Acute Respiratory Inflammation in Children and Black Carbon in Ambient Air before and during the 2008 Beijing Olympics

BACKGROUND: Epidemiologic evidence for a causative association between black carbon (BC) and health outcomes is limited. OBJECTIVES: We estimated associations and exposure-response relationships between acute respiratory inflammation in schoolchildren and concentrations of BC and particulate matter with an aerodynamic diameter of <= 2.5 mu m (PM2.5) in ambient air before and during the air pollution intervention for the 2008 Beijing Olympics. METHODS: We measured exhaled nitric oxide (eNO) as an acute respiratory inflammation biomarker and hourly mean air pollutant concentrations to estimate BC and PM2.5 exposure. We used 1,581 valid observations of 36 subjects over five visits in 2 years to estimate associations of eNO with BC and PM2.5 according to generalized estimating equations with polynomial distributedlag models, controlling for body mass index, asthma, temperature, and relative humidity. We also assessed the relative importance of BC and PM2.5 with two-pollutant models. RESULTS: Air pollution concentrations and eNO were clearly lower during the 2008 Olympics. BC and PM2.5 concentrations averaged over 0-24 hr were strongly associated with eNO, which increased by 16.6% [95% confidence interval (CI), 14.1-19.2%] and 18.7% (95% CI, 15.0-22.5%) per interquartile range (IQR) increase in BC (4.0 mu g/m(3)) and PM2.5 (149 mu g/m(3)), respectively. In the two-pollutant model, estimated effects of BC were robust, but associations between PM2.5 and eNO decreased with adjustment for BC. We found that eNO was associated with IQR increases in hourly BC concentrations up to 10 hr after exposure, consistent with effects primarily in the first hours after exposure. CONCLUSIONS: Recent exposure to BC was associated with acute respiratory inflammation in schoolchildren in Beijing. Lower air pollution levels during the 2008 Olympics also were associated with reduced eNO.