Academic journal article Environmental Health Perspectives

Association of Lung Function with Declining Ambient Air Pollution. (Children's Health)

Academic journal article Environmental Health Perspectives

Association of Lung Function with Declining Ambient Air Pollution. (Children's Health)

Article excerpt

Recent studies have found a declining prevalence of respiratory infections in East German children, along with a tremendous improvement of air pollution since 1990. The present study evaluates the effects of improved air quality on lung function. Three consecutive cross-sectional surveys of schoolchildren ages 11-14 years from three communities in East Germany were performed in 1992-1993, 1995-1996, and 1998-1999. Lung function tests were available from 2,493 children. The annual mean of total suspended particulates (TSP) declined from 79 to 25 [micro]g/[m.sup.3], whereas levels for sulfur dioxide declined from 113 to 6 [micro]g/[m.sup.3]. Mean forced vital capacity (FVC) and forced expiratory volume in 1 sec (FE[V.sub.1]) of the children increased from 1992-1993 to 1998-1999. The adjusted percent change of the geometric mean of FVC was 4.7% for a 50 [micro]g/[m.sup.3] decrease of TSP (p = 0.043) and 4.9% for a decrement of 100 [micro]g/[m.sup.3] S[O.sub.2] (p = 0.029). Effects on FE[V.sub.1] were smaller and not statistically significant. Our study indicates that a reduction of air pollution in a short time period may improve children's lung function. Key words: air pollution, children, East Germany, pulmonary function, repeated cross-sectional study. Environ Health Perspect 111:383-387 (2003). doi:10.1289/ehp.5355 available via [Online 25 October 2002]


Several regional cross-sectional studies in the United States and Europe have shown consistently higher rates of bronchitis and bronchitic symptoms among children with higher exposure to total suspended particulates (TSP) than in children living in less polluted areas (Avol et al. 2001; Dockery et al. 1989; Gauderman et al. 2000; Heinrich et al. 2000, 2002; Peters et al. 1999). Recently published reviews of health effects of air pollution (Committee of the Environmental and Occupational Health Assembly 1996a, 1996b; Pope and Dockery 1999) reported chronic adverse health effects even at relatively low levels of ambient particulates in urban areas.

Studies addressing the effects of higher exposure to TSP and their effect on children's lung function are more inconsistent (Dockery et al. 1989; James et al. 2000; Peters et al. 1999; Schwartz 1989; Stern et al. 1994). A Canadian cross-sectional study in the 1980s found statistically significant (p < 0.01) mean decrements in forced vital capacity (FVC) and forced expiratory volume in 1 sec (FE[V.sub.1]) in school children from moderately elevated exposures of sulfate and ozone (Stern et al. 1994). Dockery et al. (1989) saw no indication of chronic effects of air pollution on any lung function measure in more than 5,000 children participating in the Six Cities Study of Air Pollution and Health, whereas the analyses of data from the Second National Health and Nutrition Examination Survey (NHANES II) of children and youths ages 6-24 revealed significant negative correlations of FVC and FE[V.sub.1] with annual concentrations of TSP, nitrogen dioxide, and ozone (Schwartz 1989). A recent study conducted in southern California reported a significant relationship between air pollution level and lung function parameters (James et al. 2000; Peters et al. 1999). Particulate matter < 10 tam in diameter (P[M.sub.10]) and N[O.sub.2] were significantly associated with decreases in FVC and FE[V.sub.1].

Since German reunification in 1990, ambient sulfur dioxide (S[O.sub.2]) and TSP in East Germany have declined tremendously. We speculated that this reduction of air pollution might lead to an improvement of children's lung function. We therefore examined the association between declining air pollution (TSP, S[O.sub.2]) and lung function parameters (FVC, FE[V.sub.1]) by repeated examinations of children living in East Germany.


Design and study area. Three consecutive regional cross-sectional surveys were performed 1992-1993, 1995-1996, and 1998-1999. …

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