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PubMed1999

Use of personal passive samplers for measurement of NO(2), NO, and O(3) levels in panel studies.

We measured personal exposure to nitrogen dioxide (NO(2)), nitrogen monoxide (NO), and ozone (O(3)), using personal passive samplers during three 4-day periods, in a panel study of asthmatics continuing the normal activities of everyday life. Fifty-five adults, mean age 42 years, 53% men, and 39 children, mean age 11 years, 67% boys, wore two Ogawa passive samplers simultaneously: one for O(3), the other for NO(2) and NO. Mean outdoor pollution was measured at a regional monitoring network. Personal exposure levels were scattered; they were (on average) higher than stationary-site levels for NO and lower for NO(2) and O(3). In adults, 41% of the variance of personal exposure to NO(2) was explained by mean stationary-site measurement levels (P<0.0001). Twenty-one percent additional variance was explained by living near a main road, not having an extractor fan over the cooker, older age, and male sex. NO and O(3) personal exposures correlated poorly with stationary-site measurements. In panel studies of the health effects of air pollution, personal exposure to NO(2) and NO can be measured satisfactorily by passive samplers: such measurements are necessary for NO but not for NO(2). For O(3), accurate personal exposure measurement remains a challenge and further technical development is required.

Activities of Daily Living↗
PubMedDate not supplied

Short-term effects of air pollution on mortality in the cities of Rouen and Le Havre, France, 1990-1995.

In this study, the authors examined the short-term effects of ambient air pollution on mortality across 2 French cities: Rouen and Le Havre. In Poisson regression models, which controlled for day-of-week effects, the authors used nonparametric smoothing to control for temporal trend, weather, and influenza epidemics. In Rouen, an interquartile range increase of 60.5-94.1 microg/m3 of ozone was associated with an increase of 4.1% (95% confidence interval = 0.6, 7.8) of total mortality. Daily variations in sulfur dioxide (interquartile range increase = 17.6-36.4 microg/m3) were also associated with an 8.2% increase (95% confidence interval = 0.4, 16.6) in respiratory mortality. An increase of 6.1% (95% confidence interval = 1.5, 10.9) of cardiovascular mortality was also observed with an interquartile range increase of nitrogen dioxide (i.e., 25.3-42.2 microg/m3). With respect to Le Havre, an interquartile range increase in daily levels of sulfur dioxide (11.3-35.6 microg/m3) was associated with an increase of approximately 3% (95% confidence interval = 0.8, 5) of cardiovascular mortality. For particulate matter less than or equal to 13 microm in diameter (interquartile increase = 21.5, 45.4 microg/m3), an increase of 6.2% (95% confidence interval = 0.1, 12.8) was observed. The estimates of pollutant effects and their standard deviations were slightly affected by the degree of smoothing temporal variations in this study. When low collinearity was present, the 2-pollutant models provided acceptable estimates of pollutant effects. They suggested that the ozone effect was independent of the Black Smoke effect, and that the effects of sulfur dioxide and nitrogen dioxide were unlikely to be confounded by ozone concentrations. However, high collinearity leads to large estimates of the pollutant coefficient variances and, therefore, leads to inaccurate estimates of pollutant effects. The analysis of the contributory effects of different pollutant mixtures requires further investigation in those instances in which high collinearity between pollutants is present.

Air Pollutants↗
PubMed2002

A combined analysis of the short-term effects of photochemical air pollutants on mortality within the EMECAM project.

In recent years, some epidemiologic studies have attributed adverse effects of air pollutants on health not only to particles and sulfur dioxide but also to photochemical air pollutants (nitrogen dioxide and ozone). The effects are usually small, leading to some inconsistencies in the results of the studies. Furthermore, the different methodologic approaches of the studies used has made it difficult to derive generic conclusions. We provide here a quantitative summary of the short-term effects of photochemical air pollutants on mortality in seven Spanish cities involved in the EMECAM project, using generalized additive models from analyses of single and multiple pollutants. Nitrogen dioxide and ozone data were provided by seven EMECAM cities (Barcelona, Gijón, Huelva, Madrid, Oviedo, Seville, and Valencia). Mortality indicators included daily total mortality from all causes excluding external causes, daily cardiovascular mortality, and daily respiratory mortality. Individual estimates, obtained from city-specific generalized additive Poisson autoregressive models, were combined by means of fixed effects models and, if significant heterogeneity among local estimates was found, also by random effects models. Significant positive associations were found between daily mortality (all causes and cardiovascular) and NO(2), once the rest of air pollutants were taken into account. A 10 microg/m(3) increase in the 24-hr average 1-day NO(2)level was associated with an increase in the daily number of deaths of 0.43% [95% confidence interval (CI), -0.003-0.86%] for all causes excluding external. In the case of significant relationships, relative risks for cause-specific mortality were nearly twice as much as that for total mortality for all the photochemical pollutants. Ozone was independently related only to cardiovascular daily mortality. No independent statistically significant relationship between photochemical air pollutants and respiratory mortality was found. The results in this study suggest that, given the present levels of photochemical pollutants, people living in Spanish cities are exposed to health risks derived from air pollution.

