Skip to main content

Advertisement

SpringerLink
Log in

The relationship between air pollution and asthma in Malaysian schoolchildren

  • Published:
Air Quality, Atmosphere & Health Aims and scope Submit manuscript

Abstract

Rapid increases in traffic volumes in countries such as Malaysia may lead to exposure to poor air quality both outdoors and indoors. This study investigated asthma symptoms among Malaysian schoolchildren in relation to indoor and outdoor air pollution in urban and semi-rural settings in a school-based cross-sectional study of 1,952 schoolchildren living in urban and semi-rural areas. Parents completed a questionnaire including questions on asthma symptoms and environmental risk factors. Air pollutant concentrations were measured at 16 schools. Analysis used multiple logistic regression controlling for sociodemographic and indoor air pollution factors. A total of 11.4, 7.6, 9.5 and 7.0 % schoolchildren had asthma, current wheeze, dry cough at night and wheezing after exercise, respectively. Asthma and dry cough were significantly higher among urban schoolchildren. A 10-μg/m3 increase in outdoor NO2 level was associated with a twofold increase in the reporting of current wheeze (odds ratio (OR) 1.90; 95 % confidence interval (CI) 1.02–3.52); a 10-μg/m3 increase in indoor PM2.5 was similarly associated with a twofold increase in the reporting of wheeze during exercise (OR 2.08; 95 % CI 1.02–4.26). Secondhand smoke (SHS), mold and the presence of new furniture at home were also linked to asthma symptoms. NO2 concentrations in urban Malaysia frequently exceed those of the international standards. Exposure to traffic-related air pollution may be linked to asthma symptoms among children in Malaysia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Afroz R, Hassan MN, Ibrahim NA (2003) Review of air pollution and health impacts in Malaysia. Environ Res 92:71–77

    Article  CAS  Google Scholar 

  • Annesi-Maesano I, Moreau D, Caillaud D et al (2007) Residential proximity fine particles related to allergic sensitisation and asthma in primary school children. Respir Med 101:1721–729

    Article  Google Scholar 

  • Asher MI, Montefort S, Björkstén B et al (2006) Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC phases I and III repeat multicountry cross-sectional surveys. Lancet 368:733–743

    Article  Google Scholar 

  • Azizi BHO, Henry RL (1991) The effects of indoor environmental factors on respiratory illness in primary school children in Kuala Lumpur. Int J Epidemiol 20:144–150

    Article  CAS  Google Scholar 

  • Clancy L, Goodman P, Sicnlair H, Dockery DW (2002) Effect of air-pollution control on death rates in Dublin, Ireland: an intervention study. Lancet 360:1210–4

    Article  Google Scholar 

  • Cook DG, Strachan DP (1999) Summary of effects of parental smoking on the respiratory health of children and implications for research. Thorax 54:357–365

    Article  CAS  Google Scholar 

  • Delfino RJ (2002) Epidemiologic evidence for asthma and exposure to air toxics: linkages between occupational, indoor, and community air pollution research. Environ Health Perspect 110:573–589

    Article  CAS  Google Scholar 

  • Delfino RJ, Zeiger RS, Seltzer JM et al (1998) Symptoms in pediatric asthmatics and air pollution: differences in effects by symptom severity, anti-inflammatory medication use and particulate averaging time. Environ Health Perspect 106:751

    Article  CAS  Google Scholar 

  • Delfino RJ, Gong H Jr, Linn WS et al (2003) Asthma symptoms in Hispanic children and daily ambient exposures to toxic and criteria air pollutants. Environ Health Perspect 111:647–656

    Article  CAS  Google Scholar 

  • Dockery DW, Rich DQ, Goodman PG, et al. (2013) Effect of air pollution control on mortality and hospital admissions in Ireland. Research report 176. Health Effects Institute, Boston, MA

  • Esworthy R (2013) Report on air quality: EPA's 2013 changes to the particulate matter (PM) standard. Accessed on 24 January 2014. https://www.fas.org/sgp/crs/misc/R42934.pdf

  • Fromme H, Diemer J, Dietrich S et al (2008) Chemical and morphological properties of PM in school classrooms and outdoor air. Atmos Environ 42:6597–6605

    Article  CAS  Google Scholar 

  • Gauderman WJ, Avol E, Lurmann F et al (2005) Childhood asthma and exposure to traffic and NO2. Epidemiol 16:737–743

    Article  Google Scholar 

  • Goyal R, Khare M (2009) Indoor-outdoor concentrations of RSPM in classroom of a naturally ventilated school building near an urban traffic roadway. Atmos Environ 43:6026–6038

    Article  CAS  Google Scholar 

  • Hulin M, Annesi-Maesano I, Caillaud D (2011) Indoor air quality at school and allergy and asthma among schoolchildren: differences between rural and urban areas. Rev Fr Allergol 51:419–424

    Article  Google Scholar 

  • Kim JL, Elfman L, Wieslander G et al (2011) Respiratory health among Korean pupils in relation to home, school and outdoor environment. J Korean Med Sci 26:166–173

    Article  Google Scholar 

  • Lee YL, Lin YC, Hsiue TR et al (2003) Indoor and outdoor environmental exposures, parental atopy, and physician-diagnosed asthma in Taiwanese schoolchildren. Pediatric 112:e385

    Google Scholar 

  • Lee YL, Hwang BF, Lin YC et al (2007) Time trend of asthma prevalence among school children in Taiwan: ISAAC phase I and III surveys. Pediatr Allergy Immunol 18:188–195

    Article  Google Scholar 

  • Malaysian Department of Environment (2011) Environmental quality report 2010. Department of Environment, Malaysia

    Google Scholar 

  • Malaysian Department of Road Transport (2009) Transport statistics. Ministry of Transport, Malaysia

