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Eur Respir J 2002; 20:691-702
Copyright ©ERS Journals Ltd 2002


Increased asthma medication use in association with ambient fine and ultrafine particles

S. von Klot1, G. Wölke1, T. Tuch2, J. Heinrich1, D.W. Dockery3, J. Schwartz3, W.G. Kreyling4, H.E. Wichmann1,2 and A. Peters1,2

1 GSF - National Research Center for Environment and Health, Institute of Epidemiology, Neuherberg, Germany, 2 Ludwig-Maximilians-University of Munich, Chair of Epidemiology, Institute of Medical Informatics, Biometry and Epidemiology, Munich, Germany, 3 Harvard School of Public Health, Dept of Environmental Health, Boston, MA, USA, 4 GSF - National Research Center for Environment and Health, Institute of Inhalation Biology, Neuherberg, Germany

CORRESPONDENCE: S. von Klot, GSF - Institute of Epidemiology, P.O. Box 1129, D-85758, Neuherberg, Germany. Fax: 49 8931873380. E-mail: klot@gsf.de

Keywords: asthma symptoms, inhaled ß2-agonists, inhaled corticosteroids, particulate air pollution, wheezing

Received: August 21, 2001
Accepted April 2, 2002

This study was funded by: GSF funding, HEI funding Contract 95/10, and EU funding ENV4-CT960205.

The association between particulate air pollution and asthma medication use and symptoms was assessed in a panel study of 53 adult asthmatics in Erfurt, Germany in winter 1996/1997.

Number concentrations of ultrafine particles, 0.01–0.1 µm in diameter (NC0.01–0.1), mean 17,300·cm–3, and mass concentrations of fine particles 0.01–2.5 µm in diameter (MC0.01–2.5), mean 30.3 µg·m–3, were measured concurrently. They were not highly correlated (r=0.45). The associations between ambient particle concentrations and the prevalence of inhaled ß2-agonist, corticosteroid use and asthma symptoms, were analysed separately with logistic regression models, adjusting for trend, temperature, weekend, holidays, and first order autocorrelation of the error.

Cumulative exposures over 14 days of ultrafine and fine particles were associated with corticosteroid use. ß2-agonist use was associated with 5-day mean NC0.01–0.1 and MC0.01–2.5. The prevalence of asthma symptoms was associated with ambient particle concentrations. The results suggest that reported asthma medication use and symptoms increase in association with particulate air pollution and gaseous pollutants such as nitrogen dioxide.




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