A Panel Study on Lung Function and Bronchial Inflammation among Children Exposed to Ambient SO2 from an Oil Refinery
Abstract
:1. Introduction
2. Materials and Methods
2.1. Setting
2.2. Pollutants Assessment
2.3. Statistical Analysis
3. Results
3.1. Descriptive Subject Data
3.2. Descriptive Exposure Data
3.3. Regression Models for Respiratory Function
3.4. Regression Models for Fractional Exhaled Nitric Oxide
4. Discussion
4.1. Strengths and Weaknesses
4.2. External Consistency
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Informed Consent
Notation of Prior Abstract Publication/Presentation
Appendix A
FEV1 | GEE Distributed Lag Multipollutant Model a | GEE jackknife b Subject Measure | Re c | AR-re d | Independent e | GEE Distributed Lag Multipollutant Model (week day) f | ||
---|---|---|---|---|---|---|---|---|
PV | p-Value | p-Value | p-Value | p-Value | p-Value | p-Value | Sign g | |
SO2 | ||||||||
Lag0 | 1.51 | 0.215 | 0.252 | 0.193 | 0.578 | 0.233 | 0.452 | 0/6 |
Lag1 | −1.20 | 0.081 | 0.105 | 0.103 | 0.670 | 0.328 | 0.320 | 0/6 |
Lag2 | −2.79 | <0.001 | <0.001 | <0.001 | 0.003 | <0.003 | 0.033 | 5/6 |
ICC h = 0.66 | ICC = 0.63 AC = 0.49 |
Appendix B
FeNO | Tobit Distributed Lag Multipollutant Model a | Tobit jackknife b Subject Measure | Re c | AR-re d | Independent e | Tobit Distributed Lag Multipollutant Model-(week day) f | ||
---|---|---|---|---|---|---|---|---|
PV | p-Value | p-Value | p-Value | p-Value | p-Value | p-Value | # sign | |
SO2 | ||||||||
0–8 | 18.57 | 0.019 | 0.073 | 0.051 | 0.016 | 0.015 | 0.159 | 4/6 |
8 p.m.–8 a.m. | 38.12 | 0.009 | 0.047 | 0.030 | 0.015 | 0.007 | 0.118 | 4/6 |
ICC g = 0.77 | ICC = 0.70 AC h = 0.44 |
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Characteristics of Children Enrolled | Panel 5 n = 233 | Panel 20 n = 54 |
---|---|---|
Age (years), mean (sd) | 10.65 (1.85) | 10.44 (1.69) |
Height a (cm), mean (sd) Δ = 1.55; 2.34 | 145.60 (11.49) | 143.55 (10.51) |
Weight a (kg), mean (sd) Δ = −0.44; 1.22 | 40.52 (12.84) | 40.99 (12.64) |
Sex, n (%) | ||
Males | 117 (50.21) | 31 (57.4) |
Females | 116 (49.79) | 23 (42.6) |
Number of spirometric measurements, median (iqr) | 5 (1) | 15 (3) |
% predicted FEV1 b, n (%) | ||
<80 | 5 (3) | 2 (4) |
80–90 | 16 (8) | 9 (17) |
90–95 | 31 (16) | 12 (22) |
95–99 | 37 (19) | 6 (11) |
100+ | 102 (54) | 25 (46) |
FEV1 (l), mean (sd) | 2.33 (0.61) | 2.21 (0.60) |
FEF 25–75% (L/s), mean (sd) | 2.72 (0.85) | 2.47 (0.74) |
Wheezing, n (%) | 32 (14) | 25 (46) |
