A Cohort Study of Indoor Nitrogen Dioxide and House Dust Mite Exposure in Asthmatic Children

Objective: The purpose of this study was to investigate dose–response relationships between asthma symptoms and indoor nitrogen dioxide (NO₂) and house dust mite allergen (HDM) in children. Methods: Asthmatic children from 18 primary schools in Adelaide, Australia, kept a daily symptoms diary over 1...

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Veröffentlicht in:Journal of occupational and environmental medicine 2006-05, Vol.48 (5), p.462-469
Hauptverfasser: Nitschke, Monika, Pilotto, Louis S., Attewell, Robyn G., Smith, Brian J., Pisaniello, Dino, Martin, James, Ruffin, Richard E., Hiller, Janet E.
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container_end_page 469
container_issue 5
container_start_page 462
container_title Journal of occupational and environmental medicine
container_volume 48
creator Nitschke, Monika
Pilotto, Louis S.
Attewell, Robyn G.
Smith, Brian J.
Pisaniello, Dino
Martin, James
Ruffin, Richard E.
Hiller, Janet E.
description Objective: The purpose of this study was to investigate dose–response relationships between asthma symptoms and indoor nitrogen dioxide (NO₂) and house dust mite allergen (HDM) in children. Methods: Asthmatic children from 18 primary schools in Adelaide, Australia, kept a daily symptoms diary over 12 weeks. Home and classroom NO₂ levels were measured repeatedly in winter 2000. HDM levels were obtained from beds. Lung function tests were performed at the beginning and at the end of the study period. Results: Data on exposure and respiratory outcomes were gathered for 174 children. For school exposure, the estimated relative symptom rate (RR) for a 10-ppb increase in NO₂ for difficulty breathing during the day was 1.09 (95% confidence interval [CI] = 1.03-1.15), at night 1.11 (95% CI = 1.05-1.18), and for chest tightness at night 1.12 (95% CI = 1.07-1.17). Significant symptom rate increases were also found for kitchen NO₂ exposure. This was supported by a negative dose–response relationship between percentage predicted forced expiratory volume in 1 second and NO₂ (-0.39%; 95% CI = -0.76 to -0.02) for kitchen exposure. Significant threshold effects using a 10-μg/g cutoff point for HDM exposure were established in the sensitized children for nighttime wheeze (RR = 3.62, 95% CI = 1.49-8.77), daytime cough (RR = 1.64, 95% CI = 1.14-2.36), and daytime asthma attack (RR = 1.95, 95% CI = 1.06-3.60). Conclusion: This study has established reliable risk estimates for exacerbations of asthma symptoms in children based on dose-response investigations of indoor NO₂ and HDM.
doi_str_mv 10.1097/01.jom.0000215802.43229.62
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Significant threshold effects using a 10-μg/g cutoff point for HDM exposure were established in the sensitized children for nighttime wheeze (RR = 3.62, 95% CI = 1.49-8.77), daytime cough (RR = 1.64, 95% CI = 1.14-2.36), and daytime asthma attack (RR = 1.95, 95% CI = 1.06-3.60). Conclusion: This study has established reliable risk estimates for exacerbations of asthma symptoms in children based on dose-response investigations of indoor NO₂ and HDM.</description><identifier>ISSN: 1076-2752</identifier><identifier>EISSN: 1536-5948</identifier><identifier>DOI: 10.1097/01.jom.0000215802.43229.62</identifier><identifier>PMID: 16688002</identifier><identifier>CODEN: JOEMFM</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams &amp; Wilkins</publisher><subject>Adolescent ; Air ; Air Pollution, Indoor - analysis ; Arthropods ; Asthma ; Asthma - physiopathology ; Australia ; Biological and medical sciences ; Chemical and industrial products toxicology. 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Methods: Asthmatic children from 18 primary schools in Adelaide, Australia, kept a daily symptoms diary over 12 weeks. Home and classroom NO₂ levels were measured repeatedly in winter 2000. HDM levels were obtained from beds. Lung function tests were performed at the beginning and at the end of the study period. Results: Data on exposure and respiratory outcomes were gathered for 174 children. For school exposure, the estimated relative symptom rate (RR) for a 10-ppb increase in NO₂ for difficulty breathing during the day was 1.09 (95% confidence interval [CI] = 1.03-1.15), at night 1.11 (95% CI = 1.05-1.18), and for chest tightness at night 1.12 (95% CI = 1.07-1.17). Significant symptom rate increases were also found for kitchen NO₂ exposure. This was supported by a negative dose–response relationship between percentage predicted forced expiratory volume in 1 second and NO₂ (-0.39%; 95% CI = -0.76 to -0.02) for kitchen exposure. 