• Triin Veber University of Tartu, Tartu, Estonia
  • Kaja Julge University of Tartu; Tartu University Hospital, Tartu, Estonia
  • Tiina Rebane Tartu University Hospital, Tartu, Estonia
  • Marje Muusikus Health Board, Tallinn, Estonia
  • Marek Maasikmets Estonian Environmental Research Centre, Tallinn, Estonia
  • Aser Sikk Estonian Environmental Research Centre, Tallinn, Estonia
  • Diana Sudakova Tartu University Hospital, Tartu, Estonia
  • Tanel Tamm University of Tartu, Tartu, Estonia
  • Daiga Parsova University of Tartu, Tartu, Estonia
  • Märten Lukk Health Board, Tallinn, Estonia
  • Kristina Aidla Health Board, Tallinn, Estonia
  • Leena Albreht Health Board, Tallinn, Estonia
  • Jüri Ruut Health Board, Tallinn, Estonia
  • Jelena Tomasova TNP Consultations
  • Hans Orru University of Tartu, Tartu, Estonia; Umea University, Umea, Sweden


industrial air pollution, benzene, hydrogen sulphide, benzo(a)pyrene, particulate matter, fine particles, respiratory health, allergy, asthma


Background: Industrial areas in North-Eastern Estonia are concentrated on power generation from oil shale, oil shale extraction and shale oil production. Compared to other counties of Estonia, children in Ida-Viru county have higher prevalence of respiratory symptoms and asthma. There is high concern that industry-related air pollution affects children health.

Aim: Current study aimed to assess the effect of industry specific pollutants on children respiratory health in industrial area in Estonia.

Methods:  Altogether 1,041 3–4 grade schoolchildren from 20 schools in Ida-Viru County participated in the cross-sectional study. We conducted questionnaire study on respiratory health and subsequently made clinical examinations to measure fractional exhaled nitric oxide (FeNO), spirometry and allergies (from blood samples). The annual average concentrations of industry-specific air pollutants as benzene, hydrogen sulphide, benzo(a)pyrene and particulate matter (PM10) and fine particles (PM2,5) were modelled in Ida-Viru County using Eulerian air quality dispersion model and participants’ home and school addresses were linked to air pollution exposure. The emissions originated from oil shale industry were also modelled separately to differentiate the effects. We used adjusted logistic regression models to assess how the pollutants exposure has affected respiratory health and allergies among children.

Results: It appeared that parents of Ida-Virumaa children assess the risks of air pollution more often very important than elsewhere in Estonia. Compared to earlier studies in 2014/2015, the asthma prevalence in 2019 had increased (from 13.0 to 13,8%), but there were significantly less children with high FeNO levels (≥30 ppb). This might indicate the trend of better diagnosis and treatment. Regression analysis showed that main drivers of weakened respiratory health and allergy prevalence, are air pollutants like benzene, PM10 and PM2.5. When we assessed separately the effects of only oil shale sector induced pollutants exposure, several more associations with respiratory outcomes appeared to be statistically significant, especially for PM2.5.

Conclusion(s): We can see in some extent children’s health improvement compared to previous studies in the area, but several respiratory outcomes remain high compared to other regions of Estonia. Exposure to air pollutants, especially oil shale sector based, increase the odds for respiratory outcomes.


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