Air Qual Atmos Health (2010) 3:149158

DOI 10.1007/s11869-010-0063-x

Assessment of intra-urban variability in indoor air quality

and its impact on childrens health
B. K. Padhi & Pratap Kumar Padhy & Lokanath Sahu &
V. K. Jain & Rupak Ghosh

Received: 30 June 2008 / Accepted: 5 January 2010 / Published online: 9 March 2010
# Springer Science+Business Media B.V. 2010

Abstract The results from a number of studies suggest that

children living close to busy roads may have impaired
respiratory health. The study reported here was designed
specifically to test the hypothesis that exhaust from traffic
has an impact on indoor air quality and childrens
respiratory health. Children living at three different locations in a suburban area in India were enrolled in the study,
and the concentrations of indoor air quality parameters were
measured at selected households during the period March
2006February 2007 using portable air quality monitors.
Respiratory symptoms were identified by means of a
questionnaire completed by parents and from the results
of a pulmonary function test (PFT) carried out using an
electronic Spiro Meter. The logistic regression model
revealed associations between respiratory symptoms and
traffic-related indoor air pollutants among our study
population. The prevalence of respiratory disorders was
greater among children living in close proximity to traffic
sources than among those living more distant from these
sources, even after the adjustment of confounding factors.
We also found intra-urban variability of indoor air quality

B. K. Padhi : V. K. Jain
School of Environmental Sciences,
Jawaharlal Nehru University,
New Delhi, India
P. K. Padhy (*) : L. Sahu
Centre for Environmental Studies,
Visva-Bharati University,
Santiniketan, West Bengal, India
e-mail: padhypk@gmail.com
R. Ghosh
Suri Sadar Hospital,
West Bengal, India

and associated differences in respiratory symptoms. Our

findings support the hypothesis that traffic has an impact on
indoor air quality and that it is associated with childrens
health. The findings from this study have important policy
and program implications, including the need for public
information campaigns designed to inform people about the
risks of exposure to traffic exhausts.
Keywords Children . Indoor air pollution . Intra-urban .
Lung function . Respiratory symptoms . Traffic

Introduction
The World Health Organization (WHO) reports that 25% of
all preventable diseases are due to a poor physical
environment (World Health Organization 2002). It has also
been reported that over 40% of the global burden of
diseases attributed to environmental factors falls on
children, who account for about 10% of the worlds
population (Murray and Lopez 1996; Tamburlini et al.
2002). Air pollution is the single largest environmentrelated cause of ill health among children in most countries.
Motor vehicle emissions are a major source of air pollution
throughout the world (Mage et al. 1996; Mayer 1999;
Samet 2007) and there is widespread public concern over
their effect on asthma, particularly among children (Venn et
al. 2001; Janssen et al. 2003). Air pollution from motor
vehicles is one of the most serious and rapidly growing
problems in urban centers of India (UNEP/WHO 1992;
CRRI 1999). The problem of air pollution has assumed
serious proportions in some of the major metropolitan cities
of India, with vehicular emissions having been identified as
one of the major contributors to the deteriorating air quality
(CPCB 2001).

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Numerous epidemiological studies have documented

adverse effects of air pollution on health (Wjst et al.
1993; Oberdorster et al. 1995; Kramer et al. 2000; Aneja et
al. 2001; Vedal et al. 2003). In sub-urban areas, motor
vehicle emissions are likely to vary substantially within a
small area, and researchers have begun to document
differences in traffic-related pollutants on a neighborhood
scale (Hoek et al. 2002; Lebret et al. 2002; Wilsona et al.
2005; Samet 2007). A number of recent epidemiological
studies have found associations between residential proximity to busy roads and a variety of adverse respiratory
health outcomes in children, including respiratory symptoms, asthma exacerbations, and decrements in lung
function (Ghose et al. 2005; Kaushik et al. 2006).
Therefore, it is important to evaluate the extent to which
proximity to traffic may affect the indoor air quality. The
indoor environment is especially relevant in such studies
because pollutants, such as, ambient particulate matter
(PM), carbon monoxide (CO), nitrogen oxide (NO), nitrogen
dioxide (NO2), sulphur dioxide (SO2), and ozone (O3) may
penetrate from the outside. The study of air pollution
exposures at the intra-urban scale therefore presents a
challenge in a new era of exposure assessment in epidemiological research and one that has been recently identified as
a preferential area for future work (Brunekreef and Holgate
2002; Sajani et al. 2004; Jerrett et al. 2005; Padhi and Padhy
2008). The study reported here examined the impact of
traffic on indoor air quality and childrens health at the intraurban spatial scale within a suburban area in India.

