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levels compared to those children living in less exposed areas (Braun-Fahrlander, Vuille et al.
1997). In a prospective, observational study over one year and comparing 1025 children
presenting with wheezy episodes with other admissions as a control group, the day to day
variations in the concentration of ozone were associated with an increased incidence in acute
wheezy episodes @uchdahl, Parker et al. 1996). Children living along a busy street were
found to have a higher prevalence for most respiratory symptoms than children living along a
quiet street. This was most significant for medication use and for episodes of wheeze
(Oosterlee, Drijver et al. 1996). Children admitted with asthma were more likely to live in an
area of high traffic flow compared to admissions for non-respiratory reasons or a community
sample of children with a significantly linear trend observed for traffic flow for children
living less than 500 metres from a main road @dwards, Walters et al. 1994). This study also
showed that children were more likely to be admitted for non-respiratory reasons compared to
the community sample of children if they lived within 200 metres of a main road. Similarly
results for atopy and road traffic have also been demonstrated with, for example, higher rates
of allergic sensitization found in children playing more than one hour per day near major
traffic thoroughfares (Brunekreef, Janssen et al. 1997).
Some studies have incorporated lung function testing to look at the effects of air pollution.
The lungs develop throughout childhood, with peak lung function occurring between 20 and
25 years, followed by a plateau of ten years before beginning to decline. A deficit in growth
caused by air pollution effects, for example, would most likely translate into a reduced
baseline function that would be carried throughout life (Gilliland, Gauderman et al. 2ffi2;
Gauderman 2006). Air pollution data from monitoring stations in twelve California
communities demonstrated that a greater proportion of young adults with and FEVr less than
80Vo predrcted lived in the areas of higher carbon and PM10 (Gauderman, Vora et al.2007).
An inverse dose dependent relationship was found between the carbon content of airway
macrophages in induced sputum and FEVr, FVC and FEFzs-zs in healthy children living in an
area with a variation of PMl0, primarily due to emissions from road traffic (Kulkarni, Pierse
et al. 2O06). Reviewing the age goup six years to 24 years of age, FVC, FEVr and PEF all
showed statistically significant negative correlations with the annual concentrations of total
suspended particles, NOz and ozone (Schwartz 1989). The relationships still persisted when
children with pre-existing respiratory illnesses and smokers were included. Furthermore in a
longitudinal three year study, children exposed to high PMl0 levels during the summer had a
reduced growth of FEVr and FEFzs-zs (Horak, Studnicka et al. 2002). A reduction in lung
function with higher levels of ozone was also demonstrated in children from three schools in
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