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Open Access Research article

The relationship of air pollution and surrogate markers of endothelial dysfunction in a population-based sample of children

Parinaz Poursafa1, Roya Kelishadi2*, Ahmadreza Lahijanzadeh3, Mohammadreza Modaresi4, Shaghayegh Haghjouy Javanmard5, Raheleh Assari6, Mohammad Mehdi Amin7, Faramarz Moattar1, Abbasgholi Amini4 and Babak Sadeghian3

Author Affiliations

1 Faculty of Environment and Energy, Science and Research Branch, Islamic Azad University, Tehran, Iran

2 Pediatrics Department, Child Health Promotion Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

3 Environmental Protection Department, Isfahan, Iran

4 Pediatrics Department, Pediatric Prevention Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

5 Department of Physiology, Applied Physiology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

6 Pediatrics Department, School of Medicine, Pediatric Prevention Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

7 Department of Environmental Health Engineering, Environment Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

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BMC Public Health 2011, 11:115  doi:10.1186/1471-2458-11-115

Published: 18 February 2011

Abstract

Background

This study aimed to assess the relationship of air pollution and plasma surrogate markers of endothelial dysfunction in the pediatric age group.

Methods

This cross-sectional study was conducted in 2009-2010 among 125 participants aged 10-18 years. They were randomly selected from different areas of Isfahan city, the second large and air-polluted city in Iran. The association of air pollutants' levels with serum thrombomodulin (TM) and tissue factor (TF) was determined after adjustment for age, gender, anthropometric measures, dietary and physical activity habits.

Results

Data of 118 participants was complete and was analyzed. The mean age was 12.79 (2.35) years. The mean pollution standards index (PSI) value was at moderate level, the mean particular matter measuring up to 10 μm (PM10) was more than twice the normal level. Multiple linear regression analysis showed that TF had significant relationship with all air pollutants except than carbon monoxide, and TM had significant inverse relationship with ozone. The odds ratio of elevated TF was significantly higher in the upper vs. the lowest quartiles of PM10, ozone and PSI. The corresponding figures were in opposite direction for TM.

Conclusions

The relationship of air pollutants with endothelial dysfunction and pro-coagulant state can be an important factor in the development of atherosclerosis from early life. This finding should be confirmed in future longitudinal studies. Concerns about the harmful effects of air pollution on children's health should be considered a top priority for public health policy; it should be underscored in primordial and primary prevention of chronic diseases.