Luftibus in the School: a Study on the Respiratory Health of Schoolchildren.
Condition: Respiratory Disease
MeSH terms: Respiratory Tract Diseases; Respiration Disorders
Study type: Observational

Summary: 
      This study assessed the respiratory health of schoolchildren from the canton of Zurich by
      combining self-reported information on respiratory symptoms with lung function test results
      and air pollution measurements.

      Luftibus in the school (LUIS) is a population-based study conducted in the canton of Zurich,
      Switzerland. Between the years 2013 and 2016 a bus with equipment for lung function testing
      and air pollution measurement visited numerous schools across the canton Zurich. The parents
      of the schoolchildren filled in a questionnaire with validated questions on upper and lower
      respiratory symptoms, trigger factors, diagnosis, treatment of respiratory symptoms, health
      behavior and environmental factors. The children were interviewed using a shorter
      questionnaire. Fieldworkers measured lung function (spirometry and double tracer gas
      single-breath washout) and an airway inflammation test (fractional exhaled nitric oxide) in
      the bus. The recruited population included 3500 schoolchildren aged 6 to 16 years from the
      canton of Zurich.

      Respiratory symptoms and their influence on physical activity and sleep have a strong impact
      on children's quality of life and school performance. The results of this study will provide
      new insights on schoolchildren's respiratory health that may help to establish new
      recommendations and influence policy makers' decisions.
    

Detailed description: 
      Background:

      Few population-based studies have recently investigated the epidemiology of childhood
      respiratory symptoms in Switzerland.

      Objectives:

      The Luftibus in the school study was setup to assess the respiratory health of schoolchildren
      from the canton of Zurich and to investigate relationships between respiratory symptoms, lung
      function and air pollution.

      Methods:

      Recruitment and participation:

      All schools in the canton of Zürich were invited to participate in the LUIS study. Those
      schools interested in participating were approached. The eligible study population were
      children aged 6 to 16 years with parental consent from the schools that agreed to
      participate. Prior to each school visit, parents received a letter with information about the
      project, an informed consent form and a questionnaire. During the school visit, trained field
      workers performed lung function tests in children at the school, interviewed the children
      using a short questionnaire and collected the parental questionnaires. A subsample of the
      schools was visited again one year after the first visit in order to collect follow-up
      information, using the same procedure and gathering the same measurements.

      Information collected:

      - Parental questionnaire: Frequency, duration, severity, triggers of upper and lower
      respiratory symptoms, previous doctor diagnosis of asthma, use of medication, health
      behaviors, environmental factors, household characteristics and family history.

      - Children's questionnaire: Respiratory symptoms, asthma diagnosis, medication and smoking.

      - Anthropometric data: Height and weight were measured by fieldworkers in the schools in a
      standardized way.

      - Complementary tests: Spirometry, fractional exhaled nitric oxide (FeNO) and double tracer
      gas single-breath washout (SBW) were performed in the school by trained fieldworkers
      according to ATS criteria.

      - Air pollution measurements: Air pollution detectors placed on the roof of the bus measured
      nitrogen dioxide (NO2), inhalable particles of 10 micrometers or less in diameter (PM10) and
      ozone concentration at the school site.

      Study database:

      The study questionnaire database was created using Epidata, which allows data entry and data
      extraction in CVS format.

      Funding:

      Lung League of Zurich
    

Observational model: Other
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Community sample of schoolchildren from the canton of Zürich
      
Keywords: Asthma; Wheeze; Cough; Snoring; Bronchial obstruction; Air pollution