The effects of long -term exposure to air pollution on respiratory symptoms and respiratory hospitalization ( for asthma, bronchitis or pneumonia ) were assessed in a cross -sectional study of children ( ages 7 ± 11 years, N = 667 ) living in a moderately industrialized city in Central Slovakia. Individual health, residence and family history data obtained through the CESAR study were coupled, using Geographic Information System ( GIS ) technologies, with total suspended particulate ( TSP ) exposure estimates derived from dispersion modeling of almost all local stationary sources. These data were used to assess, at the intra -city level and child -specific level, the potential for TSP as a risk factor for respiratory disease in children. TSP, PM 10 , and PM 2.5 monitored ambient concentrations are highly correlated in the study location. Modeled TSP concentrations resulting from local source emissions are dominated by a large wood processing facility, suggesting variation in exposures among children. The prevalence of respiratory non -asthmatic symptoms and hospitalizations was associated with increased TSP. No association between long -term exposure to TSP and asthma diagnosis or wheeze symptoms was found. Logistic regression modeling indicated a significant increase in hospital admissions for asthma, bronchitis or pneumonia associated with increasing air pollution ( OR 2.16, CI, 1.01 ± 4.60 ) , doctor -diagnosed bronchitis ( OR 1.53, CI, 1.02 ± 2.30 ) , and parent -reported chronic phlegm ( OR 3.43, CI, 1.64 ± 7.16 ) , expressed as odds for a 15 g / m 3 increase in estimated TSP exposure, and these increases are not due to differences in socio -economic, health care or other identified factors.