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Background: Although short-term exposure to ambient particulate matter has increasingly been linked with cardiovascular diseases, it is not quite clear how physical characteristics of particles, such as particle size may be responsible for the association. This study aimed at investigating whether daily changes in number or mass concentrations of accurately size-segregated particles in the range of 3nm-10μm are associated with daily cardiovascular emergency room visits in Beijing, China., Methods: Cardiovascular emergency room visit counts, particle size distribution data, and meteorological data were collected from Mar. 2004 to Dec. 2006. Particle size distribution data was used to calculate particle number concentration in different size fractions, which were then converted to particle mass concentration assuming spherical particles. We applied a time-series analysis approach. We evaluated lagged associations between cardiovascular emergency room visits and particulate number and mass concentration using distributed lag non-linear models up to lag 10. We calculated percentage changes of cardiovascular emergency room visits, together with 95% confidence intervals (CI), in association with an interquartile range (IQR, difference between the third and first quartile) increase of 11-day or 2-day moving average number or mass concentration of particulate matter within each size fraction, assuming linear effects. We put interaction terms between season and 11-day or 2-day average particulate concentration in the models to estimate the modification of the particle effects by season., Results: We observed delayed associations between number concentration of ultrafine particles and cardiovascular emergency room visits, mainly from lag 4 to lag 10, mostly contributed by 10-30nm and 30-50nm particles. An IQR (9040cm(-3)) increase in 11-day average number concentration of ultrafine particles was associated with a 7.2% (1.1-13.7%) increase in total, and a 7.9% (0.5-15.9%) increase in severe cardiovascular emergency room visits. The delayed effects of particulate mass concentration were small. Regarding immediate effects, 2-day average number concentration of Aitken mode (30-100nm) particles had strongest effects. An IQR (2269cm(-3)) increase in 2-day average number concentration of 30-50nm particles led to a 2.4% (-1.5-6.5%) increase in total, and a 1.7% (-2.9-6.5%) increase in severe cardiovascular emergency room visits. The immediate effects of mass concentration came mainly from 1000-2500nm particles. An IQR (11.7μgm(-3)) increase in 2-day average mass concentration of 1000-2500nm particles led to an around 2.4% (0.4-4.4%) increase in total, and a 1.7% (-0.8-4.2%) increase in severe cardiovascular emergency room visits. The lagged effect curves of number and mass concentrations of 100-300nm particles or 300-1000nm particles were quite similar, indicating that using particulate number or mass concentrations seemed not to affect the cardiovascular effect (of particles within one size fraction). The effects of number concentration of ultrafine particles, sub-micrometer particles (3-1000nm) and 10-30nm particles were substantially higher in winter comparing with in summer., Conclusions: Elevated concentration levels of sub-micrometer particles were associated with increased cardiovascular morbidity. Ultrafine particles showed delayed effects, while accumulation mode (100-1000nm) particles showed immediate effects. Using number or mass concentrations did not affect the particle effects., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Background: Several cross-sectional studies during the past 10 years have observed an increased risk of allergic outcomes for children living in damp or mouldy environments., Objective: The objective of this study was to investigate whether reported mould or dampness exposure in early life is associated with the development of allergic disorders in children from eight European birth cohorts., Methods: We analysed data from 31 742 children from eight ongoing European birth cohorts. Exposure to mould and allergic health outcomes were assessed by parental questionnaires at different time points. Meta-analyses with fixed- and random-effect models were applied. The number of the studies included in each analysis varied based on the outcome data available for each cohort., Results: Exposure to visible mould and/or dampness during first 2 years of life was associated with an increased risk of developing asthma: there was a significant association with early asthma symptoms in meta-analyses of four cohorts [0-2 years: adjusted odds ratios (aOR), 1.39 (95% CI, 1.05-1.84)] and with asthma later in childhood in six cohorts [6-8 years: aOR, 1.09 (95% CI, 0.90-1.32) and 3-10 years: aOR, 1.10 (95% CI, 0.90-1.34)]. A statistically significant association was observed in six cohorts with symptoms of allergic rhinitis at school age [6-8 years: aOR, 1.12 (1.02-1.23)] and at any time point between 3 and 10 years [aOR, 1.18 (1.09-1.28)]., Conclusion: These findings suggest that a mouldy home environment in early life is associated with an increased risk of asthma particularly in young children and allergic rhinitis symptoms in school-age children., (© 2011 John Wiley & Sons A/S.)

