Thematic Poster Session

Hall A-34 - 12:50-14:40

T UESDAY, S EPTEMBER 15 TH 2009

P4060 Individual status, genetics, environment and childhood asthma: a meta-analysis of case-control studies in China Weijian Jiang 1 , Minhui Chen 2 . 1 Department of Pharmacy, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, China; 2 Guangzhou Institute of Respiratory Diseases, First Afliated Hospital of Guangzhou Medical College, Guangzhou, China Background: Studies of epidemiology have assessed the association of many risk factors with childhood asthma in China. However, there is heterogeneity in the published literature regarding its role in childhood asthma. Objective: To review published literature and perform a meta-analysis summarizing the evidence in support of the association between childhood asthma and three exposure factors (passive smoking, family history of asthma and individual allergic status). Methods: We systematically searched online database which included China Journals Full-text Database and China Master Theses Full-text Database for publications since 2002. The meta-analysis included only original studies. It was used to derive a combined odds ratio (OR) and 95% condence interval (CI) and test for heterogeneity in the ndings between studies. Results: Six studies met inclusion criteria. Compared with control, family history of asthma conferred the most signicant increased odds of childhood asthma, with an OR of 6.20 (95% CI, 3.99-8.41). Similar increase in the OR of childhood asthma due to individual allergic status (OR, 4.83; 95%CI, 2.53-7.13), and passive smoking (OR, 3.13; 95%CI, 2.23-4.03) was also observed. In this analysis, there was no evidence of heterogeneity that was statistically signicant (P<0.01). Conclusions: This meta-analysis found strong and consistent associations between family history of asthma and childhood asthma in China. It also suggests that there may be important effects of passive smoking and individual allegoric status on childhood asthma. This warrants further investigation in large studies and meta-analysis.

348. Epidemiology of childhood asthma: prevalence, risk factors and quality of life
P4058 Wheezing during the rst year of life: a population based survey in Madrid, Spain Gloria Garcia-Hernandez, Antonio Martinez-Gimeno, Carmen Luna-Paredes, Francisca Gomez-Acebo-Jerico, Juan-Luis Anton-Pacheco. Pediatric Airway Unit, Hospital Universitario 12 de Octubre, Madid, Spain Data on the prevalence and severity of wheezing disorders in the rst year of life are scarce. We performed a population based survey using a previously validated questionnaire (Mallol J et al. Int Arch Allergy Immunol. 2007;144:44-50) to assess the prevalence and severity of wheezing during the rst year of life and its potential association with some risk factors. 6810 questionnaires were distributed in primary care centres of the 11th health district of Madrid, Spain, and the parents of 2240 infants (1060 males) lled out and returned the questionnaire when the infants were 12-15 month-old (response rate: 32.9%). The percentage of infants whose parents reported at least one episode of wheeze during the rst year of life was 38.4% (45.3% among males, 32.2% among females), 13.4% had suffered more than three episodes, 3,6% more than six and 18,8% had visited emergency rooms for this reason. 8.9% had received a physicians diagnosis of asthma. Factors associated with an increased prevalence of wheeze (multivariate logistic regression model) were an atopic rst degree relative, paracetamol use during pregnancy by the mother, diabetes during pregnancy, premature rupture of membranes, caesarean section, day care attendance, smoking at home (mainly by the mother) and pets at home. Parents origin and mothers food intake during pregnancy were not associated with an increase of prevalence of wheeze. We conclude that the prevalence of wheezing disorders during the rst year of life is high in Madrid. Main factors associated with an increase of its prevalence are family atopy, prenatal and perinatal factors, day care attendance and smoking at home.

P4061 Prevalence of asthma among adolescents in tobacco growing area of the Republic of Uzbekistan Shukhrat Ziyadullaev, Nazira Khaitova, Nematilla Aralov. Therapy, Samarkand State Medical Institute, Samarkand, Uzbekistan; Therapy, Samarkand State Medical Institute, Samarkand, Uzbekistan; Therapy, Samarkand State Medical Institute, Samarkand, Uzbekistan Aim: To study the epidemiological situation of bronchial asthma among children in adolescence Urgut tobacco growing region of the Republic of Uzbekistan. Methods: The methods of the survey included: a survey by questionnaire ISAAC; study of lung ventilation function in the unit SPIROSIFT SP-5000 (Fukuda DENSHI, Japan) with automatic processing parameters, a provocative and dilatation tests. Results: We have examined 2711 adolescent children - students in colleges and lyceums Urgut tobacco growing area. According to our data, children and adolescents with the presence of asthma was 393, representing 14.5% of all surveyed. Conclusions: The bronchial asthma in adolescence is relatively more prevalent in the region of the Republic of Uzbekistan tobacco growing that may be related to the cultivation of tobacco products and the adverse impact of tobacco production in the bronchial system.

