Abstract
This cross-sectional epidemiological study collected health data for 2,470 school children between 5 and 14 years of age (89% of eligible children) who had lived most of their lives in either one of two counties strongly impacted by industrial pollution (Bitterfeld and Hettstedt) or in a neighboring county without any sources of industrial pollution (Zerbst). The objective of the study was to examine whether regional differences--with respect to the occurrence of childhood respiratory diseases and symptoms or allergies--exist and, if such differences are found, whether they persist when we adjust for the effects of known risk factors such as medical and sociodemographic factors or factors related to the indoor environment. Controlling for medical, sociodemographic, and indoor factors, according to parental reports, children residing in Hettstedt have about a 50% increased lifetime prevalence for physician-diagnosed allergies, eczema, and bronchitis compared to children from Zerbst and about twice the number of respiratory symptoms such as wheeze, shortness of breath, and cough without cold. Sensitization to common aeroallergens according to skin prick tests [odds ratio (OR) = 1.38; 95% confidence interval (CI), 1.02-1.86] and specific IgE levels (OR = 1.75; CI, 1.31-2.33) was more common for children from Hettstedt than children from the nonpolluted county. Bitterfeld children, on the other hand, more often received a diagnosis of asthma and eczema than children residing in Zerbst and also showed slightly increased sensitization rates. In conclusion, industrial pollution related to mining and smelting operations in the county of Hettstedt were associated with a higher lifetime prevalence of respiratory disorders and an increased rate of allergic sensitization in children between the ages of 5 and 14 years. Further studies are needed to determine what role the high dust content of heavy metals plays in Hettstedt.
Full text
PDF









Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Ackermann-Liebrich U., Leuenberger P., Schwartz J., Schindler C., Monn C., Bolognini G., Bongard J. P., Brändli O., Domenighetti G., Elsasser S. Lung function and long term exposure to air pollutants in Switzerland. Study on Air Pollution and Lung Diseases in Adults (SAPALDIA) Team. Am J Respir Crit Care Med. 1997 Jan;155(1):122–129. doi: 10.1164/ajrccm.155.1.9001300. [DOI] [PubMed] [Google Scholar]
- Asher M. I., Keil U., Anderson H. R., Beasley R., Crane J., Martinez F., Mitchell E. A., Pearce N., Sibbald B., Stewart A. W. International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods. Eur Respir J. 1995 Mar;8(3):483–491. doi: 10.1183/09031936.95.08030483. [DOI] [PubMed] [Google Scholar]
- Björnsson E., Plaschke P., Norrman E., Janson C., Lundbäck B., Rosenhall A., Lindholm N., Rosenhall L., Berglund E., Boman G. Symptoms related to asthma and chronic bronchitis in three areas of Sweden. Eur Respir J. 1994 Dec;7(12):2146–2153. doi: 10.1183/09031936.94.07122146. [DOI] [PubMed] [Google Scholar]
- Black P. N., Sharpe S. Dietary fat and asthma: is there a connection? Eur Respir J. 1997 Jan;10(1):6–12. doi: 10.1183/09031936.97.10010006. [DOI] [PubMed] [Google Scholar]
- Bodner C., Godden D., Seaton A. Family size, childhood infections and atopic diseases. The Aberdeen WHEASE Group. Thorax. 1998 Jan;53(1):28–32. doi: 10.1136/thx.53.1.28. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 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]
- Bråbäck L., Breborowicz A., Dreborg S., Knutsson A., Pieklik H., Björkstén B. Atopic sensitization and respiratory symptoms among Polish and Swedish school children. Clin Exp Allergy. 1994 Sep;24(9):826–835. doi: 10.1111/j.1365-2222.1994.tb01805.x. [DOI] [PubMed] [Google Scholar]
- Charpin D., Kleisbauer J. P., Lanteaume A., Vervloet D., Lagier F., Charpin J. Existe-t-il un facteur urbain dans l'asthme et l'allergie? Rev Mal Respir. 1988;5(2):109–114. [PubMed] [Google Scholar]
- Corbo G. M., Forastiere F., Dell'Orco V., Pistelli R., Agabiti N., De Stefanis B., Ciappi G., Perucci C. A. Effects of environment on atopic status and respiratory disorders in children. J Allergy Clin Immunol. 1993 Oct;92(4):616–623. doi: 10.1016/0091-6749(93)90086-u. [DOI] [PubMed] [Google Scholar]
- 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]
- Dockery D. W., Speizer F. E., Stram D. O., Ware J. H., Spengler J. D., Ferris B. G., Jr Effects of inhalable particles on respiratory health of children. Am Rev Respir Dis. 1989 Mar;139(3):587–594. doi: 10.1164/ajrccm/139.3.587. [DOI] [PubMed] [Google Scholar]
- Heinrich J., Nowak D., Wassmer G., Jörres R., Wjst M., Berger J., Magnussen H., Wichmann H. E. Age-dependent differences in the prevalence of allergic rhinitis and atopic sensitization between an eastern and a western German city. Allergy. 1998 Jan;53(1):89–93. doi: 10.1111/j.1398-9995.1998.tb03779.x. [DOI] [PubMed] [Google Scholar]
