Local road traffic activity and the prevalence, severity, and persistence of wheeze in school children: combined cross sectional and longitudinal study
Andrea Venna, Sarah Lewisa, Marie Coopera, Richard Hubbarda, Ian Hillb, Rachel Boddyb, Margaret Bellb, John Brittona
a Division of
Respiratory Medicine, University of Nottingham, b Transport Research Group
Correspondence to: Dr Andrea Venn, Division of Respiratory Medicine, Clinical Sciences Building, City Hospital, Hucknall Road, Nottingham NG5 1PB, UK
OBJECTIVES
To
investigate the relation between local road traffic activity and the
occurrence, severity, and persistence of wheeze in children.
METHODS
Data on wheeze
and asthma were collected in a cross sectional questionnaire survey of
22 968 primary school children (age 4-11) and 27 826 secondary
school children (age 11-16) in the Nottingham area. Direct measures of
road traffic flow were made in the locality of each school and combined
with Local Authority traffic data for major roads to estimate local
traffic activity in vehicle metres/day/km2. Assessment of
the effects of potential confounders was performed in nested
case-control groups of 6576 primary and 5936 secondary children. Data
on frequency of wheeze were collected for the cases to study disease
severity. Longitudinal data on a historical cohort of 883 children who
reported wheeze when aged 4-11 in 1988 were used to study the
persistence of wheeze into adolescence.
RESULTS
Unadjusted
prevalence of wheeze in the past year within schools varied widely but
was not associated with traffic activity in the school locality
(weighted regression coefficient
=
0.01, p=0.93 for primary
schools,
=
0.18, p=0.26 for secondary schools). The risk of wheeze
in individual primary school children was not associated with
traffic activity analysed as a continuous variable, although there was
some suggestion of a weak, non-linear plateau effect. Similar effects
were found for diagnosed asthma and recent cough. There was no evidence
of any relation between traffic activity and risk of wheeze in
secondary school children. There were positive but non-significant dose
related effects of traffic activity on wheeze severity in primary and
secondary children and on persistence of wheeze in the longitudinal cohort.
CONCLUSIONS
Traffic
activity in the school locality is not a major determinant of wheeze in children.
Keywords: wheeze; traffic pollution; children
© 2000 by Occupational and Environmental Medicine
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