American Journal of Epidemiology Vol. 134, No. 2: 204-219
Copyright © 1991 by The Johns Hopkins University School of Hygiene and Public Health
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Association of Indoor Nitrogen Dioxide with Respiratory Symptoms and Pulmonary Function in Children
1Department of Epidemiology, Harvard School of Public Health Boston, MA
2Department of Environmental Health, Harvard School of Public Health Boston, MA
3Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School Boston, MA
4Department of Biostatistics, Harvard School of Public Health Boston, MA
Reprint requests to Dr. Douglas W. Dockery, Department of Environmental Health, Harth School of Public Health, 655 Huntington Ave., Boston, MA 02115.
The effect of indoor nitrogen dioxide on the cumulative incidence of respiratory symptoms and pulmonary function level was studied in a cohort of 1,567 white children aged 7–11 years examined in six US cities from 1983 through 1988. Week-long measurements of nitrogen dioxide were obtained at three indoor locations over 2 consecutive weeks in both the winter and the summer months. The household annual average nitrogen dioxide concentration was modeled as a continuous variable and as four ordered categories. Multiple logistic regression analysis of symptom reports from a questionnaire administered after indoor monitoring showed that a 15-ppb increase in the household annual nitrogen dioxide mean was associated with an increased cumulative incidence of lower respiratory symptoms (odds ratio (OR) = 1.4, 95% confidence interval (95% Cl) 1.1–1.7). The response variable indicated the report of one or more of the following symptoms: attacks of shortness of breath with wheeze, chronic wheeze, chronic cough, chronic phlegm, or bronchitis. Girls showed a stronger association (OR = 1.7, 95% Cl 1.3–2.2) than did boys (OR = 1.2, 95% Cl 0.9–1.5). An analysis of pulmonary function measurements showed no consistent effect of nitrogen dioxide. These results are consistent with earlier reports based on categorical indicators of household nitrogen dioxide sources and provide a more specific association with nitrogen dioxide as measured in children's homes. Am J Epidemiol 1991; 134: 204–19.
air pollutants; child; household articles; lung; nitrogen dioxide; respiratory function tests; respiratory tract diseases
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