Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #114516

Azadeh Tasslimi, BA¹, Stanley H. Weiss, MD¹, Amy L. Davidow, PhD², and Clifford P. Weisel, PhD³. (1) Department of Preventive Medicine & Community Health / Epidemiology, UMDNJ - New Jersey Medical School & New Jersey School of Public Health, 30 Bergen St, Bldg 16, Suite ADMC 1614, Newark, NJ 07107-3000, 973 972-4623, tassliaz@UMDNJ.EDU, (2) Department Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School, 185 South Orange Ave, Newark, NJ 07103-2714, (3) Environmental and Occupational Health Sciences Institute, UMDNJ - EOHSI /Robert Wood Johnson Medical School & NJ School of Public Health, 170 Frelinghuysen Road, EOSHI 3-314, Piscataway, NJ 08855

In spring 2003, a prospective study of asthmatics in northwestern NJ was conducted. Participants completed a web-based questionnaire daily to record symptoms, medication use, exposures and PEFR; ongoing data monitoring was conducted. Mean 5-minute air concentrations of SO2 were continuously collected but not known to the participants. 64 students, 54% female, 9-18 y/o (mean=13yrs) participated; mean participation 115 days. PEFR recorded on 85% (4777 of 5601 participant-days). At levels well below federal standards for safe levels of SO2, we previously found significant reductions in peak flow in 35 students: 33 were “somewhat sensitive” and 2 students “very sensitive,” using a mixed-effects model (SAS).

In each group, presence of symptoms was compared with lower/higher levels of prior-day mean SO2 (< 5ppb vs. 5<x<21ppb), using Fisher's 2-tailed exact test. The magnitude of effect with higher SO2 differed. For the 33 somewhat sensitive subjects, symptoms associated with SO2 were: wheezing (OR=1.3, p<0.05), coughing (OR=1.5, p<0.001), coughing/wheezing-after-exercise (OR=1.5, p=0.01), coughing/wheezing-due-to-laughing (OR=2.3, p<0.01). The respiratory symptoms experienced by the 2 sensitive students differed. These 2 students were analyzed separately: Student 1: coughing (OR=5.0, p<0.001), coughing/wheezing-due-to-laughing (OR=17.0, p<0.0001); Student 2: coughing (OR=1.5, p<0.001), coughing/wheezing-after-exercise (OR=10.6, p<0.05), asthma attacks (OR=3.4, p=0.09). Thus, the 2 previously identified sensitive students were at particularly great risk for symptoms at quite modest SO2 levels. These clinical symptoms in conjunction with diminished PEFR raise concern that stricter regulation of SO2 emissions, or monitoring local SO2 so that asthma action plans can be based on levels, may be needed to protect some asthmatics.

Learning Objectives:

• At the end of this session, the participant will be able to identify various types of respiratory symptoms experienced by asthmatics, and understand the possible effects of quite low level concentrations of sulfur dioxide on the risk of symptoms in asthmatic children and adolescents.

Keywords: Air Pollutants, Asthma

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation