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      Early life exposure to air pollution and incidence of childhood asthma, allergic rhinitis and eczema

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          Abstract

          Rationale

          There is growing evidence that air pollution may contribute to the development of childhood asthma and other allergic diseases. In this follow-up of the Toronto Child Health Evaluation Questionnaire (T-CHEQ) study, we examined associations between early life exposures to air pollution and incidence of asthma, allergic rhinitis and eczema from birth through adolescence.

          Methods

          1286 T-CHEQ participants were followed from birth until outcome (March 31, 2016) or loss to follow-up, with a mean of 17 years of follow-up. Concentrations of nitrogen dioxide (NO 2), ozone (O 3) and particulate matter with a 50% cut-off aerodynamic diameter of 2.5 µm (PM 2.5) from January 1, 1999 to December 31, 2012 were assigned to participants based on their postal codes at birth using ground observations, chemical/meteorological models, remote sensing and land-use regression models. Study outcomes included incidence of physician-diagnosed asthma, allergic rhinitis and eczema. Cox proportional hazard regression models were used to estimate hazard ratios per interquartile range of exposures and outcomes, adjusting for potential confounders.

          Results

          Hazard ratios of 1.17 (95% CI 1.05–1.31) for asthma and 1.07 (95% CI 0.99–1.15) for eczema were observed for total oxidants (O 3 and NO 2) at birth. No significant increase in risk was found for PM 2.5.

          Conclusions

          Exposures to oxidant air pollutants (O 3 and NO 2) but not PM 2.5 were associated with an increased risk of incident asthma and eczema in children. This suggests that improving air quality may contribute to the prevention of asthma and other allergic disease in childhood and adolescence.

          Abstract

          This study found that exposure to total oxidants at birth increased the risk of developing asthma by 17% and eczema by 7%. Adverse impacts of exposure to air pollutants, particularly ozone and nitrogen dioxide, may have their origins in early life. http://bit.ly/33PClYN

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          Most cited references35

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          Oxidative Stress and Air Pollution Exposure

          Maura Lodovici, Elisabetta Bigagli (2011)
          Air pollution is associated with increased cardiovascular and pulmonary morbidity and mortality. The mechanisms of air pollution-induced health effects involve oxidative stress and inflammation. As a matter of fact, particulate matter (PM), especially fine (PM2.5, PM < 2.5  μ m) and ultrafine (PM0.1, PM < 0.1  μ m) particles, ozone, nitrogen oxides, and transition metals, are potent oxidants or able to generate reactive oxygen species (ROS). Oxidative stress can trigger redox-sensitive pathways that lead to different biological processes such as inflammation and cell death. However, it does appear that the susceptibility of target organ to oxidative injury also depends upon its ability to upregulate protective scavenging systems. As vehicular traffic is known to importantly contribute to PM exposure, its intensity and quality must be strongly relevant determinants of the qualitative characteristics of PM spread in the atmosphere. Change in the composition of this PM is likely to modify its health impact.
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            A joint ERS/ATS policy statement: what constitutes an adverse health effect of air pollution? An analytical framework

            George Thurston, Howard M. Kipen, Isabella Annesi-Maesano … (2017)
            The American Thoracic Society has previously published statements on what constitutes an adverse effect on health of air pollution in 1985 and 2000. We set out to update and broaden these past statements that focused primarily on effects on the respiratory system. Since then, many studies have documented effects of air pollution on other organ systems, such as on the cardiovascular and central nervous systems. In addition, many new biomarkers of effects have been developed and applied in air pollution studies.This current report seeks to integrate the latest science into a general framework for interpreting the adversity of the human health effects of air pollution. Rather than trying to provide a catalogue of what is and what is not an adverse effect of air pollution, we propose a set of considerations that can be applied in forming judgments of the adversity of not only currently documented, but also emerging and future effects of air pollution on human health. These considerations are illustrated by the inclusion of examples for different types of health effects of air pollution.
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              International consensus on (ICON) pediatric asthma.

              E Baraldi, J Pongracic, D. Price … (2012)
              Asthma is the most common chronic lower respiratory disease in childhood throughout the world. Several guidelines and/or consensus documents are available to support medical decisions on pediatric asthma. Although there is no doubt that the use of common systematic approaches for management can considerably improve outcomes, dissemination and implementation of these are still major challenges. Consequently, the International Collaboration in Asthma, Allergy and Immunology (iCAALL), recently formed by the EAACI, AAAAI, ACAAI, and WAO, has decided to propose an International Consensus on (ICON) Pediatric Asthma. The purpose of this document is to highlight the key messages that are common to many of the existing guidelines, while critically reviewing and commenting on any differences, thus providing a concise reference. The principles of pediatric asthma management are generally accepted. Overall, the treatment goal is disease control. To achieve this, patients and their parents should be educated to optimally manage the disease, in collaboration with healthcare professionals. Identification and avoidance of triggers is also of significant importance. Assessment and monitoring should be performed regularly to re-evaluate and fine-tune treatment. Pharmacotherapy is the cornerstone of treatment. The optimal use of medication can, in most cases, help patients control symptoms and reduce the risk for future morbidity. The management of exacerbations is a major consideration, independent of chronic treatment. There is a trend toward considering phenotype-specific treatment choices; however, this goal has not yet been achieved. © 2012 John Wiley & Sons A/S.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Eur Respir J
                Journal ID (iso-abbrev): Eur. Respir. J
                Journal ID (publisher-id): ERJ
                Journal ID (hwp): erj
                Title: The European Respiratory Journal
                Publisher: European Respiratory Society
                ISSN (Print): 0903-1936
                ISSN (Electronic): 1399-3003
                Publication date Collection: February 2020
                Publication date (Electronic): 20 February 2020
                Volume: 55
                Issue: 2
                Electronic Location Identifier: 1900913
                Affiliations
                [1 ]Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
                [2 ]Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
                [3 ]Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
                [4 ]Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada
                [5 ]Analytical Studies Branch, Statistics Canada, Ottawa, ON, Canada
                [6 ]Fielding School of Public Health, The University of California, Los Angeles, CA, USA
                [7 ]Air Quality Research Division, Environment and Climate Change Canada, Dorval, QC, Canada
                [8 ]Dept of Physics and Atmospheric Science, Dalhousie University, Halifax, NS, Canada
                [9 ]Dept of Energy, Environmental and Chemical Engineering, Washington University in St Louis, St Louis, MO, USA
                [10 ]Harvard-Smithsonian Center for Astrophysics, Cambridge, MA, USA
                [11 ]College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
                Author notes
                Teresa To, Child Health Evaluative Sciences, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada. E-mail: teresa.to@ 123456sickkids.ca
                Author information
                https://orcid.org/0000-0002-5132-7121
                https://orcid.org/0000-0003-2632-8402
                Article
                Publisher ID: ERJ-00913-2019
                DOI: 10.1183/13993003.00913-2019
                PMC ID: 7031706
                PubMed ID: 31806712
                SO-VID: 9c49450b-99f5-40f9-bb14-6b6d9c72170a
                Copyright © The content of this work is copyright of the authors or their employers. Design and branding are copyright ©ERS 2020
                License:

                This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.

                History
                Date received : 7 May 2019
                Date accepted : 7 November 2019
                Funding
                Funded by: Health Canada, open-funder-registry 10.13039/501100000008;
                Award ID: HT421-163216/001/SS
                Categories
                Subject: Original Articles
                Subject: Asthma and Pollution
                Subject: 2
                Subject: 11

                ScienceOpen disciplines: Respiratory medicine
                Data availability:
                ScienceOpen disciplines: Respiratory medicine

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