Effect of Early Life Exposure to Air Pollution on Development of Childhood Asthma

Background There is increasing recognition of the importance of early environmental exposures in the development of childhood asthma. Outdoor air pollution is a recognized asthma trigger, but it is unclear whether exposure influences incident disease. We investigated the effect of exposure to ambient air pollution in utero and during the first year of life on risk of subsequent asthma diagnosis in a population-based nested case–control study. Methods We assessed all children born in southwestern British Columbia in 1999 and 2000 (n = 37,401) for incidence of asthma diagnosis up to 3–4 years of age using outpatient and hospitalization records. Asthma cases were age- and sex-matched to five randomly chosen controls from the eligible cohort. We estimated each individual’s exposure to ambient air pollution for the gestational period and first year of life using high-resolution pollution surfaces derived from regulatory monitoring data as well as land use regression models adjusted for temporal variation. We used logistic regression analyses to estimate effects of carbon monoxide, nitric oxide, nitrogen dioxide, particulate matter ≤ 10 μm and ≤ 2.5 μm in aerodynamic diameter (PM10 and PM2.5), ozone, sulfur dioxide, black carbon, woodsmoke, and proximity to roads and point sources on asthma diagnosis. Results A total of 3,482 children (9%) were classified as asthma cases. We observed a statistically significantly increased risk of asthma diagnosis with increased early life exposure to CO, NO, NO2, PM10, SO2, and black carbon and proximity to point sources. Traffic-related pollutants were associated with the highest risks: adjusted odds ratio = 1.08 (95% confidence interval, 1.04–1.12) for a 10-μg/m3 increase of NO, 1.12 (1.07–1.17) for a 10-μg/m3 increase in NO2, and 1.10 (1.06–1.13) for a 100-μg/m3 increase in CO. These data support the hypothesis that early childhood exposure to air pollutants plays a role in development of asthma.

[1]  R. Slama,et al.  Traffic-Related Atmospheric Pollutants Levels during Pregnancy and Offspring’s Term Birth Weight: A Study Relying on a Land-Use Regression Exposure Model , 2007, Environmental health perspectives.

[2]  W S Linn,et al.  A study of twelve Southern California communities with differing levels and types of air pollution. II. Effects on pulmonary function. , 1999, American journal of respiratory and critical care medicine.

[3]  S J London,et al.  A study of twelve Southern California communities with differing levels and types of air pollution. I. Prevalence of respiratory morbidity. , 1999, American journal of respiratory and critical care medicine.

[4]  Michael Brauer,et al.  Within-urban variability in ambient air pollution: Comparison of estimation methods , 2008 .

[5]  T Bellander,et al.  Traffic-related air pollution and respiratory health during the first 2 yrs of life , 2002, European Respiratory Journal.

[6]  Michael Brauer,et al.  Models of Exposure for Use in Epidemiological Studies of Air Pollution Health Impacts , 2008 .

[7]  B. Ritz,et al.  Effect of Air Pollution on Preterm Birth Among Children Born in Southern California Between 1989 and 1993 , 2000, Epidemiology.

[8]  D. Strachan,et al.  Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys , 2006, The Lancet.

[9]  Mark C. Swanson,et al.  Clearing the Air: Asthma and Indoor Air Exposures , 2001 .

[10]  T. To,et al.  Persistence and remission in childhood asthma: a population-based asthma birth cohort study. , 2007, Archives of pediatrics & adolescent medicine.

[11]  E. von Mutius The environmental predictors of allergic disease. , 2000, The Journal of allergy and clinical immunology.

[12]  Kiros Berhane,et al.  Traffic, Susceptibility, and Childhood Asthma , 2006, Environmental health perspectives.

[13]  B. Ostro,et al.  Air pollution and emergency room visits for asthma in Santa Clara County, California. , 1997, Environmental health perspectives.

[14]  Fredrik Nyberg,et al.  Traffic-Related Air Pollution and Childhood Respiratory Symptoms, Function and Allergies , 2008, Epidemiology.

[15]  J. Zelikoff,et al.  THE TOXICOLOGY OF INHALED WOODSMOKE , 2002, Journal of toxicology and environmental health. Part B, Critical reviews.

[16]  T I M O T H Y L A R S O N,et al.  A Spatial Model of Urban Winter Woodsmoke Concentrations , 2022 .

[17]  N. Anthonisen,et al.  Risk of physician-diagnosed asthma in the first 6 years of life. , 2004, Chest.

[18]  Michael Brauer,et al.  Intake fraction of urban wood smoke. , 2009, Environmental science & technology.

[19]  H. Wichmann,et al.  Atopic diseases, allergic sensitization, and exposure to traffic-related air pollution in children. , 2008, American journal of respiratory and critical care medicine.