In this study, we evaluated the association between prenatal and postnatal exposure to environmental tobacco smoke and the development of insulin resistance in 10 year old children. Fasting blood samples were collected from 470 children participating in two prospective birth cohorts. Of those 276 were selected population based and enriched with 194 children exceeding the 85th percentile of body mass index in this age group. Children already having diabetes type 1 or 2 at the age of 10 years were excluded. Fasting blood insulin and glucose levels and calculated HOMA index for insulin resistance assessment were analysed using generalised additive models. Potential confounders were adjusted for. Insulin resistance was increased by 24% in children frequently exposed to environmental tobacco smoke during childhood (MR(adj) = 1.24, p = 0.001), while glucose levels were not. Exclusion of prenatally exposed children did not attenuate the association (MR(adj) = 1.25, p = 0.006). After stratification, the effect sizes were identical within overweight children and the population based sample of children. Insulin resistance and fasting insulin levels were increasing with increasing numbers of cigarettes smoked in children's home. Maternal smoking during the third trimester of pregnancy increased children's insulin levels (MR(adj) = 1.19, p = 0.037), and even more so, if children were exclusively breastfed after birth (MR(adj) = 1.31, p = 0.016). Increased mean ratios were found for smoking of a third person in addition to maternal smoking. Positive dose-dependent associations and independent effects of postnatal exposure suggest involvement of environmental tobacco smoke in the risk for development of insulin resistance in children., (Copyright © 2011 Elsevier GmbH. All rights reserved.)

There is concern about indoor air quality as a possible cause for health impairment. Exposure to indoor renovation activities has been shown to be associated with airway symptoms and allergic manifestations in children. The aim of this study is to analyse immune markers responsible for disease development in relation to renovation activities. Within the LISAplus (Life style Immune System Allergy) birth cohort study, blood samples of 6-yr-old children were analysed for concentration of the inflammatory markers interleukin (IL)-8, IL-6, tumour necrosis factor-alpha, MCP-1 and IL-10. Data on indoor renovation activities (painting, flooring, new furniture) were assessed with a questionnaire filled in by the parents. Data on cytokine blood concentrations and exposure variables were available for 250 children. Increased levels of IL-8 and MCP-1 in children's blood were related to renovation activities. In particular, new floor covering was associated with increased inflammatory markers. Among floor covering materials only wall-to-wall carpets were associated with elevated IL-8 and Monocyte Chemoattractant Protein-1 (MCP-1) levels. No association between the single renovation activities painting and furnishing and blood concentration of inflammatory markers has been found. Our data shows that IL-8 and MCP-1 may be suitable markers for monitoring inflammatory reactions in relation with renovation activities. Among renovation activities floor covering seems to induce the strongest inflammatory reactions.

Rationale: In vitro studies, animal experiments, and human exposure studies have shown how ambient air pollution increases the risk of atopic diseases. However, results derived from observational studies are inconsistent., Objectives: To assess the relationship between individual-based exposure to traffic-related air pollutants and allergic disease outcomes in a prospective birth cohort study during the first 6 years of life., Methods: We studied 2,860 children at the age of 4 years and 3,061 at the age of 6 years to investigate atopic diseases and allergic sensitization. Long-term exposure to particulate matter (PM(2.5)), PM(2.5) absorbance, and long-term exposure to nitrogen dioxide (NO(2)) was assessed at residential addresses using geographic information systems based regression models and air pollution measurements. The distance to the nearest main road was used as a surrogate for traffic-related air pollutants., Measurements and Main Results: Strong positive associations were found between the distance to the nearest main road and asthmatic bronchitis, hay fever, eczema, and sensitization. A distance-dependent relationship could be identified, with the highest odds ratios (ORs) for children living less than 50 m from busy streets. For PM(2.5) absorbance, statistically significant effects were found for asthmatic bronchitis (OR, 1.56; 95% confidence interval [CI], 1.03-2.37), hay fever (OR, 1.59; 95% CI, 1.11-2.27), and allergic sensitization to pollen (OR, 1.40; 95% CI, 1.20-1.64). NO(2) exposure was associated with eczema, whereas no association was found for allergic sensitization., Conclusions: This study provides strong evidence for increased risk of atopic diseases and allergic sensitization when children are exposed to ambient particulate matter.