Materials and methods

Study area
Bolpur is situated between latitude 24N and longitude
87E in the north-western part of West Bengal, a highly
populated state in the eastern part of India. It is one of the
growing urban cities in India. Uncontrolled and mixed
vehicular density on insufficient and badly cared road
space, inadequate parking facilities, low turnover of old
vehicles with too frequent breakdowns, and undisciplined
drivers together with a bad traffic management strategy
have profound effects on the air quality of this area. In
addition to these factors, the widespread use of solid
biomass fuels in food and tea stalls has worsened the
situation and poses a threat to human health. The study area
was divided into three sampling sites, namely, site-I (within
0.5 km of the main road), site-II (within 1.0 km of the main
road), and site-III (within 5.0 km of the main road). The
condition of the terrain in all three sites was comparable.
Site selection was based on vehicle density, road condition,
proximity to other stationary sources, and human habitat.

Air Qual Atmos Health (2010) 3:149158

Indoor Air Quality (IAQ) measurements

The IAQ investigation at the households enrolled in the
study was conducted from June 2006 to July 2007. In each
sample area, the indoor air quality was studied in detail in
20 representative households selected from among the
larger group on which health data were collected. These
households were selected on the basis of fuel use, indoor
smoking, and other potential sources of indoor air pollution.
The selection criteria were the use of LPG (liquefied
petroleum gas) as a cooking fuel and no indoor smoking.
Each investigated household was monitored on at least two
to three, and 24-h average value was taken as the final
result. The air quality parameters measured in this study
were of CO, CO2, NO, NO2, SO2, O3, and suspended
SPM as well as relative humidity (RH) and temperature.
Instruments were positioned at the center of the living
room, 0.5 m above the ground, at least 0.5 m away from the
walls, and 1 m away from potential sources of air
pollutants. All gaseous pollutants as well as temperature
and RH were measured by a portable multigas air quality
monitor (YES Plus, Canada), whereas the, SPM was
monitored by a Handy Sampler (model KDM HS-7;
KDM. Pvt. Ltd., New Delhi, India) using pre-weighed
Whatman-GF/A glass fiber filter paper (USEPA 1971).
Study subjects
In each sampling site, we selected approximately 100
households (site-I:108, site-II: 105, site-III: 110) that used
LPG for cooking for enrollment in this study. The households
were virtually indistinguishable from each other in terms of
socio-economic status, economy, diet, home construction,
and access to health care. They were expressly matched on
these key characteristics in order to minimize the potential for
confounding factors and to provide some control of all major
known and suspected risk factors for indoor air quality and
respiratory diseases. There were 435 children in these
households (site-I 145, site-II 138, site-III 152) aged between
6 and 10 years who were included in this study.
Study of respiratory symptoms of children
A questionnaire developed on the pattern of IUATLD
(International Union Against Tuberculosis and Lung
Disease) (Burney et al. 1989) and ISAAC (International
Study of Asthma and Allergies in Childhood) (Asher et al.
1995), with a few modifications, was used for evaluating
respiratory health. The questionnaire contained questions
on personal characteristics (name, sex, age, height, weight,
parents smoking habit, family income, mothers education,
etc.), respiratory symptoms [history of cough with or
without any expectoration, amount of expectoration/day,

