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Evaluation of the Relationship between Fractional Exhaled Nitric Oxide (FeNO) with Indoor PM 10 , PM 2.5 and NO 2 in Suburban and Urban Schools

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  • Khairul Nizam Mohd Isa

    (Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang 43400, Selangor, Malaysia
    Environmental Health Research Cluster (EHRc), Environmental Healthcare Section, Institute of Medical Science Technology, Universiti Kuala Lumpur, Kajang 43000, Selangor, Malaysia)

  • Juliana Jalaludin

    (Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang 43400, Selangor, Malaysia)

  • Saliza Mohd Elias

    (Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang 43400, Selangor, Malaysia)

  • Norlen Mohamed

    (Environmental Health Unit, Level 2, E3, Disease Control Division, Ministry of Health, Putrajaya 62590, Wilayah Persekutuan Putrajaya, Malaysia)

  • Jamal Hisham Hashim

    (Department of Health Sciences, Faculty of Engineering and Life Science, Universiti Selangor, Shah Alam Campus, Seksyen 7, Shah Alam 40000, Selangor, Malaysia)

  • Zailina Hashim

    (Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang 43400, Selangor, Malaysia)

Abstract

Numerous epidemiological studies have evaluated the association of fractional exhaled nitric oxide (FeNO) and indoor air pollutants, but limited information available of the risks between schools located in suburban and urban areas. We therefore investigated the association of FeNO levels with indoor particulate matter (PM 10 and PM 2.5 ), and nitrogen dioxide (NO 2 ) exposure in suburban and urban school areas. A comparative cross-sectional study was undertaken among secondary school students in eight schools located in the suburban and urban areas in the district of Hulu Langat, Selangor, Malaysia. A total of 470 school children (aged 14 years old) were randomly selected, their FeNO levels were measured, and allergic skin prick tests were conducted. The PM 2.5 , PM 10 , NO 2 , and carbon dioxide (CO 2 ), temperature, and relative humidity were measured inside the classrooms. We found that the median of FeNO in the school children from urban areas (22.0 ppb, IQR = 32.0) were slightly higher as compared to the suburban group (19.5 ppb, IQR = 24.0). After adjustment of potential confounders, the two-level hierarchical multiple logistic regression models showed that the concentrations of PM 2.5 were significantly associated with elevated of FeNO (>20 ppb) in school children from suburban (OR = 1.42, 95% CI = 1.17–1.72) and urban (OR = 1.30, 95% CI = 1.10–1.91) areas. Despite the concentrations of NO 2 being below the local and international recommendation guidelines, NO 2 was found to be significantly associated with the elevated FeNO levels among school children from suburban areas (OR = 1.11, 95% CI = 1.06–1.17). The findings of this study support the evidence of indoor pollutants in the school micro-environment associated with FeNO levels among school children from suburban and urban areas.

Suggested Citation

  • Khairul Nizam Mohd Isa & Juliana Jalaludin & Saliza Mohd Elias & Norlen Mohamed & Jamal Hisham Hashim & Zailina Hashim, 2022. "Evaluation of the Relationship between Fractional Exhaled Nitric Oxide (FeNO) with Indoor PM 10 , PM 2.5 and NO 2 in Suburban and Urban Schools," IJERPH, MDPI, vol. 19(8), pages 1-12, April.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:8:p:4580-:d:791073
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    References listed on IDEAS

    as
    1. Khairul Nizam Mohd Isa & Zailina Hashim & Juliana Jalaludin & Leslie Thian Lung Than & Jamal Hisham Hashim, 2020. "The Effects of Indoor Pollutants Exposure on Allergy and Lung Inflammation: An Activation State of Neutrophils and Eosinophils in Sputum," IJERPH, MDPI, vol. 17(15), pages 1-18, July.
    2. Hanne Krage Carlsen & Peter Boman & Bodil Björ & Anna-Carin Olin & Bertil Forsberg, 2016. "Coarse Fraction Particle Matter and Exhaled Nitric Oxide in Non-Asthmatic Children," IJERPH, MDPI, vol. 13(6), pages 1-11, June.
    3. Dian Huang & Qinglan Li & Xiaoxue Wang & Guangxin Li & Liqun Sun & Bing He & Li Zhang & Chunsheng Zhang, 2018. "Characteristics and Trends of Ambient Ozone and Nitrogen Oxides at Urban, Suburban, and Rural Sites from 2011 to 2017 in Shenzhen, China," Sustainability, MDPI, vol. 10(12), pages 1-17, December.
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