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Pollution and the young combined analyses of cross-sectional studies of respiratory health of children and air pollution

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Pollution and the Young: Combined analyses of cross-sectional studies of respiratory health of children and air pollution (PATY). This project has brought together the data and expertise from 12 recent studies into air pollution and children's health A large programme of pooled analyses have been conducted, on associations between several environmental risk factors and a spectrum of children's allergic and respiratory disorders. The original researchers from each study have been engaged in all phases of the project, from establishing protocols to the dissemination of results, and the studies themselves include some of the largest and most in-depth cross-sectional studies on the topic, in and beyond Europe. The data from 12 countries, reached a combined study size of some 67,445 children from 140 areas. Respiratory diseases are principal endpoints of interest, and Associations between particulate matter in all areas, together with NO2 and SO2 for some areas, have been investigated in relation to respiratory symptoms and lung function. Individual data are available from each study to control for potential confounding including socio-economic factors, smoking and indicators of indoor air quality. By design, the studies selected are highly compatible, in terms of outcomes, pollution measures, and a range of potential confounding factors. Careful quality assessments of the pollution data have been carried out, including visits to monitoring sites, to ensure comparability of measures across areas. Outdoor air pollutants, primarily PM10 and NO2, have been confirmed to have adverse effects on children's health in these populations. NO2 was shown to be associated most strongly with allergic symptoms, while PM10 was more strongly linked to symptoms such as phlegm and cough. Neither pollutant was found to have strong associations overall with asthma, nor with symptoms of asthma such as wheeze. Nor were any consistent effects found of PM10 on children's lung function. The role of indoor air factors was also examined. Independent effects of current parental smoking and of maternal smoking during pregnancy were very evident, and adverse effects of parental smoking were seen for asthma, wheeze, cough and bronchitis - though less evident for reported allergy - and also for measures of lung function. Mould in the house showed the most robust associations of all, showing consistent adverse effects across all the symptoms and in all the studies. Low parental education was associated with a decreased risk of hay fever, inhalant allergy, itchy rash and eczema in school children. Furthermore, low parental education was associated with an increased prevalence of nocturnal dry cough and morning cough and wheeze. No clear association was found between parental education and prevalence of doctor diagnosed asthma and bronchitis. Although part of the associations between socio-economic groups with regard to the children's health were explained by differences in prevalence of parental allergy, smoking during pregnancy, and crowding, the differences remained after adjusting for these variables.

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