Effects of indoor air pollution on respiratory health of children and adolescents.
| Study | Population/Area | Indoor exposure | Outcomes | Effect estimation |
|---|---|---|---|---|
| Simoni et al., 2010 [169] | Italy, France, Denmark, Norway, and Sweden | CO2 in the classroomPM10 in classrooms | Dry cough, rhinitis, nasal patency | OR 2.99 (95% CI 1.65–5.44)OR 2.07 (95% CI 1.14–3.73)Reduced patency |
| Cibella et al., 2015 [168] | 303 adolescents (10–17 years), Palermo | NO2 indoor (spring and winter) | Asthma, respiratory symptoms, lung function | NO2 indoor > outdoor; elevated levels associated with current asthma, wheezing, and decreased respiratory function |
| Cilluffo et al., 2022 [60] | 179 asthmatic children (5–16 years), Palermo | Maternal smoking during pregnancy, overcrowding | Asthma control | Maternal smoking (OR 3.82, 95% CI 1.11–13.06) and overcrowding (OR 3.38, 95% CI 1.29–8.81) associated with uncontrolled asthma |
| Sarno et al., 2025 [170] | 4,899 children (6–14 years), 23 EU countries | School indoor air quality, mould, environmental factors | Asthma, allergies, respiratory symptoms | High geographical variability; more symptoms in Southern Europe; Important role of the indoor environment |
| Baloch et al., 2020 [171] | 5,175 children (6–14 years), 23 EU countries (including Italy) | School indoor air quality: benzene, limonene, CO, radon, ozone | Upper airway symptoms | OR 1.62 (95% CI 1.27–2.08)OR 1.72 (95% CI 1.33–2.22)OR 1.27 (95% CI 1.01–1.60)OR 1.36 (95% CI 1.04–1.78)OR 1.99 (95% CI 1.56–2.52) |
| Benzene, limonene, PM2.5, ozone | Lower airway symptoms | OR 1.73 (95% CI 1.30–2.31)OR 1.40 (95% CI 1.05–1.88)OR 1.32 (95% CI 1.00–1.75)OR 2.24 (95% CI 1.69–2.97) | ||
| Baloch et al., 2025 [172] | 5,140 children (6–14 years), 22 EU countries (including Italy) | High concentration of endotoxins in classrooms | Runny nose, nasal obstruction, irritative cough, dry throat, breathing difficulty | OR 1.30 (95% CI 1.13–1.49)OR 1.23 (95% CI 1.07–1.41)OR 1.19 (95% CI 1.02–1.38)OR 1.19 (95% CI 1.01–1.41)OR 1.30 (95% CI 1.02–1.64) |
| Moshammer et al., 2025 [173] | 4,581 children (6–14 years), 21 EU countries (including Italy) | High concentration of endotoxins in classrooms | Lung function | For most parameters of lung function, a linear decline was observed with increasing endotoxin levels, without a clear threshold effect |
Upper airway symptoms: runny nose/nasal obstruction; lower airway symptoms: dry throat/sore throat/irritative cough/breathing difficulty. CI: confidence interval; CO: carbon monoxide; CO2: carbon dioxide; EU: European Union; NO2: nitrogen dioxide; OR: odds ratio; PM10: atmospheric particulate matter with a diameter ≤ 10 μm; PM2.5: atmospheric particulate matter with a diameter ≤ 2.5 μm.
Supplementary materials for this article are available at: https://www.explorationpub.com/uploads/Article/file/1009135_sup_1.pdf.
This document represents a virtuous example of national scientific collaboration, born from the joint commitment of experts of nine scientific societies, which have shared skills, data and strategic vision to address one of the most urgent challenges of contemporary public health.
We thank the Presidents of the nine Scientific Societies that have joined the initiative with promptness and conviction, recognizing its urgency and strategic value: Prof. Vincenzo Patella, President of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC); Prof. Lorenzo Richiardi, President of the Italian Association of Epidemiology (AIE); Prof. Francesco Murzilli, President of the Association of Italian Territorial and Hospital Allergists and Immunologists (AAIITO); Prof. Raffaele Scala, President of the Italian Association of Hospital Pulmonologists (AIPO); Prof. Gian Luigi Marseglia, President of the Italian Society of Paediatric Allergology and Immunology (SIAIP); Prof. Augusto Arsieni, President of the Italian Society of Aerobiology, Medicine and Environment (SIAMA); Prof. Maurizio Coggiola, President of the Italian Society of Occupational Medicine (SIML); Prof. Stefania La Grutta, President of the Italian Society for Childhood Respiratory Diseases (SIMRI); Prof. Paola Rogliani, President of the Italian Society of Pneumology (SIP).
The experts of the inter-society Task Force are: Manuela De Sario, Silvia Maritano (AIE); Paolo Borrelli, Gabriele Cortellini (AAIITO); Carlo Barbetta, Francesco Menzella (AIPO); Manlio Milanese, Giovanni Viegi (SIAAIC); Cristiana Indolfi, Giovanni Traina (SIAIP); Augusto Arsieni, Emma Tedeschini (SIAMA); Massimo Corradi, Nicola Murgia (SIML); Giuliana Ferrante, Raffaella Nenna (SIMRI); Laura Carrozzi, Sara Maio (SIP).
GV: Conceptualization, Writing—original draft, Writing—review & editing, Supervision. SM: Writing—original draft, Writing—review & editing. AA: Writing—original draft, Writing—review & editing. CB: Writing—original draft, Writing—review & editing. PB: Writing—original draft, Writing—review & editing. LC: Writing—original draft, Writing—review & editing. MC: Writing—original draft, Writing—review & editing. GC: Writing—original draft, Writing—review & editing. MDS: Writing—original draft, Writing—review & editing. GF: Writing—original draft, Writing—review & editing. CI: Writing—original draft, Writing—review & editing. SM: Writing—original draft, Writing—review & editing. FM: Writing—original draft, Writing—review & editing. MM: Writing—original draft, Writing—review & editing. NM: Writing—original draft, Writing—review & editing. RN: Writing—original draft, Writing—review & editing. ET: Writing—original draft, Writing—review & editing. GT: Writing—original draft, Writing—review & editing. VP: Supervision. All authors read and approved the submitted version.
Vincenzo Patella, who is the Editorial Board Member and Guest Editor of Exploration of Asthma & Allergy; Manlio Milanese, who is the Guest Editor of Exploration of Asthma & Allergy. The remaining authors declare that they have no conflicts of interest.
Not applicable.
Not applicable.
Not applicable.
Not applicable.
Not applicable.
© The Author(s) 2026.
Open Exploration maintains a neutral stance on jurisdictional claims in published institutional affiliations and maps. All opinions expressed in this article are the personal views of the author(s) and do not represent the stance of the editorial team or the publisher.