P4059 Prevalence of childhood asthma in Greece: plateau has been reached after 30 years Sotirios Fouzas 1 , Eugenia Panagiotopoulou 1 , Evangelos Liolios 2 , Angeliki Pantiora 1 , Maria Trigka 1 , Michael B. Anthracopoulos 1 , Kostas N. Priftis 3 . 1 Respiratory Unit, Pediatric Department, University Hospital of Patras, Patras, Greece; 2 Pediatrician, Health Center of Chalandritsa, Patras, Greece; 3 Department of Alergy-Pneumonology, Penteli Childrens Hospital, P. Penteli, Athens, Greece Background and aim: The prevalence of asthma was measured by parental questionnaire among 3rd and 4th grade public school students in the city of Patras, Greece in 1978, 1991, 1998 and 2003. The prevalence of current asthma (physician diagnosed asthma [PDA] or 2 episodes of wheezing during the last two years) was 1.5%, 4.6%, 6.0% and 6.9%, respect vely. Lifetime prevalence (ever had physician diagnosed asthma PDA or wheezing) was 8.0%, 9.6% and 12.4% in 1991, 1998 and 2003, respectively. Methods: Using identical methodology regarding means and size of population sampled, timing of survey, standardized parental questionnaire, collection and conrmation of responses (Anthracopoulos et al. Thorax 2001;56:569-71) we surveyed the same target population (n=2,688) in 2008. Results: The prevalence of current asthma was 6.9% (n=186) and that of lifetime asthma 12.6% (n=338). PDA among current wheezers was 69%, 69%, 71%, 77% and 60% in 1978, 1991, 1998, 2003 and 2008, respectively. PDA among noncurrent (difference between lifetime and current) wheezers was 61%, 79%, 85% and 76% in the 1991, 1998, 2003 and 2008, respectively. Conclusion: The continuous increase, albeit at a slowing rate, of childhood asthma during 1978-2003 reached a plateau in 2008. The increasing trend of asthma diagnosis among wheezers during 1978-2003 has reversed during the 2003-2008 period.

P4062 Prevalence of asthma in children of chemical warfare victims Majid Mirsadraee 1 , Abolfazl Mozaffari 2 , Davood Attaran 3 . 1 Department of Pulmonary Medicine, Islamic Azad University of Mashhad, Mashhad, Khorasan Razavi, Islamic Republic of Iran; 2 Department of Pulmonary Medicine, Ghom University of Medical Sciences, Islamic Republic of Iran; 3 Department of Pulmonary Medicine, Mashhad University of Medical Science, Islamic Republic of Iran Objective: The objective of this study was to determine the prevalence of asthma in children of chemical warfare victim (CWV) and compare it to asthmatic children in the general population. Materials and methods: Four hundred and nine children from 130 CWV fathers and 440 children from 145 asthmatic parents participated in this study. Spirometry demonstrated an obstructive pattern with variable response to bronchodilator. A standard questionnaire of the European Respiratory Society, released for epidemiological survey of asthma in children, was adapted to the requirements of the present study with minimal changes. Results: The mean age and SD in children of the CWV group was 136.6 years, which showed no signicant difference with the control group. The prevalence of asthma in the CWV group was 15%; this was not signicantly different from the control group (12.5%). The children of the CWV group reported a signicantly greater incidence of wheezing per year (1.183.1 per year) but the control group reported more severe attacks leading to speech difculties (3%) and coughing (7%). Increasing family size (characterized in terms of children per family unit) cause decrement in the number of subjects suffering from asthmatic symptoms in both groups (r=0.86, p= 0.001).

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gave informed consent, they were asked to ll in a questionnaire that captured the presence of DCN and the risk factors associated with it. Associations between DCN and risk factors were analyzed using the Chi square test and expressed as adjusted odds ratios (OR). Results: The overall prevalence of DCN amongst 3639 evaluable children was 15.9%. Family history of atopy [OR: 4.32 (3.27-5.70)], damp walls in classroom [OR:1.96 (1.29-2.31)], damp walls at home [OR:1.73 (1.12-2.55)], use of mosquito coil at home, [OR:1.95 (1.50-2.57)], snoring [OR:1.85 (1.34-2.57)], residence close to busy road [OR:1.69 (1.12-2.55)], parental smoking [OR:1.64 (1.22-2.21)], and school situated within 300m from main road [OR:1.56 (1.11-2.18)] were signicantly associated with the presence of DCN. Conclusion: Several risk factors are associated with the prevalence of dry cough at night amongst school children in India.
Figure 1

Conclusion: Chemical agents can be the cause of asthma in the offspring of CWV. An increase in family size decreases the prevalence of asthma in the asthmatic control group.