Asthma, n (%) | 18 (8) | 18 (33) |
Nocturnal cough, n (%) | 39 (17) | 34 (63) |
Chest tightness, n (%) | 11 (5) | 10 (18) |
Asthma medications, n (%) | 15 (6) | 14 (26) |
Absence of symptoms, n (%) | 175 (75) | 9 (17) |
Asthma exacerbations, n (%) | 9 (4) | 9 (17) |
Number of fractional exhaled NO measurements, median (iqr) | 15 (2) | |
Fractional exhaled NO (ppb), mean (sd) | 20.29 (22.42) | |
Asthma negative, n = 36, mean (sd) | 13.12 (13.85) | |
Asthma positive, n = 18, mean (sd) | 34.63 (29.07) | |
Inhaled steroids, n (%) | 12 (22) |
Weekday | ||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Monday | Tuesday | Wednesday | Thursday | Friday | Saturday | Total | ||||||||||
Week | Panel | S | F | S | F | S | F | S | F | S | F | S | F | S | F | |
1 | 5 | 23 | 40 | 39 | 30 | 35 | - | 167 | ||||||||
1 | 20 | - | 8 | 14 | 16 b | 6 | 6 | 7 | 6 | 10 | 13 | - | - | 37 | 49 | |
2 | 20 | - | - | - | - | - | - | 16 | 25 | 16 | 19 | - | - | 32 | 44 | |
3 | 20 | - | - | - | - | 33 | 38 | - | - | - | - | 5 | 6 | 38 | 44 | |
4 | 20 | - | - | 30 | 45 | - | - | - | - | - | - | 4 | 5 | 34 | 50 | |
5 | 5 | 20 | 75 | 27 | 28 | 22 | 18 | 190 | ||||||||
5 | 20 | - | - | 40 | 44 | - | - | - | - | - | - | 7 | 7 | 47 | 51 | |
6 | 20 | - | - | 29 | 31 | - | - | - | - | - | - | 11 | 15 b | 40 | 46 | |
7 | 20 | - | - | - | - | 37 | 39 | - | - | - | - | 11 | 11 | 48 | 50 | |
8 | 20 | - | - | - | - | - | - | 34 a | 38 | - | - | 13 | 13 | 47 | 51 | |
9 | 5 | 23 | 79 | 24 | 23 | 21 | 23 | 193 | ||||||||
9 | 20 | - | - | 42 | 42 | - | - | - | - | - | - | 9a | 9 | 51 | 51 | |
10 | 20 | - | - | - | - | 36 a | 38 | - | - | - | - | 13 | 15 | 49 | 53 | |
11 | 20 | - | - | - | - | 41 | 46 | Easter School Holiday | 41 | 46 | ||||||
12 | 20 | Easter School Holiday | - | - | 11 | 13 b | - | - | 11 | 13 | ||||||
13 | 5 | 20 | 42 | 23 | 20 | 46 | 29 | 180 | ||||||||
13 | 20 | - | - | 5 | 6 | - | - | - | - | 20 | 20 | 17 | 19 | 42 | 45 | |
14 | 20 | 36 | 40 | - | - | - | - | - | - | - | - | - | - | 36 | 40 | |
15 | 20 | School Holiday | ||||||||||||||
16 | 20 | - | 23 | - | - | - | - | - | - | - | - | 19 a | 19 b | 19 | 42 | |
17 | 5 | 41 | 42 | 26 | 21 | 27 | 22 | 179 | ||||||||
17 | 20 | 19 | 24 b | - | - | - | - | - | - | - | - | 19 | 20 | 38 | 44 | |
18 | 20 | - | - | - | - | 23 | 23 b | - | - | - | - | 24 | 25 | 47 | 48 | |
19 | 20 | 25 | 25 | 24 a | 25 | - | - | - | - | - | - | - | - | 49 | 50 | |
20 | 20 | - | - | - | - | 31 | 35 b | - | - | - | - | 10 | 12 | 41 | 47 | |
