22 / 67
20
Multi-Year Research Grants
Prevalence, Extent and Geographical Distribution of Asthma and Atopic
Diseases in Young Adults in Israel and the Relationship with Air Quality
Background: Air pollution from mobile sources is associated with increasing asthma
prevalence. In Israel, traffic is a major air pollution source. We conducted a retrospective
cross-sectional study to evaluate the possible association and its extent between exposure
to nitrogen oxides, markers of traffic-related air pollution and asthma prevalence in
young adults in Israel.
Methods: A searchable database of air pollution in Israel was constructed for the years
1997-2008, based on information from the Ministry for Environmental Protection and
the Israel Electric Company. The study included 36,874 young males who underwent
the Israel Defense Forces (IDF) health examination and lived in one of twenty cities with
at least one air monitoring station. We used half-hourly measurements of NO, NO
2
, and
NO
x
. As proxy for cumulative lifetime exposures to traffic pollution, we examined 1-, 2-,
and 3-year average NO, NO
2
, and NO
x
concentrations assigned to each subject based on
city of residence and date of medical examination using logistic regression models, and
accounting for other confounders.
Results: Physician-diagnosed asthma prevalence occurred in 6.5% of the subjects, 3.4%
with active asthma and 3.1% with non-active asthma. Socio-demographic factors, birth
country of father, birth country, cognitive abilities, education-level, body mass index,
socio-economic status and number of children in the family, were also associated with
asthma prevalence. After accounting for these factors we found high association of
asthma with NO, NO
2
and NO
x
exposure.
Conclusions: Consistent and significant positive associations were found between
asthma prevalence and NO
x
levels which are lower than the exposure standards set
by environmental protection agencies. Among the active asthma group, odd ratios
were considerably higher for NO
2
and NO
x
than among the non-active asthma group,
especially at the highest quintile of exposure. It is possible that residual confounding
due to covariates that were not included in the current modeling approach may explain
some of the observed findings regarding asthma prevalence.
Implications for Israel: The NO
x
pollution standard in Israel is high (as in other
countries). Our results suggest that the standards should be lower in order to reduce
asthma prevalence.
Yinon Rudich
1
| Jeremy Sarnat
2
Arnon Afek
3
| Shlomo Moshe
4
Ron Frimer
5
| Alon Peretz
6
Nili Greenberg
5
1. Weizmann Institute of Science
2. Emory University, USA
3. The Chaim Sheba Medical Center
at Tel Hashomer
4. Maccabi Healthcare Services
5. Medical Corps, Israel Defense
Force (IDF)
6. Clalit Health Services
2008-2012