Adolescent↗
PubMed1987

Mechanism of autocatalytic oxidation of oxyhemoglobin by nitrite.

Oxidation of oxyhemoglobin by nitrite is characterized by the presence of a lag phase followed by autocatalysis. The stoichiometry of the overall reaction is described by the following equation: 4HbO2 + 4NO2- + 4H+ = 4Hb+ + 4NO3- + O2 + 2H2O (Hb denotes hemoglobin monomer). During the oxidation, we detected a free radical at g = 2.005, which is very similar to the methemoglobin free radical generated by the reaction with hydrogen peroxide. Nitrosylhemoglobin was not detected. The oxidation was delayed by the addition of KCN or catalase, but was not modified by superoxide dismutase in phosphate buffer. In bistris buffer, however, superoxide dimutase markedly prolonged the lag phase. The results suggest that during the oxidation, the methemoglobin peroxide compound is generated and converts nitrite into nitrogen dioxide by its peroxidatic activity. Nitrogen dioxide oxidizes oxyhemoglobin to methemoglobin and nitrite, yielding the autocatalytic phase.

Electron Spin Resonance Spectroscopy↗
PubMedDate not supplied

A survey of effects of gaseous and aerosol pollutants on pulmonary function of normal males.

A total of 231 normal male human subjects were exposed for 4 hr to air, ozone, nitrogen dioxide, or sulfur dioxide; to sulfuric acid, ammonium bisulfate, ammonium sulfate, or ammonium nitrate aerosols; or to mixtures of these gaseous and aerosol pollutants. Only one concentration of each pollutant was used. This study, therefore, represents a preliminary survey, intended to allow direct comparison of studies to plan future research. During exposure each subject had two 15-min exercise sessions on a treadmill at 4 mph and 10% grade. Environmental conditions were mildly stressful, i.e., temperature = 30 degrees C and relative humidity = 60%. A battery of 19 measurements of pulmonary function was performed just prior to exposure (air control); 2 hr into the exposure, following the first exercise session; 4 hr into the exposure, following the second exercise session; and 24 hr after exposure. Significant differences were noted in specific airway resistance (SRAW), forced vital capacity (FVC), and forced expiratory flow at 50% of FVC (FEF50) and in related measurements in those experimental groups exposed to ozone or to ozone plus aerosols. None of the aerosols alone, nitrogen dioxide or sulfur dioxide alone, or mixtures of nitrogen dioxide or sulfur dioxide with aerosols produced significant effects. A distribution analysis of subject responsivity to ozone gave a normal distribution among subjects not exposed to ozone, and a distribution shifted to the right and skewed to the right among those exposed to ozone alone or in mixture, with no evidence of bimodal distribution of ozone sensitivity.

Aerosols↗
PubMed1997

A delivery system for inhalation of nitric oxide evaluated with chemiluminescence, electrochemical fuel cells, and capnography.