- Jedrychowski W., Flak E. Effects of air quality on chronic respiratory symptoms adjusted for allergy among preadolescent children. Eur Respir J. 1998 Jun;11(6):1312–1318. doi: 10.1183/09031936.98.11061312. [DOI] [PubMed] [Google Scholar]
- Jedrychowski W. Review of recent studies from central and Eastern Europe associating respiratory health effects with high levels of exposure to "traditional" air pollutants. Environ Health Perspect. 1995 Mar;103 (Suppl 2):15–21. doi: 10.1289/ehp.95103s215. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Luttmann H., Grömping U., Kreienbrock L., Treiber-Klötzer C., Wolf-Ostermann K., Wichmann H. E. Kohortenstudie zu Atemwegserkrankungen und Lungenfunktion bei Schulkindern in Südwestdeutschland. Teil 2: Regionale Einflüsse auf Atemwegserkrankungen in Mannheim und im Raum Freiburg. Zentralbl Hyg Umweltmed. 1994 Aug;196(2):114–138. [PubMed] [Google Scholar]
- Nowak D., Heinrich J., Jörres R., Wassmer G., Berger J., Beck E., Boczor S., Claussen M., Wichmann H. E., Magnussen H. Prevalence of respiratory symptoms, bronchial hyperresponsiveness and atopy among adults: west and east Germany. Eur Respir J. 1996 Dec;9(12):2541–2552. doi: 10.1183/09031936.96.09122541. [DOI] [PubMed] [Google Scholar]
- Pope C. A., 3rd, Bates D. V., Raizenne M. E. Health effects of particulate air pollution: time for reassessment? Environ Health Perspect. 1995 May;103(5):472–480. doi: 10.1289/ehp.95103472. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Schwartz J., Gold D., Dockery D. W., Weiss S. T., Speizer F. E. Predictors of asthma and persistent wheeze in a national sample of children in the United States. Association with social class, perinatal events, and race. Am Rev Respir Dis. 1990 Sep;142(3):555–562. doi: 10.1164/ajrccm/142.3.555. [DOI] [PubMed] [Google Scholar]
- Schwartz J. Lung function and chronic exposure to air pollution: a cross-sectional analysis of NHANES II. Environ Res. 1989 Dec;50(2):309–321. doi: 10.1016/s0013-9351(89)80012-x. [DOI] [PubMed] [Google Scholar]
- Schwartz J. Particulate air pollution and chronic respiratory disease. Environ Res. 1993 Jul;62(1):7–13. doi: 10.1006/enrs.1993.1083. [DOI] [PubMed] [Google Scholar]
- Sears M. R. Epidemiology of childhood asthma. Lancet. 1997 Oct 4;350(9083):1015–1020. doi: 10.1016/S0140-6736(97)01468-2. [DOI] [PubMed] [Google Scholar]
- Trepka M. J., Heinrich J., Krause C., Schulz C., Lippold U., Meyer E., Wichmann H. E. The internal burden of lead among children in a smelter town--a small area analysis. Environ Res. 1997 Feb;72(2):118–130. doi: 10.1006/enrs.1996.3720. [DOI] [PubMed] [Google Scholar]
- Trepka M. J., Heinrich J., Wichmann H. E. The epidemiology of atopic diseases in Germany: an east-west comparison. Rev Environ Health. 1996 Jul-Sep;11(3):119–131. doi: 10.1515/reveh.1996.11.3.119. [DOI] [PubMed] [Google Scholar]
- Weiland S. K., Mundt K. A., Rückmann A., Keil U. Self-reported wheezing and allergic rhinitis in children and traffic density on street of residence. Ann Epidemiol. 1994 May;4(3):243–247. doi: 10.1016/1047-2797(94)90103-1. [DOI] [PubMed] [Google Scholar]
- Wichmann H. E., Heinrich J. Health effects of high level exposure to traditional pollutants in East Germany--review and ongoing research. Environ Health Perspect. 1995 Mar;103 (Suppl 2):29–35. doi: 10.1289/ehp.95103s229. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wjst M., Popescu M., Trepka M. J., Heinrich J., Wichmann H. E. Pulmonary function in children with initial low birth weight. Pediatr Allergy Immunol. 1998 May;9(2):80–90. doi: 10.1111/j.1399-3038.1998.tb00308.x. [DOI] [PubMed] [Google Scholar]
- Wjst M., Reitmeir P., Dold S., Wulff A., Nicolai T., von Loeffelholz-Colberg E. F., von Mutius E. Road traffic and adverse effects on respiratory health in children. BMJ. 1993 Sep 4;307(6904):596–600. doi: 10.1136/bmj.307.6904.596. [DOI] [PMC free article] [PubMed] [Google Scholar]
- von Mutius E., Fritzsch C., Weiland S. K., Röll G., Magnussen H. Prevalence of asthma and allergic disorders among children in united Germany: a descriptive comparison. BMJ. 1992 Dec 5;305(6866):1395–1399. doi: 10.1136/bmj.305.6866.1395. [DOI] [PMC free article] [PubMed] [Google Scholar]
- von Mutius E., Martinez F. D., Fritzsch C., Nicolai T., Roell G., Thiemann H. H. Prevalence of asthma and atopy in two areas of West and East Germany. Am J Respir Crit Care Med. 1994 Feb;149(2 Pt 1):358–364. doi: 10.1164/ajrccm.149.2.8306030. [DOI] [PubMed] [Google Scholar]
- von Mutius E., Weiland S. K., Fritzsch C., Duhme H., Keil U. Increasing prevalence of hay fever and atopy among children in Leipzig, East Germany. Lancet. 1998 Mar 21;351(9106):862–866. doi: 10.1016/S0140-6736(97)10100-3. [DOI] [PubMed] [Google Scholar]