[20]  D. Postma,et al.  Air pollution and development of asthma, allergy and infections in a birth cohort , 2007, European Respiratory Journal.

[21]  S. Morgan,et al.  On the validity of area-based income measures to proxy household income , 2008, BMC health services research.

[22]  B. Brunekreef,et al.  Motor vehicle exhaust and chronic respiratory symptoms in children living near freeways. , 1997, Environmental research.

[23]  P. Loy International Classification of Diseases--9th revision. , 1978, Medical record and health care information journal.

[24]  Altaf Arain,et al.  A review and evaluation of intraurban air pollution exposure models , 2005, Journal of Exposure Analysis and Environmental Epidemiology.

[25]  Joshua Millstein,et al.  Birth Outcomes and Prenatal Exposure to Ozone, Carbon Monoxide, and Particulate Matter: Results from the Children’s Health Study , 2005, Environmental health perspectives.

[26]  C. Simpson,et al.  Changes in Lung Function and Airway Inflammation Among Asthmatic Children Residing in a Woodsmoke-Impacted Urban Area , 2008, Inhalation toxicology.

[27]  Michael Brauer,et al.  Application of land use regression to estimate long-term concentrations of traffic-related nitrogen oxides and fine particulate matter. , 2007, Environmental science & technology.

[28]  R Neutra,et al.  Examining associations between childhood asthma and traffic flow using a geographic information system. , 1999, Environmental health perspectives.

[29]  M. Wjst,et al.  Road traffic and adverse effects on respiratory health in children. , 1993, BMJ.

[30]  W. Morgan,et al.  Asthma and wheezing in the first six years of life. The Group Health Medical Associates. , 1995, The New England journal of medicine.

[31]  F. Perera,et al.  Polycyclic aromatic hydrocarbons, environmental tobacco smoke, and respiratory symptoms in an inner-city birth cohort. , 2004, Chest.

[32]  T. To,et al.  Case verification of children with asthma in Ontario , 2006, Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology.

[33]  J. Jaakkola,et al.  Home Dampness and Molds, Parental Atopy, and Asthma in Childhood: A Six-Year Population-Based Cohort Study , 2004, Environmental health perspectives.

[34]  Romain Neugebauer,et al.  Air Pollution and Pulmonary Function in Asthmatic Children: Effects of Prenatal and Lifetime Exposures , 2008, Epidemiology.

[35]  P. Nafstad,et al.  Effects of pre- and postnatal exposure to parental smoking on early childhood respiratory health. , 2007, American journal of epidemiology.

[36]  A Biggeri,et al.  Road traffic and adverse respiratory effects in children. SIDRIA Collaborative Group. , 1998, Occupational and environmental medicine.

[37]  Michael Brauer,et al.  Centre for Health Services and Policy Research, and , 2022 .

[38]  L. Sheppard,et al.  An association between fine particles and asthma emergency department visits for children in Seattle. , 1999, Environmental health perspectives.

[39]  M Chiron,et al.  Traffic related air pollution and incidence of childhood asthma: results of the Vesta case-control study , 2003, Journal of epidemiology and community health.

[40]  W James Gauderman,et al.  Childhood Asthma and Exposure to Traffic and Nitrogen Dioxide , 2005, Epidemiology.

[41]  D. Pearlman Worldwide time trends in the , 2022 .

[42]  G. Böhm,et al.  Association between air pollution and intrauterine mortality in São Paulo, Brazil. , 1998, Environmental health perspectives.

[43]  U Gehring,et al.  Respiratory health and individual estimated exposure to traffic-related air pollutants in a cohort of young children , 2006, Occupational and Environmental Medicine.

[44]  Bert Brunekreef,et al.  Estimating Long-Term Average Particulate Air Pollution Concentrations: Application of Traffic Indicators and Geographic Information Systems , 2003, Epidemiology.

[45]  K. Pinkerton,et al.  Air pollutant effects on fetal and early postnatal development. , 2007, Birth defects research. Part C, Embryo today : reviews.

[46]  Bert Brunekreef,et al.  Air pollution from traffic and the development of respiratory infections and asthmatic and allergic symptoms in children. , 2002, American journal of respiratory and critical care medicine.

[47]  C. Derauf,et al.  Agreement between maternal self-reported ethanol intake and tobacco use during pregnancy and meconium assays for fatty acid ethyl esters and cotinine. , 2003, American journal of epidemiology.

[48]  S. Weiland,et al.  Urban traffic and pollutant exposure related to respiratory outcomes and atopy in a large sample of children , 2003, European Respiratory Journal.

[49]  M. Bobák Outdoor air pollution, low birth weight, and prematurity. , 2000, Environmental health perspectives.

[50]  Ayne,et al.  ASTHMA AND WHEEZING IN THE FIRST SIX YEARS OF LIFE , 1995 .