OBJECTIVE: To evaluate a system for delivery of inhaled nitric oxide. DESIGN: Prospective, laboratory study. SETTING: Engineering laboratory. SUBJECTS: A standard ventilator (Servo Ventilator 300), supplemented with extra gas modules for nitric oxide delivery. INTERVENTIONS: Two ventilator-integrated gas modules, delivering < or = 10 parts per million (ppm) or < or = 100 ppm of nitric oxide, were used in adult and neonatal modes during volume-controlled ventilation. Set nitric oxide concentration and FIO2 were systematically changed and compared with the measured concentration. Short-term mixing was tested in adult, pediatric, and neonatal modes by substituting nitric oxide with CO2, and measuring the delivered concentration by a fast-response CO2 analyzer during five successive respiratory cycles. Long-term mixing was tested with the administration of 25 ppm of nitric oxide for 7 days. MEASUREMENTS AND MAIN RESULTS: Delivered concentration of nitric oxide and nitrogen dioxide were simultaneously measured at the Y-place by two methods-chemiluminescence and electro-chemical fuel cells. The maximum absolute difference between set and measured concentrations of nitric oxide in the adult mode was 0.6 ppm at a set concentration of 10 ppm and 2.7 ppm at a set concentration of 100 ppm. In the neonatal mode, the maximal difference was 3.1 ppm at a set concentration of 100 ppm. Nitrogen dioxide concentration increased with increasing concentration of nitric oxide and oxygen to 2.6 ppm (as measured by the chemiluminescence analyzer) and 3.6 ppm (as measured by the electro-chemical fuel cell), at a setting of 100 ppm of nitric oxide with an FIO2 of 0.90 in the neonatal mode (2 L/min). During the short-term test of mixing stability throughout the respiratory cycles, a constant set CO2 concentration varied maximally by +/-6.2% from the set value in the neonatal mode, whereas the variance was by +/-6.5% in pediatric mode, and by +/-8.0% in the adult mode. During the long-term test, nitric oxide concentration varied maximally by +/-2.6% (as measured by the chemiluminescence analyzer) and by +/-2.3% (as measured by the electrochemical fuel cell). CONCLUSIONS: An accurate precision in delivered nitric oxide concentration was achieved during intermittent flow ventilation, and this accuracy was independent of tested ventilator settings. The delivery system administered an almost stable concentration throughout a respiratory cycle and during long-term delivery. If the mixing point is in the inspiratory part of the ventilator, valid measurement of nitric oxide and nitrogen dioxide delivery concentrations are possible. Both techniques for measuring nitric oxide and nitrogen dioxide have drawbacks.

Administration, Inhalation↗
PubMed2006

Low levels of air pollution induce changes of lung function in a panel of schoolchildren.

In search of sensitive screening parameters for assessing acute effects of ambient air pollutants in young schoolchildren, the impact of 8-h average air pollution before lung function testing was investigated by oscillatory measurements of resistance and spirometry with flow-volume loops. At a central elementary school in Linz, the capital of Upper Austria, 163 children aged 7-10 yrs underwent repeated examinations at the same time of day during 1 school year, yielding a total of 11-12 lung function tests per child. Associations to mass concentrations of particulate matter and nitrogen dioxide (NO(2)) measured continuously at a nearby monitoring station were tested, applying the Generalised Estimating Equations model. Reductions per 10 microg.m(-3) (both for particles and for NO(2)) were in the magnitude of 1% for most lung function parameters. The most sensitive indicator for acute effects of combustion-related pollutants was a change in maximal expiratory flow in small airways. NO(2) at concentrations below current standards reduced (in the multipollutant model) the forced expiratory volume in one second by 1.01%, maximal instantaneous forced flow when 50% of the forced vital capacity remains to be exhaled (MEF(50%)) by 1.99% and MEF(25%) by 1.96%. Peripheral resistance increased by 1.03% per 10 microg.m(-3) of particulate matter with a 50% cut-off aerodynamic diameter of 2.5 mum (PM(2.5)). Resistance is less influenced by the child's cooperation and should be utilised more often in environmental epidemiology when screening for early signs of small airway dysfunction from urban air pollution, but cannot replace the measurement of MEF(50%) and MEF(25%). In the basic model, the reduction of these parameters per 10 microg.m(-3) was highest for NO(2), followed by PM(1), PM(2.5) and PM(10), while exposure to coarse dust (PM(10)-PM(2.5)) did not change end-expiratory flow significantly. All acute effects of urban air pollution found on the lung function of healthy pupils were evident at levels below current European limit values for nitrogen dioxide. Thus, planned reduction of nitrogen dioxide emission (Euro 5; vehicles that comply with the emission limits as defined in Directive 99/96/EC) of 20% in 2010 would seem to be insufficient.

Air Pollution↗
PubMed2005

Aqueous atmospheric chemistry: formation of 2,4-dinitrophenol upon nitration of 2-nitrophenol and 4-nitrophenol in solution.

