CHILDHOOD MORBIDITY AND AIR POLLUTION IN THE
TEPLICE PROGRAM
Dostál Miroslav, Hertz-Picciotto Irva, James Rebecca, Keller Jean, Dejmek Jan, Selevan Sherry, Kotěšovec František,Nožička Jiří, Gomez-Caminero Andreas, Wegienka Ganesa, Šrám Radim
Institute of Exp. Medicine, Academy of Sciences, Prague, Czech Republic Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Washington, D.C., USA District Institute of Hygiene, Prachatice, Czech Republic |
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Summary:
Background. A study of morbidity of children aged 0 to 3 years was conducted in two districts in the Czech
Republic. Comparisons were made between children living in Teplice district, known for its high air pollution, and
children living in Prachatice, a district with consistently lower particulate and SO 2 exposures.
Methods and Results. The children were selected for the follow up based on deliveries from May 1994 to December
1966. Childhood morbidity during the first three years of life of 452 children was extracted from their pediatric
records. Diagnoses were coded using the International Classification of Diseases – 10
th
edition, and categorized into
broad groupings. Children born in Teplice experienced a significantly higher rate of otitis media and otalgia,
gastrointestinal infections, upper respiratory infections, and pneumonia, but did not differ in their risk for bronchitis
or for viral infections such as varicella. These findings remained after multiple linear regression models adjusted for
education, maternal age, maternal smoking, and other smokers in the household, breastfeeding, and attendance at
day care.
Conclusions. Air pollution may alter early childhood susceptibility to infection, but other differences between the
districts must be considered: systematic diagnostic differences for several health outcomes comparing pediatricians
in Teplice vs. Prachatice, differences in health-care seeking behavior by the parents, and inadequate control for
confounding.
Key words:
air pollution, morbidity, infant health, child health, otitis media, bronchitida, pne umonia, upper
respiratory infection.
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