Respiratory hospitalizations of children and residential exposure to traffic air pollution in Jerusalem

Although exposure to traffic-related air pollution has been reported to be associated with respiratory morbidity in children, this association has not been examined in Israel. Jerusalem is ranked among the leading Israeli cities in transport-related air pollution. This case-control study examined whether pediatric hospitalization for respiratory diseases in Jerusalem is related to residential exposure to traffic-related air pollution. Cases (n = 4844) were Jerusalem residents aged 0-14 years hospitalized for respiratory illnesses between 2000 and 2006. These were compared to children admitted electively (n = 2161) or urgently (n = 3085) for non-respiratory conditions. Individual measures of exposure included distance from residence to nearest main road, the total length of main roads, traffic volume, and bus load within buffers of 50, 150, and 300 m around each address. Cases were more likely to have any diesel buses passing within 50 m of their home (adjusted odds ratios = 1.16 and 1.10, 95% confidence intervals 1.04-1.30 and 1.01-1.20 for elective and emergency controls, respectively). Our findings indicated that older girls (5-14) and younger boys (0-4) had increased risks of respiratory hospitalization, albeit with generally widened confidence intervals due to small sample sizes. Our results add to the limited body of evidence regarding associations between diesel exhaust particles and respiratory morbidity. The findings also point to possible differential associations between traffic-related air pollution and pediatric hospitalization among boys and girls in different age groups.