J Danova

Outdoor Air concentrations of nitrogen dioxide and sulfur dioxide and prevalence of wheezing in school children

We report analysis of data on outdoor air pollution and respiratory symptoms in children collected in the Czech part of the international Small Area Variations in Air pollution and Health (SAVIAH) Project, a methodological study designed to test the use of geographical information systems (GIS) in studies of environmental exposures and health at small area level. We collected the following data in two districts of Prague: (1) individual data on 3,680 children (response rate 88%) by questionnaires; (2) census-based socio-demographic data for small geographical units; (3) concentrations of nitrogen dioxide (NO2) and sulfur dioxide (SO2) measured by passive samplers in three 2-week surveys at 80 and 50 locations, respectively. We integrated all data into a geographical information system. Modeling of NO2 and SO2 allowed estimation of exposure to outdoor NO2 and SO2 at school and at home for each child. We examined the associations between air pollution and prevalence of wheezing or whistling in the chest in the last 12 months by logistic regression at individual level, weighted least squares regression at small area (ecological) level and multilevel modeling. The results varied by the level of analysis and method of exposure estimation. In multilevel analyses using individual data, odds ratios per 10 microg/m3 increase in concentrations were 1.16 (95% CI = 0.95-1.42) for NO2, and 1.08 (95% CI = 0.97-1.21) for SO2. While mapping of spatial distribution of NO2 and SO2 in the study area appeared valid, the interpolation from outdoor to personal exposures requires consideration.

Severe childhood burns in the Czech Republic: risk factors and prevention

OBJECTIVE To assess risk factors for paediatric burn injuries in the Czech Republic and to suggest preventive measures. METHODS This study included all children aged 0-16 years hospitalized during 1993-2000 at the Prague Burn Centre and data from the Czech Ministry of Health on national paediatric burn hospitalizations during 1996-2006. Personal, equipment and environmental risk factors were identified from hospital records. FINDINGS The incidence of burn admissions among 0-14 year-olds increased from 85 to 96 per 100,000 between 1996 and 2006, mainly due to a 13% increase among 1-4 year-olds. Between 1993-2000 and 2006, the proportion of burn victims in the country hospitalized at the Prague Burn Centre increased from 9% to 21%. Detailed data were available on 1064 children (64% boys). Around 31% of all burn hospitalizations were in 1 year-olds. Some 79% of burns occurred at home: 70% in the kitchen, 14% in the living room or bedroom and 11% in the bathroom. Of the 18% occurring outdoors, 80% involved boys. Scalds from hot liquids accounted for 70% of all burns. The mean hospital stay was 22 days for boys and 18 days for girls. CONCLUSION Most burns involved scalds from hot liquids at home: beverages in kitchens and water in bathrooms. There is a need for passive preventive measures, such as redesigned domestic cooking and eating areas, safer electrical kettles and temperature control devices for bathrooms. Educational programmes should be developed for parents and caregivers. A national plan for child burn prevention with specific targets would be helpful.

SOCIOECONOMIC-FACTORS AND HEIGHT OF PRESCHOOL-CHILDREN IN THE CZECH-REPUBLIC

The effect of socioeconomic factors on growth was investigated among 2275 children 3 to 6 years old attending nurseries in the Czech Republic. Measured heights of children were converted into height-for-age z scores. After adjustment for birthweight, parental height, and other socioeconomic variables, only mothers education was independently and significantly associated with childrens height; adjusted differences in z scores between children of secondary- and university-educated mothers and children of mothers with only primary education were 0.12 and 0.31, respectively. This is equivalent to 0.5 and 1.5 cm, respectively, for children 5 years old.