Background: The influence of cat allergen exposure in early childhood on the development of sensitization and allergic diseases is complex. Little is known about the natural course of the sensitization development within individuals., Objective: We investigated the association between cat allergen exposure in infancy and cat ownership and cat contact during childhood and the development of cat sensitization and allergic diseases up to age 6 years using a longitudinal analysis approach., Methods: Overall, 2166 children from an ongoing birth cohort study were included in the analysis. House dust samples were collected 3 months after birth. Cat allergen levels were extracted. Blood samples were collected when the children were 2 and 6 years old. Information on the allergic symptoms of children and doctor-diagnosed allergic disease were collected at each follow-up using questionnaires., Results: Cat allergen exposure in infancy was positively associated with sensitization at age 2 years but not at age 6 years. No associations existed between cat allergen exposure in infancy and allergic symptoms and diseases up to age 6 years. Cumulative allergen exposure from cat ownership and regular cat contact increased the risk of cat sensitization up to age 6 years., Conclusion: Cat allergen exposure in infancy increases the risk of sensitization development in early childhood but not in school-age children. Cumulative allergen exposure from cat ownership and regular cat contact during childhood contribute to sensitization development up to school age., Clinical Implications: Cat allergen avoidance at home alone might be not effective to prevent the development of allergic sensitization in young children.

Airborne particles represent a very important pollutant with respect to healthy housing conditions. The snag is that in lack of indoor data epidemiological studies focusing on submicron and ultrafine (<100 nm in diameter) particles are usually forced to use outdoor particle concentrations only. On the other hand it is known that people spend most of their time indoors. The aim of this paper is therefore to give a short comprehensive overview of the indoor/outdoor problem with regard to submicron and ultrafine particles, investigating how indoor particle size distributions correlate with outdoor concentrations in the absence of significant indoor sources. In the absence of a major indoor source, total indoor particle number concentrations were always lower than outdoor concentrations. The highest ratios between indoor and outdoor concentrations tend to correlate with lower rather than higher total outdoor particle number concentrations. Concentration ratios depend on particle size. Time lags of the correlation coefficients between the concentrations of indoor and outdoor particles of different diameters have been determined to assess the time the particles need to enter the indoor site through closed modern-type windows. Typical lag times of 0.5-3 h between somewhat smaller indoor particles and somewhat larger outdoor particles have been observed. To assess the resulting particle burden for humans, a suitably weighted average emphasizing indoor aerosol particles must be used. To classify the health effects of particles of different diameters, different decreases of particle number concentrations depending on the particle sizes must be taken into account if indoor concentrations cannot be measured and outdoor concentrations are used in place of indoor measurements. In urban areas, ultrafine particles originate primarily from rapidly increasing traffic, which is the dominating source at many urban sites. The influence of traffic on outdoor and indoor concentrations is therefore of special interest., ((c) 2006 Wiley Periodicals, Inc.)

Ambient aerosol has been identified as a major pollutant affecting human health. Standards to reduce particles mass concentrations have therefore been established in many countries. Recent studies suggest that the number concentration of aerosol particles, which is dominated by the ultrafine size range smaller than 100 nm in diameter, may be independently associated with health effects. Currently, epidemiological evidence for such effects is conflicting. We have measured aerosol size distributions at two stations (urban background, street canyon) located at a distance of 1.5 km for a time period of 1 year. Number concentrations and particle size distributions at both sites were significantly different. Short-term correlation between the two sites was weak for individual measurements of number concentrations and size bins of ultrafine particles (0.19-0.46). Correlation coefficients for hourly and daily averages in selected size ranges ranged from 0.35 to 0.46. On the other hand, the correlation coefficient for daily average particle volume concentrations was found to be 0.67. About 10% to 20% of the population of European cities lives close to roads with traffic densities comparable to our site. The underestimation of the exposure of a considerable part of a study population may therefore severely influence the outcome of epidemiological studies focused on health effects associated with ultrafine particles. A single background measurement site may not be sufficient for exposure assessment in these studies without taking spatial and temporal variability into account.