P4063 Increased prevalence of childhood asthma in Pune city, India Maria Cheraghi 1,2 , Sapna Madas 1 , Sundeep Salvi 1 . 1 Clinical Research, Chest Research Foundation, Pune, Maharashtra, India; 2 School of Health Sciences, University of Pune, Pune, Maharashtra, India The prevalence of current wheeze amongst school children in Pune city, India, in 2002 using the ISAAC questionnaire was 3.0%. There has been an unprecedented growth and development in Pune city over the last 6 years. The Aim of this study was to investigate the change in prevalence of childhood asthma in Pune city using the same study tools after 6 years. Methods: 6198 children between the ages of 6-7 and 13-14, from 17 randomly selected schools, were invited to participate in this study. Parents of 3909 children who consented were administered the ISAAC questionnaire. Prevalence of current wheeze and asthma were determined using descriptive statistics. Results: The prevalence of current wheeze increased by 1.8-fold to 5.4% (6.2% amongst 6-7yr olds and 4.6% amongst 13-14yr olds). The prevalence of current wheeze amongst children studying in private schools was 5.9%, while those studying in municipal corporation schools were 4.7%. The prevalence of current asthma was 6.7% (7% amongst 6-7yr olds and 6.3% amongst 13-14yr olds). Asthma was more prevalent amongst boys (8.1%) than girls (4.9%) [OR 1.49 (1.04-2.13)]. Conclusion: The prevalence of asthma has increased rapidly over a short period of time amongst school children in Pune city, India.

P4066 Asthma risk factors in scholars in Manaus, Amazonas, Brasil Maria Socorro Cardoso 1 , Dirceu Sol 2 , Ana Luisa Fernandes 2 , Raquel Cavalcante 1 . 1 Clnica Mdica, Universidade Federal do Amazonas, Manaus, Brazil; 2 Pediatria, Universidade Federal de So Paulo, So Paulo, Brazil; 3 Medicina, Universidade Federal de So Paulo, So Paulo, Brazil; 4 Clnica Mdica, Universidade Federal do Amazonas, Manaus, Brazil Introduction: In Manaus, the prevalence of children from 13 to 14 years with asthma, based on the question 2 of ISAAC wheezing in the last 12 months was 18,1%, considered high. These ndings indicate that this prevalence is as high as in other Brazilian cities. Objectives: Study the asthma risk factors in 450 children asthmatic or not. It is based on the question number 2 of ISAAC questionnaire. Material and methods: It was utilized a standardized questionnaire with informations about socioeconomic level, environmental, nutritional, hereditary, allergen and gestational factors and previous infectious events. Results: In the univariate analysis, the asthma was associated with humidity stains in the walls (IC95% 1,06 2,44), consummation of meat (IC95% 0,27-0,87), sharing the room in the rst year of life (IC95% 1,19 3,22), the covering of the bedroom in the rst year (IC95% 0,32 0,83), asthmatic mother (IC95% 1,33 5,22), the birth weight < 2500g (0,25 0,70), mould at the walls or ceiling (IC95% 1,43 4,14) and window in the bedroom in the rst year (IC95% 0,20 0,51). At the multivariate were detected as risk factors: asthmatic mother (IC95% 1,08 - 3,67) and as protection factor the birth weight < 2500 g (IC95% 0,26 0,99) and window in the bedroom during the rst year of life (IC95% 0,08 0,95). Conclusion: The knowledge of the risk factors is important to future prevention politics and to control the pathology.

