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Low levels of air pollution induce changes of lung function in a panel of schoolchildren

¹ Institute of Environmental Health, Medical University of Vienna, and ² Austrian Academy of Sciences, Clean Air Commission, Vienna, Austria.

CORRESPONDENCE: M. Neuberger, Institute of Environmental Health, Kinderspitalgasse 15, A-1095 Vienna, Austria. Fax: 43 1427764799. E-mail: Manfred.neuberger{at}meduniwien.ac.at

Keywords: Lung function, nitrogen dioxide, particulate matter, resistance, schoolchildren

Received: August 2, 2005
Accepted January 22, 2006

In search of sensitive screening parameters for assessing acute effects of ambient air pollutants in young schoolchildren, the impact of 8-h average air pollution before lung function testing was investigated by oscillatory measurements of resistance and spirometry with flow–volume loops.

At a central elementary school in Linz, the capital of Upper Austria, 163 children aged 7–10 yrs underwent repeated examinations at the same time of day during 1 school year, yielding a total of 11–12 lung function tests per child. Associations to mass concentrations of particulate matter and nitrogen dioxide (NO₂) measured continuously at a nearby monitoring station were tested, applying the Generalised Estimating Equations model.

Reductions per 10 µg·m^–3 (both for particles and for NO₂) were in the magnitude of 1% for most lung function parameters. The most sensitive indicator for acute effects of combustion-related pollutants was a change in maximal expiratory flow in small airways. NO₂ at concentrations below current standards reduced (in the multipollutant model) the forced expiratory volume in one second by 1.01%, maximal instantaneous forced flow when 50% of the forced vital capacity remains to be exhaled (MEF_50%) by 1.99% and MEF_25% by 1.96%. Peripheral resistance increased by 1.03% per 10 µg·m^–3 of particulate matter with a 50% cut-off aerodynamic diameter of 2.5 µm (PM_2.5). Resistance is less influenced by the child's cooperation and should be utilised more often in environmental epidemiology when screening for early signs of small airway dysfunction from urban air pollution, but cannot replace the measurement of MEF_50% and MEF_25%. In the basic model, the reduction of these parameters per 10 µg·m^–3 was highest for NO₂, followed by PM₁, PM_2.5 and PM₁₀, while exposure to coarse dust (PM₁₀–PM_2.5) did not change end-expiratory flow significantly.

All acute effects of urban air pollution found on the lung function of healthy pupils were evident at levels below current European limit values for nitrogen dioxide. Thus, planned reduction of nitrogen dioxide emission (Euro 5; vehicles that comply with the emission limits as defined in Directive 99/96/EC) of 20% in 2010 would seem to be insufficient.

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