Environmental Science and Pollution Research

, Volume 20, Issue 7, pp 4831–4846 | Cite as

Analysis of the association between air pollution and allergic diseases exposure from nearby sources of ambient air pollution within elementary school zones in four Korean cities

  • H.-H. Kim
  • C.-S. Lee
  • J.-M. Jeon
  • S.-D. Yu
  • C.-W. Lee
  • J.-H. Park
  • D.-C. Shin
  • Y.-W. LimEmail author
Research Article


The objectives of this study were to survey elementary school students regarding the environmental conditions of their elementary schools and to assess the relationship between air pollution and allergic disease using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Therefore, this study was designed as a cross-sectional study. In this study, seven elementary schools were selected and they were classified into three categories. The selection included one school with no traffic-related or other pollutants, three with traffic-related pollutants, and three with traffic-related and other pollutants from industrial and filling station sources. The ISAAC questionnaire survey was given to all of the students except to those in the 1st grade who were presumed to be less likely to be exposed to the school environment than the remainder of the students attending those seven schools. The assessment of allergic disease was conducted on a total of 4,545 students. Three school zones with critical exposure were selected within each school and they were evaluated based on the levels of black carbon (BC), PM10, SO2, NO2, and O3. There was a significant increase in the risks based on the odds ratios of treatment experiences (within 1 year) for allergy-related diseases such as asthma and allergic rhinitis (a) in the school group with traffic-related pollutants and the school group with complex pollutants were 2.12 (1.41–3.19) and 1.59 (1.06–2.37), respectively, in comparison to the school groups with no exposure to pollutants. This was determined based on the odds ratio of symptoms and treatment experiences for allergy-related diseases by group based on the home town zone as a reference. Also, in the case of atopic dermatitis, the odds ratio of treatment experiences (within 1 year) was 1.42 (1.02–1.97), which indicated elevated risks compared to the students in the S1 school. A regression analysis was used to assess the relationship between the substances and the symptomatic experiences within the last year. There were significant increases in the odds ratio of the symptoms associated with allergic rhinitis and the BC and SO2 in the complex pollution areas. The results of the assessment of the relationship between atopic dermatitis-associated symptoms and O3 showed that the odds ratio increased with statistical significance.


Air pollution Elementary school Allergic diseases ISAAC Traffic Complex source 



This work was carried out with the support of “Research of Air Pollution at School Zone (2011)” of the National Institute of Environmental Research, Ministry of Environment, Republic of Korea.


  1. Ali M, Athar M (2008) Air pollution due to traffic, air quality monitoring along three sections of National Highway N-5. Pakistan. Environ Monit Assess 136:219–226CrossRefGoogle Scholar
  2. American Legacy Foundation (2005) More than 13 million American children regularly breathing secondhand smoke in their homes, cars: American Legacy Foundation and Ad Council launch first campaign to call attention to and educate public about dangers of secondhand smoke (press release). American Legacy Foundation, Washington, January 11Google Scholar
  3. Annesi-Maesano I, Moreau D, Caillaud D, Lavaud F, Moullec YL, Taytard A, Pauli G, Charpin D (2007) Residential proximity fine particles related to allergic sensitisation and asthma in primary school children. Respir med 101:1721–1729CrossRefGoogle Scholar