P4064 Risk factors for childhood asthma in Pune city, India Maria Cheraghi 1,2 , Bill Brashier 1 , Sapna Madas 1 , Sundeep Salvi 1 . 1 Clinical Research, Chest Research Foundation, Pune, Maharashtra, India; 2 School of Health Sciences, University of Pune, Pune, Maharshtra, India We aimed to study the risk factors associated with childhood asthma in Pune city, India, since these have not been well studied. 6198 boys and girls between the ages of 6-7 and 13-14, from 17 randomly selected schools were invited to participate in this study. Parents of 3909 children consented. They then lled the ISAAC questionnaire (to determine asthma prevalence) and an additional set of questions that captured the presence of potential risk factors. Associations between asthma prevalence and risk factors were analyzed using the Chi square test, and expressed as adjusted OR. Results: Risk factors associated with childhood asthma included: family history of asthma [OR:7.24 (5.17-10.12)], caesarian delivery [OR:4.01 (2.84-5.67)], use of biomass fuel for cooking [OR: 3.19 (1.24-8.21)], no separate kitchen [OR:2.37 (1.44-3.90)], mixed feeds versus breast milk alone during rst 6 months [OR:2.03 (1.43-2.88)], snoring [OR:1.88 (1.26-2.81)], preterm birth [OR:1.73 (1.12-2.64)], damp walls at home [OR:1.69 (1.16-2.45)], male sex [OR:1.49 (1.04-2.13)] and parental smoking [OR:1.45 (1.0-2.11)]. Conclusion: Apart from known risk factors noted in western countries, preterm birth, snoring, damp walls at home, no separate kitchen at home and use of biomass fuel for cooking were new risk factors associated with childhood asthma in Pune city, India.

P4067 Pilot study of adverse respiratory effects in working children in Pakistan Sughis Muhammad 1 , Umair Ikram-Dar 2 , Tim S. Nawrot 3 , Benoit Nemery 1 . 1 Department of Public Health, Occupational and Environmental Medicine, Unit of Lung Toxicology, Katholieke Universiteit Leuven, Leuven, Vlaamse Brabant, Belgium; 2 Department of Pharmaceutical Sciences, Lahore College of Pharmaceutical Sciences, Lahore, Punjab, Pakistan; 3 Centre for Environmental Research, Universiteit Hasselt, Diepenbeek, Belgium Introduction: Few studies have documented the adverse health effects of child labour. In a pilot study, we investigated respiratory health in schoolchildren and children engaged in different occupations in Lahore. Exhaled nitric oxide (eNO) represents a novel non-invasive method to assess airway inammation in asthma. This endpoint has not yet been studied much in occupational settings. Methods: We administered a respiratory questionnaire, and measured spirometry (Spirobank) and eNO (Niox Mino) in 8 to 12 y old schoolchildren (n=220) and children engaged in carpet weaving (n=40) or making bricks (n=40). Results: The mean age of the children (160 boys, 140 girls) was 9.8 y (SD 1.5 y) and did not differ between the groups. Only 38% of the children were able to perform spiromety, but 83% performed the eNO measurement. Children from homes where biomass burning was used for cooking and heating had signicantly poorer lung function than those from homes using gas. Independent of age, gender, height, reported exposure to indoor smoking and biomass burning, children working in the carpet weaving industry had signicantly lower eNO [11.40 ppb (95% CI 9.64 to 13.44)] than schoolchildren [14.82 ppb (95% CI 13.83 to 15.90)] and those working in the brick kiln industry [17.0 ppb (95% CI 14.40 to 20.0)]. Discussion: Exposure to biomass burning in the home was associated with poorer lung function in children. The lower values of eNO in the children engaged in carpet weaving could be due to their (presumably) high exposure to organic dust, which could be similar to the decrease in eNO observed in adult smokers. This study is one of the rst investigations of the adverse respiratory effects of child labour.

P4065 Prevalence of and risk factors associated with dry cough at night (DCN) amongst school children in Pune city, India Maria Cheraghi 1,2 , Bill Brashier 1 , Sapna Madas 1 , Sundeep Salvi 1 . 1 Clinical Research, Chest Research Foundation, Pune, Maharashtra, India; 2 School of Health Sciences, Univercity of Pune, Pune, Maharashtra, India Dry cough at night may be an early presenting feature of childhood asthma. We aimed at investigating the prevalence of and risk factors associated with dry cough at night amongst school children in Pune city, India. Methods: 6198 boys and girls between the ages of 6-7 and 13-14 from 17 randomly selected schools were invited to participate in this study. After the parents

P4068 Effects of biomass combustion exposition in children Luiz F.F. Silva, Paulo H.N. Saldiva, Silvia Saldiva, Marisa Dolhnikoff, Bandeira Cientica Project. Pathology, University of Sao Paulo, Sao Paulo, SP, Brazil Background: The use of biomass as cook stove fuel is widespread in poor areas of