Air Qual Atmos Health (2010) 3:149158

winter exacerbations, history of hemoptysis and amount,

history of any post-nasal drip, history of any wheezing,
history of chest tightness, doctor-diagnosed asthma, and
any systematic complaints (fever, headache, etc.)].
Lung function measurement
Our study was designed specifically to investigate trafficrelated indoor air pollution on the lung function of children.
Of the 435 children from the selected households, lung
function measurements were performed on only 240
children (site-I 78, site-II 82, site-III 80); the remaining
children had already had been diagnosed with a systematic
respiratory illnesses. The lung function parameters, such as
peak expiratory flow (PEF), forced vital capacity (FVC),
forced expiratory volume in 1 s (FEV1), forced expiratory
flow (FEF), slow vital capacity (SVC), were measured on
an electronic Spiro Meter (model DT Spiro; Maestros
Medline Systems, Mumbai, India) interfaced to a personal
computer. All pulmonary function tests (PFT) were carried
out at a fixed time of the day (09001300 hours) to minimize
the diurnal variation. The spirometer was calibrated daily and
operated within the ambient temperature range. The lung
function test of our study was based on the operation manual
of the instrument with special reference to the official
statement of the American Thoracic Society of Standardization of Spirometry (American Thoracic Society 1987). Each
subject was instructed to stand upright in a stable position, to
place the mouthpiece in the mouth while keeping the nose
closed, and then to make a maximal inspiratory effort and to
blow out with a maximal effort. The test was repeated five
times after adequate rest, and the data were transferred from
the spirometer to the computer for analysis.
Anthropometric measurements
Height, weight, and the circumference of the waist (WC) and
hip were recorded using a standard technique (Lohman et al.
1988) by the recorder. Height and weight were measured to
the nearest 0.1 cm and 0.5 kg, respectively. Waist and hip
circumferences were measured with an inelastic tape to the
nearest 0.2 cm. Body mass index (BMI) and waisthip ratio
(WHR) were computed using the following formula:

BMI Weightkg Heigth2 m2
WHR Waist circumferencecm=Hip circumferencecm

Statistical analysis
Analysis of the descriptive statistics, such as mean,
standard deviation (SD) of anthropometry, air pollutants,
and respiratory functions of the subjects, was performed.

151

The General Linear Model (GLM) was applied to study the

relationship of intra-urban variation of indoor air quality. To
investigate the relationship between PFT and air pollutants,
we used multiple regression analysis. Finally, to explore the
relationship between respiratory symptoms and the exposure to pollutants, we used multiple logistic regression
analysis, in which the potential confounding factors were
controlled. The adjusted odds ratios (ORs) and their 95%
confidence intervals (CIs) were computed. The adjusted
ORs were calculated for an interquartile range (IQR) of
measured pollutant concentrations (i.e., the OR for a given
health outcome given a pollutant concentration at the 75th
percentile of the distribution relative to that at the 25th
percentile). All statistical analyses were performed using
the SPSS statistical package ver. 10.0 (SPSS, Chicago, IL).

Results
The basic socio-demographic characteristics of the study
households are given in Table 1. Houses were similar in
terms of type and structure. On average, each house had
three rooms and housed eight people. The majority of the
houses were naturally ventilated.
The summary statistics of indoor air quality along with
micro-meteorological conditions are described in Table 2.
The indoor concentrations of all the pollutants were greater
in houses located at 0.5 km of the main road. The highest
mean levels of indoor air quality parameters were measured
in houses located at 0.5 km of the main road: 240.0, 2525.0,
42.5, 55.0, 48.7, 22.0 ppb for the gaseous components
(CO, CO2, NO, NO2, SO2, and O3, respectively) and
185.0 g/m3 for SPM. In comparison, the lowest mean
levels were recorded in houses located 5.0 km away from
the main road and averaged 138.9, 2127.0, 22.3, 25.6, 20.0,
and 10.5 ppb for the gaseous components (CO, CO2, NO,
NO2, SO2, O3, respectively) and 87.5 g/m3 for SPM.
These differences in the levels of the measured pollutants
are highly significant (p <0.001) (Table 2). We found a
decrease in the concentrations of all indoor air quality
parameters with increasing distance from the main road,
indicating that increases in the distance from automobile
sources is correlated to a decrease in the concentrations of
air quality parameters. The GLM with Scheffes posthoc
test was applied and revealed that there is a statistically
significant difference in the indoor concentrations of air
quality parameters at the different study locations (Table 2).
Table 3 shows the anthropometric characteristics of the
study subjects, and Table 4 shows the results of the PFT on
the study subjects. A comparison of PFT values among the
three study groups using one-way analysis of variance
(ANOVA) with Turkeys posthoc test revealed statistically
significant differences between the lung function results of the

