Many time-series studies have shown positive associations between air pollutants and asthma morbidity. However, few studies have included pollen as a potential confounder when examining this relationship.This study analysed the short-term association between air pollutants (sulphur dioxide (SO 2 ), particles measured with a median aerodynamic diameter of v10 mm (PM10), nitrogen dioxide (NO 2 ) and ozone (O 3 )) and asthma emergency room admissions in Madrid, Spain, in 1995-1998, adjusting for four types of pollen with allergenic potential (Olea europaea, Plantago sp., Poaceae and Urticaceae). Data were analysed using autoregressive Poisson regression and generalised additive models (GAM).The strongest associations were observed at 1 day lag for O 3 , and 3 days lag for the remaining pollutants. Using Poisson regression, a single-pollutant model showed that a 10-mg?m -3 rise in pollutant level led to relative risks of: 1.039 for PM10; 1.029 for SO 2 ; 1.033 for NO 2 ; and 1.045 for O 3 . Adjustment for the different types of pollen led to no substantial variation in these associations. In the multipollutant models for cold-season pollutants (including PM10, SO 2 and the four types of pollen) and photochemical pollutants (including NO 2 , O 3 and the four types of pollen) the associations for PM10, NO 2 and O 3 held, but no relationship with SO 2 was evident. GAM analysis yielded the same results, both in terms of lags and of quantification of the effect for all pollutants.In conclusion, the usual air pollution levels in Madrid were associated with an increase in asthma emergency room admissions, and this association remained controlling for the presence of ambient pollen. Eur Respir J 2003; 22: 802-808.