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developing countries. The biomass generates a type of pollution that differs from common air pollution in terms of primary pollutants concentration and secondary oxidants. The effects of common air pollution are largely investigated. However, there are few data concerning the effects of domestic pollution on respiratory health. We recently showed an increase in respiratory symptoms (cough and dyspnea) and decreased lung function in exposed adults (ATS 2009). We aimed to evaluate the respiratory symptoms and lung function in children exposed to biomass combustion [B], compared with those exposed to butane gas combustion [G]. Methods: We evaluate 458 non-smoker individuals under 20 years-old in 180 houses in a rural comunity in the northeast of Brazil. Questionnaires were applied to evaluate respiratory symptoms [cough with sputum (cough), wheezing, dyspnea, sneeze, coryza] and social and economic conditions. Pre and post bronchodilator lung function tests were applied in 40 individuals. Black carbon (BC) was analyzed in lters located near the cook stove for three days, using reectance levels, in both groups. Results: There were a signicant increase in black carbon index in lters exposed in B compared to G (p<0.001). The analysis of symptoms between B and G showed an increased odds ratio (OR) for cough (OR=1,51, p=0.001), wheezing (OR=1.9, p=0.001), and sneezing (OR=1.7, p=0.002). No differences were found in FEV1 and FEV1/FVC ratio. Conclusion: Exposure to biomass combustion in children is related specially to upper respiratory symptoms, even though lung function alteration could not be observed yet in this individuals. Sup: CNPq, LIM, FAPESP.
Association between wheeze in last 12 months and HGV density within 100 m from childrens schools HGV density on school roads n Low Medium High 149 286 155 Wheeze in the last 12 months unadj OR [95%CI] p-value 1.00 3.14 [1.67-5.91] 2.31 [1.14-4.65] n adj OR [95%CI] p-value

128 1.00 <0.001 209 2.61 [1.17-5.86] 0.020 0.019 127 2.68 [1.14-6.47] 0.028

OR adjusted for childs sex, age, eczema and hay fever, parental smoking and parental asthma.

Conclusions: School exposure to HGV related air pollution increases the risk of childhood wheeze, and is of greater relevance than place of residence or other measures of vehicle trafc density.

P4071 Knowledge about childrens environmental health in Europe Leith Sly 1,2 , Tania Gavidia 1,3 , Franca Rusconi 4 , Enrico Lombardi 4 , Merci Kusel 1,3 , Peter Sly 1,3 . 1 WHO Collaborating Centre for Child Health Research, Telethon Institute for Child Health Research, Perth, WA, Australia; 2 Health, Safety and Environment, School of Public Health, Curtin University of Technology, Perth, Australia; 3 Clinical Sciences, Centre for Child Health Research, University of Western Australia, Perth, Australia; 4 Respiratory Medicine, Anna Meyer University-Hospital for Children, Florence, Italy A number of childhood diseases are linked to unsafe and degraded environments. However, many health care providers (HCP) are unable to recognize, assess and manage environmentally-related diseases in children. To obtain a better understanding of their awareness of potential environmental threats to childrens health, a survey was conducted amongst members of the pediatric assembly of the ERS and the Societa Italiana per le Malattie Respiratorie Infantili (SIMRI). All members were invited to participate through a web based questionnaire in English enquiring into the extent of their awareness of issues in childrens environmental health (CEH). Responses were received from 61 ERS and 21 SIMRI members, with 86% being pediatricians or pediatric subspecialists, 55% male, 61.5% between the ages of 46-60 years and 94% living in urban areas. 26.3% of respondents considered their knowledge of CEH to be average with most knowledge gained from conferences (92%) and journal articles (80%). Respondents were most familiar with indoor and ambient air pollution and least familiar with endocrine disruptor chemicals, contaminated soils and issues surrounding waste disposal. Most (55%) did not recognise that boys and girls interacted with their environment differently or could be differentially affected. 89% saw the provision of professional training in CEH as a function that should be undertaken by their professional society; however few were aware of any such activity. 84% of respondents were unaware of the Graduate Certicate in CEH that has been accredited by EBAP. Members of the pediatric assembly of the ERS and of SIMRI are interested in education on CEH but few are aware of the opportunities available.