  4. Baldauf R, Watkins N, Heist D, Bailey C, Rowley P, Shores R (2009) Near-road air quality monitoring: factors affecting network design and interpretation of data. Air Qual Atmos Health 2:1–9CrossRefGoogle Scholar
  5. Brauer M, Hoek G, Smit HA, de Jongste JC, Gerritsen J, Postma DS, Kerkhof M, Brunekreef B (2007) Air pollution and development of asthma, allergy and infections in a birth cohort. Eur Respir J 29:879–888CrossRefGoogle Scholar
  6. Brunekreef B, Janssen NAH, de Hartog J, Harssema H, Knape M, van Vliet P (1997) Air pollution from truck traffic and lung function in children living near motorways. Epidemiology 8:298–303CrossRefGoogle Scholar
  7. Buthbumrung N, Mahidol C, Navasumrit P, Promvijit J, Hunsonti P, Autrup H, Ruchirawat M (2008) Oxidative DNA damage and influence of genetic polymorphisms among urban and rural schoolchildren exposed to benzene. Chem Biol Interact 172:185–194CrossRefGoogle Scholar
  8. Canha N, Almeida M, Freitas MDC, Almeida SM, Wolterbeek H, Wolterbeek T (2011) Seasonal variation of total particulate matter and children respiratory diseases at Lisbon primary schools using passive methods. Procedia Environ Sci 4:170–183CrossRefGoogle Scholar
  9. Carlisle AJ, Sharp NCC (2001) Exercise and outdoor ambient air pollution. Br J Sports Med 35:214–222CrossRefGoogle Scholar
  10. CDC (Centers for Disease Control and Prevention) (2006) The health consequences of involuntary exposure to tobacco smoke: a report of the Surgeon General. U.S. Dept. of Health and Humans Services, Centers for Diseases Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta, Available: Google Scholar
  11. Cleland V, Timperio A, Salmon J, Hume C, Baur LA, Crawford D (2009) Predictors of time spent outdoors among children: 5-year longitudinal findings. J Epidemiol Community Health. doi: 10.1136/jech.2009.087460
  12. Diapouli E, Chaloulakou A, Mihalopoulos N, Spirellis N (2008) Indoor and outdoor PM mass and number concentrations at schools in the Athens area. Environ Monit Assess 136:13–20CrossRefGoogle Scholar
  13. Dockery DW, Cunningham J, Damokosh AI, Neas LM, Spengler JD, Koutrakis P, Ware JH, Raizenne M, Speizer FE (1996) Health effects of acid aerosols on North American children: respiratory symptoms. Environ Health Perspect 104:500–505CrossRefGoogle Scholar
  14. English P, Neutra R, Scalf R, Sullivan M, Waller L, Zhu L (1999) Examining associations between childhood asthma and traffic flow using a geographic information system. Environ Heal Perspect 107:761–767CrossRefGoogle Scholar
  15. EPA (Environmental Protection Agency) (2010) (Online) Available: Accessed 16 June 2010
  16. Godish T (2004) Air quality, 4th edn. Lewis, Boca RatonGoogle Scholar
  17. Guo H, Morawska L, He C, Gilbert D (2008) Impact of ventilation scenario on air exchange rates and on indoor particle number concentrations in an air-conditioned classroom. Atmos Environ 42:757–768CrossRefGoogle Scholar
  18. Health Effects Institute (2010) Traffic-related air pollution: a critical review of the literature on emissions, exposure, and health effects. Health Effects Institute, BostonGoogle Scholar
  19. Heindrich J, Schwarze PE, Stilianakis N, Momas I, Medina S, Totlandsdal AI, van Bree L, Kuna-Dibbert B, Kryzanowski M (2005) Studies on health effects of transport-related pollution. In: Krzyzanowski M, Kuna-Dibbert B, Schneider J (eds) Health effects of transport-related pollution. Regional Office for Europe of the World Health Organization (WHO), Copenhagen, pp 125–126Google Scholar
  20. Hirsch T, Weiland SK, von Mutius E, Safeca AF, Grafe H, Csaplovics E, Duhme H, Keil U, Leupold W (1999) Inner city air pollution and respiratory health and atopy in children. Eur Respir J 14:669–677CrossRefGoogle Scholar