Background: Other factors besides a genetic disposition seem to play a role in the development of allergic disorders. Exposure to risk factors such as indoor air pollution is becoming increasingly interesting, especially during early childhood., Methods: Within an epidemiological study (LISS: Leipzig infection, allergy and airway diseases study among school starters, involving 2536 children, birth cohort 1991/92, carried out in 1997/98) the effect of indoor exposure on physician-confirmed eczema and allergic symptoms has been investigated. The exposure situation has been characterized on hand of the redecoration activities (painting, floor covering and new furniture) before birth and in the first years of life., Results: Highly exposed children showed a significant effect on allergic disorders. The lifetime prevalences without any vs. all three redecoration activities were for allergic symptoms 9.3% vs. 17.2% and for eczema 11.5% vs. 20.4%. Adjusted for confounders, the redecoration associated burden led to odds ratios of 1.8 (95% CI: 1.3-2.6) for allergic symptoms and 1.9 (95% CI: 1.4-2.7) for eczema., Conclusion: Exposure emissions due to redecoration activities seem to be associated with the risk of eczema and allergic symptoms. Thus, prevention of allergic disorders should include the avoidance of such activities around birth and in the first year of life.

The liver is an important target organ in exposure to foreign substances or their metabolites. Early changes in the metabolic capacity of the liver may be a first sign of the effect of an exposure and an indication of an early (pre)pathological process. For the noninvasive testing of this metabolic capacity, a special diagnostic tool has been developed and demonstrated under real exposure conditions. The main questions investigated were (1) whether the liver detoxification capacity of children is affected by long-term low exposure in a highly polluted area and (2) to what extent redevelopment in once heavily polluted industrial areas contributes to improvement in the health measured in the children from the changed detoxification capacity. Kindergarten children from a heavily polluted industrial area and a control area were observed over a prolonged period during redevelopment of the industrial area. The liver's detoxification capacity was assessed with a stable-isotope-based diagnostic test, the [(15)N]methacetin test. In addition, the region-specific external exposure (indicator components were chlorinated compounds) and internal load were measured. The difference in the children's internal load between the exposed and control groups reflected the differences in exposure (exposed children had an internal load 2.3 times greater than that of the control children). The exposed children showed a 6% lower liver detoxification capacity. A reduction in pollution by about 70% as a result of remediation was reflected in improved liver detoxification capacity, and the difference between the polluted and control areas was no longer significant. Prolonged exposure to low concentrations of xenobiotics can disturb hepatic functioning. The proposed test can be used as a tool to determine the effects of multicomponent exposure and is well suited for bioeffect monitoring., (Copyright 2004 Wiley Periodicals, Inc. Environ Toxicol 19: 103-108, 2004)

The effect of remediation activities in formerly high-loaded industrial areas is measured conventionally in terms of decreased toxic loads. It is more difficult to investigate the effect on physiological parameters of the people living there. A non-invasive 15N-based organ function test, the [15N]methacetin urine test, was adapted to environmental-medical purposes for the detection of small deviations from the norm-range hepatic detoxification capacity. Parallel to the measurement of region-specific external exposure (especially by tri- and tetrachloro ethylene) and of the corresponding internal load (urinary trichloro acetic acid), the hepatic mono oxygenation capacity was determined. The study cohort consisted of 35 kindergarten children who were 3.3+/-0.5 years old at the beginning of the study. They lived in a high-polluted industrial village (n = 23) and in a non-polluted control village close by (n = 12), respectively. Children living in the polluted area were exposed a 2.3 times higher load and showed detoxification capacities 6% lower than the children in the control area. Improvement of the environmental situation led to exposure data decreasing by 70%, which is also reflected in smaller internal load and improved liver detoxification of the children in the polluted area. Then, between loaded and control area the mean hepatic detoxification was no longer significantly different (0.6%). The study shows that chronic low-dose exposure can disturb a hepatic function and that thereafter the capacity is recovered quickly in children. The stable isotope-based test is suited to characterize a health effect of multicomponent exposure by bioeffect monitoring within the framework of screening and testing the remediation efficiency.

Asthma is of increasing concern especially in industrialized countries. This cross-sectional study was to assess the influence of spatial and temporal variations in the urban air pollution profile on asthmatic disease. The prevalences presented are based on physician-diagnosed asthmatic and allergic disease data, collected between 1993 and 1995. Seven hundred and thirty-six preschool children (age 2 to 7, mean 5.7 years) of 37 daycare centres in the City of Leipzig participated in the study. Variations were observed in the lifetime prevalences of asthma and allergy with differences in a residential area's ambient pollution profile. Depending on the level of traffic (high or low), children residing in areas with a dominant coal-heating emission profile had more frequently a diagnosis of asthma, 17.5% and 8.8% (95% confidence intervals [CI]: 10.8...23.5 and 5.8...11.6, respectively), as compared to those, living in centrally heated areas 13.4% and 5.8% (CI: 6.6...19.3 and 1.2...9.6, respectively). Allergic disorders occurred more often in areas with a predominantly traffic-associated pollution profile, 14.3% and 9.6% vs. 5.8% and 3.7% (CI: 7.4...20.3 and 6.4...12.5; 1.2...9.6 and 0.2...6.5, respectively). Interestingly, asthmatic disease was not necessarily associated with a clinical history of allergies. Of the children with physician-diagnosed asthma, 83.7% were not reported to have a concurrent diagnosis of allergies nor to show clinical symptoms. This suggests that environmental exposures (i.e., complex pollution mixtures associated with residential coal-heating and/or traffic) may have differentially influenced the phenotypic expression of asthma. A qualitative discussion is presented on the occurrence of "asthma without reported allergies" in Leipzig.