Field studies have shown that the powerful phytotoxic agent 2,4-dinitrophenol is very likely to form in the atmospheric aqueous phase upon nitration of 2-nitrophenol or 4-nitrophenol. However, until now, the nitration pathway and the relative importance of the two mononitrophenols as sources of 2,4-dinitrophenol were not known. The present study shows that 2,4-dinitrophenol formation from mononitrophenols can take place upon photolysis and photooxidation of nitrite/nitrous acid (NO2-/HONO) and that nitrogen dioxide plays a key role in the process. A possible pathway might be the reaction between light-excited mononitrophenols (both 2- and 4-isomers) and nitrogen dioxide, in the presence of oxygen. As an alternative, nitration might involve *NO3 + *NO2. Possible sources of nitrogen dioxide in the atmospheric aqueous phase are dissolution from the gas phase and oxidation of NO2-. In the latter case, however, it is necessary that NO2- oxidation is faster than the oxidation of mononitrophenols. This would happen, for instance, in the presence of hematite under irradiation. Radiation absorption and scattering by hematite would also inhibit the direct photolysis of nitrophenols. The formation rate and the yield of 2,4-dinitrophenol are slightly higher when starting from 2-nitrophenol than those from 4-nitrophenol, but they are compensated by the higher concentration of 4-nitrophenol in the atmospheric aqueous phase.

2,4-Dinitrophenol↗
PubMed2003

Effects of carbon dioxide and nitrogen on adhesive growth and expressions of E-cadherin and VEGF of human colon cancer cell CCL-228.

AIM: To study the effects of carbon dioxide on the metastatic capability of cancer cells, and to compare them with that of nitrogen. METHODS: The colon cancer cell CCL-228 was treated with 100 % carbon dioxide or nitrogen at different time points and then cultured under normal condition. Twelve hours after the treatment, the survival rates of suspension cells and the expressions of e-cadherin and VEGF were examined. RESULTS: After 60 min of carbon dioxide and longer time of nitrogen treatment, the suspended cells increased and the expression of e-cadherin decreased while the expression of VEGF was enhanced significantly. And the effects of nitrogen were similar to, but weaker than, those of carbon dioxide. CONCLUSION: Carbon dioxide may improve the metastatic capability of cancer cells and its effects are significantly stronger than that of nitrogen. A sequential use of carbon dioxide and nitrogen in pneumoperitoneum may take the advantage of both gases.

Cadherins↗
PubMed1993

A new model of progressive pulmonary fibrosis in rats.

Sprague-Dawley rats were exposed for 6 h daily to 0.8 ppm of ozone and 14.4 ppm of nitrogen dioxide. Approximately 7 to 10 wk after the initiation of exposure, animals began to demonstrate respiratory insufficiency and severe weight loss. About half of the rats died between Days 55 and 78 of exposure; no overt ill effects were observed in animals exposed to filtered air, to ozone alone, or to nitrogen dioxide. Biochemical findings in animals exposed to ozone and nitrogen dioxide included increased lung content of DNA, protein, collagen, and elastin, which was about 300% higher than the control values. The collagen-specific crosslink hydroxy-pyridinium, a biomarker for mature collagen in the lung, was decreased by about 40%. These results are consistent with extensive breakdown and remodeling of the lung parenchyma and its associated vasculature. Histopathologic evaluation showed severe fibrosis, alveolar collapse, honeycombing, macrophage and mast cell accumulation, vascular smooth muscle hypertrophy, and other indications of severe progressive interstitial pulmonary fibrosis and end-stage lung disease. This unique animal model of progressive pulmonary fibrosis resembles the final stages of human idiopathic pulmonary fibrosis and should facilitate studying underlying mechanisms and potential therapy of progressive pulmonary fibrosis.

Administration, Inhalation↗
PubMed2002

Evaluation of the first phase of sulfur dioxide and nitrogen oxides provisions of the 1990 Clean Air Act: a plant-based approach.