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Air Qual Atmos Health (2010) 3:149158

Table 1 Comparison of socio-demographic characteristics of the households in the study areas

Variable

0.5km from main road (%),

n=108

1.0km from main road (%),

n=105

5.0km from main road (%),

n=110

11.1
88.9

13.3
85.7

18.2
81.8

9.2
90.8

12.4
87.6

4.6
95.4

86.1
13.9

85.7
14.3

77.3
22.7

16.7
83.3

21.0
79.0

27.3
72.7

37.0
48.1
14.9

57.1
28.6
14.3

47.3
36.4
16.3

4.6
27.8
67.6

8.5
42.8
48.7

13.7
45.4
40.9

23.1
76.9

19.1
80.9

25.5
74.5

Materials used for house construction

Mud, grasses, and bamboos
Stones and bricks
Mechanical ventilation
Yes
No
Separate kitchen
Yes
No
Number of people in the house
<5
>5
No. of smokers in the house
None
One
Two or more
Childs mothers education
Uneducated
Primary school
Secondary school
Monthly average family income in US$
<100
>100

Table 2 Comparison of indoor air quality (IAQ) among the study sites during study period
Air quality parameters

CO (ppb)
CO2 (ppb)
NO (ppb)
NO2 (ppb)
SO2 (ppb)
O3 (ppb)
SPM (g/m3)
Temperature (C)
Relative humidity (%)

0.5km from main road

(site-I)

1.0km from main road

(site-II)

5.0km from main road

(site-III)

Meana

2575%

Meana

2575%

Meana

2575%

240.5
2525.0
42.5
55.0
48.7
22.0
185.0
25.0
63.3

180.0372.0
1200.04130.0
18.365.8
22.580.2
24.073.5
10.838.5
140.0236.0
12.232.0
58.070.0

185.8
2134.0
31.8
30.5
28.5
18.5
115.0
24.2
65.8

125.0235.0
1050.03275.0
12.745.9
15.352.0
12.037.5
10.025.3
105.8138.5
10.530.2
58.368.5

138.9
2127.0
22.3
25.6
20.0
10.5
87.5
23.5
63.0

83.5175.1
1015.03125.0
10.033.5
12.237.5
10.832.0
8.520.2
72.8102.0
10.530.0
58.567.0

P valueb

0.0003
0.0001
0.0001
0.0002
0.001
0.001
0.0001
0.05
0.05

SPM Suspended particulate matter, CO carbon monoxide, CO2 carbon dioxide, NO nitrogen oxide, NO2 nitrogen dioxide, SO2 sulphur dioxide,
O3 ozone
a
b

24-h average

General Linear Model (GLM) with Scheffes posthoc test revealed that: site-I had significantly greater means compared to site-II and -III; site-II
had significantly greater mean compared to site-III; site III had significantly smaller mean compared to all sites

Air Qual Atmos Health (2010) 3:149158

153

Table 3 Basic anthropometric characteristics of the study subjects

Variables

0.5km from main road

(n=145)

1.0km from main road

(n=138)

5.0km from main road

(n=152)

P value

8.01.0
61.53
97.93
13.50.91
0.920.23
44.87
3.44

7.51.5
64.63
96.37
13.60.87
0.850.15
50.0
5.07

8.01.0
56.25
92.10
13.30.90
0.890.17
38.75
1.97

0.135
0.113
0.153
0.231
0.173
0.08
0.12

Age, years (mean SD)

Sex (male, %)
Race/ethnicity (Asian Indian, %)
BMI kg/m2 (mean SD)
WHR (mean SD)
Nutritional status (good, %)
Disease history, including anemia (yes, %)
BMI Body mass index, WHR waist-to-hip ratio

