Prevalence of asthma and mean levels of air pollution: Results from the French PAARC survey

Among the possible explanations for the recent increase in the prevalence of asthma in several countries, air pollution is one of the foremost public health concerns. Data from the 'Pollution Atmospherique et Affections Respiratoires Chroniques' (PAARC) survey collected in 24 areas of seven French towns during 1974-1976 were reanalysed to assess the relationship between the prevalence of asthma and the following air pollutants: sulphur dioxide (specific (SO2) and acidimetric methods), total suspended particles (TSP), black smoke (BS), nitrogen dioxide and nitric oxide. Correlation coefficients between annual mean levels of pollution and prevalence of asthma in the different areas were first calculated. Random- effects models were then estimated. Of the 20,310 adults aged 25-59 yrs, 1,291 (6.4%) were found to be asthmatics as well as 195 (6.1%) of the 3,193 children aged 5-9 yrs. A geographical correlation between asthma and annual mean level of SO2 (ranging 17-85 μg · m-3) was found (r=-0.45, p=0.01) in adults. No relationship was found in children. After controlling for age, educational level, smoking, and geographical clustering with a multivariate random-effects model, the relationship remained significant in adults for SO2 (odds ratio for a 50 μg m-3 increase=1.24, confidence interval 1.08- 1.44, p=0.0035). It also remained significant when taking into account only the people reporting their last asthma attack occurring after settling in the study area. These results are consistent with the known short-term effects of SO2 in asthma and demonstrate the necessity for further studies on delayed effects of air pollution in respiratory diseases.