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ABSTRACT
Numerous studies demonstrated that exposure to ambient air pollutants contributes to severity and frequency of asthma exacerbations. However, whether common air pollutants, such as nitrogen dioxide (NO2) and sulfur dioxide (SO2), exert differential effects on asthma occurrence and severity is unclear. The aim of this investigation was to determine whether exposure to NO2 and/or SO2 may initiate different long-term effects on prevalence and severity of asthma in young adults. Medical records of 137,040 males, 17 years old, who underwent standard premilitary service health examinations during 1999–2008 were examined. Air-pollution data for NO2 and SO2 were linked to the place of residence of each subject. The influence of specific air pollutants on asthma prevalence and severity was evaluated using bivariate logistic regression, controlling for individuals’ sociodemographic attributes. For both ambient air pollutants, there was a significant dose-response effect on severity of asthma at ambient concentrations below the current National Ambient Air Quality Standards. However, in residential areas with high levels of SO2 (13.3–592.7µg/m3) and high levels of NO2 (27.2–43.2µg/m3) the risk of asthma occurrence was significantly higher than that in residential areas with high levels of NO2 (27.2–43.2 µg/m3) and intermediate levels (6.7–13.3 µg/m3) of SO2 pollution. The effects of exposure to SO2 and NO2 air pollutants on the respiratory airways system appear to differ, with possible implications regarding medical management, even in cases of exposure to mixtures of these pollutants.
Acknowledgments
The authors acknowledge help and information provided by Adi Ben-Nun (The Hebrew University of Jerusalem), Dr. Levana Kordova and Ela Green (Ministry of Environmental Protection), Independent Unions of Towns (Ashkelon, Ashdod-Yavneh, Hedera, Haifa), the Israel Electric Company, and Natalya Rybnikova (Haifa University).
Ethics approval
This study was approved by the Ethics Committee of the Israeli Defense Forces (number 1205-2012-2).