P4069 Environmental tobacco smoke exposure (ETS) and respiratory morbidity in school age children Carolina Constant 1 , Isabel Sampaio 1 , Filipa Negreiro 2 , Pedro Aguiar 2 , Ana Margarida Silva 1 , Marisa Salgueiro 1 , Cristina Bastardo 1 , Teresa Bandeira 1 . 1 Respiratory Unit. Department of Paediatrics, Santa Marias University Hospital, Lisbon, Portugal; 2 Department of Biostatistics, Eurotrials - Consultores Cientcos, S.A., Lisbon, Portugal Tobacco smoke is a risk factor for COPD and a major public health problem. Prenatal maternal smoking and post-natal ETS lead to dose-dependent decrease in lung function and respiratory morbidity. Inuence of different socioeconomic indicators and ETS in the home has also been suggested. Methods: Data on 313 children (52% male) from 4 public schools in Lisbon was analyzed [1st (54%) and 4th graders]. ETS assessment and respiratory symptoms were based on a self-answered questionnaire. All children performed standard spirometry in the school setting (MicroLab Spiro V1.34) and 54% were acceptable according to ATS/ERS criteria. Descriptive and bivariate analysis of the most relevant variables was done, followed by multiple logistic regression analysis adjusted to the variables with clinical/statistical relevance. Results: ETS in the home was found in 41% (maternal smoking during pregnancy 18%, smoking mother 32%, smoking father 38%). Smoking fathers had lower education and less qualied occupation. Cough was more frequent in children with a smoking mother (adjusted OR=2.1 95%CI 1.1-4.0) and wheezing in children with maternal smoking during pregnancy and smoking parents. All differences were signicant (p<0.05). No association was found between parental education and cough/wheeze or ETS and respiratory infections/asthma diagnosis/decreased spirometric values. Conclusions: Children in Lisbon are frequently exposed to ETS which results in signicant respiratory morbidity. Targeted interventions must have social conditions in consideration. In this study eld spirometry was not helpful in early detection of lung function disability in children associated with ETS.

P4072 Functional state of the respiratory system in children-residents of the radioactive contaminated territories Kolpakov Igor, Stepanova Yevgenya, Vdovenko Vitaliy, Parkhomenko Vera, Leonovich Elena. Radiation Paediatrics, Congenital and Hereditary Pathology, SI"Research Center for Radiation Medicine of AMS of Ukraine, Kiev, Ukraine Background: The ecologically determinated states are the most frequently manifested as the functional deviations and general symptoms at the early stages. Aim: An evaluation of the functional state of the respiratory system in children who are living at the radioactive contaminated territories after Chornobyl catastrophe. Methods: 168 children who are living at the radioactive contaminated territories with the density of soil contamination by isotopes 137 Cs from 185 to 555 kBk/m2 were examined for assessing the functional state of the respiratory system. Control group consisted of 75 children. The ventilation capability was determinated. Parameters of unrespiratory pulmonary functions were examined by the condensate of expired air (CEA). pH of CEA, properties of respiratory surfactant, lipid fatty acid spectrum of pulmonary surfactant were detected. The peculiarities of the cellulare and humoral immunity were studied. Results: Bronchial hyperreactivity, a decrease of pulmonary surfactant in CEA, an increased intensity of free radical pulmonary processes, and the decrease in pH CEA were frequently revealed in children the of main group in comparison with controls. Lipid fatty acid spectrum of pulmonary surfactant was characterized by the activation of the lipide peroxidation processes and the deviation in balance of fatty acids on the side of -6 family. Changes on the side of the immune system were characterized by the decreased number T and B-lymphocytes, the decreased level of serum IgA and inhibition of neutrophile phagocytic function. Conclusion: The results of examinations point out the necessity of prophylactic measures in this children contingents.

P4070 High density truck trafc near schools but not homes is associated with childhood wheeze Nara Tagiyeva 1 , David Green 2 , Geraldine McNeill 2 , Peter Helms 1 , Jon Ayres 3 . 1 Child Health, University of Aberdeen, Aberdeen, United Kingdom; 2 Environmental and Occupational Medicine, University of Aberdeen, Aberdeen, United Kingdom; 3 Environmental and Respiratory Medicine, University of Birmingham, Birmingham, United Kingdom Background: Associations among proximity of homes and/or schools to main roads and respiratory symptoms vary in signicance and by trafc type (cars and/or trucks) Objectives: To investigate associations among exposure to road trafc near homes and schools and childhood wheezing. Methods: Population-based study of Aberdeen primary school children aged 7-12 yrs. Proximity of homes and/or attended schools to the nearest road and trafc density for all vehicles and for heavy goods vehicles (HGVs) were used as measures of exposure. Results: Questionnaires were returned by 3271 children (57%). Geo-referenced home and school addresses were available in 1347 (41%) of respondents. No association was found between reported wheeze and location of homes or attended schools. However wheeze prevalence increased with increasing HGV trafc within 100m of schools (2 13.59 p <0.001), an association that remained after adjustment for confounders (OR for highest to lowest density 2.68 95% CI 1.14-6.47).

