Traffic Air Pollution and Other Risk Factors for Respiratory Illness in Schoolchildren in the Niger-Delta Region of Nigeria

BACKGROUND Association of childhood respiratory illness with traffic air pollution has been investigated largely in developed but not in developing countries, where pollution levels are often very high. OBJECTIVES In this study we investigated associations between respiratory health and outdoor and indoor air pollution in schoolchildren 7-14 years of age in low socioeconomic status areas in the Niger Delta. METHODS A cross-sectional survey was carried out among 1,397 schoolchildren. Exposure to home outdoor and indoor air pollution was assessed by self-report questionnaire. School air pollution exposures were assessed using traffic counts, distance of schools to major streets, and particulate matter and carbon monoxide measurements, combined using principal components analysis. Hierarchical logistic regression was used to examine associations with reported respiratory health, adjusting for potential confounders. RESULTS Traffic disturbance at home (i.e., traffic noise and/or fumes evident inside the home vs. none) was associated with wheeze [odds ratio (OR) = 2.16; 95% confidence interval (CI), 1.28-3.64], night cough (OR = 1.37; 95% CI, 1.03-1.82), phlegm (OR = 1.49; 95% CI, 1.09-2.04), and nose symptoms (OR = 1.40; 95% CI, 1.03-1.90), whereas school exposure to a component variable indicating exposure to fine particles was associated with increased phlegm (OR = 1.38; 95% CI, 1.09-1.75). Nonsignificant positive associations were found between cooking with wood/coal (OR = 2.99; 95% CI, 0.88-10.18) or kerosene (OR = 2.83; 95% CI, 0.85-9.44) and phlegm compared with cooking with gas. CONCLUSION Traffic pollution is associated with respiratory symptoms in schoolchildren in a deprived area of western Africa. Associations may have been underestimated because of nondifferential misclassification resulting from limitations in exposure measurement.