Particulate air pollution and other environmental and demographic risk factors associated with pneumonia in Bangkok children : an epidemiologic study
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Date
1994
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York University, North York, ON, CA
Abstract
Pneumonia is currently the major killer of children in the developing world, and
air pollution has been implicated as one of the causes. Little research has been done in
the area of third world urban air pollution and pneumonia. A pilot case-control study
was conducted at the Children's Hospital in Bangkok Thailand, between February and
July 1993, to examine the association between particulate levels in Bangkok homes and
the risk of childhood pneumonia in the under 2 age group, to examine environmental
sources of particulates, and also to explore other environmental and demographic risk
factors for pneumonia. In this study 61 cases and 67 controls were enroled. Pneumonia
cases came from two inpatient wards, and the controls came primarily from a well baby
immunization clinic at the same hospital. Interviews were conducted in the hospital, and
then cases and controls were visited at home for an environmental audit of their homes
which included a 24 hour sample of inhalable particulates called 'PM10', a measure of the fine particulate matter most relevant to respiratory health. Univariate analyses and
multivariate logistic regression were performed in order to obtain unadjusted and adjusted
odds ratios (OR) and their confidence intervals (CI), used as a measure of strength of
association between the various risk factors and pneumonia.
The results of this study indicate a preliminary estimate of relative risk of
pneumonia of at least 2.0 for children from homes with PM10 levels over 150 ug/m3
,
adjusted for nutritional status, maternal education, childcare and ventilation. As
expected, in this pilot study, this association was not significant (OR 2.06, CI 0.51-
8.40). Using PM10 as a continuous variable however, gives an almost statistically
significant adjusted odds ratio of 3.27 (CI 0.96-11.18) for every 100 ug/m3 increment in
PM10. From the univariate analysis, however there was no evidence of a dose response
relationship. Almost 40% of the study population, were exposed to levels of PM10 over
the U.S. EPA standard of 150 ug/m3
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Keywords
ENVIRONMENTAL HEALTH, AIR POLLUTION, PNEUMONIA, CHILDREN, TOWNS, THAILAND, RISK, DATA COLLECTING, RESEARCH RESULTS, MATHEMATICAL MODELS