Chest
Volume 106, Issue 4, October 1994, Pages 1056-1060
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Clinical Investigations: Occupational/Environmental
Bronchial Responsiveness in Children Exposed to Atmospheric Pollution in Hong Kong

https://doi.org/10.1378/chest.106.4.1056Get rights and content

Bronchial responsiveness was studied by histamine challenge in 423 school children with mean (SEM) age of 10.85 (0.05) years living in two districts of Hong Kong with contrasting levels of air pollution. Differences between districts of residence were observed, with a higher prevalence of bronchial hyperreactivity (BHR) in children living in the more polluted district (χ2=7.74, df=3, p=0.052). Bronchial hyperreactivity was defined as a 20 percent or greater drop in FEV1. The district effect remained after exclusion of children with a history of wheeze and those diagnosed asthmatic for prevalence of BHR (χ2=8.93, df=3, p=0.030) and for degree of bronchial reactivity (BR) after adjustment for other socioeconomic factors and smoking in the home (z=1.97, p=0.049). Bronchial reactivity was defined as the percentage drop in FEV1 per cumulative histamine dose from postsaline to end dose. The results demonstrate that studies on bronchial responsiveness can be used to assess the effects of air quality on the respiratory health of children and will be employed to measure the impact of new air quality control measures in Hong Kong.

Section snippets

Geographic Location

This study examined the factors associated with BR during a large survey of respiratory health in primary school children living in two districts in Hong Kong with contrasting levels of atmospheric pollution.16 Kwai Tsing district (KDT) has about 8,000 industrial outlets21 and a residential population of 441,000 (8 percent of the total Hong Kong population),22 living mostly in high-rise low-cost housing. The second district, southern district (SDT), is principally residential (population 257,000

Environmental Air Quality

The mean (minimum and maximum) levels of SO2, NO2, RSP, and TSP (µg/m3) in ambient air in the two districts for the year 1989 to 1990 (September to June) as measured from fixed air monitoring stations situated in the two districts were as follows:

Kwai TsingSouthern
So2117 (72, 177)9 (4, 16)
NO240 (31, 49)21 (15, 26)
RSP54 (44, 68)30 (30, 44)
TSP94 (73, 133)54 (43, 70)

(Environmental Protection Department, Hong Kong Government).

There were 423 (79.2 percent) eligible children who received a

Discussion

One major concern about the effects of atmospheric pollution on the respiratory system of a child is the potential effect on lung growth and pulmonary disease in adulthood. Most studies using respiratory questionnaires have shown a high prevalence of symptoms in children exposed to atmospheric pollution.2, 7, 8, 16, 28, 29 The results of the first year of our study carried out in 1989 showed a consistently higher prevalence of respiratory symptoms in children from KDT16 who were exposed to a

ACKNOWLEDGMENTS

The authors wish to thank the Kwai Tsing District Board, Glaxo Hong Kong Limited, The Royal Hong Kong Jockey Club, and the Mary Sun Medical Scholarship Fund (Hong Kong—Cambridge Link) for their financial support. We acknowledge the help of staff members, in particular, Mr. Joseph Liu, from the Department of Community Medicine, The University of Hong Kong and Queen Mary Hospital, in the fieldwork, and finally, we thank all the schools, head teachers, and children for their cooperation and

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