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P4073 Spirometry and lung volumes correlated to birth weigh in healthy children Magnus Dencker 1 , Sven Valind 1 , Ola Thorsson 1 , Magnus Karlsson 2 , Per Wollmer 1 . 1 Dept of Clinical Sciences, Clinical Physiology and Nuclear Medicine, Malm, Sweden; 2 Dept of Clinical Sciences, Clinical and Molecular Osteoporosis Research, Malm, Sweden Introduction: Little is known about the correlation between birth weight and all standard lung volume measurements and spirometric values. Aims and objectives: The aim of this study was to correlate birth weight with lung volumes and standard spirometric values in healthy pre-pubertal children. Methods: We studied a sample of 202 children, boys n=113 and girls n=89, aged 7.9-11.0 years. We measured; forced expiratory volume 1 sec (FEV1.0 ), vital capacity (VC), total lung capacity (TLC), functional residual capacity (FRC) and residual volume (RV), using body pletysmography. Data on birth weight was retrieved from form hospital records. Results: Average birth weight was 3438646 g (range: 1126-4700 g). The overall correlation between birth weight and lung volume measurements was poor. Best univariate correlations, with adjustment for sex, between birth weight and lung function were found with FEV1.0 (r=0.24, P<0.005) and VC (r=0.24, P<0.005). However, multiple regression analysis showed that adding current height to the model made birth weight an insignicant predictor to lung function variable. Conclusions: Birth weight does not appear to inuence lung volumes or FEV1.0 at ten years of age in healthy children. Height and aerobic tness explained 58% of the variability in TLC, with aerobic tness alone explaining 6%. Forced expiratory volume in 1s was not associated with aerobic tness (p=0.15). Neither total- nor moderate-vigorous physical activity was associated with lung function or -volumes in adolescents with or without asthma. Conclusions: Aerobic tness but not physical activity is associated with total lung capacity in adolescents with and without asthma; however, we can not conclude that there is any causal relationship.

P4076 Quality of life among children with asthma and their caregivers Joshua Lawson 1 , James Dosman 1 , Donna Rennie 1 , Ambikaipakan Senthilselvan 2 . 1 Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada; 2 School of Public Health Sciences, University of Alberta, Edmonton, AB, Canada Background: While quality of life (QOL) among children with asthma has been of interest recently, its determinants of and association with caregiver QOL has been studied infrequently. Aims and objectives: We examined the correlation between QOL among children with asthma and their caregivers as well as the determinants of child and caregiver QOL. Methods: We included children (6-18 years) with doctors diagnosed asthma from Humboldt, Canada and its surrounding area. Data was collected by questionnaires. QOL was assessed by the Juniper Paediatric Asthma Quality of Life Questionnaire (PAQLQ) for children (n=70) and the Juniper Paediatric Asthma Caregiver Quality of Life Questionnaire (PACQLQ) for parents (n=75). Both instruments use a 7 point scale (7=best outcome). Results: The mean total PAQLQ score was 6.2 (SD=0.7) while the mean total PACQLQ was 6.5 (SD=0.7). The correlation between the PAQLQ and PACQLQ was not signicant (p=0.25). Lower mean PAQLQ and PACQLQ scores were found with report of cough, doctors visits for asthma, asthma drug use and asthma disturbing sleep, all in the past 12 months. After adjusted analyses, there were signicant (p<0.05) inverse associations between PACQLQ and asthma drug use and living on or visiting a farm regularly, but positive associations with heavy activity level. For the PAQLQ, there were signicant (p<0.05) positive associations with parents education status and living on or visiting a farm regularly. Conclusions: These results suggest that childrens and caregivers QOL are not correlated with each other and that the determinants may differ. Investigation into these determinants may help improve QOL among children with asthma and their caregivers. Funding by CIHR MOP-57907.

