Inhomogeneity in response to air pollution in European children (PEACE project).

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Abstract
OBJECTIVES: The PEACE study is a multicentre panel study of the acute effects of particles with a 50% cut off aerodynamic diameter of 10 microns (PM10), black smoke (BS), sulphur dioxide (SO2), and nitrogen dioxide (NO2) on respiratory health of children with chronic respiratory symptoms. In the complete panels no consistent association between air pollution and respiratory health was found. The study evaluated whether potentially more sensitive subgroups in the panels did show effects of air pollution. METHODS: To evaluate heterogeneity in response to air pollution, effect estimates of air pollution on peak expiratory flow (PEF) and respiratory symptoms were calculated in subgroups based on presence of chronic respiratory symptoms, use of respiratory medication, atopy, sex, and baseline lung function. RESULTS: The association between PEF and air pollution was positive in asthmatic children who used respiratory medication whereas the associations tended to be negative in children who did not use respiratory medication selected only on cough. No consistent association was found among asthmatic children who did not use medication. The association between daily prevalence of symptoms and concentrations of air pollution was not different between these subgroups. CONCLUSION: None of the predefined potentially more sensitive subgroups showed a consistent association between air pollution, PEF, and respiratory symptoms.