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Toxic occupational diseases</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children &amp; youth</topic><topic>Chronic obstructive pulmonary disease, asthma</topic><topic>Cohort Studies</topic><topic>Dermatophagoides pteronyssinus</topic><topic>Dust</topic><topic>Environmental pollutants toxicology</topic><topic>Female</topic><topic>Gas, fumes</topic><topic>Human exposure</topic><topic>Humans</topic><topic>Indoor air quality</topic><topic>Inhalation Exposure - analysis</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Nitrogen dioxide</topic><topic>Nitrogen Dioxide - isolation &amp; purification</topic><topic>ORIGINAL ARTICLES</topic><topic>Pneumology</topic><topic>Pyroglyphidae - pathogenicity</topic><topic>Schools</topic><topic>Toxicology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nitschke, Monika</creatorcontrib><creatorcontrib>Pilotto, Louis S.</creatorcontrib><creatorcontrib>Attewell, Robyn G.</creatorcontrib><creatorcontrib>Smith, Brian J.</creatorcontrib><creatorcontrib>Pisaniello, Dino</creatorcontrib><creatorcontrib>Martin, James</creatorcontrib><creatorcontrib>Ruffin, Richard E.</creatorcontrib><creatorcontrib>Hiller, Janet E.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Pollution Abstracts</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><jtitle>Journal of occupational and environmental medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nitschke, Monika</au><au>Pilotto, Louis S.</au><au>Attewell, Robyn G.</au><au>Smith, Brian J.</au><au>Pisaniello, Dino</au><au>Martin, James</au><au>Ruffin, Richard E.</au><au>Hiller, Janet E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Cohort Study of Indoor Nitrogen Dioxide and House Dust Mite Exposure in Asthmatic Children</atitle><jtitle>Journal of occupational and environmental medicine</jtitle><addtitle>J Occup Environ Med</addtitle><date>2006-05</date><risdate>2006</risdate><volume>48</volume><issue>5</issue><spage>462</spage><epage>469</epage><pages>462-469</pages><issn>1076-2752</issn><eissn>1536-5948</eissn><coden>JOEMFM</coden><abstract>Objective: The purpose of this study was to investigate dose–response relationships between asthma symptoms and indoor nitrogen dioxide (NO₂) and house dust mite allergen (HDM) in children. Methods: Asthmatic children from 18 primary schools in Adelaide, Australia, kept a daily symptoms diary over 12 weeks. Home and classroom NO₂ levels were measured repeatedly in winter 2000. HDM levels were obtained from beds. Lung function tests were performed at the beginning and at the end of the study period. Results: Data on exposure and respiratory outcomes were gathered for 174 children. For school exposure, the estimated relative symptom rate (RR) for a 10-ppb increase in NO₂ for difficulty breathing during the day was 1.09 (95% confidence interval [CI] = 1.03-1.15), at night 1.11 (95% CI = 1.05-1.18), and for chest tightness at night 1.12 (95% CI = 1.07-1.17). Significant symptom rate increases were also found for kitchen NO₂ exposure. This was supported by a negative dose–response relationship between percentage predicted forced expiratory volume in 1 second and NO₂ (-0.39%; 95% CI = -0.76 to -0.02) for kitchen exposure. Significant threshold effects using a 10-μg/g cutoff point for HDM exposure were established in the sensitized children for nighttime wheeze (RR = 3.62, 95% CI = 1.49-8.77), daytime cough (RR = 1.64, 95% CI = 1.14-2.36), and daytime asthma attack (RR = 1.95, 95% CI = 1.06-3.60). Conclusion: This study has established reliable risk estimates for exacerbations of asthma symptoms in children based on dose-response investigations of indoor NO₂ and HDM.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams &amp; Wilkins</pub><pmid>16688002</pmid><doi>10.1097/01.jom.0000215802.43229.62</doi><tpages>8</tpages></addata></record>
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source MEDLINE; Journals@Ovid Complete; JSTOR Archive Collection A-Z Listing
subjects Adolescent
Air
Air Pollution, Indoor - analysis
Arthropods
Asthma
Asthma - physiopathology
Australia
Biological and medical sciences
Chemical and industrial products toxicology. Toxic occupational diseases
Child
Child, Preschool
Children & youth
Chronic obstructive pulmonary disease, asthma
Cohort Studies
Dermatophagoides pteronyssinus
Dust
Environmental pollutants toxicology
Female
Gas, fumes
Human exposure
Humans
Indoor air quality
Inhalation Exposure - analysis
Male
Medical sciences
Nitrogen dioxide
Nitrogen Dioxide - isolation & purification
ORIGINAL ARTICLES
Pneumology
Pyroglyphidae - pathogenicity
Schools
Toxicology
title A Cohort Study of Indoor Nitrogen Dioxide and House Dust Mite Exposure in Asthmatic Children
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