Abstract
BACKGROUND: Asthma is common in children with indoor pollutants influencing the development of the disease. Since children spend most of their time outside their homes within the school environment, school indoor air quality can directly influence their respiratory health. AIMS: This study aims to analyze the indoor and outdoor air quality of Maltese schools and if an association exists between indoor pollutants and respiratory health in children. SETTINGS AND DESIGN: Five primary schools were selected with 9- to 11-year-old students participating. MATERIALS AND METHODS: Standardized health questionnaires and lung function tests were utilized. Indoor and outdoor air sampling together with traffic counts were carried out. STATISTICAL ANALYSIS USED: SPSS version 21 was used and the Chi-squared, logistic regression, and Pearson's correlation were used. RESULTS: The mean indoor PM 2.5 level of 17.78 μg/m(3) and CO (9.11 ppm) exceeded World Health Organization thresholds. Indoor ozone levels exceeded the mean European school's indoor ozone concentration of 8 μg/m(3). High exposure to formaldehyde, NO(2), and ozone was associated with atopy in children. Heavy vehicles passing near the schools were associated with current wheezing (P < 0.001) but not nocturnal cough (P = 0.34). CONCLUSIONS: School indoor and outdoor environment has a direct impact on children's respiratory health. This study has identified significant associations between high exposures to indoor air pollutants, school characteristics, and upper and lower airway inflammation.