International Journal of Epidemiology, Vol 28, 293-299, Copyright © 1999 by International Epidemiological Association
G Hoek, D Wypij and B Brunekreef
BACKGROUND: Studies of acute effects of outdoor air pollution on acute
respiratory symptoms in children generally rely on reports by parents.
Little is known about the validity of parental reporting of symptoms of
their children. We therefore compared symptoms reported by the parents with
self-reported symptoms and measured pulmonary function of 741 7-11-
year-old Dutch children. We also analysed the association of symptoms
reported by the child or parent and outdoor air pollution. METHODS: The
parents of the children completed a daily diary of symptoms of their
children for about 3 months. The children reported presence of acute
respiratory symptoms in the preceding week before a pulmonary function test
was conducted (6-10 test days). RESULTS: Children reported between 80% and
220% more acute respiratory symptoms than their parents for them in the
same period. The agreement between symptom reports by the parent and the
child was low to moderate (Kappa between 0.22 for eye irritation and 0.43
for fever). Presence of cough reported by child or parent was associated
with similar small decrements in forced vital capacity (FVC), forced
expiratory volume in one second (FEV1.0) and especially peak expiratory
flow (PEF) and maximal mid-expiratory flow (FEF25-75). The largest
pulmonary function decrements were found when symptoms were reported by
both parent and child. Symptoms reported by either child or parent were not
associated with air pollution. CONCLUSIONS: Symptom reports of the children
were more prevalent but did not agree well with parental reports. The
similar association with pulmonary function suggested that self-reported
symptoms were neither superior nor inferior to symptoms reported by the
parents.
ARTICLES
Self-reporting versus parental reporting of acute respiratory symptoms of children and their relation to pulmonary function and air pollution
Department of Environmental Sciences, University of Wageningen, The Netherlands.
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