Over a 5-yr period, the Leipzig's Allergy Risk Study (LARS) investigated the influence of typical indoor-contaminant burdens on the development of allergies and upper respiratory tract infections in allergy-prone children. Typical indoor volatile organic compounds (VOCs) and excretion of certain VOC metabolites in urine were measured in children 3 yr of age. Data analyses were based on parent-completed questionnaires, exposure measurements, and medical examinations. Evaluation of passive smoking was of special interest. Generally, residences with a high burden of passive smoking had higher benzene concentrations than residences inhabited by nonsmokers. Obstructive bronchitis was observed more frequently in children exposed to increased concentrations of benzene, as well as toluene, styrene, and m,p-xylene. In addition, atopic symptoms were associated with excretion of certain VOC metabolites. For example, the authors found an association between eczema and exposure to toluene and between eczema and increased excretion of the toluene metabolite S-benzylmercapturic acid. The results suggest that if an association with certain health effects is to be demonstrated, evaluation of external exposures should be supplemented with evaluations of internal exposure.

To investigate mould effects on health, the concentration of mould spores in air and dust was determined during a prospective cohort study. Clinical outcome was estimated by questionnaires and determination of specific IgE antibodies and intracellular cytokine production of T cells. A significant association was observed between the incidence of respiratory tract infections and exposure to Penicillium spores. Moreover, Aspergillus exposure was found to be associated with allergic rhinitis or related symptoms. In addition, T cells of children exposed to Aspergillus showed a significantly lower content of TH1 cytokines (IFN-gamma, TNF-alpha, IL-2) producing cells. Our data suggest that mould exposure is associated with several effects on health, depending on the species involved.

The association between indoor exposure to volatile organic compounds (VOC), prevalence of allergic sensitization and cytokine secretion profile of peripheral T cells was studied in 3 year old children of the LARS study (Leipzig Allergy Risk Children Study) to investigate the role of VOC exposure as a risk factor for the development of atopic disease. Indoor VOC exposure was measured over a period of 4 weeks in infants' bedrooms using a passive sampling system. Specific IgE antibodies to food, indoor and outdoor allergens were measured by the Pharmacia CAP system and correlated to VOC exposure (n = 120). In addition, cytokine producing peripheral T cells (interleukin(IL)-4, interferon(IFN)-gamma) were measured in a subgroup of 28 children by means of intracellular cytokine staining. For the first time we were able to show that exposure to alkanes (C6, C9, C10) and aromatic compounds (toluene, o-xylene, m + p-xylene, 2-, 3- and 4-ethyl-toluene, chlorobenzene) may contribute to the risk of allergic sensitization to the food allergens milk and egg white (Odds ratios between 5.7 and 11.2). Moreover, significantly reduced numbers of CD3+/CD8+ peripheral T cells were found in children exposed to alkanes (C9-C13), naphthalene and chlorobenzene. Exposure to benzene, ethylbenzene and chlorobenzene was associated with higher percentages of IL-4 producing CD3+ T cells. Both an increase in IL-4 producing type 2 T cells and a reduction of IFN-gamma producing type 1 T cells may contribute to a type 2 skewed memory in response to allergens. Therefore, we suggest exposure to VOCs in association with allergic sensitization to be mediated by a T cell polarization toward the type 2 phenotype.