Total Panel 5 | 127 | 278 | 139 | 122 | 151 | 92 | 909 | |||||||||
Total Panel 20 | 80 | 120 | 184 | 109 | 207 | 225 | 57 | 69 | 57 | 65 | 162 | 176 | 747 | 864 |
Exposure (μg/m3) | Mean (sd) | Median | Min | Max | IQ Range |
---|---|---|---|---|---|
SO2 24-h mean | 4.7 (4.3) | 3.7 | 0.6 | 20.7 | 4.2 |
SO2 0–8 a.m. | 2.9 (4.2) | 1.3 | 0.2 | 21.9 | 2.7 |
SO2 8 p.m.–8 a.m. | 2.2 (2.5) | 1.1 | 0.2 | 13.3 | 1.8 |
SO2 Lag1 | 4.4 (4.9) | 3.0 | 0.6 | 26.1 | 3.4 |
SO2 Lag2 | 5.6 (6.6) | 3.0 | 0.6 | 29.0 | 5.5 |
SO2 Lag0–2 | 4.9 (3.8) | 3.7 | 0.7 | 18.8 | 2.9 |
SO2 1-h max lag0 | 49.6 (60.5) | 29.0 | 1.5 | 289.5 | 53.6 |
SO2 1-h max lag1 | 45.4 (57.4) | 22.5 | 1.4 | 254.3 | 56.5 |
SO2 1-h max lag2 | 81.1 (160.8) | 30.3 | 1.6 | 822.7 | 45.9 |
SO2 3-h max moving average lag0 | 34.7 (50.1) | 16.7 | 1.5 | 266.1 | 37.6 |
SO2 3-h max moving average lag1 | 30.1 (41.5) | 14.8 | 1.3 | 218.7 | 43.0 |
SO2 3-h max moving average lag2 | 50.9 (99.9) | 19.6 | 1.4 | 466.5 | 39.6 |
NO2 Lag0–2 | 11.7 (3.6) | 12.5 | 5.7 | 16.9 | 6.9 |
NO24-h mean | 12.9 (5.4) | 13.7 | 2.6 | 23.2 | 6.9 |
NO2 1-h max | 40.7 (18.4) | 40.1 | 8.0 | 79.7 | 23.7 |
PM10 Lag0–2 | 21.5 (6.2) | 22.2 | 8.6 | 32.2 | 7.4 |
PM10 24-h mean | 22.8 (10.6) | 21.7 | 5.4 | 48.0 | 16.5 |
PM10 1-h max | 66.1 (42.1) | 54.7 | 19.0 | 208.1 | 61.5 |
O3 Lag0–2 | 62.8 (10.8) | 64.3 | 35.3 | 81.5 | 15.5 |
O3 8-h max moving average | 62.9 (11.5) | 63.5 | 38.5 | 84.0 | 20.7 |
Temperature (°C) | 14.1 (4.5) | 12.8 | 6.0 | 24.2 | 6.4 |
Relative humidity (%) | 74.8 (12.9) | 76.5 | 50.6 | 96.2 | 23.0 |
FEV1 | Panel 5 | Panel 20 | ||||
Average lag0–2 | PV a | 90% CI | p-Value | PV | 90% CI | p-Value |
SO2 | −3.37 | −5.39; −1.30 | 0.008 | −3.51 | −4.77; −2.23 | <0.001 |
NO2 | 1.79 | −1.18; 4.85 | 0.325 | 3.98 | 2.28; 5.70 | <0.001 |
PM10 | −0.08 | −1.82; 1.70 | 0.943 | −0.89 | −1.77; −0.01 | 0.096 |
O3 | −1.31 | −1.71; 0.90 | <0.001 | −1.02 | −1.6; −0.44 | 0.004 |
FEF 25–75% | Panel 5 | Panel 20 | ||||
Average lag0–2 | PV | 90% CI | p-Value | PV | 90% CI | p-Value |
SO2 | −6.99 | −11.49; −2.27 | 0.016 | −3.08 | −5.94; −0.13 | 0.086 |
NO2 | 2.18 | −4.51; 9.33 | 0.601 | 5.20 | 0.88; 9.70 | 0.047 |
PM10 | −0.59 | −4.43; 3.40 | 0.804 | 0.82 | −0.96; −2.64 | 0.450 |
O3 | −1.99 | −2.83; −1.14 | 0.000 | −1.97 | −3.13; −0.80 | 0.006 |
Distributed Lag Model | FEV1 | ||
---|---|---|---|
SO2 (μg/m3) | PV a | 90% CI | p-Value |
24-H Mean | |||
Lag0 | −0.22 | −1.06; 0.63 | 0.669 |
Lag1 | 0.73 | −0.02; 1.48 | 0.109 |