  21. Ho WC, Hartley WR, Myers L, Lin MH, Lin YS, Lien CH, Lin RS (2007) Air pollution, weather, and associated risk factors related to asthma prevalence and attack rate. Environ Res 104:402–409CrossRefGoogle Scholar
  22. Hugg TT, Jaakkola MS, Ruotsalainen RO, Pushkarev VJ, Jaakkola JJ (2007) Parental smoking behaviour and effects of tobacco smoke on children’s health in Finland and Russia. Eur J Pub Health 8(1):55–62Google Scholar
  23. INCA (2009) INCA comparative tables (Online). International Review of Curriculum and Assessment Framework Internet Archive (INCA), London, Available: (accessed 11.06.10)Google Scholar
  24. Janssen NA, Brunekreef B, van Vliet P, Aarts F, Meliefste K, Harssema H, Fischer P (2003) The relationship between air pollution from heavy traffic and allergic sensitization, bronchial hyperresponsiveness, and respiratory symptoms in Dutch schoolchildren. Environ Health Perspect 111:1512–1518CrossRefGoogle Scholar
  25. John K, Karnae S, Crist K, Kim M, Kulkarni A (2007) Analysis of trace elements and ions in ambient fine particulate matter at three elementary schools in Ohio. J Air Waste Manag Assoc 57:394–406CrossRefGoogle Scholar
  26. Jones AP (1999) Indoor air quality and health. Atmos Environ 33:4535–4564CrossRefGoogle Scholar
  27. Kanaya Y, Komazaki Y, Pochanart P, Liu Y, Akimoto H, Gao J, Wang T, Wang Z (2008) Mass concentrations of black carbon measured by four instruments in the middle of central east china in June 2006. Atmos Chem Phys 8:7637–7649CrossRefGoogle Scholar
  28. Keuken M, Sanderson E, Aalst R, Borken J, Schneider J (2005) Contribution of traffic to levels of ambient air pollution in Europe. In: Krzyzanowski M, Kuna-Dibbert B, Schneider J (eds) Health Effects of Transport-related Air Pollution. European Office of the World Health Organization (WHO), Copenhagen, pp 53–54Google Scholar
  29. Kim JJ, Smorodinsky S, Lipsett M, Singer BC, Hodgson AT, Ostro B (2004) Traffic-related air pollution near busy roads. The East Bay Children’s Respiratory Health Study. Am J Respir Crit Care Med 170:520–526CrossRefGoogle Scholar
  30. Koponen IK, Asmi A, Keronen P, Puhto K, Kulmala M (2001) Indoor air measurement campaign in Helsinki. Finland 1999—the effect of outdoor air pollution on indoor air. Atmos Environ 35:1465–1477CrossRefGoogle Scholar
  31. Kramer U, Koch T, Ranft U, Ring J, Behrendt H (2000) Traffic-related air pollution is associated with atopy in children living in urban areas. Epidemiology 11:64–70CrossRefGoogle Scholar
  32. Kulkarni N, Grigg J (2008) Effect of air pollution on children. Paediatr Child Health 18:238–243CrossRefGoogle Scholar
  33. Lam TH, Hedley AJ, Chung SF, Macfarlane DJ (1999) Child Health and Activity Research Group (CHARG). Passive smoking and respiratory symptoms in primary school children in Hong Kong. Hum Exp Toxicol 18(4):218–223CrossRefGoogle Scholar
  34. Latha KM, Badarinath KVS (2003) Black carbon aerosols over tropical urban environment—a case study. Atmos Res 69:125–133CrossRefGoogle Scholar
  35. Lee YL, Lin YC, Hwang BF, Guo YL (2005) Changing prevalence of asthma in Taiwanese adolescents: two surveys 6 years apart. Pediatr Allergy Immunol 16:157–164CrossRefGoogle Scholar
  36. Leickly FE (2003) Children, their school environment, and asthma. Ann Allergy Asthma Immunol 90:3–5CrossRefGoogle Scholar
  37. Lin S, Munsie JP, Hwang SA, Fitzgerald E, Cayo MR (2002) Childhood asthma hospitalization and residential exposure to state route traffic. Environ Res 88:73–81CrossRefGoogle Scholar
  38. Mastrangelo G, Clonfero E, Pavznerllo S, Fedeli U, Fadda E, Turato A, Piccinni S, Montagnani R, Marcer G (2003) Exposure to diesel exhaust enhances total IgE in non-atopic dockers. Int Arch Occup Environ Heal 76:63–68Google Scholar
  39. McConnell R, Berhane K, Gililand F, London SJ, Vora H, Avol E, Gauderman WJ, Margolis HG, Lurmann F, Thomas DC et al (1999) Air pollution and bronchitic symptoms in Southern California children with asthma. Environ Health Perspect 53:241–247Google Scholar