P4074 Pulmonary function tests and indicators of obesity in children Marco Sala 1 , Marzia Mandelli 1 , Michela Salvioni 1 , Francesco Cetta 2 , Silvia Scaglioni 1 , Marcello Giovannini 1 . 1 Pediatric Department, San Paolo Hospital University of Milan, Milan, Italy; 2 Department of Surgery, University of Siena, Siena, Italy Background: Poor data are available about effects of obesity and fat distribution on pulmonary function tests in children. Aim: To evaluate the inuence of obesity on respiratory function in children. Methods: 73 children (40 [54.8%] female 33 [45.2%] male; mean [SD] age 10 [2.01]; range 6-14) affected by essential obesity underwent spirometry, plethysmography, anthropometrical measurements and DEXA (Dual energy X-ray Absorptiometry). Considered parameters were FEV1 , FVC, FEV1 /FVC, FEF25, 50 and 75, ITGV (intra thoracic gas volume), VR (residual volume), TLC (total lung capacity), VRE (expiratory residual volume), ITGV/TLC,VR/TLC and IC (inspiratory capacity). Clinical features evaluated were: years of obesity, weight, height, percentage of overweight, Body Mass Index (BMI), BMI z-score, BMI corrected for age, waist and hip circumferences, skinfolds; arm, trunk, total lean and fat mass measured by DEXA. Results: FEV1 (mean 107, SD 10,7), FEV1 /FVC (109.1, 7.3), FEF25 (94.9, 18.1), 50 (105.6, 23.6) and 75 (112.3, 33.5), ITGV (120, 25.5), VR (179, 57.2), VRE (68.6, 46.9), ITGV/TLC (106.7, 18.2), VR/TLC (148.7, 29.5), IC (113.1, 30.1) signicantly differed by Zapletals predictive values for non-obese children (0.000 <p<0.03). There was a signicant correlation between FVC (mean [SD] 99 [10]) and BMI (p=0.009), BMI z-score (p=0.006) and BMI corrected by age (p=0.02). A longer history of obesity was related to higher values of ITGV (p=0.04) and ITGV/TLC (p=0.01) and lower IC (p=0.008). Conclusion: we found some altereted respiratory volumes in obese children but we didnt identify correlations with the degree of obesity. However some indicators of impaired respiratory mechanic are related to a longer history of obesity.

P4077 Assessment of quality of life in Iranian asthmatic children and their caregivers Fariborz Zandieh, Maryam Sayanjali, Shima Sayanjali. Asthma, Allergy and Immunology, Isfahan University of Medical Sciences, Isfahan, Islamic Republic of Iran Interest in the impact of illness on day to day function is leading investigators to include both disease specic and generic health related quality of life (HR QOL) questionnaires. In response to this need, we used the Junipers pediatric asthma quality of life questionnaire (PAQLQ) and Junipers Pediatric Asthma Caregivers Quality of Life Questionnaire (PACQLQ) that has been developed based on guidelines for construction of over a dozen validated disease specic quality of life instruments. The PAQLQ consists of 23 items that in children with asthma have been identied as troublesome in their daily lives and PACQLQ that contains 13 items in two domains of emotional and activities disturbances. The study design consisted of an 18 month single cohort study. Patients participating in the study were 113 children, 7-17 years of age, with a wide range of asthma severity and their caregivers. For each patient a PAQLQ and for each caregiver a PACQLQ was completed. One week before visit patients recorded morning peak ow rates, medication use and symptoms in a diary. After complete physical examination, for determining of asthma severity, spirometry was performed. The questionnaires after statically analysis showed good levels of both longitudinal and cross sectional correlations with the conventional asthma indices and with general quality of life. We found that consistently QOL in boys were more disturbed than females, a good relevancy between severity of asthma and QOL scores and more disturbances of QOL in caregivers of male asthmatic patients than caregivers of female asthmatic patients.

P4075 Physical activity and aerobic tness; associated with lung function? Sveinung Berntsen 1,2,3 , Karin C. Ldrup Carlsen 1,4 , Sigmund A. Anderssen 2 , Kai-Hkon Carlsen 2,4,5 . 1 Dep. of Paediatrics, Oslo University Hospital, Ullevl, Oslo, Norway; 2 Dep. of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway; 3 Dep. of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway; 4 Faculty of Medicine, University of Oslo, Oslo, Norway; 5 Voksentoppen, Dep. of Paediatrics, Oslo University Hospital, Oslo, Norway Background: There is contradictory evidence whether physical activity and aerobic tness are positively associated with lung function in adolescents. The Aim: Aim of the present study was to determine whether physical activity and aerobic tness are positively associated with lung function and -volumes in adolescents with and without asthma. Methods: 174 adolescents (13-14yrs), 95 with asthma (65 boys) and 79 controls (41 boys) performed maximal running on a treadmill with oxygen consumption measurements. Peak oxygen consumption was dened as aerobic tness. The participants also wore an activity monitor, SenseWear Pro2 Armband for four consecutive days. Lung function and volumes were measured using maximum forced expiratory ow-volume curves and whole body plethysmography. Results: We found no indications of any differences between adolescents with and without asthma in any outcome variables except lower forced expiratory ow at 50% of forced vital capacity in the asthmatics. Consequently, we present analyses for pooled data only. Aerobic tness was positively associated with total lung capacity (TLC) (p=0.001) as well as the ratio residual volume to TLC (p=0.03).

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