groups. Children living in the households at 0.5 km of the

main road were found to have lower a lung function than those
who lived in the households located 5.0 km away from the
main road (PEF=3.2, 3.9, and 4.3, FVC=2.0, 3.5, and 3.8,
FEV1 =1.5, 2.1, and 2.8, FEF2575% =1.8, 2.5, and 2.9, and
SVC,=2.5, 3.2, and 3.6 l/s for site-I, -II, and III, respectively).
Correlations among indoor air quality variables are
reported in Table 5. With the exception of temperature
and RH, all of the air quality variables were found to be
positively correlated, with stronger correlations for CO,
NO, NO2, and SO2. The correlations between potential
confounders and pulmonary function results are presented
in Table 6. Age, BMI, WHR, environmental tobacco
smoke, and living habitat were important factors affecting
the lung function of our study subjects.
Multiple regressions were used to test the association
between indoor air pollutant concentrations and lung
function variability among the study subjects. The results
of the adjusted pulmonary function tests regressed on
indoor air pollution data are presented in Table 7. These
regressions of adjusted pulmonary function values for
children residing at 0.5 km of the main road showed that
NO2 and SPM were most strongly associated with lower
values of PEF, FVC, FEV1, FEF2575%, and SVC. We
found statistically significant relationships between air
pollutant levels and pulmonary function tests in the three

groups. SPM exposure was associated with statistically

significant decreases in all five measures of pulmonary
function, and theses associations were stronger than those
of the other pollutants measured.
The effects of traffic-related indoor air pollution on the
prevalence of asthma, wheeze, and shortness of breath are
summarized in Table 8. Unlike many other studies, we
observed a significant association between the prevalence
of respiratory symptoms in the study populations and
indoor air pollution exposures. The results of the logistic
regression analysis are shown in Table 8. Not all the data on
respiratory symptoms collected during the survey are
presented in this tableonly the significant respiratory
symptoms associated with the exposure to air pollutants.
The results revealed that the observed differences in air
pollutant level had a significant impact on respiratory health
even after these were adjusted for confounding factors. The
children living at 0.5 km of the main road had a higher risk
of developing respiratory symptoms or diseases than those
living in 5.0 km away from the main road.

Discussion
We have studied the relationship between traffic-related
indoor air pollution and the development of asthmatic

Table 4 Comparison of pulmonary function test results in children stratified by the distance of the houses from the main road
Variables (l/s)

PEF
FVC
FEV1
FEF2575%
SVC

0.5km from main road

(n=78)

1.0km from main road

(n=82)

5.0km from main road

(n=80)

P value

3.21.0
2.00.7
1.50.8
1.80.5
2.50.8

3.90.5
3.50.35
2.10.3
2.50.23
3.20.35

4.30.62
3.80.78
2.80.25
2.90.31
3.60.42

0.001
0.002
0.005
0.001
0.004

PEF Peak expiratory flow, FVC forced vital capacity FEV1 forced expiratory volume in 1 s, FEF forced expiratory flow, SVC slow vital capacity
All values are given as the mean SD

154

Air Qual Atmos Health (2010) 3:149158

Table 5 Correlations among pollutants and weather variables

Variables

CO

CO2

NO

NO2

SO2

CO
CO2
NO
NO2
SO2
O3
SPM
Temp

1.0
0.79
0.63
0.61
0.56
0.34
0.41
0.12

1.0
0.25
0.21
0.13
0.11
0.09
0.18

1.0
0.78
0.45
0.63
0.36
0.24

1.0
0.52
0.58
0.43
0.21

1.0
0.32
0.49
0.15

RH

0.31

0.28

0.35

0.20

0.15

O3

SPM

Temperature

1.0
0.13
0.35

1.0
0.29

1.0

0.11

0.38

0.46

Relative humidity

1.0

symptoms and respiratory infections among children living

in a suburban setting in India. To the best of our
knowledge, this is the first epidemiological study in India
to evaluate relationships between traffic-related indoor air
pollution and respiratory symptoms. We found that the
children in our study who lived near a busy road had a
significantly increased chance of having bronchitis symptoms and doctor-diagnosed asthma than those living further
away from a main road. These monitoring results indicate a
significant difference between the indoor air quality of the
roadside-situated households and those situated further
away from roads. Vehicles in major metropolitan cities are
estimated to account for 70% of the CO, 50% of the
hydrocarbons, 3040% of the NOx, 30% of the SPM, and
10% of the SO2 of the total pollution, with two thirds of
this contributed by two wheelers alone. These high levels of
pollutants are the main causal factors of respiratory and
other air pollution-related ailments, including lung cancer
and asthma (CPCB 2001). The localized vehicular pollution
contributes to about 1.1% of all deaths annually worldwide
and has recently been estimated to be responsible for up to 6%
of all deaths annually in Europe (Knzli et al. 2000). Several
studies indicate that traffic on roads is a major source of air
pollutants in urban areas, but relatively few studies have
evaluated the specific effects of traffic-related air pollution
on individuals living close to traffic-intensive roads.

