Effects of outdoor air pollution on the respiratory health of children and adolescents.
| Study | Population/Area | Outdoor exposure | Outcomes | Effect estimation |
|---|---|---|---|---|
| Squillacioti et al., 2019 [62] | 187 children (7–11 years) | NDVI; urban exposure to NO2 (average 55.6 μg/m3) | Asthma, bronchitis, wheezing; respiratory function | Higher NDVI associated with lower risk of asthma (OR 0.13), bronchitis (OR 0.14) and wheezing (OR 0.25). Reduction of forced expiratory flow between 25 and 75% of forced vital capacity (FEF25–75) in children less exposed to greenness |
| Zammit et al., 2020 [66] | Primary school children, Sicily (n = 1,190) and Malta (n = 1,210) | PM2.5 and elemental composition (V, Pb, Ni, Zn) | Asthma, rhinitis, medication use | ↑ PM2.5 associated with ↑ risk of asthma (OR ≈ 1.04); V and Pb more associated with respiratory outcomes |
| Bonato et al., 2021 [67] | 98 children (5.3 ± 2.9 years) with and without wheezing | PM10, NO2, SO2 (preceding 90 days) | Bronchial remodeling, inflammation | PM10 associated with basal membrane thickening and ↑ eosinophils; greater effect in children with wheezing |
| Bonato et al., 2021 [68] | 34 preschool children | PM10, NO2, SO2 (acute exposure) | Epithelial antiviral response | NO2 associated with ↓ IFN-β and ↑ Rhinovirus replication |
| Di Cicco et al., 2022 [63] | 85 children (0–17 years) hospitalized | Total pollens; spores of Alternaria alternata | Asthma/asthma-like hospitalizations (indicators of respiratory exacerbation) | Increments of 10 granules/m3 associated with ↑ risk of hospitalization: Lag 0 OR 1.054; Lag 1 OR 1.037; Lag 2 OR 1.021. More marked effects in sensitized, males, and > 10 years |
| Cilluffo et al., 2022 [60] | 179 asthmatic children | Urban greenness (NDVI), traffic, NO2 | Asthma control | ↓ Urban green areas associated with uncontrolled asthma (OR ≈ 2.66); no association with NO2 or traffic |
| Panunzi et al., 2023 [65] | 7,525 subjects (0–21 years; ~6,800 < 18 years) | PM10, PM2.5, NO2 (ELAPSE/EPISAT models), distance from plants | Allergological, ENT, pneumological visits; hospitalizations and respiratory ED accesses | PM10 associated with ↑ allergy visits (RR 1.32; 95% CI 1.14–1.52). J-curve with higher rates < 2 km and > 20 km from the industrial plants. NO2 not significant |
| Sarno et al., 2024 [64] | 2,367 children (6–14 years) | Residence near crops treated with pesticides | Upper airway, ocular, skin, systemic symptoms | Upper airway (rhinitis/nasal symptoms): OR 2.25. Ocular symptoms: OR 3.81. Skin: OR 2.60 |
| Cilluffo et al., 2018 [59] | 219 children (8–10 years) | NDVI, “greyness”, distance from traffic (≤ 200 m), NO2 | Nasal, ocular, respiratory symptoms | Low NDVI associated with ↑ rhinitis (OR 1.47, 95% CI 1.07–2.03). Residence ≤ 200 m from traffic associated with ↑ rhinitis (OR 1.49, 95% CI 1.12–1.98). NO2 not significant |
Lag: time interval in days between peak exposure to pollutant and health event. CI: confidence interval; ED: emergency department; ENT: ear, nose and throat; NDVI: normalized difference vegetation index; NO2: nitrogen dioxide; OR: odds ratio; PM2.5: atmospheric particulate matter with a diameter ≤ 2.5 μm; PM10: atmospheric particulate matter with a diameter ≤ 10 μm; RR: relative risk; SO2: sulphur dioxide.
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.
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