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      Outdoor particulate matter and childhood asthma admissions in Athens, Greece: a time-series study

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          Abstract

          Background

          Particulate matter with diameter less than 10 micrometers (PM 10) that originates from anthropogenic activities and natural sources may settle in the bronchi and cause adverse effects possibly via oxidative stress in susceptible individuals, such as asthmatic children. This study aimed to investigate the effect of outdoor PM 10 concentrations on childhood asthma admissions (CAA) in Athens, Greece.

          Methods

          Daily counts of CAA from the three Children's Hospitals within the greater Athens' area were obtained from the hospital records during a four-year period (2001-2004, n = 3602 children). Mean daily PM 10 concentrations recorded by the air pollution-monitoring network of the greater Athens area were also collected. The relationship between CAA and PM 10 concentrations was investigated using the Generalized Linear Models with Poisson distribution and logistic analysis.

          Results

          There was a statistically significant (95% CL) relationship between CAA and mean daily PM 10 concentrations on the day of exposure (+3.8% for 10 μg/m 3 increase in PM 10 concentrations), while a 1-day lag (+3.4% for 10 μg/m 3 increase in PM 10 concentrations) and a 4-day lag (+4.3% for 10 μg/m 3 increase in PM 10 concentrations) were observed for older asthmatic children (5-14 year-old). High mean daily PM 10 concentration (the highest 10%; >65.69 μg/m 3) doubled the risk of asthma exacerbations even in younger asthmatic children (0-4 year-old).

          Conclusions

          Our results provide evidence of the adverse effect of PM 10 on the rates of paediatric asthma exacerbations and hospital admissions. A four-day lag effect between PM 10 peak exposure and asthma admissions was also observed in the older age group.

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          Redox activity of airborne particulate matter at different sites in the Los Angeles Basin.

          Ruth A. Schmitz, Mildred K. Cho, Constantinos Sioutas … (2005)
          Epidemiologic studies have shown associations between ambient particulate matter (PM) and adverse health outcomes including increased mortality, emergency room visits, and time lost from school and work. The mechanisms of PM-related health effects are still incompletely understood, but a hypothesis under investigation is that many of the adverse health effects may derive from oxidative stress, initiated by the formation of reactive oxygen species (ROS) within affected cells. While the adverse effects from PM have historically been associated with the airborne concentration of PM and more recently fine-particle PM, we considered it relevant to develop an assay to quantitatively measure the ability of PM to catalyze ROS generation as the initial step in the induction of oxidative stress. This ability of PM could then be related to different sources, chemical composition, and physical and spatial/temporal characteristics in the ambient environment. The measurement of ROS-forming ability in relation to sources and other factors will have potential relevance to control of redox-active PM. If oxidative stress represents a relevant mechanism of toxicity from PM, the measurement of redox activity represents a first step in the elucidation of the subsequent downstream processes. We have developed an assay for PM redox activity, utilizing the reduction of oxygen by dithiothreitol which serves as an electron source. We have found that PM will catalyze the reduction of oxygen and have examined the distribution and chemical characteristics of the redox activity of PM fractions collected in different sites in the Los Angeles Basin. Samples of concentrated coarse, fine, and ultrafine PM, obtained with aerosol concentrators, were studied with regard to their chemical properties and redox activity. Redox activity was highest in the ultrafine fraction, in agreement with results indicating ultrafines were the most potent toward inducing that heme oxygenase expression and depleting intracellular glutathione, which has relevance to induction of oxidative stress. Comparison of the redox activity with chemical composition showed a reasonable correlation of redox activity with elemental carbon (r(2)=0.79), organic carbon (r(2)=0.53), and with benzo[ghi]perylene (r(2)=0.82), consistent with species typically found in mobile emission sources.
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            The September epidemic of asthma exacerbations in children: A search for etiology

