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2625456 
Journal Article 
Abstract 
Sulfur dioxide (SO2) as an air pollutant is not wholly accountable for the rising prevalence of asthma among Chinese children: a case study in Chongqing 
Song, A; Deng, L; Liao, Q; Zhao, G; Chen, J; Liu, E 
2010 
Yes 
American Journal of Respiratory and Critical Care Medicine
ISSN: 1073-449X
EISSN: 1535-4970 
181 
A1893 
English 
WOS:000208771001101 
is part of a larger document 3452678 Proceedings of the American Thoracic Society 2010 International Conference, May 14-19, 2010, New Orleans
Introduction: Although pathogenesis of asthma is still a major challenge in medical science, epidemiology studies have shown that the incidence of asthma is associated with the level of air pollution. However, there are many pollutants in the air including sulfur dioxide (SO2) that may contribute to the initiation and/or exacerbation of asthma, and the role of each specific air pollutant is not fully elucidated. Here, we investigated the association of SO2 level and asthma incidence among Chinese children in Chongqing. The rationale is that in Chongqing SO2 is the primary air pollutant due to its history of using high sulfur content coal as energy source for both the once booming heavy industries and the densely populated residents in the past. In addition, the city’s unique geography, low altitude with surrounding mountain ranges that reduce seasonal winds, can enhance the lingering of SO2 in the air. Therefore, SO2 may be the culprit for the prevalence of respiratory diseases including child asthma in Chongqing.

Methods: Data from 1996 to 2008 of SO2 content in the air of Chongqing’s nine central districts were collected from the city’s Environment Protection Bureau. These nine districts include three heavy industrial areas and five densely populated residential areas as test areas, and one farming/tourism area as control. Clinical cases of child asthma were provided by Chongqing Children's Hospital and segregated according to the patient’s residence. The Change of SO2 with time and association with asthma were studied by statistical analysis.

Results: On average, SO2 content in Chongqing decreased from 0.207mg/m^3 in 1997 to 0.063 mg/m^3 in 2008. Although the reduction of SO2 pollution has been continuous during the past decade, but it accelerated during 2005-08, directly associated with the city’s Blue Sky Campaign. Despite the continuous reduction of SO2 content in the air, the incidence of child asthma has been continuously rising from 5% in 1998 to 11% in 2008.

Conclusion: SO2 is a trigger of asthma attacks, but it can not be held responsible for rising prevalence of asthma among Chinese children, at least in the case of Chongqing. This suggests that SO2 control alone may not result in significant improvement of respiratory health of the populace, and instead a more comprehensive approach toward clean air should be adopted. 
American Thoracic Society 2010 International Conference 
New Orleans, LA 
May 14-19, 2010