A qualitative comparison of our results can be made with

those from several previous studies. Chattopadhyay et al.
(2007) studied the levels of PM10 and volatile organic
compounds in motor vehicle exhaust and the lung function
of 505 residents of Kolkata (India) and found that changes
in lung function were associated with higher traffic loads
and an increased deterioration of respiratory function. In
this study, 3.76% of the subjects had restrictive impairment,
3.17% had obstructive impairment, and 1.98% had both.
Ghose et al. (2005) studied the status of urban air pollution
and its impact on human health in the city of Kolkata and
found that SPM, NOx, and CO levels were associated with
respiratory disorders and had a negative effect on human
health. Sharma et al. (2004) studied the effects of
particulate air pollution on the respiratory health of subjects
who lived in three different areas of Kanpur, India and
found that an increase of 100 g/m3 in PM10 was
associated with a reduction of approximately 3.2 l/min in
mean PEF rate for an individual. Nitta et al. (1993)
conducted a cross-sectional study in Tokyo, Japan and
found that exposure to automobile exhaust may be
associated with an increased risk of certain respiratory
symptoms, including chronic cough, chronic phlegm,
chronic wheezing, and chest cold with phlegm. Sekine et
al. (2004) studied the long-term effects of exposure to
automobile exhaust on the pulmonary function of female

Table 6 Partial correlations of

lung function measurements
with potential confounders

Variable

PEF

FVC

FEV1

Age
Sex
BMI
WHR
Nutritional status
Environmental tobacco smoke
Living habitat
Parents respiratory diseases

0.13**
0.08*
0.19**
0.15**
0.03
0.25***
0.09*
0.10**

0.08*
0.05
0.11**
0.09*
0.02
0.18***
0.1**
0.08*

0.05*
0.12*
0.10**
0.13**
0.08*
0.31***
0.11**
0.09*

Significant at: *P<0.05;

**P<0.01; ***P <0.001

FEF2575%
0.04*
0.07*
0.08*
0.10**
0.01
0.11**
0.08*
0.09*

SVC
0.03
0.04
0.09*
0.07*
0.03
0.23***
0.09*
0.06*

Air Qual Atmos Health (2010) 3:149158

155

Table 7 Regression of the pulmonary function test results on indoor air pollutants stratified by distance from the main roada
PFT pollutantb

PEF
CO
NO
NO2
SO2
O3
SPM
FVC
CO
NO
NO2
SO2
O3
SPM
FEV1
CO
NO
NO2
SO2
O3
SPM
FEF2575%
CO
NO
NO2
SO2
O3
SPM
SVC
CO
NO
NO2
SO2
O3
SPM

0.5km from main road (n=78)

B (SE)

1.0km from main road (n=82)

B (SE)

5.0km from main road (n=80)

B (SE)

38.31
42.25
55.71
48.37
20.52
58.30

(53.0)*
(28.0)**
(20.5)***
(30.5)**
(35.6)*
(17.5)***

22.11
20.00
18.53
25.28
5.00
42.50

(65.0)*
(38.5)**
(13.0)***
(20.5)**
(29.8)*
(11.15)***

8.25
6.42
3.65
5.83
10.31
8.79

(62.0)
(25.0)
(30.5)
(32.5)
(40.6)
(15.5)*

36.21
41.00
53.11
37.17
15.32

(73.8) *
(20.0)**
(15.3)***
(28.5)**
(30.1)*

27.13
31.56
43.15
35.78
11.28

(48.0)*
(25.0)**
(22.5)***
(32.1)**
(39.3)*

9.24
7.32
5.18
7.42
18.21

(61.0)
(35.3)
(20.5)
(30.5)
(42.3)

