A cohort study with children living in an air-polluted region--a model for public health.

Regions with heavy industry are in many ways regions of crisis. The health of the population is primarily affected by the different air pollutants. Dust, with all its organic (dioxins and furans) and inorganic (heavy metals) contents, makes up the greatest part of the air-borne pollutants. The influence on health of environmental pollution was ascertained through the determination of different parameters (functional methods and determination of physiological parameters). This influence could be observed in children over a period of 8 years with regular investigations (e.g. determination of pulmonary function by spirometry and immunological parameters). Besides this exogenous load the persons are exposed to other environmental stresses-shift work, unemployment, alcoholism and divorce-which have a particular influence on the attitude and the upbringing of the children. Sixty per cent of the children in this polluted region ate no breakfast in the morning. Consequently it could be shown that the blood sugar in 70% of the children was below 70 mg/dl. Additionally, a relatively high amount of COHb (2.5% to 3%), and an increased concentration of serum IgE (47% of children with a concentration over 100 IU/ml), could be detected. Through a change in the environmental awareness of the children and their consequent influence, an effort should be made to achieve a positive effect on the health of the whole population. The children were given a chance to participate in various sports for the whole day during a week in the mountains at 1200 m. The teachers exercised with the children for at least 8 h per day. Besides gymnastics the program consisted of downhill and cross-country skiing. In addition, the children were offered a balanced and natural diet and they were instructed accordingly. This week of activity led to a clear reduction of the concentration of COHb, but to a far less clear improvement in the concentration of blood sugar and the pulmonary function.