Air pollution and respiratory health of children: the PEACE panel study in Krakow., Poland.

The Krakow panel study was performed as part of the Pollution Effects on Asthmatic Children in Europe (PEACE) project. The aim of the study was to examine the acute effects of short-term changes in air pollution on symptomatic children. Krakow served as the urban area and Rabka, a small health resort 70 km south of Krakow, as the control area. In the first stage, two panels of children (86 from urban and 80 from control area) were selected according to relevant answers to a screening questionnaire. For 12 winter weeks a diary study was performed. Children measured their peak expiratory flow twice a day and made notes on respiratory signs and symptoms, as well as on medication use. Monitoring stations collected data on air pollution in both areas for the same 12 weeks. Multivariate regression models did not show a consistent relationship between air pollution and peak expiratory flow or with respiratory symptom prevalence or incidence. No effect of air pollution could be established

Daily variations in air pollution and respiratory health in a multicentre study: the PEACE project.

The Pollution Effects on Asthmatic Children in Europe (PEACE) study is a multicentre study of the acute effects of particles with a 50% cut-off aerodynamic diameter of 10 μm (PM10), black smoke (BS), sulphur dioxide (SO2) and nitrogen dioxide (NO2) on the respiratory health of children with chronic respiratory symptoms. The study was conducted in the winter of 1993/1994 by 14 research centres in Europe. A total of 2,010 children, divided over 28 panels in urban and suburban locations, was followed for at least 2 months. Exposure to air pollution was monitored on a daily basis. Health status was monitored by daily peak expiratory flow (PEF) measurements and a symptom diary. The association between respiratory health and air pollution levels was calculated with time series analysis. Combined effect estimates of air pollution on PEF or the daily prevalence of respiratory symptoms and bronchodilator use were calculated from the panel-specific effect estimates. Fixed effect models were used and, in cases of heterogeneity, random effect models. No clear associations between PM10, BS, SO2 or NO2 and morning PEF, evening PEF, prevalence of respiratory symptoms or bronchodilator use could be detected. Only previous day PM10 was negatively associated with evening PEF, but only in locations where BS was high compared to PM10 concentrations. There were no consistent differences in effect estimates between subgroups based on urban versus suburban, geographical location or mean levels of PM10, BS, SO2 and NO2. The lack of association could not be attributed to a lack of statistical power, low levels of exposure or incorrect trend specifications. In conclusion, the PEACE project did not show effects of particles with a 50% cutoff aerodynamic diameter of 10 μm, black smoke, sulphur dioxide or nitrogen dioxide on morning or evening peak expiratory flow or the daily prevalence of respiratory symptoms and bronchodilator use

Daily variations in air pollution and respiratory health in a multicentre study: the PEACE project

The Pollution Effects on Asthmatic Children in Europe (PEACE) study is a multicentre studs of the acute effects of particles with a 50% rut-off aerodynamic diameter of 10 mu m (PM10), black smoke (BS), sulphur dioxide (SOL) and nitrogen dioxide (NO2) on the respiratory health of children with chronic respiratory symptoms, The study was conducted in the winter of 1993/1994 by 14 research centres in Europe. A total of 2,010 children, divided over 28 panels in urban and suburban locations, was followed For at least 2 months. Exposure to air pollution was monitored on a daily basis, Health status was monitored hy daily peak expiratory how (PEF) measurements and a symptom diary. The association between respiratory health and air pollution levels was calculated with time series analysis. Combined effect estimates of air pollution on PEI: or the daily prevalence of respiratory symptoms and bronchodilator use were calculated from the panel-specific effect estimates, Fixed effect models were used and, in cases of heterogeneity, random effect models. No clear associations between PM10, BS, SO2 or NO2 and morning PEF, evening PEI, prevalence of respiratory symptoms or bronchodilator use could be detected. Only previous day PM10 was negatively associated with evening PEF, but only in locations where BS was high compared to PM10 concentrations. There were no consistent differences in effect estimates between subgroups based on urban versus suburban, geographical location or mean levels of PM10, BS, SO2 and NO2. The lack of association could not be attributed to a lack of statistical power, low levels of exposure or incorrect trend specifications, In conclusion, the PEACE project did not show effects of particles with a 50% cutoff aerodynamic diameter of IO pm, black smoke, sulphur dioxide or nitrogen dioxide on morning or evening peak expiratory how or the daily prevalence of respiratory symptoms and bronchodilator use

Inter-laboratory comparison of flow-volume curve measurements as quality control procedure in the framework of an international epidemiological study (PEACE project)

The aim of this work was to describe the results of a simple quality control procedure for the flow-volume curve adopted in a multicentre epidemiological study (PEACE). In 14 centres, 8-15 individuals (n = 157) performed forced vital capacity (FVC) manoeuvres following a standard protocol with both the local spirometer/pneumotachograph and a portable spirometer (i.e. the 'reference instrument' for this study). Deviances of measurements were assessed by computing the differences (Delta d) between the former and the latter, the ratios of such differences on portable spirometer values (Delta%) and the coefficients of variation (CV). The portable spirometer yielded lower mean Delta FVC and Delta FEV1 (forced in 1 sec) than local instruments (except for two and four centres, respectively). In most instances, differences were statistically significant. Absolute mean Delta%FVC ranged from 4.9-18.2%, while Delta%FEV1 ranged from 2.3-18.5%. The Bland and Altman analysis showed a good agreement between the portable and local instruments, except for two centres, where a systematic trend towards higher individual absolute Delta FVC and Delta FEV1 was observed. The overall variability, assessed by CV, was within 6.2% and 5.1% for FVC and FEV1, respectively: it was similar to other quality control studies ranging from 2.0-5.5% for FVC and 2.2-5.8% for FEV1. Our results point out the importance of performing interlaboratory comparisons as a quality control procedure in multicentre epidemiological studies on lung function, and of stimulating manufacturers to extend the accuracy and precision of the instruments