Department of Nursing, School of Health Sciences, Cyprus University of Technology, Nicosia, Cyprus.
Environ Health. 2010 Jun 18;9:28. doi: 10.1186/1476-069X-9-28.
Several studies have reported associations between respiratory outcomes in children and a range of self-reported, administrative or geographical indicators of traffic pollution. First-time investigation into the frequency of asthmatic symptoms among 7-8 year-old Cypriot children in 1999-2000 showed increased prevalence in the capital Nicosia compared to other areas. Geographical differences on an island the size of Cyprus may reflect environmental and/or lifestyle factors. This study investigates the relationship between self-reported symptoms and residential exposure to motor vehicle emissions among Nicosia schoolchildren.
The addresses of children in the metropolitan area of Nicosia who participated in the original survey (N = 1,735) were geo-coded and the level of exposure of each child was assessed using distance- and emission-based indicators (i.e. estimated levels of particulate matter and nitrogen oxides emissions due to motor vehicles on main roads around the residence). Odds ratios of wheezing and asthma diagnosis in relation to levels of exposure were estimated in logistic regression models adjusting for person-based factors, co-morbidity and intra-school clustering.
We found an increased risk of wheezing at distances less than 50 m from a main road and/or only among those experiencing the highest levels of exposure. The strongest effect estimates were observed when exposure was defined in terms of the cumulative burden at all roads around the residence. Adjusted odds ratios for current wheezing were 2.33 (95% CI 1.27, 4.30) amongst the quartile of participants exposed to the highest levels of PM at all roads 50 m of their residence and 2.14 (95% CI 1.05, 4.35) for NOx, with no effect at intermediate levels of exposure. While the direction of effect was apparent at longer distances, differences were generally not statistically significant.
Children experiencing the highest burden of emissions in Nicosia seem to be at a higher risk of reporting asthmatic symptoms. Due to the small number of children residing at close proximity to main roads and lack of evidence of risk at intermediate levels of exposure or longer distances, the observed pattern alone does not explain the generally higher prevalence observed in urban Nicosia compared to other areas.
多项研究报告称，儿童的呼吸道疾病与一系列自我报告、行政或地理指标的交通污染有关。1999-2000 年，塞浦路斯首次对 7-8 岁儿童的哮喘症状进行调查，结果显示首都尼科西亚的发病率高于其他地区。塞浦路斯这样一个小岛的地理差异可能反映了环境和/或生活方式因素。本研究调查了尼科西亚学童自我报告的症状与居住环境中机动车排放物之间的关系。
对参与原始调查的尼科西亚大都市区儿童的地址进行地理编码，并使用距离和排放指标（即居住地周围主要道路上由于机动车造成的颗粒物和氮氧化物排放的估计水平）评估每个儿童的暴露程度。在校内聚类的基础上，采用基于逻辑回归模型的个体因素、合并症调整，评估暴露水平与喘息和哮喘诊断的比值比。
我们发现，距离主要道路小于 50 米或仅在暴露水平最高的儿童中，喘息的风险增加。当暴露定义为居住地周围所有道路上的累积负担时，观察到最强的效应估计值。调整后的当前喘息比值比为居住地周围所有道路上最高 PM 水平的参与者的四分位数为 2.33（95%CI 1.27，4.30），而居住地周围所有道路上最高 NOx 水平的参与者为 2.14（95%CI 1.05，4.35），暴露水平处于中间时没有影响。虽然在较长距离时，效应的方向是明显的，但差异通常不具有统计学意义。
尼科西亚受排放物污染影响最大的儿童似乎报告哮喘症状的风险更高。由于靠近主要道路的儿童人数较少，且在中间暴露水平或较长距离内没有风险证据，仅观察到的模式无法解释与其他地区相比，城市尼科西亚普遍较高的发病率。
