Medicina e società
Inquinamento extradomiciliare e malattie respiratorie del bambino
AIR POLLUTION AND LUNG DISEASES
AUGUSTA BATTISTINI1, ROBERTA MARVASI2
1Libero docente, Clinica Pediatrica, Università di Parma
2Tecnico, Università di Parma
Aprile 2005 - pagg. 240 -245
Abstract
The two most important air pollutants are: particulate mater with a diameter less than 10 μm
or PM10 and ozone (O3), the first prevailing from October to April the second during summer.
Epidemiological studies suggest that every 10 μm/m3 increase in PM10 is associated with
approximately a 3% increase in respiratory mortality and a 2-3% increase in admissions and
care visits for respiratory disease. The values registered in Parma in January and February
2005 suggest that PM10 frequently (1-2 days over 3) was responsible of a 10% increase of
cough, bronchitis, pneumonia and asthma episodes in children. Each 50 μg/m3 increase in
O3 is associated with a 50% increase in allergic rhinitis, cough and hospital admissions for
respiratory disease. The concentration reached in Parma in July and August 2004 suggests
that O3 frequently causes such an increase in respiratory problems. Long term O3 and PM10
exposure can induce new cases of asthma and adversely affects lung development leading
to a reduced lung volume as children reach adulthood. The paediatrician informed about the
relationship between local air quality and respiratory disease can provide a starting point for
discussion and education.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Bibliografia
tement:
Ambient air pollution: health hazards
to children. Pediatrics 2004;114:1699-707.
2. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. National Heart, Lung and Blood Institute, Bethesda, Maryland, USA 2002.
3. Battistini A, Sansebastiano G, Zoni R, Pessina V, De’ Munari E. Asma e inquinamento intradomiciliare da processi di combustione (riscaldamento e gas per cucinare). Riv Ital Pediatr 2000;26:302-13.
4. Pope C A, Burnett R T, Thun M J, et al. Lung cancer, cardiopulmonary mortality and longterm exposure to fine particulate air pollution. JAMA 2002;287:1132-41.
5. Pope CA III, Dockery DW. Epidemiology of particle effects. In: Air Pollution and Health, San Diego, Ed. Holgate ST. 1999:673-705.
6. Dietert RR, Etzel RA, Chen D, et al. Workshop to identify critical windows of exposure for children’s health: immune and respiratory systems work group summary. Environ Health Perspect 2000;108(suppl. 3):483-90.
7. Plopper CG, Fanucchi MV. Do urban environmental pollutants esacerbate childhood lung diseases? Environ Health Perspect 2000; 108:A252-3.
8. Gauderman WJ, Avol E, Gilliland F, Vora H, et al. The effect of air pollution on lung development from 10 to 18 years of age. N Engl J Med 2004;351:1057-67.
9. Thurston GD, Ito K. Epidemiological studies of ozone exposure effects. In: Air Pollution and Health, San Diego Ed. Holgate ST 1999:485-510.
10. Wong GWK, Leung TF. The effects of air pollution on asthma in children. Clin Pulm Med 2005;12:1-6.
11. Brauer M, Hoek G, Van Vliet P, et al. Air pollution from traffic and the development of respiratory infections and asthmatic and allergic symptoms in children. Am J Respir Crit Care Med 2002;166:1092-8.
12. Gehring U, Cyrys J, Sedlmeir G, et al. Traffic- related air pollution and respiratory health during the first 2 yrs of life. Eur Respir J 2002;19:690-8.
13. Martinez FD. What have we learned from the Tucson children’s respiratory studies? Paediatr Respir Rev 2002;3:193-7.
14. Shima M, Adachi M. Effect of outdoor and indoor nitrogen dioxide on respiratory symptoms in school children. Int J Epidemiol 2000;29:862-70.
15. McConnell R, Berhane K, Gilliland F, et al. Asthma in exercising children exposed to ozone: a cohort study. Lancet 2002;359:386-91.
16. Weiler JM, Layton T, Hunt M. Asthma in United States Olympic athletes who participated in the 1996 summer games. J Allergy Clin Immunol 1998;102:722-6.
17. Friedman MS, Powell KE, Hutwagner L, Graham LM, Teague WG. Impact of changes in transportation and commuting behaviours during the 1996 summer Olympic games in Atlanta on air quality and childhood asthma. JAMA 2001;285:897-905.
18. Kim JJ, Smorodinsky S, Lipsett M, Singer BC, Hodgson AT, Ostro B. Traffic-related air pollution near Busy roads. The east bay children’s respiratory health study. Am J Respir Crit Care Med 2004;170:520-6.
19. Janssen NA, Brunekreef B, van Vliet P, Aarts F, Meliefste K, Harssema H, Fischer P. The relationship between air pollution from heavy traffic and allergic sensitisation, bronchial hyperresponsiveness, and respiratory symptoms in Dutch schoolchildren. Environ Health Perspect 2003;111:1512-8.