Epidemiologic evidence indicates that respiratory disease in infancy and childhood has respiratory health consequences in later life. Pulmonary function is considered a good index of early effects. This study assessed the relationship of pulmonary function in preschool children in Leipzig, Germany, and exposure to high levels of air pollution during early childhood. Spirometric measures were taken of 235 preschoolers (126 boys, 109 girls, mean age 5.1 +/- 1.3 years) attending 16 randomly selected daycare centres, using the 'Bosch Spiro 501' spirometer. The results showed decrements in the average FVC (85.5% predicted [pred]) and FEV1 (90.2% pred) differing with spatial variations in the ambient air pollution burden of the children's residential area. Exposure to a pollution profile of heavy traffic and/or domestic heating showed markedly lower FVC (78.9% and 85.5% pred, respectively) and FEV1 (82.4% and 88.5% pred). Miller's Diagnostic Quadrant Model of Disease Classification, categorizing pulmonary function data for preliminary diagnostic purposes, assessed the lung function values (FVC% pred/relative FEV1 [FEV1/FVC]%) of a significant number of children as 'restrictions' (n = 52; 22.1%). Summarizing: variations in spirometric indices were observed across exposure groups with a significant number of children showing signs of a restrictive ventilatory function. These cross-sectional data, however, do not permit to conclude with any degree of certainty that this is indicative of an early sign of a functional deficit.

Introduction: The Leipzig Allergy High-Risk Children Study (LARS) is a prospective nested cohort control study about the influence of chemical indoor exposure in dwellings on the health outcome of atopy-risk children during the first years of life., Design and Methods: 475 premature children and children with allergic risk factors have been selected out of the 1995/1996 birth cohort in the city of Leipzig. Twenty-five volatile organic compounds (VOC) were measured in the infant's bedrooms using passive sampling systems for 4 weeks after birth. The babies underwent a medical examination at the age of six weeks and 1 year. The parents answered a questionnaire., Results: Correlations between VOC exposures and infections were calculated by multiple logistic regression. Selected VOC show a direct association to actually painted dwellings (OR = 2.4; 95% Cl 1.1-5.3). An increase of risk of pulmonary infections was observed in infants aged 6 weeks if restoration (painting OR 5.6; 95% Cl 1.3-24.0) or flooring connected with painting had occurred during the pregnancy period. Higher concentration of styrene (> 2.0 micrograms/m3, indicator for flooring) elevated the risk of pulmonary infections in six-week-old infants (OR = 2.1; 95% Cl 1.1-4.2). Environmental benzene > 5.6 micrograms/m3 increased the risk of airway infections in six-week-old babies (OR = 2.4; 95% Cl 1.28-4.48). Smoking in the dwelling (OR = 2.0; 95% Cl 1.1-3.5) as well as restoration (OR = 1.9; 95% Cl 1.1-3.5) are also risk factors of the development of wheezing in the one-year-old child., Conclusions: The data give indications in order to prevent allergies and chronic lung diseases in atopy risk children exposure to chemicals from indoor air should be minimised from birth on.

Threshold values are of prime importance in providing a sound basis for public health decisions. A key issue is determining threshold or maximum exposure values for pollutants and assessing their potential health risks. Environmental epidemiology could be instrumental in assessing these levels, especially since the assessment of ambient exposures involves relatively low concentrations of pollutants. This paper presents a statistical method that allows the determination of threshold values as well as the assessment of the associated risk using a retrospective, longitudinal study design with a prospective follow-up. Morbidity data were analyzed using the Fourier method, a time-series analysis that is based on the assumption of a high temporal resolution of the data. This method eliminates time-dependent responses like temporal inhomogeneity and pseudocorrelation. The frequency of calls for respiratory distress conditions to the regional Mobile Medical Emergency Service (MMES) in the city of Leipzig were investigated. The entire population of Leipzig served as a pool for data collection. In addition to the collection of morbidity data, air pollution measurements were taken every 30 min for the entire study period using sulfur dioxide as the regional indicator variable. This approach allowed the calculation of a dose-response curve for respiratory diseases and air pollution indices in children and adults. Significantly higher morbidities were observed above a 24-hr mean value of 0.6 mg SO2/m3 air for children and 0.8 mg SO2/m3 for adults.(ABSTRACT TRUNCATED AT 250 WORDS)

Longitudinal epidemiologic studies using descriptive and analytical techniques are suitable for deriving threshold values applicable to extreme emission cases once potential disturbing quantities have been systematically eliminated. Eliminating time responses and thus reducing the problem to the deviation of the related morbidities from the mean curve as a function of the agent concerned, is an essential element of the method. An approach varied according to this method makes it possible to utilize the entire information contained in epidemiologic and air protection data without having to use integrative techniques which would also reduce value and time resolution.