  40. McConnell R, Islam T, Shankardass K, Jerrett M, Lurmann F, Gilliland F, Gauderman J, Avol E, Kuenzli N, Yao L, Peters J, Berhane K (2010) Childhood incident asthma and traffic-related air pollution at home and school. Environ Heal Perspect 118(7):1021–1026CrossRefGoogle Scholar
  41. Mejia JF, Wraith D, Mengersen K, Morawska L (2007) Trends in size classified particle number concentration in subtropical Brisbane, Australia, based on a 5 years study. Atmos Environ 41:1064–1079CrossRefGoogle Scholar
  42. Mi YH, Norback D, Tao J, Mi YL, Ferm M (2006) Current asthma and respiratory symptoms among pupils in Shanghai, China: influence of building ventilation, nitrogen dioxide, ozone, and formaldehyde in classrooms. Indoor Air 16:454–464CrossRefGoogle Scholar
  43. Mutius E, Sherrill DL, Fritzsch C, Martinez FD, Lebowitz MD (1995) Air pollution and upper respiratory symptom in children from East Germany. Eur Respir J 8:723–728Google Scholar
  44. Patel MM, Chillrud SN, Correa JC, Feinberg M, Hazi Y, Deepti KC, Prakash S, Ross JM, Levy D, Kinney PL (2009) Spatial and temporal variations in traffic-related particulate matter at New York City High Schools. Atmos Environ 43:4975–4981CrossRefGoogle Scholar
  45. Peacock J, Symonds P, Jackson P, Bremmer SA, Scarlett JF, Strachan DP (2003) Acute effects of winter air pollution on respiratory function in schoolchildren in southern England. Occup Environ Med 60:82–89CrossRefGoogle Scholar
  46. Penard-Morand C, Charpin D, Raherison C, Kopferschmitt C, Caillaud D, Lavaud F, Annesi-Maesano I (2005) Long-term exposure to background air pollution related to respiratory and allergic health in schoolchildren. Clin Exp Allergy 35:1279–1287CrossRefGoogle Scholar
  47. Perter J, Hedley AJ, Wong CM, Lam TH, Ong SG, Liu J, Sepiegelhalter DJ (1996) Effets of an ambient air pollution intervention and environmental tobacco smoke on children’s respiratory health in Hong Kong. Int J Epidemiol 25(4):821–828CrossRefGoogle Scholar
  48. Peters JM, Avol E, Navidi W, London SJ, Gauderman WJ, Lurmann F, Linn WS, Margolis H, Rappaport E, Gong H, Thomas DC (1999) A study of twelve Southern California communities with differing levels and types of air pollution: I: prevalence of respiratory morbidity. Am J Respir Crit Care Med 159:760–767CrossRefGoogle Scholar
  49. Raysoni AU, Sarnat JA, Sarnat SE, Garcia JH, Holguin F, Luevano SF, Li WW (2011) Binational school-based monitoring of traffic-related air pollutions in El Paso, Texas (USA) and Ciudad Juarez, Chihuahua (Mexico). Environ Pollut 159:2476–2486CrossRefGoogle Scholar
  50. Richmond-Bryant J, Bukiewicz L, Kalin R, Galarraga C, Mirer F (2011) A multi-site analysis of the association between black carbon concentrations and vehicular idling, traffic, background pollution, and meteorology during school dismissals. Sci Total Environ 409:2085–2093CrossRefGoogle Scholar
  51. Richmond-Bryant J, Saganich C, Bukiewicz L, Kalin R (2009) Associations of PM2.5 and black carbon concentrations with traffic, idling, background pollution, and meteorology during school dismissals. Sci Total Environ 407:3357–3364CrossRefGoogle Scholar
  52. Rijnders E, Janssen NAH, van Vliet PHN, Brunekreef B (2001) Personal and outdoor nitrogen dioxide concentrations in relation to degree of urbanization and traffic density. Environ Heal Perspect 109(3):411–417Google Scholar
  53. Rundell KW, Caviston R, Hollenbach AM, Murphy K (2006) Vehicular air pollution, playgrounds, and youth athletic fields. Inhal Toxicol 18:541–547CrossRefGoogle Scholar
  54. Sarnat JA, Moise T, Shpund J, Liu Y, Pachon JE, Qasrawi R, Abdeen Z, Brenner S, Nassar K, Schauer JJ (2010) Assessing the spatial and temporal variability of fine particulate matter components in Israeli, Jordanian, and Palestinian cities. Atmos Environ 44:2383–2392CrossRefGoogle Scholar
