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VOLUME 111 | NUMBER 12 | September 2003 • Environmental Health Perspectives
Children’s Health Article
Exposure to traffic-related air pollution has
been implicated in impairment of respiratory
health in children in several recent studies,
although the literature is not entirely unequiv-
ocal (Brauer et al. 2002; Brunekreef et al.
1997; Ciccone et al. 1998; Duhme et al. 1996;
Edwards et al. 1994; Gehring et al. 2002;
Hirsch et al. 1999; Kramer et al. 2000;
Livingstone et al. 1996; Oosterlee et al. 1996;
Pershagen et al. 1995; van Vliet et al. 1997;
Weiland et al. 1994; Wjst et al. 1993). Some
of these studies were questionnaire based, relat-
ing self-reported exposures to self-reported
health outcomes (Ciccone et al. 1998; Duhme
et al. 1996; Weiland et al. 1994). Others have
used objective measures of exposure such as dis-
tance to busy roads, traffic counts, and mod-
eled or measured air pollution concentrations
(Brunekreef et al. 1997; Oosterlee et al. 1996;
Pershagen et al. 1995; Roorda-Knape et al.
1998; van Vliet et al. 1997; Wjst et al. 1993),
and objective measures of respiratory function
such as spirometry (Brunekreef et al. 1997;
Wjst et al. 1993) and allergic sensitization by
skin prick test (SPT) or serum immunoglobu-
lin E (IgE) determination (Kramer et al. 2000).
Some studies have also employed health care
use data to assess the health impact of exposure
to traffic-related air pollution (Edwards et al.
1994; Livingstone et al. 1996; Pershagen et al.
1995). Collectively, these studies suggest that
living in situations with high exposure to traf-
fic-related air pollution increases the prevalence
of chronic respiratory symptoms; however, a
relationship with lung function or allergic sen-
sitization has been studied insufficiently to
draw firm conclusions. Most studies have not
been able to single out specific components of
traffic-related air pollution, although some of
the questionnaire studies have focused on self-
reported exposure to truck traffic (Ciccone et
al. 1998; Duhme et al. 1996; Weilan