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Home / The International Journal of Tuberculosis and Lung Disease, Volume 22, Number 7

Levels of fractional exhaled nitric oxide in children in relation to air pollution in Chinese day care centres

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OBJECTIVE: To study fractional exhaled nitric oxide (FeNO) levels among pre-school children in day care centres (DCCs) in relation to indoor and outdoor air pollution in northern China.

DESIGN: This was a cross-sectional study among children aged 5 years from 34 classrooms at 10 randomly selected DCCs in Taiyuan, China. A total of 507 (99%) children participated. Air pollution and carbon dioxide (CO2) levels were measured in the classroom and outside the school. Linear mixed models were applied for statistical analysis.

RESULTS: The geometric mean FeNO was 9.1 ± 1.5 parts per billion; 11.6% of children had wheeze, 6.0% had dry cough, 26.4% rhinitis symptoms, 1.6% ever physician-diagnosed asthma and 29.2% ever physician-diagnosed pneumonia. FeNO levels were associated with current wheeze (P = 0.04) and ever physician-diagnosed pneumonia (P = 0.05). The mean indoor concentrations were particulate matter with a diameter of <2.5 μm (PM2.5) 268 μg/m3, sulfur dioxide (SO2) 40.5 μg/m3, nitrogen dioxide (NO2) 43.0 μg/m3 and CO2 827 parts per million. Outdoor concentrations were PM2.5 244 μg/m3, SO2 106.6 μg/m3 and NO2 40.9 μg/m3. PM2.5 levels inside (P = 0.002) and outside DCCs (P = 0.05) were associated with FeNO levels.

CONCLUSION: PM2.5 levels inside and outside DCCs in China can contribute to airway inflammation in pre-school children. Children with current wheeze and ever physician-diagnosed pneumonia may have higher FeNO levels.

Keywords: China; airway inflammation; particulate matter; pre-school children; respiratory symptoms

Document Type: Research Article

Affiliations: 1: Institute of Environmental Science, Shanxi University, Taiyuan 2: School of Public Health, Fudan University, Shanghai 3: College of Chemistry and Chemical Engineering, Taiyuan University of Technology, Taiyuan, Shanxi, China 4: Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden

Publication date: 01 July 2018

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  • The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as COVID-19, asthma, COPD, child lung health and the hazards of tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details.

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