Electric power generating plants that use coal were among the key targets of Title IV of the 1990 Clean Air Act. Under the first phase of the act, 110 coal-fired electric power plants were required to reduce their sulfur dioxide emissions by 1995 and nitrogen oxide emissions by 1996. Phase 2 of the act requires even greater reduction of sulfur dioxide emissions by 2000 and nitrogen oxide emissions by 2008. This study examines whether the 107 targeted plants (three plants went off-line) have achieved the desired sulfur dioxide and nitrogen oxide emission levels. The analysis of sulfur dioxide is based on data from 1990, 1995, and 1999. The findings show that although sulfur oxide increased by 3% from 1995 to 1999, it decreased by 45% over the 1990-1999 period at the firm level for the targeted firms. The findings also indicate that the overall reduction in sulfur dioxide was achieved by utilizing low sulfur coal and by purchasing emission allowances. So far as nitrogen oxides are concerned, there has been a reduction of 14% over the 1990-1999 period, of which 7% was achieved during the 1995-1999 period. An evaluation of emissions at the plant level indicates that several plants do not meet the emissions level for sulfur dioxide or nitrogen oxides. These results provide a mixed scorecard for reduction in emissions both for sulfur dioxide and nitrogen oxides. Even though there is reduction in the emissions on an overall basis at the firm level, several plants that have not been able to reduce emissions deserve special attention to meet the goals of the act in reducing emissions.

Air Pollution↗
PubMed1978

Airborne bacteria in an urban environment.

Samples were taken at random intervals over a 2-year period from urban air and tested for viable bacteria. The number of bacteria in each sample was determined, and each organism isolated was identified by its morphological and biochemical characteristics. The number of bacteria found ranged from 0.013 to 1.88 organisms per liter of air sampled. Representatives of 19 different genera were found in 21 samples. The most frequently isolated organisms and their percent of occurence were Micrococcus (41%), Staphylococcus (11%), and Aerococcus (8%). The bacteria isolated were correlated with various weather and air pollution parameters using the Pearson product-moment correlation coefficient method. Statistically significant correlations were found between the number of viable bacteria isolated and the concentrations of nitric oxide (-0.45), nitrogen dioxide (+0.43), and suspended particulate pollutants (+0.56). Calculated individually, the total number of Micrococcus, Aerococcus, and Staphylococcus, number of rods, and number of cocci isolated showed negative correlations with nitric oxide and positive correlations with nitrogen dioxide and particulates. Statistically significant positive correlations were found between the total number of rods isolated and the concentration of nitrogen dioxide (+0.54) and the percent relative humidity (+0.43). The other parameters tested, sulfur dioxide, hydrocarbons, and temperature, showed no significant correlations.

Air Microbiology↗
PubMed2006

Vehicle exhaust exposure in an incident case-control study of adult asthma.

The objective of this case-control study was to evaluate whether traffic-related air pollution exposure at home increases the risk of asthma in adults and to compare two commonly used exposure variables and differences between urban and rural living. Incident cases of asthma and matched controls of subjects aged 20-60 yrs were recruited in Luleå, Sweden. In total 203 cases and 203 controls were enrolled in the study. Exposure was estimated by traffic flow and measured levels of outdoor nitrogen dioxide (NO2) in the surrounding environment of each home, respectively. The relationship between measured levels of NO2 and traffic flow was studied using linear regression. The results indicated a nonsignificant tendency between living in a home close to a high traffic flow and an increased risk of asthma. The association between asthma and measured NO2 was weak and not significant, but the skin-prick test result acted as an effect modifier with a borderline significant association among positives. The correlation between traffic flow and outdoor NO2 was low. The results suggest that living close to high traffic flows might increase the asthma incidence in adults, while the tendency for nitrogen dioxide was only seen among atopics. Traffic flow and nitrogen dioxide had a lower than expected correlation.

Adult↗
PubMed2004

Exposure to NO2 and nitrous acid and respiratory symptoms in the first year of life.

BACKGROUND: Effects of nitrogen dioxide (NO2) on respiratory health have been the subject of extensive research. The outcomes of these studies were not consistent. Exposure to nitrous acid, which is a primary product of combustion, and is also formed when NO2 reacts with water, may play an important role in respiratory health. We estimate the independent effects of exposure to nitrogen dioxide and nitrous acid on respiratory symptoms during the first year of life. METHODS: Nitrogen dioxide and nitrous acid concentrations were measured once (1996-1998) in the homes of 768 infants who were at risk for developing asthma. Infants were living in southern New England. The frequency of respiratory symptoms in these children was recorded during the first year of life. RESULTS: Infants living in homes with an NO2 concentration exceeding 17.4 ppb (highest quartile) had a higher frequency of days with wheeze (rate ratio = 2.2; 95% confidence interval = 1.4-3.4), persistent cough (1.8; 1.2-2.7), and shortness of breath (3.1; 1.8-5.6) when compared with infants in homes that had NO2 concentrations lower than 5.1 ppb (lowest quartile), controlling for nitrous acid concentration. Nitrous acid exposure was not independently associated with respiratory symptoms. CONCLUSIONS: Among infants at risk for developing asthma, the frequency of reported respiratory symptoms in the first year of life was associated with levels of NO2 not currently considered to be harmful.

