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Association between reported exposure to road traffic and respiratory symptoms in children: evidence of bias.
Int J Epidemiol. 2006 Jun; 35(3):779-86.IJ

Abstract

BACKGROUND

Many studies showing effects of traffic-related air pollution on health rely on self-reported exposure, which may be inaccurate. We estimated the association between self-reported exposure to road traffic and respiratory symptoms in preschool children, and investigated whether the effect could have been caused by reporting bias.

METHODS

In a random sample of 8700 preschool children in Leicestershire, UK, exposure to road traffic and respiratory symptoms were assessed by a postal questionnaire (response rate 80%). The association between traffic exposure and respiratory outcomes was assessed using unconditional logistic regression and conditional regression models (matching by postcode).

RESULTS

Prevalence odds ratios (95% confidence intervals) for self-reported road traffic exposure, comparing the categories 'moderate' and 'dense', respectively, with 'little or no' were for current wheezing: 1.26 (1.13-1.42) and 1.30 (1.09-1.55); chronic rhinitis: 1.18 (1.05-1.31) and 1.31 (1.11-1.56); night cough: 1.17 (1.04-1.32) and 1.36 (1.14-1.62); and bronchodilator use: 1.20 (1.04-1.38) and 1.18 (0.95-1.46). Matched analysis only comparing symptomatic and asymptomatic children living at the same postcode (thus exposed to similar road traffic) showed similar ORs, suggesting that parents of children with respiratory symptoms reported more road traffic than parents of asymptomatic children.

CONCLUSIONS

Our study suggests that reporting bias could explain some or even all the association between reported exposure to road traffic and disease. Over-reporting of exposure by only 10% of parents of symptomatic children would be sufficient to produce the effect sizes shown in this study. Future research should be based only on objective measurements of traffic exposure.

Authors+Show Affiliations

Swiss Paediatric Respiratory Research Group, Department of Social and Preventive Medicine, University of Berne, Switzerland. kuehni@ispm.unibe.chNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16513809

Citation

Kuehni, Claudia E., et al. "Association Between Reported Exposure to Road Traffic and Respiratory Symptoms in Children: Evidence of Bias." International Journal of Epidemiology, vol. 35, no. 3, 2006, pp. 779-86.
Kuehni CE, Strippoli MP, Zwahlen M, et al. Association between reported exposure to road traffic and respiratory symptoms in children: evidence of bias. Int J Epidemiol. 2006;35(3):779-86.
Kuehni, C. E., Strippoli, M. P., Zwahlen, M., & Silverman, M. (2006). Association between reported exposure to road traffic and respiratory symptoms in children: evidence of bias. International Journal of Epidemiology, 35(3), 779-86.
Kuehni CE, et al. Association Between Reported Exposure to Road Traffic and Respiratory Symptoms in Children: Evidence of Bias. Int J Epidemiol. 2006;35(3):779-86. PubMed PMID: 16513809.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association between reported exposure to road traffic and respiratory symptoms in children: evidence of bias. AU - Kuehni,Claudia E, AU - Strippoli,Marie-Pierre F, AU - Zwahlen,Marcel, AU - Silverman,Michael, Y1 - 2006/03/02/ PY - 2006/3/4/pubmed PY - 2007/2/13/medline PY - 2006/3/4/entrez SP - 779 EP - 86 JF - International journal of epidemiology JO - Int J Epidemiol VL - 35 IS - 3 N2 - BACKGROUND: Many studies showing effects of traffic-related air pollution on health rely on self-reported exposure, which may be inaccurate. We estimated the association between self-reported exposure to road traffic and respiratory symptoms in preschool children, and investigated whether the effect could have been caused by reporting bias. METHODS: In a random sample of 8700 preschool children in Leicestershire, UK, exposure to road traffic and respiratory symptoms were assessed by a postal questionnaire (response rate 80%). The association between traffic exposure and respiratory outcomes was assessed using unconditional logistic regression and conditional regression models (matching by postcode). RESULTS: Prevalence odds ratios (95% confidence intervals) for self-reported road traffic exposure, comparing the categories 'moderate' and 'dense', respectively, with 'little or no' were for current wheezing: 1.26 (1.13-1.42) and 1.30 (1.09-1.55); chronic rhinitis: 1.18 (1.05-1.31) and 1.31 (1.11-1.56); night cough: 1.17 (1.04-1.32) and 1.36 (1.14-1.62); and bronchodilator use: 1.20 (1.04-1.38) and 1.18 (0.95-1.46). Matched analysis only comparing symptomatic and asymptomatic children living at the same postcode (thus exposed to similar road traffic) showed similar ORs, suggesting that parents of children with respiratory symptoms reported more road traffic than parents of asymptomatic children. CONCLUSIONS: Our study suggests that reporting bias could explain some or even all the association between reported exposure to road traffic and disease. Over-reporting of exposure by only 10% of parents of symptomatic children would be sufficient to produce the effect sizes shown in this study. Future research should be based only on objective measurements of traffic exposure. SN - 0300-5771 UR - https://www.unboundmedicine.com/medline/citation/16513809/Association_between_reported_exposure_to_road_traffic_and_respiratory_symptoms_in_children:_evidence_of_bias_ DB - PRIME DP - Unbound Medicine ER -