Respiratory damage in children exposed to urban pollution

Pediatr Pulmonol. 2003 Aug;36(2):148-61. doi: 10.1002/ppul.10338.


Southwest Metropolitan Mexico City (SWMMC) children are chronically exposed to complex mixtures of air pollutants. In a cross-sectional arm of our study, we investigated the association between exposure to SWMMC atmosphere and nasal abnormalities, hyperinflation, and interstitial markings assessed by chest X-rays, lung function changes, several serum cytokines, and endothelin-1 in 174 children aged 5-17 years vs. 27 control children residents in low-polluted areas. Control children had no nasal lesions, and only one child showed an abnormal chest X-ray. SWMMC children exhibited nasal abnormalities (22%), hyperinflation (67%), interstitial markings (49%), and a mild restrictive pattern by spirometry (10%). Interstitial markings were associated with a decrease in predicted values of FEF(25-75), FEF(75), and the FEV(1)/FVC ratio. Boys had a higher probability of developing interstitial markings with age (P = 0.004). Blood smear findings included toxic granulations in neutrophils and schistocytes. SWMMC children had more serum IL10 and IL6 and less IL8 than controls. In a longitudinal arm of our study, we found a significant seasonal drop in FVC and FEV(1) associated with a 6-month period of high ozone and PM(10) levels. Our data strongly suggest that a lifelong exposure to urban air pollution causes respiratory damage in children. Moreover, a cytokine network becomes imbalanced, with a shift towards upregulation of anti-inflammatory cytokines. Consequently, these children are potentially at risk for developing chronic lung disease and other systemic effects later in life.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Age Factors
  • Air Pollutants / analysis
  • Air Pollutants / toxicity*
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Cytoplasmic Granules / pathology
  • Endothelin-1 / blood
  • Erythrocytes, Abnormal / pathology
  • Female
  • Humans
  • Hyperemia / diagnosis
  • Inhalation Exposure / adverse effects*
  • Interleukins / blood
  • Longitudinal Studies
  • Lung / diagnostic imaging
  • Lung / physiopathology
  • Male
  • Mexico / epidemiology
  • Nasal Cavity / abnormalities
  • Neutrophils / pathology
  • Ozone / analysis
  • Radiography
  • Seasons
  • Sex Factors
  • Urban Population*


  • Air Pollutants
  • Endothelin-1
  • Interleukins
  • Ozone