Air Pollution, Indoor↗
PubMed2005

Particulate air pollution and the rate of hospitalization for congestive heart failure among medicare beneficiaries in Pittsburgh, Pennsylvania.

The authors used a case-crossover approach to evaluate the association between ambient air pollution and the rate of hospitalization for congestive heart failure among Medicare recipients (aged > or =65 years) residing in Allegheny County (Pittsburgh area), Pennsylvania, during 1987-1999. They also explored effect modification by age, gender, and specific secondary diagnoses. During follow-up, 55,019 patients were admitted with a primary diagnosis of congestive heart failure. In single-pollutant models, particulate matter with an aerodynamic diameter of <10 microm (PM(10)), carbon monoxide, nitrogen dioxide, and sulfur dioxide-but not ozone-were positively and significantly associated with the rate of admission on the same day. The strongest associations were observed with carbon monoxide, nitrogen dioxide, and PM(10). The associations with carbon monoxide and nitrogen dioxide were the most robust in two-pollutant models, remaining statistically significant even after adjusting for other pollutants. Patients with a recent myocardial infarction were at greater risk of particulate-related admission; otherwise, there was no significant effect modification by age, gender, or other secondary diagnoses. These results suggest that short-term elevations in air pollution from traffic-related sources may trigger acute cardiac decompensation in heart failure patients and that those with certain comorbid conditions may be more susceptible to these effects.

Age Factors↗
PubMed2001

Air pollution from traffic at the residence of children with cancer.

The hypothesis that exposure to traffic-related air pollution increases the risk of developing cancer during childhood was investigated. The authors enrolled 1,989 children reported to the Danish Cancer Registry with a diagnosis of leukemia, tumor of the central nervous system, or malignant lymphoma during 1968-1991 and 5,506 control children selected at random from the entire childhood population. The residential histories of the children were traced from 9 months before birth until the time of diagnosis of the cases and a similar period for the controls. For each of the 18,440 identified addresses, information on traffic and the configuration of streets and buildings was collected. Average concentrations of benzene and nitrogen dioxide (indicators of traffic-related air pollution) were calculated for the relevant period, and exposures to air pollution during pregnancy and during childhood were calculated separately. The risks of leukemia, central nervous system tumors, and all selected cancers combined were not linked to exposure to benzene or nitrogen dioxide during either period. The risk of lymphomas increased by 25% (p for trend = 0.06) and 51% (p for trend = 0.05) for a doubling of the concentration of benzene and nitrogen dioxide, respectively, during the pregnancy. The association was restricted to Hodgkin's disease.

Adolescent↗
PubMed2002

[Traffic-related air pollution at the place of residence and risk of cancer among children].

INTRODUCTION: The hypothesis that exposure to traffic-related air pollution increases the risk of cancer developing during childhood was investigated. MATERIALS AND METHODS: We enrolled 1,989 children notified to the Danish Cancer Registry with a diagnosis of leukaemia, tumour of the central nervous system (CNS), or malignant lymphoma during 1968-1991, and 5,506 control children selected at random from the entire childhood population. The residential histories of the children were traced from nine months before birth up to the time of diagnosis, as was a similar period for the controls. Information on traffic and the configuration of streets and buildings was collected for each of the 18,440 identified addresses. Concentrations of benzene and nitrogen dioxide (indicators of traffic-related air pollution) were calculated for the relevant residential periods, and combined into exposures to air pollution during pregnancy and childhood, respectively. RESULTS: The risks of leukaemia, CNS tumours, and all selected cancers combined were not related to exposure to benzene or nitrogen dioxide during either period. The risk of lymphomas increased by 25% (p for trend = 0.06) and 51% (p for trend = 0.05) for a doubling of the concentration of benzene and nitrogen dioxide, respectively, during the pregnancy. The association was restricted to Hodgkin's disease. DISCUSSION: On the basis of a low potential for selection bias, information bias, and confounding factors, we conclude that traffic-related air pollution at the residence of children is not linked to the risk of leukaemia or CNS tumour, which are the two major types of childhood cancer. The results indicated a possible association between air pollution and the risk of Hodgkin's disease, but the evidence allows of no firm conclusion at present.

Adolescent↗