates were found to be risk factors of children's respiratory health, including being younger in the study group, being male, having been breast-fed, sharing bedrooms, sharing beds, room being smoky during cooking, eye irritation during cooking, parental smoking, and a history of parental asthma. In several of the second-stage variance-weighted linear regressions, we examined associations between district-specific adjusted prevalence rates and district-specific ambient levels of each pollutant. We found positive associations between morbidity prevalence and outdoor levels of PM of all size fractions, but the association appeared to be stronger for coarse particles (PM(10-2.5)). The results also present some evidence that ambient levels of NO(x) and SO(2) were positively associated with children's respiratory symptoms, but the evidence for these two gaseous pollutants appeared to be weaker than that for the PM.

Full Text

The Full Text of this article is available as a PDF (515.5 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Braun-Fahrländer C., Vuille J. C., Sennhauser F. H., Neu U., Künzle T., Grize L., Gassner M., Minder C., Schindler C., Varonier H. S. Respiratory health and long-term exposure to air pollutants in Swiss schoolchildren. SCARPOL Team. Swiss Study on Childhood Allergy and Respiratory Symptoms with Respect to Air Pollution, Climate and Pollen. Am J Respir Crit Care Med. 1997 Mar;155(3):1042–1049. doi: 10.1164/ajrccm.155.3.9116984. [DOI] [PubMed] [Google Scholar]
  2. Cunningham J., O'Connor G. T., Dockery D. W., Speizer F. E. Environmental tobacco smoke, wheezing, and asthma in children in 24 communities. Am J Respir Crit Care Med. 1996 Jan;153(1):218–224. doi: 10.1164/ajrccm.153.1.8542119. [DOI] [PubMed] [Google Scholar]
  3. Dockery D. W., Cunningham J., Damokosh A. I., Neas L. M., Spengler J. D., Koutrakis P., Ware J. H., Raizenne M., Speizer F. E. Health effects of acid aerosols on North American children: respiratory symptoms. Environ Health Perspect. 1996 May;104(5):500–505. doi: 10.1289/ehp.96104500. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Ferris B. G. Epidemiology Standardization Project (American Thoracic Society). Am Rev Respir Dis. 1978 Dec;118(6 Pt 2):1–120. [PubMed] [Google Scholar]
  5. Gold D. R., Rotnitzky A., Damokosh A. I., Ware J. H., Speizer F. E., Ferris B. G., Jr, Dockery D. W. Race and gender differences in respiratory illness prevalence and their relationship to environmental exposures in children 7 to 14 years of age. Am Rev Respir Dis. 1993 Jul;148(1):10–18. doi: 10.1164/ajrccm/148.1.10. [DOI] [PubMed] [Google Scholar]
  6. Health effects of outdoor air pollution. Committee of the Environmental and Occupational Health Assembly of the American Thoracic Society. Am J Respir Crit Care Med. 1996 Jan;153(1):3–50. doi: 10.1164/ajrccm.153.1.8542133. [DOI] [PubMed] [Google Scholar]
  7. Health effects of outdoor air pollution. Part 2. Committee of the Environmental and Occupational Health Assembly of the American Thoracic Society. Am J Respir Crit Care Med. 1996 Feb;153(2):477–498. doi: 10.1164/ajrccm.153.2.8564086. [DOI] [PubMed] [Google Scholar]
  8. Neas L. M., Dockery D. W., Ware J. H., Spengler J. D., Ferris B. G., Jr, Speizer F. E. Concentration of indoor particulate matter as a determinant of respiratory health in children. Am J Epidemiol. 1994 Jun 1;139(11):1088–1099. doi: 10.1093/oxfordjournals.aje.a116952. [DOI] [PubMed] [Google Scholar]
  9. Ostro B. D., Hurley S., Lipsett M. J. Air pollution and daily mortality in the Coachella Valley, California: a study of PM10 dominated by coarse particles. Environ Res. 1999 Oct;81(3):231–238. doi: 10.1006/enrs.1999.3978. [DOI] [PubMed] [Google Scholar]
  10. Peters J. M., Avol E., Navidi W., London S. J., Gauderman W. J., Lurmann F., Linn W. S., Margolis H., Rappaport E., Gong H. A study of twelve Southern California communities with differing levels and types of air pollution. I. Prevalence of respiratory morbidity. Am J Respir Crit Care Med. 1999 Mar;159(3):760–767. doi: 10.1164/ajrccm.159.3.9804143. [DOI] [PubMed] [Google Scholar]
  11. Pikhart H., Bobak M., Kriz B., Danova J., Celko M. A., Prikazsky V., Pryl K., Briggs D., Elliott P. Outdoor air concentrations of nitrogen dioxide and sulfur dioxide and prevalence of wheezing in school children. Epidemiology. 2000 Mar;11(2):153–160. doi: 10.1097/00001648-200003000-00012. [DOI] [PubMed] [Google Scholar]
  12. Qian Z., Chapman R. S., Tian Q., Chen Y., Lioy P. J., Zhang J. Effects of air pollution on children's respiratory health in three Chinese cities. Arch Environ Health. 2000 Mar-Apr;55(2):126–133. doi: 10.1080/00039890009603399. [DOI] [PubMed] [Google Scholar]
  13. Qian Z., Zhang J., Wei F., Wilson W. E., Chapman R. S. Long-term ambient air pollution levels in four Chinese cities: inter-city and intra-city concentration gradients for epidemiological studies. J Expo Anal Environ Epidemiol. 2001 Sep-Oct;11(5):341–351. doi: 10.1038/sj.jea.7500170. [DOI] [PubMed] [Google Scholar]
  14. Shen S., Qin Y., Cao Z., Shang J., Liu Y., Yang X., Deng Y., Huang J., Fu Z., Song X. Indoor air pollution and pulmonary function in children. Biomed Environ Sci. 1992 Jun;5(2):136–141. [PubMed] [Google Scholar]
  15. Ware J. H., Dockery D. W., Spiro A., 3rd, Speizer F. E., Ferris B. G., Jr Passive smoking, gas cooking, and respiratory health of children living in six cities. Am Rev Respir Dis. 1984 Mar;129(3):366–374. doi: 10.1164/arrd.1984.129.3.366. [DOI] [PubMed] [Google Scholar]
  16. Zhang J., Qian Z., Kong L., Zhou L., Yan L., Chapman R. S. Effects of air pollution on respiratory health of adults in three Chinese cities. Arch Environ Health. 1999 Nov-Dec;54(6):373–381. doi: 10.1080/00039899909603368. [DOI] [PubMed] [Google Scholar]

Articles from Environmental Health Perspectives are provided here courtesy of National Institute of Environmental Health Sciences

RESOURCES