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The aim of this study was to link the concentrations of particulate matter with an aerodynamic diameter below 2.5 μm (PM2.5) and associated heavy metals with occurrence of wheezing and hospitalizations due to wheezing in 111 children who live near metallurgical plants in Targoviste City, Romania. A group of 72 children with high levels of immunoglobulin E (IgE) and eosinophils, as well as frequent wheezing episodes, was geolocated on digital thematic maps. Monitoring campaigns and medical assessments were performed over two consecutive years (2013-2014). The multiannual average concentrations of PM2.5 ranged from 4.6 to 22.5 μg m(-3), up to a maximum value of 102 μg m(-3). Significant correlations (p &lt; 0.01) were observed between the locations of the children with respiratory issues and the PM2.5 multiannual average (r = 0.985) and PM2.5 maximum (r = 0.813). Fe, Ni, Cd, and Cr were the main marker elements of the emissions from steel production and metal-working facilities in the Targoviste area. The results support the hypothesis that increased PM2.5 levels directly influence wheezing symptom and asthma attacks in the analyzed group. IgE, eosinophils, and wheezing episodes may be considered key indicators with which to evaluate the adverse effects of PM2.5 air pollution on children's health.

Quantifying the impact of PM2.5 and associated heavy metals on respiratory health of children near metallurgical facilities