Imperial College London


Faculty of MedicineNational Heart & Lung Institute

Imperial College Junior Research Fellow



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BibTex format

author = {Butland, BK and Anderson, HR and van, Donkelaar A and Fuertes, EI and Brauer, M and Brunekreef, B and Martin, RV and ISAAC, Phase Three Study Group},
doi = {10.1007/s11869-018-0582-4},
journal = {Air Quality, Atmosphere and Health},
pages = {755--764},
title = {Ambient air pollution and the prevalence of rhinoconjunctivitis in adolescents: A worldwide ecological analysis},
url = {},
volume = {11},
year = {2018}

RIS format (EndNote, RefMan)

AB - Whether exposure to outdoor air pollution increases the prevalence of rhinoconjunctivitis in children is unclear. Using data from Phase Three of the International Study of Asthma and Allergies in childhood (ISAAC) we investigated associations of rhinoconjunctivitis prevalence in adolescents with model-based estimates of ozone, and satellite-based estimates of fine (diameter <2.5µm) particulate matter (PM2.5) and nitrogen dioxide (NO2). Information on rhinoconjunctivitis (defined as self-reported nose symptoms without a cold or flu accompanied by itchy watery eyes in the past 12 months) was available on 505,400 children aged 13-14 years, in 183 centres in 83 countries. Centre-level prevalence estimates were calculated and linked geographically with estimates of long-term average concentrations of NO2, ozone and PM2.5. Multi-level models were fitted adjusting for population density, climate, sex and Gross National Income. Information on parental smoking, truck traffic and cooking fuel was available for a restricted set of centres (77 in 36 countries). Between-centres within-countries, the estimated change in rhinoconjunctivitis prevalence per 100 children, was 0.171 (95% Confidence Interval; -0.013, 0.354) per 10% increase in PM2.5, 0.096 (-0.003, 0.195) per 10% increase in NO2 and -0.186 (-0.390, 0.018) per 1 ppbV increase in ozone. Between-countries, rhinoconjunctivitis prevalence was significantly negatively associated with both ozone and PM2.5. In the restricted dataset, the latter association became less negative following adjustment for parental smoking and open fires for cooking. In conclusion, there were no significant within-country associations of rhinoconjunctivitis prevalence with study pollutants. Negative between-country associations with PM2.5 and ozone require further investigation.
AU - Butland,BK
AU - Anderson,HR
AU - van,Donkelaar A
AU - Fuertes,EI
AU - Brauer,M
AU - Brunekreef,B
AU - Martin,RV
AU - ISAAC,Phase Three Study Group
DO - 10.1007/s11869-018-0582-4
EP - 764
PY - 2018///
SN - 1873-9326
SP - 755
TI - Ambient air pollution and the prevalence of rhinoconjunctivitis in adolescents: A worldwide ecological analysis
T2 - Air Quality, Atmosphere and Health
UR -
UR -
VL - 11
ER -