Document Detail

Household levels of nitrogen dioxide and pediatric asthma severity.
MedLine Citation:
PMID:  23337243     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Adverse respiratory effects in children with asthma are associated with exposures to nitrogen dioxide (NO2). Levels indoors can be much higher than outdoors. Primary indoor sources of NO2 are gas stoves, which are used for cooking by one-third of U.S. households. We investigated the effects of indoor NO2 exposure on asthma severity among an ethnically and economically diverse sample of children, controlling for season and indoor allergen exposure.
METHODS: Children 5-10 years of age with active asthma (n = 1,342) were recruited through schools in urban and suburban Connecticut and Massachusetts (2006-2009) for a prospective, year-long study with seasonal measurements of NO2 and asthma severity. Exposure to NO2 was measured passively for four, month-long, periods with Palmes tubes. Asthma morbidity was concurrently measured by a severity score and frequency of wheeze, night symptoms, and use of rescue medication. We used adjusted, hierarchical ordered logistic regression models to examine associations between household NO2 exposure and health outcomes.
RESULTS: Every 5-fold increase in NO2 exposure above a threshold of 6 ppb was associated with a dose-dependent increase in risk of higher asthma severity score (odds ratio = 1.37 [95% confidence interval = 1.01-1.89]), wheeze (1.49 [1.09-2.03]), night symptoms (1.52 [1.16-2.00]), and rescue medication use (1.78 [1.33-2.38]).
CONCLUSIONS: Asthmatic children exposed to NO2 indoors, at levels well below the U.S. Environmental Protection Agency outdoor standard (53 ppb), are at risk for increased asthma morbidity. Risks are not confined to inner city children, but occur at NO2 concentrations common in urban and suburban homes.
Kathleen Belanger; Theodore R Holford; Janneane F Gent; Melissa E Hill; Julie M Kezik; Brian P Leaderer
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Epidemiology (Cambridge, Mass.)     Volume:  24     ISSN:  1531-5487     ISO Abbreviation:  Epidemiology     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-04     Completed Date:  2013-07-23     Revised Date:  2014-05-01    
Medline Journal Info:
Nlm Unique ID:  9009644     Medline TA:  Epidemiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  320-30     Citation Subset:  IM    
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MeSH Terms
Air Pollution, Indoor / adverse effects*,  analysis
Asthma / chemically induced,  physiopathology*
Child, Preschool
Environmental Exposure / adverse effects*,  analysis
Environmental Monitoring / methods
Family Characteristics
Hypersensitivity / diagnosis
Logistic Models
Nitrogen Dioxide / adverse effects*
Prospective Studies
Severity of Illness Index
Grant Support
Reg. No./Substance:
S7G510RUBH/Nitrogen Dioxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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