  55. Sawant AA, Na K, Zhu X, Cocker K, Butt S, Song C, Cocker DR III (2004) Characterization of PM2.5 and selected gas-phase compounds at multiple indoor and outdoor sites in Mira Loma, California. Atmos Environ 38:6269–6278CrossRefGoogle Scholar
  56. Singer BC, Hodgson AT, Hotchi T, Kim JJ (2004) Passive measurement of nitrogen oxides to assess traffic-related pollutant exposure for the East Bay Children’s Respiratory Health Study. Atmos Environ 38:393–403CrossRefGoogle Scholar
  57. Strachan D, Sibbald B, Weiland S, Ait-Khaled N, Anabwani G, Anderson HR, Asher MI, Beasley R, Biorksten B, Burr M, Clayton T, Crane J, Ellwood P, Keil U, Lai C, Mallol J, Martinez F, Mitchell E, Montefort S, Pearce N, Robertson C, Shah J, Stewart A, von Mutius E, Williams H (1997) Worldwide variations in prevalence of symptoms of allergic rhinoconjunctivitis in children: the International Study of Asthma and Allergies in Childhood (ISAAC). Pediatr Allergy Immunol 8(4):161–176CrossRefGoogle Scholar
  58. Suh MN, Kim HH, Sohn MH, Kim KE, Kim CS, Shin DC (2011) Prevalence of allergic diseases among Korean school-age children: a nationwide cross-sectional questionnaire study. J Korean Med Sci 26:332–338CrossRefGoogle Scholar
  59. Tanaka K, Miyake Y, Arakawa M, Sasaki S, Ohya Y (2007) Prevalence of asthma and wheeze in relation to passive smoking in Japanese children. Ann Epidemiol 17(12):1004–1010CrossRefGoogle Scholar
  60. Van Roosbroeck S, Li R, Hoek G, Lebret E, Brunekreef B, Spiegelman D (2008) Traffic-related outdoor air pollution and respiratory symptoms in children: the impact of adjustment for exposure measurement error. Epidemiology 19:409–416CrossRefGoogle Scholar
  61. Van Roosbroeck S, Wichmann J, Janssen NAH, Hoek G, van Wijnen JH, Lebret E, Brunekreef B (2006) Long-term personal exposure to traffic-related air pollution among school children, a validation study. Sci Total Environ 368:565–573CrossRefGoogle Scholar
  62. Venn A, Lewis S, Cooper M, Hubbard R, Hill I, Boddy R, Bell M, Britton J (2000) Local road traffic activity and the prevalence, severity, and persistence of wheeze in school children: combined cross sectional and longitudinal study. Occup Environ Med 57:152–158CrossRefGoogle Scholar
  63. Weiland SK, Mundt KA, Ruckmann A, Keil U (1994) Self-reported wheezing and allergic rhinitis in children and traffic density on street of residence. Ann Epidemiol 4:243–247CrossRefGoogle Scholar
  64. Wichmann J, Janssen NAH, van der Zee S, Brunekreef B (2005) Traffic-related differences in indoor and personal absorption coefficient measurements in Amsterdam, the Netherlands. Atmos Environ 39:7384–7392CrossRefGoogle Scholar
  65. World Health Organization (WHO) (2005) WHO air quality guidelines global update. Report on a working group meeting. Born, Germany, 18–20 October 2005Google Scholar
  66. Zhao Z, Zheng Z, Wang Z, Ferm M, Liang Y, Norback D (2008) Asthmatics symptoms among pupils in relation to winter indoor and outdoor air pollution in schools in Taiyuan, China. Environ Heal Perspect 116(1):90–97CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • H.-H. Kim
    • 1
  • C.-S. Lee
    • 1
  • J.-M. Jeon
    • 2
  • S.-D. Yu
    • 4
  • C.-W. Lee
    • 4
  • J.-H. Park
    • 1
  • D.-C. Shin
    • 3
  • Y.-W. Lim
    • 1
    Email author
  1. 1.Institute for Environmental ResearchYonsei University College of MedicineSeoulSouth Korea
  2. 2.Department of Civil & Environmental EngineeringSuncheon First CollegeSuncheonSouth Korea
  3. 3.Department of Preventive MedicineYonsei University College of MedicineSeoulSouth Korea
  4. 4.Environmental Health Research Division, Environmental Health Research Department, Ministry of EnvironmentNational Institute of Environmental ResearchIncheonSouth Korea

Personalised recommendations