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Table 2 Studies assessing the health effects of ambient air pollution in Sri Lanka

From: Air pollution and health in Sri Lanka: a review of epidemiologic studies

Reference, study location and data collection period Study design, subject characteristics and sample size Exposure air pollutants Health outcomes Results Adjustment for confounding factors Limitations
Cross sectional studies
Premaratna R et al. [29],
Gampaha district.
1997
Children, 1-12 years (n = 154); adults (n = 304) Not measured Respiratory symptoms & peak flow rate Higher rate of respiratory symptoms and reduction in expiratory flow rate reported in the industrialized area. No No measurement of exposure
Senanayake MP et al.[37],
Colombo.
1998 and 2003
Children, 1-15 years (1998, n = 50;
2003, n = 39)
Blood lead levels Blood lead levels 6% of children had blood lead levels
>10 μg/dl when leaded petrol was used (1998); none had levels > 10 μg/dl, one year after unleaded petrol was introduced.
No Small sample size. Comparison of different birth cohorts.
Amarasinghe J.N.P.et al.[38],
Colombo.
2002
Policemen, traffic (n = 64); non-traffic (n = 64) Blood lead levels Potential symptoms and signs resulting from high blood lead levels Abdominal discomfort, tremor and hypertension higher in traffic policemen as compared to non- traffic policemen No Control group may also have had a high exposure during the busy hours leading to misclassification
Mistry R. et al.[32],
Galle and Chandigarh. 2004
Children, 13-14 years (Galle, n = 1162; Chandigarh, n = 575) No specific types are measured Wheezing Occurrences of wheezing was higher in Galle as compared to Chandigarh No No measurement of exposure
Nandasena YLS et al.[30], Colombo and Ampara districts.
2005
Children, 9 - 15 years (n = 482) SO2
NO2
PM10
Respiratory symptoms Respiratory symptoms were higher in Colombo as compared to the rural area. Associations were overridden by household risk factors. Adjusted for cooking fuel type and mosquito coil use Only respiratory symptoms are considered
Perera GBS et al.[35],
Colombo and Ampara districts.
2005
Adults
(n = 587)
SO2
NO2
PM10
Respiratory symptoms Occurrence of respiratory symptoms were higher in Colombo as compared to the rural area Adjusted for cooking fuel type and mosquito coil use Only respiratory symptoms are considered.
Elangasinghe MA et al.[31], Kandy.
2006
12-16 year school children
(n = 760)
PM10 Respiratory health 32% of children of village school had a health indicator of 1 (a measure of perfect respiratory health) while only 8% from the city school had an index of 1. No Health indicator constructed by authors but not validated.
Other Study Designs
Senanayake, MP et al.[33],
Lady Ridgeway Children's Hospital, Colombo.
1998-1999
Ecological study, children under 12 years (n =41032) NO2, SO2 Emergency reporting for nebulization Episodes of nebulization positively correlated with most polluted days (p < 0.05) No No measurement of exposure of the children; pollutant data from single monitor in the city
Sirithunga TLJC et al.[28],
Kandy district.
2004.
Follow-up study
children 7-12 years
(n = 1033)
SO2
NO2
Ozone
Respiratory symptoms Occurrences of respiratory symptoms were higher in the Kandy city area as compared to the rural area. Yes Only outdoor passive samplers used; indoor air quality predicted with proxy variables
Thishan Dharshana KG and Coowanitwong N[34],
LRH hospital, Colombo.
2008
Ecological study PM10 Respiratory diseases Diseases categories included bronchitis, emphysema and other chronic obstructive pulmonary diseases; positive correlation (r = 0.717; p = 0.01). No Colombo Fort monitoring station may not be representative of the whole study area.