Ambient Pollution and Respiratory Outcomes among Schoolchildren in Durban; South Africa

ABSTRACT

Objectives. To examine associations between ambient air pollutants and respiratory outcomes among schoolchildren in Durban; South Africa.Methods. Primary schools from within each of seven communities in two regions of Durban (the highly industrialised south compared with the non-industrial north) were selected. Children from randomly selected grade 4 classrooms were invited to participate. Standardised interviews; spirometry; methacholine challenge testing and skin-prick testing were conducted. Particulate matter (PM); sulphur dioxide (SO2) and carbon monoxide were monitored at each school; while nitrogen oxides (NOx) and other pollutants were monitored at other sites.Results. SO2 was significantly higher in the south than in the north; while PM concentrations were similar across the city. The prevalence of symptoms consistent with asthma of any severity was 32.1. Covariate-adjusted prevalences were higher among children from schools in the south than among those from the north for persistent asthma (12.2 v. 9.6 ) and for marked airway hyperreactivity (AHR) (8.1 v. 2.8); while SO2 resulted in a twofold increased risk of marked AHR (95 confidence interval 0.98 - 4.66; p=0.056).Conclusions. Schoolchildren from industrially exposed communities experienced higher covariate-adjusted prevalences of persistent asthma and marked AHR than children from communities distant from industrial sources. Our findings are strongly suggestive of industrial pollution-related adverse respiratory health effects among these children