    Google Scholar 

  • Malaysian Ministry of Education (2007) Educational Management Information System (EMIS). Ministry of Education, Malaysia. http://emisonline.moe.gov.my/. Accessed on 16 August 2013

  • McGranahan G, Murray F (2003) Air pollution and health in rapidly developing countries. Earthscan, Canada

    Google Scholar 

  • Mi YH, Norbäck D, Tao J et al (2006) Current asthma and respiratory symptoms among pupils in Shanghai, China: influence of building ventilation, NO2, O3, and formaldehyde in classrooms. Indoor Air 16:454–464

    Article  CAS  Google Scholar 

  • Noorhassim I, Rampal KG, Hashim JH (2007) The relationship between prevalence of asthma and environmental factors in rural households. Med J Malays 50:263–267

    Google Scholar 

  • Parker RA, Rothenberg RB (1988) Identifying important results from multiple statistical tests. Stat Med 7:1031–43

    Article  CAS  Google Scholar 

  • Pattenden S, Antova T, Neuberger M et al (2006) Parental smoking and children's respiratory health: independent effects of prenatal and postnatal exposure. Tob Control 15:294–301

    Article  Google Scholar 

  • Rabinovitch N, Zhang L, Gelfand EW (2006) Urine leukotriene E4 levels are associated with decreased pulmonary function in children with persistent airway obstruction. J Allergy Clin Immunol 118:635–640

    Article  CAS  Google Scholar 

  • Ramadour M, Burel C, Lanteaume A et al (2000) Prevalence of asthma and rhinitis in relation to long-term exposure to gaseous air pollutants. Eur J Allergy Clin Immunol 55:1163–1169

    Article  CAS  Google Scholar 

  • Rampal L, Rampal S, Azhar MZ et al (2008) A national study on the prevalence and factors associated with smoking amongst Malaysians aged 18 years and above. Malays J Med Health Sc 4:41–53

    Google Scholar 

  • Studnicka M, Hackl E, Pischinger J et al (1997) Traffic-related NO2 and the prevalence of asthma and respiratory symptoms in seven year olds. Eur Respir J 10:2275–2278

    Article  CAS  Google Scholar 

  • Vork KL, Broadwin RL, Blaisdell RJ (2007) Developing asthma in childhood from exposure to secondhand tobacco smoke: insights from a meta-regression. Environ Health Perspect 115:1394–1400

    Google Scholar 

  • Weisel CP (2002) Assessing exposure to air toxics relative to asthma. Environ Health Perspect 110:527–37

    Article  CAS  Google Scholar 

  • Wichmann J, Lind T, Nilsson MAM et al (2010) PM2.5, soot and NO2 indoor-outdoor relationships at homes, pre-schools and schools in Stockholm, Sweden. Atmos Environ 44:4536–4544

    Article  CAS  Google Scholar 

  • Zhao Z, Zhang Z, Wang Z et al (2008) Asthmatic symptoms among pupils in relation to winter indoor and outdoor air pollution in schools in Taiyuan, China. Environ Health Perspect 116:90–97

    Article  CAS  Google Scholar 

  • Zuraimi MS, Tham KW, Chew FT et al (2007) The effect of ventilation strategies of childcare centres on indoor air quality and respiratory health of children in Singapore. Indoor Air 17:317–327

    Article  CAS  Google Scholar 

  • Zuraimi MS, Tham KW, Chew FT et al (2008) Home exposures to environmental tobacco smoke and allergic symptoms among young children in Singapore. Int Arch Allergy Immunol 146:57–65

    Article  CAS  Google Scholar 

Download references

Acknowledgments

This study was funded by the Scottish Centre of Indoor Air, University of Aberdeen, the Ministry of Higher Education, Malaysia and Universiti Putra Malaysia. The authors acknowledge the contribution of Nurul Ashima Rohimi, Nur Shazila Mohammed and Mohamad Razlan Abdul Rahman who assisted in the field work as research assistants. The authors acknowledge the contribution of the study participants and their parents, school administrators and teachers for their support and cooperation throughout the period of this study.

Conflict of interest

The authors have no conflict of interest to declare.

Author information

Authors and Affiliations

  1. Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang, 43400, Selangor, Malaysia

    Emilia Zainal Abidin, Irniza Rasdi & Sharifah Norkhadijah Syed Ismail

  2. Scottish Centre for Indoor Air, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, AB25 2ZD, Scotland

    Sean Semple

  3. Child Health, Royal Aberdeen Children’s Hospital, Westburn Road, Aberdeen, AB25 2ZD, Scotland

    Sean Semple

  4. Institute of Occupational and Environmental Medicine, School of Health and Population Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, England

    Jon G. Ayres

Authors
  1. Emilia Zainal Abidin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sean Semple
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Irniza Rasdi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sharifah Norkhadijah Syed Ismail
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jon G. Ayres
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Emilia Zainal Abidin.

Additional information

Contributor statement

EZA, SS, IR and JGA were involved in designing the study and in initiating the concept of the research. EZA collected all data; EZA, SS, IR, SNSI and JGA analysed and interpreted the data and wrote the manuscript. EZA, SS, IR, SNSI and JGA amended the manuscript.

Appendix

Appendix

Table 4 Multiple logistic regression on asthmatic symptoms associated with indoor and outdoor air pollution (OR (95 % CI))
Full size table

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zainal Abidin, E., Semple, S., Rasdi, I. et al. The relationship between air pollution and asthma in Malaysian schoolchildren. Air Qual Atmos Health 7, 421–432 (2014). https://doi.org/10.1007/s11869-014-0252-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11869-014-0252-0

Keywords

Search

Navigation