Lung Function of Children at Three Sites of Varying Ambient Air Pollution Levels in Uganda: A Cross Sectional
Bruce J Kirenga1,2,3, Rebecca Nantanda4, Corina de Jong5
1Department of Medicine, Makerere University, Kampala, Uganda. brucekirenga@yahoo.co.uk.
Insights
Children in high air pollution areas showed reduced lung function, including lower forced expiratory volume in one second (FEV1) and forced expiratory flow (FEF25-75). Urban residence, underweight status, biomass smoke exposure, and cough were linked to poorer lung health.
Area of Science:
- Environmental Health
- Pediatric Pulmonology
- Epidemiology
Background:
- Air pollution is a significant global health concern, particularly impacting respiratory health in children.
- Particulate matter smaller than 2.5 micrometres (PM2.5) is a key component of air pollution linked to adverse health outcomes.
- Understanding the specific impact of varying ambient air pollution levels on pediatric lung function in different geographic settings is crucial.
Purpose of the Study:
- To compare lung function parameters in Ugandan children residing in areas with high versus low ambient air pollution levels.
- To identify factors associated with lung function in children exposed to different air pollution concentrations.
Main Methods:
- Spirometry was used to measure lung function in 537 Ugandan children (mean age 11.1 years).
- Children were grouped based on residence in high pollution (Kampala, Jinja) and low pollution (Buwenge) sites, characterized by PM2.5 concentrations.
- Multiple linear regression analysis was employed to explore factors associated with lung function.
Main Results:
- Children in high PM2.5 areas (Kampala, Jinja) exhibited significantly lower mean forced expiratory volume in one second (FEV1%) and forced expiratory flow 25-75% (FEF25-75%) compared to those in low PM2.5 areas (Buwenge).
- Higher proportions of children in high pollution areas had abnormal lung function parameters (FEV1% < 80% and FEF25-75% < 80%).
- Factors associated with reduced lung function included urban residence, current cough, underweight status, and exposure to biomass smoke.
Conclusions:
- High ambient air pollution levels are associated with diminished lung function in Ugandan children.
- Urban residence, underweight, biomass smoke exposure, and cough are significant risk factors for reduced lung function in this population.
- Interventions targeting air quality improvement and addressing associated risk factors are warranted to protect pediatric respiratory health.
Abstract:
Air pollution is a major cause of sub-optimal lung function and lung diseases in childhood and adulthood. In this study we compared the lung function (measured by spirometry) of 537 Ugandan children, mean age 11.1 years in sites with high (Kampala and Jinja) and low (Buwenge) ambient air pollution levels, based on the concentrations of particulate matter smaller than 2.5 micrometres in diameter (PM2.5). Factors associated with lung function were explored in a multiple linear regression model. PM2.5 level in Kampala, Jinja and Buwenge were 177.5 µg/m³, 96.3 µg/m³ and 31.4 µg/m³ respectively (p = 0.0000). Respectively mean forced vital capacity as % of predicted (FVC%), forced expiratory volume in one second as % of predicted (FEV₁%) and forced expiratory flow 25⁻75% as % of predicted (FEF25⁻75%) of children in high ambient air pollution sites (Kampala and Jinja) vs. those in the low ambient air pollution site (Buwenge subcounty) were: FVC% (101.4%, vs. 104.0%, p = 0.043), FEV₁% (93.9% vs. 98.0, p = 0.001) and FEF25⁻75% (87.8 vs. 94.0, p = 0.002). The proportions of children whose %predicted parameters were less than 80% predicted (abnormal) were higher among children living in high ambient air pollution than those living in lower low ambient air pollutions areas with the exception of FVC%; high vs. low: FEV1 < 80%, %predicted (12.0% vs. 5.3%, p = 0.021) and FEF25⁻75 < 80%, %predicted (37.7% vs. 29.3%, p = 0.052) Factors associated with lung function were (coefficient, p-value): FVC% urban residence (-3.87, p = 0.004), current cough (-2.65, p = 0.048), underweight (-6.62, p = 0.000), and overweight (11.15, p = 0.000); FEV₁% underweight (-6.54, p = 0.000) and FEF25⁻75% urban residence (-8.67, p = 0.030) and exposure to biomass smoke (-7.48, p = 0.027). Children in study sites with high ambient air pollution had lower lung function than those in sites with low ambient air pollution. Urban residence, underweight, exposure to biomass smoke and cough were associated with lower lung function.
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