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Original Research: AIR POLLUTION |

Air Pollution and Prevalence of Bronchitic Symptoms Among Children in Taiwan

Bing-Fang Hwang, PhD; Yungling Leo Lee, MD, PhD
Author and Funding Information

From the Department of Occupational Safety and Health (Dr Hwang), College of Public Health, China Medical University, Taichung; and the Institute of Preventive Medicine and Research Center for Genes (Dr Lee), Environment and Human Health, College of Public Health, National Taiwan University, Taipei, Taiwan.

Correspondence to: Yungling Leo Lee, MD, PhD, Institute of Preventive Medicine, College of Public Health, National Taiwan University, No.17 Xu-Zhou Rd, 516R, Taipei 100, Taiwan; e-mail: leolee@ntu.edu.tw


Funding/Support: This study was supported by the National Science Council in Taiwan [Grants NSC 96-2314-B-039-019, 96-2314-B-006-053] and China Medical University [CMU 96-191].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;138(4):956-964. doi:10.1378/chest.09-2600
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Background:  There were limited studies concerning ambient air pollution exposure on development of bronchitic symptoms among children. These studies provided suggestive but inconclusive results. Therefore, the objective of this study is to assess the association between air pollutants and the prevalence of bronchitic symptoms in the Taiwan Children Health Study.

Methods:  We conducted a nationwide cross-sectional study of 5,049 Taiwanese children in 2007. Routine air pollution monitoring data were used for sulfur dioxide (SO2), nitrogen dioxides (NO2), ozone (O3), carbon monoxide (CO), and particles with an aerodynamic diameter ≤ 2.5 μm (PM2.5). The exposure parameters were calculated using the between-community 3-year average concentration. The effect estimates were presented as odds ratios (ORs) per interquartile changes for SO2, NO2, O3, CO, and PM2.5.

Results:  In the two-stage hierarchical model adjusting for confounding, the prevalence of bronchitic symptoms with asthma was positively associated with the between-community 3-year average concentrations of NO2 (adjusted OR, 1.81 per 8.79 ppb; 95% CI, 1.14-2.86), and CO (OR, 1.31 per 105 ppb; 95% CI, 1.04-1.64). The prevalence of phlegm with no asthma was related to O3 (OR, 1.32 per 8.77 ppb; 95% CI, 1.06-1.63).

Conclusions:  The results suggest that long-term exposure to outdoor air pollutants, such as NO2, CO, and O3, may increase the prevalence of bronchitic symptoms among children.

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