Urban and social origins of childhood bronchitis in England and Wales.

A survey of respiratory disease in over 10,000 children aged 6 to 10 years living in contrasting urban and rural areas of England and Wales showed pronounced social class gradient in the frequency of chronic cough, history of bronchitis, and also in disease of ears and nose. A consistent rise in the frequency of chest conditions with increasing local levels of air pollution was clearly seen only among the children of semi-skilled and unskilled workers. No such gradient was obvious for diseases of the ear and nose. These trends in chest disease in children paralleled similar trends in mortal and disabling bronchitis among adults in the same areas. The excess rate for bronchitis in children and adults found in South Wales could not be accounted for by local levels of air pollution.