Pulmonary function and urban air pollution in preschool children

Epidemiologic evidence indicates that respiratory disease in infancy and childhood has respiratory health consequences in later life. Pulmonary function is considered a good index of early effects. This study assessed the relationship of pulmonary function in preschool children in Leipzig, Germany, and exposure to high levels of air pollution during early childhood. Spirometric measures were taken of 235 preschoolers (126 boys, 109 girls, mean age 5.1 +/- 1.3 years) attending 16 randomly selected daycare centres, using the 'Bosch Spiro 501' spirometer. The results showed decrements in the average FVC (85.5% predicted [pred]) and FEV1 (90.2% pred) differing with spatial variations in the ambient air pollution burden of the children's residential area. Exposure to a pollution profile of heavy traffic and/or domestic heating showed markedly lower FVC (78.9% and 85.5% pred, respectively) and FEV1 (82.4% and 88.5% pred). Miller's Diagnostic Quadrant Model of Disease Classification, categorizing pulmonary function data for preliminary diagnostic purposes, assessed the lung function values (FVC% pred/relative FEV1 [FEV1/FVC]%) of a significant number of children as 'restrictions' (n = 52; 22.1%). Summarizing: variations in spirometric indices were observed across exposure groups with a significant number of children showing signs of a restrictive ventilatory function. These cross-sectional data, however, do not permit to conclude with any degree of certainty that this is indicative of an early sign of a functional deficit.