i) Development and standardization of epidemiological methods to document the relationship between short-term changes in exposure to air pollution and short-term changes in the health status of children with chronic respiratory symptoms.
ii) A test of the feasibility of these methods in studies among children living in a number of urban areas spread over Europe, and among children living away from these urban areas for comparison.
iii) Collection of information on the relationship between exposure to airborne particulate matter and other air pollution components in selected urban areas and changes in health status among selected groups of susceptible individuals.
The design of the study is that panels of about 75 selected children will be followed over one winter season (1993/1994). In winter, pollutant concentrations in urban air may increase due to higher emissions and/or less dispersion that in than in the other seasons. Exposure to air pollution and health status will be monitored over the observation period. In each participating country, there will be a panel of children exposed to urban air pollution, and a control panel living in an area in which air quality is largely unaffected by urban emissions. A large variety of exposure climatic conditions will be studied as locations range from Kuopio to Athens. The population to be studied will be children of (primary) school age, 7-11 years old, who have experienced chronic respiratory symptoms in the year preceding the study. The children will be selected from the general population of children with a screening questionnaire.
Assessment of exposure to air pollution will be achieved by measuring ambient air pollution, by obtaining information (questionnaires) on sources of indoor air pollution in the home, and on activity patterns of the children. In addition, indoor exposure to NO2 will be measured with passive samplers over the period of observation. Questions will be asked about exposure to environmental tobacco smoke (ETS), about unvented combustion appliances, about home dampness and about pets as well as about the location of the home with respect to busy roads or other local sources of air pollution. For health effect assessment, each panel will be followed in time for at least two months in the winter season when stagnant weather conditions, leading to increased air pollution concentrations, occur regularly in most European countries. Each subject will be equipped with a Mini-Wright peak flow meter to assess the development of peak expiratory flow over time. In addition, parents will record respiratory symptoms and the use of medication for respiratory conditions of their participating child on each day of the study period. The work will result in a core protocol that can be used by investigators throughout Europe to study changes in health status related to short-term changes in air pollution exposure - particularly of, but not necessarily restricted to, exposure to urban air pollution. The feasibility of this core protocol will be established, and new information about exposure to urban air pollution and related health effects associated with short-term changes in these exposures will become available, that can be used to support new health based guidelines and standards for air pollution.
In sub-projects, partners in Hungary, Poland and the Czech Republic will apply the study protocol to urban populations of children with chronic respiratory symptoms exposed to industrial and to "normal" urban air pollution, and to rural control populations who have lesser exposure. This extends the range of exposures that will be studied, as air pollution in central and eastern Europe is characterized by different emissions and concentration levels. In Hungary, the study will be conducted in Budapest as the 'exposed' urban area; a control area will be chosen in the vicinity of Budapest. In the Czech Republic, the study will be conducted in Prague as 'exposed' urban area and Vlasim as country-side control area. In Poland, the study will be carried out in Krakow as 'exposed' urban areas and in Rabka as control area. Populations in Teplice will also be studied. Collaboration also exists with laboratories in Lund and Umea.
Funding SchemeCSC - Cost-sharing contracts
3720 BA Bilthoven