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The pollution effects on asthmatic children in Europe (PEACE) study is a study of the acute health effects of short-term changes in ambient air pollution on children with chronic respiratory symptoms. The study was conducted in the winter of 1993-1994 following a standardised protocol by 14 research centres in Europe. Two panels of at least 75 children each were followed during at least two months. Children of primary school age, 6-12 years, who had experienced chronic respiratory symptoms in the year preceding the study, or had ever been told by a doctor that they had asthma, were selected. One panel was selected from an urban region, the other panel lived in an area in which air pollution concentrations were thought to be considerably lower. Exposure to air pollution was monitored on a daily basis. Health status was monitored by daily PEF measurements and a symptom diary. Subject characterisation was done by questionnaire, skin prick test and pulmonary function using forced expiratory manoeuvres. Daily prevalence and incidence of symptoms and medication use were calculated from the diaries and analysed using logistic regression with correction for autocorrelation. PEF was analysed using linear regression with correction for autocorrelation. Independent variables were 24 hour average concentrations of PM(10), black smoke, sulphur dioxide and nitric oxide. As confounders temperature, timetrend and weekend and/or holidays were taken into account.
Large gradients in PM(10) levels across Europe existed from north to south. The difference in PM(10) level between urban and control locations was in most study areas quite small. Overall, no clear association between changes in PEF and changes in air pollution, or between changes in incidence or prevalence of respiratory symptoms and changes in air pollution, could be detected.
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