Effects of Air Pollution on Children's Pulmonary Function in Urban and Suburban Areas of Wuhan, People's Republic of China

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Abstract
In May and June of 1988, the spirometric lung function of 604 children, who were aged 7–13 y and who were free of chronic respiratory conditions, was measured in the urban core and a suburb of Wuhan, China. During 1981–1988, ambient total suspended particulate (TSP) levels averaged 481 μg/m3 in the urban core and 167 μg/m3 in the suburb. In 1988, TSP levels, measured within 500 m of the children's homes, averaged 251 μg/m3 in the urban core and 110 μg/m3 in the suburb. Levels of sulfur dioxide and nitrogen oxides were also higher in the urban core. Proportions of families who burned coal and gas domestically were similar in both areas. In linear and logarithmic regression models, height was a stronger determinant of forced vital capacity and forced expiratory volume in 1 s than was age or weight. In linear models, the proportion of variance explained by height (R-squared) ranged from 0.54 for urban females' forced expiratory volume in 1 s to 0.77 for suburban males and females. Both forced vital capacity and forced expiratory volume in 1 s were consistently lower in urban than suburban children. The average forced vital capacity and forced expiratory volume in 1 s in children 132–144 cm tall were 6.7% and 3.8% lower, respectively, in the urban core than the suburb; suburban-urban differences increased with height. Suburban-urban differences in slopes of lung function growth curves were statistically significant for forced vital capacity but not for forced expiratory volume in 1 s. Rates of clinical upper respiratory irritation were also generally elevated in urban children. These results strongly suggest that urban ambient air pollution exposure in China contributes to retardation in the growth of children's lung function. Confirmatory longitudinal studies are in progress in Wuhan and three other Chinese cities.

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