            Neil W Johnston, Sebastian L. Johnston, Joanne M Duncan … (2004)
            Background Predictable peaks of asthma exacerbation requiring hospital treatment, of greatest magnitude in children and of uncertain etiology, occur globally after school returns. Objective We wished to determine whether asthmatic children requiring emergency department treatment for exacerbations after school return in September were more likely to have respiratory viruses present and less likely to have prescriptions for control medications than children with equally severe asthma not requiring emergent treatment. Methods Rates of viral detection and characteristics of asthma management in 57 (of 60) children age 5 to 15 years presenting to emergency departments with asthma in 2 communities in Canada between September 10 and 30, 2001, (cases) were compared with those in 157 age-matched volunteer children with asthma of comparable severity studied simultaneously (controls). Results Human picornaviruses were detected in 52% of cases and 29% of controls (P = .002) and viruses of any type in 62% of cases and 41% of controls (P = .011). Cases were less likely to have been prescribed controller medication (inhaled corticosteroid, 49% vs 85%; P < .0001; leukotriene receptor antagonist, 9% vs 21%; P = .04). Conclusion Respiratory viruses were detected in the majority of children presenting to emergency departments with asthma during the September epidemic of the disease and in a significant minority of children with asthma in the community. The latter were more likely to have anti-inflammatory medication prescriptions than children requiring emergent treatment. Such medication may reduce the risk of emergency department treatment for asthma during the September epidemic.
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              Particulate air pollution and hospital emergency room visits for asthma in Seattle.

              J. Schwartz, D. SLATER, T Larson … (1993)
              Recent studies have associated short-term exposure to respirable particulate matter (PM10) exposure with peak flow decrements, increased symptoms of respiratory irritation, increased use of asthma medications, and increased hospitalization for asthma. Increased mortality from chronic respiratory disease has also been reported. To help confirm whether PM10 exposure is a risk factor for the exacerbation of asthma, we compiled daily records of asthma emergency room visits from eight hospitals in the Seattle area. In Poisson regressions controlling for weather, season, time trends, age, hospital, and day of the week, the daily counts of emergency room visits for persons under age 65 were significantly associated with PM10 exposure on the previous day. The mean of the previous 4 days' PM10 was a better predictor (p < 0.005). The relative risk for a 30 micrograms/m3 increase in PM10 was 1.12 (95% confidence interval 1.20 to 1.04). Daily PM10 concentrations never exceeded 70% of the current ambient air quality standards during the period. The consistency of investigations of the health effects of PM10 suggest that increased attention should be given to the control of particulate matter air pollution.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Environ Health
                Title: Environmental Health
                Publisher: BioMed Central
                ISSN (Electronic): 1476-069X
                Publication date Collection: 2010
                Publication date (Electronic): 28 July 2010
                Volume: 9
                Page: 45
                Affiliations
                [1 ]Laboratory of Climatology and Atmospheric Environment, Department of Geology and Geoenvironment, University of Athens, Panepistimioupolis, 157 84 Athens, Greece
                [2 ]General Department of Mathematics, Technological and Education Institute of Piraeus, 250 Thivon and P. Ralli Str., 122 44 Athens, Greece
                [3 ]Respiratory Unit, Department of Paediatrics, University Hospital of Patras, 265 04 Rion, Greece
                [4 ]First Department of Paediatrics, University of Athens, Aghia Sophia Children's Hospital, Thebon and Lebadias Street, Athens 11527, Greece
                [5 ]Allergy-Pneumonology Department, Penteli Children's Hospital, 152 36 P. Penteli, Greece
                Article
                Publisher ID: 1476-069X-9-45
                DOI: 10.1186/1476-069X-9-45
                PMC ID: 2920864
                PubMed ID: 20667130
                SO-VID: 96f73ec5-1485-472a-b879-b06e3e606ed6
                Copyright © Copyright ©2010 Nastos et al; licensee BioMed Central Ltd.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 13 April 2010
                Date accepted : 28 July 2010
                Categories
                Subject: Research

                ScienceOpen disciplines: Public health
                Data availability:
                ScienceOpen disciplines: Public health

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