Monitoring Nitrogen Dioxide and its Effects on Asthmatic Patients: Two Different Strategies Compared

Objectives: To develop a `methodologyassessment' to evaluate the strengths and theweaknesses of two different epidemiological approachesand to identify the best suited monitoring strategy tomeasure the effects of `normal levels' of nitrogendioxide exposure on the health of an urban population.Methodology: all exposures to nitrogen dioxidewere determined with passive samplers, each samplerconsisting of 3 measuring Palmes tubes. In the firststudy the nitrogen dioxide exposure was assessed in 23school children (11 asthmatic and 12 non asthmatic).Children wore samplers for a week and parallelmeasurements were made in their kitchens, in bedroomsand outside their homes. The second study consisted ina case-control study where the relative risk ofhospital admission was calculated considering nitrogendioxide levels in a city of northern Italy. 110asthmatic patients were compared to a control group of 5322 people.Results: Personal sampler measurementshighlighted significant differences in exposure when nitrogen dioxide atmospheric levels were compared inasthmatic and healthy children (p<0.05). No otherparameters were significant in the two groups. Asignificant action of atmospheric nitrogen dioxide onhospital admission was demonstrated (p<0.01).Conclusions: Although a cause-effect relation assuch cannot be identified, the studies show a relationbetween the exposure to nitrogen dioxide and thepresence of adverse effects on people's health.However the `disadvantage' is for subjects withasthmatic pathologies, compared to the others. Tomanage this problem most effectively, a combinedapproach with the activation of specific personalmonitoring campaigns of the subjects with verifiedrisk seems necessary. This requires `reading' the dataresulting from most extensive and up to dateinformation systems, capable of a thorough controlboth of the living environment and of the clinicaloutcome of the whole population.