Lag2 | −1.43 | −1.99; −0.86 | <0.001 |
1 h max | |||
Lag0 | 0.02 | −0.03; 0.07 | 0.511 |
Lag1 | −0.01 | −0.07; 0.06 | 0.873 |
Lag2 | −0.05 | −0.07; −0.02 | 0.002 |
3 h max moving average | |||
Lag0 | 0.02 | −0.05; 0.09 | 0.608 |
Lag1 | −0.01 | −0.10; 0.09 | 0.927 |
Lag2 | −0.08 | −0.11; −0.04 | 0.001 |
SO2 (μg/m3) | FEV1 | Adjusted b | ||
---|---|---|---|---|
1 h max lag2 | RPVa | 90% CI | p-Value | FEV1 (l) |
<50 (reference category) | 0 | 2.16 | ||
50–100 | 0.64 | −0.86; 2.15 | 0.486 | 2.17 |
100–200 | −1.38 | −3.10; 0.37 | 0.194 | 2.13 |
200+ | −2.49 | −4.27; −0.67 | 0.025 | 2.11 |
FeNO | PV | 90% CI | p-Value | |
---|---|---|---|---|
h 0–8 a.m. a | ||||
SO2 | 18.57 | 5.29; 33.53 | 0.019 | |
NO2 | −7.81 | −17.45; 2.96 | 0.226 | |
PM10 | 2.61 | −2.44; 7.91 | 0.402 | |
h 8 p.m.–8 a.m. a | ||||
SO2 | 38.12 | 12.88; 69.01 | 0.009 | |
NO2 | −8.74 | −19.51; 3.48 | 0.232 | |
PM10 | 3.69 | −1.33; 8.98 | 0.230 | |
Lag0 a | ||||
SO2 | 3.00 | −7.32; 14.47 | 0.646 | |
NO2 | −7.33 | −18.52; 5.40 | 0.331 | |
PM10 | −1.56 | −6.35; 3.48 | 0.605 | |
O3 | −4.72 | −9.72; 0.56 | 0.141 |
SO2 (μg/m3) Average 8 p.m.–8 a.m. | Adjusted b | |||
---|---|---|---|---|
(quartiles) | RPV a | 90% CI | p-Value | FeNO (ppb) |
<0.1 (reference category) | 0 | 10.83 | ||
0.1–1.13 | 4.63 | −5.64; 16.03 | 0.472 | 11.33 |
1.13–2.64 | 7.55 | −6.61; 23.85 | 0.397 | 11.65 |
2.64+ | 33.18 | 14.53; 54.86 | 0.002 | 14.43 |
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Barbone, F.; Catelan, D.; Pistelli, R.; Accetta, G.; Grechi, D.; Rusconi, F.; Biggeri, A. A Panel Study on Lung Function and Bronchial Inflammation among Children Exposed to Ambient SO2 from an Oil Refinery. Int. J. Environ. Res. Public Health 2019, 16, 1057. https://doi.org/10.3390/ijerph16061057
Barbone F, Catelan D, Pistelli R, Accetta G, Grechi D, Rusconi F, Biggeri A. A Panel Study on Lung Function and Bronchial Inflammation among Children Exposed to Ambient SO2 from an Oil Refinery. International Journal of Environmental Research and Public Health. 2019; 16(6):1057. https://doi.org/10.3390/ijerph16061057
Chicago/Turabian StyleBarbone, Fabio, Dolores Catelan, Riccardo Pistelli, Gabriele Accetta, Daniele Grechi, Franca Rusconi, and Annibale Biggeri. 2019. "A Panel Study on Lung Function and Bronchial Inflammation among Children Exposed to Ambient SO2 from an Oil Refinery" International Journal of Environmental Research and Public Health 16, no. 6: 1057. https://doi.org/10.3390/ijerph16061057