20. Pope CA III. Air pollution and health - Good news and bad. N Engl J Med 2004;351: 1132-4.
21. Romieu I, Sienra-Monge JJ, Ramirez-Anguilar M, et al. Antioxidant supplementation and lung functions among children with asthma exposed to high levels of air pollutants. Am J Respir Crit Care Med 2002;166:703-9.
22. Cazzola M, Vignola AM, D’Amato G, Bousquet J. Air pollution and inflammatory airway disease: therapeutic options. European Respiratory Monograph, Ed. G. D’Amato e S.T. Holgate, 2002;7:262-82.
2. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. National Heart, Lung and Blood Institute, Bethesda, Maryland, USA 2002.
3. Battistini A, Sansebastiano G, Zoni R, Pessina V, De’ Munari E. Asma e inquinamento intradomiciliare da processi di combustione (riscaldamento e gas per cucinare). Riv Ital Pediatr 2000;26:302-13.
4. Pope C A, Burnett R T, Thun M J, et al. Lung cancer, cardiopulmonary mortality and longterm exposure to fine particulate air pollution. JAMA 2002;287:1132-41.
5. Pope CA III, Dockery DW. Epidemiology of particle effects. In: Air Pollution and Health, San Diego, Ed. Holgate ST. 1999:673-705.
6. Dietert RR, Etzel RA, Chen D, et al. Workshop to identify critical windows of exposure for children’s health: immune and respiratory systems work group summary. Environ Health Perspect 2000;108(suppl. 3):483-90.
7. Plopper CG, Fanucchi MV. Do urban environmental pollutants esacerbate childhood lung diseases? Environ Health Perspect 2000; 108:A252-3.
8. Gauderman WJ, Avol E, Gilliland F, Vora H, et al. The effect of air pollution on lung development from 10 to 18 years of age. N Engl J Med 2004;351:1057-67.
9. Thurston GD, Ito K. Epidemiological studies of ozone exposure effects. In: Air Pollution and Health, San Diego Ed. Holgate ST 1999:485-510.
10. Wong GWK, Leung TF. The effects of air pollution on asthma in children. Clin Pulm Med 2005;12:1-6.
11. Brauer M, Hoek G, Van Vliet P, et al. Air pollution from traffic and the development of respiratory infections and asthmatic and allergic symptoms in children. Am J Respir Crit Care Med 2002;166:1092-8.
12. Gehring U, Cyrys J, Sedlmeir G, et al. Traffic- related air pollution and respiratory health during the first 2 yrs of life. Eur Respir J 2002;19:690-8.
13. Martinez FD. What have we learned from the Tucson children’s respiratory studies? Paediatr Respir Rev 2002;3:193-7.
14. Shima M, Adachi M. Effect of outdoor and indoor nitrogen dioxide on respiratory symptoms in school children. Int J Epidemiol 2000;29:862-70.
15. McConnell R, Berhane K, Gilliland F, et al. Asthma in exercising children exposed to ozone: a cohort study. Lancet 2002;359:386-91.
16. Weiler JM, Layton T, Hunt M. Asthma in United States Olympic athletes who participated in the 1996 summer games. J Allergy Clin Immunol 1998;102:722-6.
17. Friedman MS, Powell KE, Hutwagner L, Graham LM, Teague WG. Impact of changes in transportation and commuting behaviours during the 1996 summer Olympic games in Atlanta on air quality and childhood asthma. JAMA 2001;285:897-905.
18. Kim JJ, Smorodinsky S, Lipsett M, Singer BC, Hodgson AT, Ostro B. Traffic-related air pollution near Busy roads. The east bay children’s respiratory health study. Am J Respir Crit Care Med 2004;170:520-6.
19. Janssen NA, Brunekreef B, van Vliet P, Aarts F, Meliefste K, Harssema H, Fischer P. The relationship between air pollution from heavy traffic and allergic sensitisation, bronchial hyperresponsiveness, and respiratory symptoms in Dutch schoolchildren. Environ Health Perspect 2003;111:1512-8.
20. Pope CA III. Air pollution and health - Good news and bad. N Engl J Med 2004;351: 1132-4.
21. Romieu I, Sienra-Monge JJ, Ramirez-Anguilar M, et al. Antioxidant supplementation and lung functions among children with asthma exposed to high levels of air pollutants. Am J Respir Crit Care Med 2002;166:703-9.
22. Cazzola M, Vignola AM, D’Amato G, Bousquet J. Air pollution and inflammatory airway disease: therapeutic options. European Respiratory Monograph, Ed. G. D’Amato e S.T. Holgate, 2002;7:262-82.