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Asthma in children exposed to nitrogen dioxide in ice arenas

¹ Institute of Environmental Medicine, and ² Sachs' Children's Hospital, Sodersjukhuset, Karolinska Institutet, and ³ Dept of Environmental Health, Stockholm County Council, Stockholm, Sweden

CORRESPONDENCE: P. Thunqvist, Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE - 171 77, Stockholm, Sweden. Fax: 46 8304571. E-mail: per.thunqvist@sachsska.sos.sll.se

Keywords: asthma, ice hockey, indoor ice arena, nitrogen dioxide, rhinitis

Received: August 12, 2001
Accepted December 25, 2001

This study was supported by grants from the Swedish Foundation of Strategic and Environmental Research (MISTRA) and the Asthma and Allergy Association of Sweden.

Very high concentrations of nitrogen dioxide (NO₂) have been measured in arenas using combustion engine-powered resurfacing machines. This study was performed to compare the occurrence of asthma in children playing ice hockey in arenas using propane-powered machines and in children attending arenas using electric machines.

Children regularly playing hockey in the arenas (nine propane, six electric) were sent a questionnaire, including questions on allergic disease and risk factors. Measurements of NO₂ were performed with passive diffusion samplers during 3 consecutive days.

The mean NO₂ concentration in the propane arenas was 276 µg·m^–3 (range 28–1015 µg·m^–3) and 11 µg·m^–3 (2–30) in the electric arenas. Questionnaires were answered by 1,536 children (78%), with an overall prevalence of asthma of 16%. The odds ratio (OR) for asthma was 0.9 (95% confidence interval (CI) 0.7–1.2) comparing propane arenas to electric. However, children in propane arenas with higher than median concentration of NO₂ reported more wheezing (OR 1.4, 95% CI 1.0–1.9) and nasal symptoms (OR 1.7, 95% CI 1.3–2.3) than children in propane arenas with lower concentrations.

In conclusion, children playing ice hockey in indoor arenas have a high prevalence of asthma, but it appears unlikely that increased exposure to combustion products, including nitrogen dioxide, is a major contributor to this excess risk.