The prevalence of respiratory symptoms and asthma among school children in three different areas of Norway

Abstract
The role of exposure to ambient air pollution has been a topic of interest as a potential risk factor for respiratory symptoms and asthma. We expected that the prevalence rates would vary in Norway between the capital, Oslo, the mountainous area Hallingdal and the industrial area Odda. Surveys were conducted in school children, aged 6-16 years, in; Oslo (n = 2577), Hallingdal (n = 1177) and Odda (n = 831). The parent-reported prevalence of wheeze in past year was almost similar in Oslo (13.1 (95% CI 11.7-14.5)) and Upper Hallingdal (14.2 (13.1-15.3)), but lower in Odda (9.0 (7.0-11.0)). The findings for severe respiratory symptoms were almost equal. The age patterns within each area differed. The risk of wheeze ever (p < 0.001) and wheeze in past year (p = 0.04) decreased with increasing age in Odda, while there was an increase in the risk of exercise induced wheeze in Oslo (p = 0.02) and Hallingdal (p < 0.001). The lifetime prevalence of asthma was lowest in Odda (5.4 (3.8-7.0)) compared to Oslo (9.4 (8.2-10.6)) and Hallingdal (8.5 (6.8-10.2)). There was a positive association between physical activity and wheeze in past year. The results do not support the hypothesis that respiratory morbidity is more common in urban than rural areas, age and physical activity can influence the prevalence rates of respiratory symptoms in school children.