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Keywords
Abstract	Background: Little information is available on the possible association between hourly short-term air pollution and peak expiratory flow (PEF) in asthmatic children. Methods: PEF was measured twice daily, from October through December, 2000, in 17 children aged 8 to 15 years hospitalized with severe asthma. A total of 1198 PEF measurements were made at 7 a.m. and 1175 at 7 p.m. Measurements were conducted immediately prior to medication under the guidance of trained nurses. PEF changes were estimated in 10-μg/m3 increments of particulate matter with a 50% cut-off aerodynamic diameter of ?2.5 μm (PM2.5), with adjustment for sex, age, height, and temperature. Lagged-hour exposures of up to 24 hours were examined. Results: Increased 24-hour mean concentration of PM2.5 was associated with a decrease in both morning and evening PEF (-3.0 l/minute; 95%CI: -4.6, -1.4 and -4.4 l/minute; 95%CI: -7.1, -1.7, respectively). In addition, hourly concentrations of PM2.5 and PEF showed a significant association between some lags of PM2.5 and PEF. Effect size was almost -3 l/minute in both morning and evening PEF for an hourly PM2.5 concentration of 10 μg/m3 in several lags. Even after adjustment for other air pollutants, some of the significant associations with PEF remained. Conclusion: Among hospitalized children with severe asthma, increased hourly concentration of PM2.5 was associated with a decrease in PEF
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Name	Affiliation	Home page	e-mail	Total pubs
Ando M	Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Japan			1
Nishimuta T	Department of Pediatrics, Shimoshizu National Hospital, 934-5 Shikawatashi, Yotsukaido, Japan			1
Nitta H	Environmental Health Science Division, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Japan			1
Shima M	Department of Public Health, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Japan			1
Watanabe H	Central Research Institute of Electric Power Industry, Energy Engineering Research Laboratory, 2–6–1 Nagasaka, Yokosuka, Kanagawa 240–0196, Japan		whiroaki@criepi.denken.or.jp	2
Yamazaki S	Department of Epidemiology and Healthcare Research, Kyoto University School of Public Health, Yoshidakonoe-cho, Sakyo-ku, Kyoto, Japan		yamazaki.shin@kt8.ecs.kyoto-u.ac.jp	2