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Is daily exposure to ozone associated with respiratory morbidity and lung function in a representative sample of schoolchildren? Results from a panel study in Greece

Journal of Exposure Science & Environmental Epidemiology volume 27, pages 346–351 (2017)Cite this article

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Abstract

Previous time series or panel studies of asthmatics have reported respiratory health effects following short-term exposure to ozone (O3). We followed 186 children aged 10 years old in Athens and Thessaloniki, Greece for 5 weeks during the academic year 2013–2014 and recorded daily their respiratory symptoms, absenteeism and peak expiratory flow (PEF). We applied mixed models controlling for various possible confounders to investigate the daily associations between O3 exposure — derived from weekly personal and fixed school site measurements calibrated using daily values of the fixed monitoring site nearest to the child’s school location — and PEF, presence of any symptom, cough and stuffy nose, as well as absenteeism. We tested the robustness of our findings to varying modeling assumptions and confounders and investigated effect modification patterns by medication use, time spent outdoors and prevalence of asthma. A 10 μg/m3 increase in O3 personal exposure was associated with increased odds of any symptom (odds ratio (OR): 1.19, 95% confidence interval (CI): 0.98, 1.44), largely attributed to the increase in the odds of stuffy nose (OR: 1.23, 95% CI: 1.00, 1.51). PEF and absenteeism were not related to O3 exposure. Our results were robust to several sensitivity analyses. Effects were modified by medication use as presence of symptoms but also decreases in PEF were mainly reported among non-users, while our effect estimates were not driven by the asthmatic subgroup of children. Our findings indicate that short-term O3 exposure may be associated with respiratory symptoms extending previously reported results for asthmatics to the general population.

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Acknowledgements

The work has been co-funded by the European Commission and the Greek government by the National Strategic Reference Framework 2007-2013 Contract Ref: RESPOZE-children/2248.

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Authors and Affiliations

  1. Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Medical School, Athens, Greece

    Evangelia Samoli, Konstantina Dimakopoulou, Dimitris Evangelopoulos, Sophia Rodopoulou, Lambrini Veneti, Ioanna Krasanaki & Klea Katsouyanni

  2. 2nd Pulmonary Department, “ATTIKON” University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece

    Anna Karakatsani

  3. Pulmonary Department, G. Papanikolaou Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Maria Sionidou, Ioannis Tsolakoglou & Despoina Papakosta

  4. School of Chemical Engineering, National Technical University of Athens, Athens, Greece

    Georgios Grivas

  5. Department of Primary Care & Public Health Sciences and Environmental Research Group, King's College, London

    Klea Katsouyanni

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  1. Evangelia Samoli
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Correspondence to Evangelia Samoli.

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Supplementary Information accompanies the paper on the Journal of Exposure Science and Environmental Epidemiology website

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Samoli, E., Dimakopoulou, K., Evangelopoulos, D. et al. Is daily exposure to ozone associated with respiratory morbidity and lung function in a representative sample of schoolchildren? Results from a panel study in Greece. J Expo Sci Environ Epidemiol 27, 346–351 (2017). https://doi.org/10.1038/jes.2016.32

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  • DOI: https://doi.org/10.1038/jes.2016.32

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