Rajesh Kumar*, Manoj Sharma*, Ashok Srivastva*, J.S.Thakur *, H.K. Parwana**, S.K. Jindal***

1. Association of outdoor air pollution and chronic respiratory morbidity in a town of northern India Rajesh Kumar*, Manoj Sharma*, Ashok Srivastva*, J.S.Thakur*, H.K. Parwana**, S.K. Jindal*** *Deptt. of Community Medicine and ***Pulmonary Medicine, PGIMER, Chandigarh, **Punjab Pollution Control Board, Patiala

2. Broad ObjectiveThe study was aimed to evaluate effects of outdoor air pollution on chronic respiratory morbidity. Specific Objectives • To monitor ambient air quality. • To estimate the prevalence of respiratory morbidity and lung functions. • To determine association between air pollution and chronic respiratory morbidity.

3. Study Area Mandi Gobindgarh Morinda Study area Reference area Area of 32 Km2 Area of 7 km2 Population 55,400 Population 21,800 Steel rolling mills and foundries. One sugar mill only. Mandi Gobindgarh Morinda

4. Material And Methods • Study Design-Cross-sectional study • Study period- 2000-2001 • Sampling method- Cluster sampling Random selection of first household and then next nearest household. • Sample size – Total -4000 Study area-2000 Reference area- 2000 • Sampling site- Mandi Gobindgarh 1. Guru ki Nagri 2. Prem Nagar Morinda 1. Rest House Colony 2. Purana Bazar

5. Study Tools • Questionnaire Respiratory symptoms and diseases, SES (Kuppuswami scale), Household environment, Smoking history, Occupational history • Physical Examination Height (cm.), Weight (kg.), Spirometery by portable Ventilometer (FVC, FEV1, PEFR, FEV1/FVC%) Exposure Monitoring • Air Sampling-weekly for two years High Volume Air Sampler-Twelve hourly- SPM, NOx, SOx, O3 Organic Vapors Sampler- Eight hourly- CO • Meterological data Wind velocity, Temperature and humidity

6. Statistical Analysis • Concentration of SPM, PM10(g/m3)SOx, NOx, CO and O3 was summarised as means and standard deviation. • Prevalence of respiratory symptoms & spirometric airflow limitation • Chi-square test • Student’s t-test • Logistic regression analysis • Interaction between the air pollution and smoking was also included in the models.

7. Annual Averages of SPM, NOx and SOx in Mandi Gobindgarh Pollutants (g/m3) • The data collected by the pollution control board shows that the quality of the ambient air in the study town was poor for a numbers of years and most of the migrant workers had resided in the town for considerable period of time.

8. Participation rate of study subjects in study and reference town

9. Air Pollution Levels *P<0.05

10. Socio-demographicand life style characteristics of study population

11. Prevalence of Respiratory Symptoms Morinda Mandi Gobindgarh • MALES • FEMALES *P<0.05

12. Prevalence (per 100) of Spirometric defects *P<0.05

13. Association between air pollution and chronic respiratory symptoms and spirometric airflow limitation

15. Summary • High level of SPM in study town. • Chronic respiratory morbidity was higher in the study town. • Smoking, Non-LPG fuel users, Inadequate lighting, Inadequate Ventilation, Dampness and Occupational dust exposure was higher but SES was lower in study town. • Logistic regression analysis reveled that high SPM level is responsible for higher respiratory morbidity even after controlling the effect of age, sex, SES, Smoking, Non-LPG fuel, Inadequate lighting and ventilation, Dampness, Occupational dust exposure. Conclusion It is concluded that people of Mandi Gobindgarh, which had quite high SPM level, have significantly more symptoms of cough, phlegm, dysponea, wheeze and obstructive defects as compared to Morinda which had all air pollutants below permissible level.

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