73.18 (27.0)***

37.30 (14.5)***

35.00
44.15
58.22
50.29
15.12
63.20

(60.0)*
(32.0)***
(21.0)***
(28.1)**
(43.0)*
(11.2)***

27.31
39.25
51.71
50.00
20.52
40.30

(53.0)*
(28.0)**
(20.5)***
(30.5)**
(35.6)*
(18.5)***

10.00
6.31
2.00
6.25
20.5
5.20

(53.1)
(25.0)
(15.3)
(22.5)
(51.3)
(29.0)*

32.51
51.25
55.00
40.37
10.00
50.00

(78.5)*
(28.0)**
(20.5)***
(32.0)**
(52.5)*
(13.2)***

28.31
42.25
55.71
30.26
20.52
38.28

(53.0)*
(28.0)**
(19.2)***
(30.5)**
(35.6)*
(23.0)***

8.23
2.25
3.20
5.18
15.38
7.13

(53.7)
(28.6)
(20.7)
(22.5)
(40.5)
(22.5)*

30.25 (53.0)*
45.15 (38.0)**

25.30 (70.8)*
38.00 (22.0)**

51.71
42.30
11.22
52.24

55.71
29.37
10.13
35.00

(18.1)***
(28.1)**
(65.2)*
(18.0)***

(17.0)***
(47.5)**
(25.31)*
(19.21)***

12.25 (32.8)*

9.15 (41.2)
2.32 (25.5)
2.78
7.70
12.52
8.25

(18.1)
(39.5)
(36.8)
(15.0)*

For definition of abbreviations, see Tables 2 and 4

a

Single pollutant models adjusted for confounding factors (sex, age, BMI, WHR, nutritional status, parental smoking, socio-economic status, and
distance from the main road)

b
Regression coefficients are scaled to the inter-quartile range (IQR) for each pollutant. Five models fit each pulmonary function test, one for each
pollutant. IQR values of average pollutant concentration: CO=85.0, NO=15.3, NO2 =20.6, SO2 =18.5, O3 =5.8, SPM=65.3 Significant at *p<
0.05; **p<0.01; ***p<0.001

adults in Tokyo, Japan and found that subjects living in

areas with high concentrations of air pollution showed
higher prevalence rates of respiratory symptoms and a
larger decrease in FEV1 than those living in areas with low
concentrations of air pollution. Shima et al. (2003) found
that the prevalence of asthma in girls living in Chiba

prefecture, Japan was higher among those living <50 m

away from major roads and increased significantly with
increases in the concentration of air pollution. Another
study in Japan by Shima and Adachi (2000) studied the
effect of outdoor and indoor NO2 on respiratory symptoms
in schoolchildren and showed a significant association

156

Air Qual Atmos Health (2010) 3:149158

Table 8 Adjusteda odds ratios (95% confidence intervals) for the association between average indoor air pollution concentrations and respiratory
symptoms
Risk factors
Usually cough for 3 month/year
Usually cold for 3 month/year
Usually phlegm for 3 month/year
Usually expectoration for 3 months/year
Usually wheeze for 3 months/year
Doctor-diagnosed asthma
Doctor-diagnosed bronchitis

0.5km from main road

(n=145)
3.13
3.51
2.15
2.00
3.10
4.15
3.20

(2.003.75)**
(3.184.00)**
(2.003.63)**
(1.953.50)*
(3.004.15)**
(3.984.95)***
(3.154.30)**

1.0km from main road

(n=138)
2.23
2.31
2.75
1.80
2.80
2.97
2.70

(2.163.45)**
(2.203.50)**
(2.583.68)**
(1.453.20)*
(2.723.95)**
(2.893.65)***
(2.523.63)**

5.0km from main road

(n=152)
1.15
1.07
1.03
1.05
1.01
1.00
1.02

(1.001.98)
(0.951.90)
(0.931.93)
(0.901.65)
(0.881.92)
(0.851.50)
(0.891.45)

Adjusted for sex, age, BMI, WHR, nutritional status, parental smoking, mothers education, number of persons in the household, household
characteristics, distance from the main road', and socio-economic status using logistic models
Significant at *p<0.05, **p<0.01, ***p<0.001

between outdoor NO2 concentrations and wheezing. In this

study, girls were more susceptible to indoor NO2 than boys.
In a Japanese study, Shima and Adachi (1996) studied the
serum immunoglobulin (Ig) E and hyaluronate levels in
children living along major roads and found that serum
hyaluronate concentrations were higher in those who lived
<50 m away from a major road than in those who lived
farther away. Those children with high serum IgE concentrations appeared to be particularly susceptible to the effects
of motor vehicle exhaust. Yamazaki et al. (2005) suggested
that traffic exposure led to lower vitality and poorer mental
health among the respondents in their study living near
roadways in Japan. Hwang et al. (2005) suggested that
long-term exposure to traffic-related pollutants, such as
NOx, CO, and O3, increases the risk of childhood asthma in
Taiwan. Yang et al. (2003) found the prevalence of preterm
delivery was significantly higher among mothers living
within 500 m of a freeway than among mothers living 500
1500 m away from the freeway in Taiwan. Lee et al. (2003)
found that doctor-diagnosed allergic rhinitis was associated
with higher non-summer temperatures and traffic-related air
pollutants in Tiwan. Song (2001) suggested that with
increases of 100 g/m3 in total suspended particulate
(TSP) and 50 ppb in SO2, the relative risk (RR) of asthma
attacks was 1.27 and 1.56, respectively, among children
living in Seoul, South Korea.
Janssen et al. (2003) showed that children attending
schools close to motorways with high truck traffic counts in
the Netherlands experienced more respiratory symptoms
than those attending schools near motorways with low truck
traffic counts. Venn et al. (2001) reported that among
children living within 150 m of a main road, the risk of
wheeze increased with increasing proximity by an OR of
1.08 (95% CI 1.001.16) per 30-m increment in primary
schoolchildren and by an OR of 1.16 (1.021.32) in
secondary schoolchildren. In our study, we found that

children living within 0.5 km of a main road were

significantly associated with a decline in PFT and increased
respiratory symptoms compared to those children who lived
5.0 km from the main road. Studies addressing the
assessment of the intra-urban variability of indoor air
pollutants in suburban environments are scarce in developing countries, and only a few studies have investigated the
intra-urban variability of outdoor air pollution (Hewit 1991;
Lebret et al. 2002; Wilsona et al. 2005). In addition, direct
comparisons are limited because the measurements of
ambient air pollutants, sources of air pollutants, and the
investigated areas are different. Results from the few
studies that have been carried out in India and the relatively
more studies carried out abroad suggest that there is a
strong relationship between air pollution and automobile
activities, but the majority of these studies used pollutant
concentrations measured at central monitoring sites to
estimate exposures and did not, in general, consider local
spatial variability in pollutant levels. Our study, in contrast,
provides the opportunity to define more accurately the
types and concentrations of air pollutants in the indoor air.
As such, it differs from all earlier studies that have
investigated the urban air pollution. The major limitation
of our study is that the respiratory suspended particulate
matter (PM10, PM2.5) was not estimated. Despite this
limitation, based on our results, we conclude that living
near busy roads leads to adverse respiratory health effects.
The results of this study are consistent with the findings of
studies in other cities where elevated levels of exposure to
motor vehicle-related pollutants on roadside microenvironments were observed (Venn et al. 2001; Janssen et
al. 2003). All of the above findings lead to the simple fact
that transportation has a great impact on indoor air quality.
In our study, the roadside-dwelling children were exposed
to elevated levels of air pollutants and were at great health
risks. Low-quality fossil fuel combustion and transportation

Air Qual Atmos Health (2010) 3:149158

exert an important influence on this increase in pollutant

concentrations. Future studies that can better characterize
exposures to traffic pollutants and their sources will provide
important information towards gaining a better understanding of the public health impacts of motor vehicle emissions
and to developing an integrated assessment that will be
helpful to the air quality concerns in epidemiological
studies.
Acknowledgments The authors acknowledge the cooperation of the
households and the local communities of the Bolpur-Santiniketan area
during the study. The financial support provided by the UGC, India to
one of the authors (B. K. Padhi) is gratefully acknowledged. The
authors are also grateful to the two anonymous reviewers for their
valuable comments and suggestions which helped in improvement of
the quality of the manuscript.

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