Adverse early-life environmental exposures and their repercussions on adult respiratory health

Mocelin, Helena Teresinha; Fischer, Gilberto Bueno; Bush, Andy

doi:10.1016/j.jped.2021.11.005

Cited by 11 publications

(11 citation statements)

References 65 publications

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“…Multiple social determinants of health have been associated with higher risk of preterm labor, including discriminatory policies, SES, immigration status, and living in neighborhoods with higher police contact rates ( 45 , 46 ). Harmful early-life exposures affect lung growth health throughout life, including secondhand smoke, poor air quality, and infections ( 47 ). Undernutrition, as well as obesity, is associated with social determinants of health and reduced pulmonary function ( 47 , 48 ).…”

Section: Determinants Of Pulmonary Functionmentioning

confidence: 99%

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Race and Ethnicity in Pulmonary Function Test Interpretation: An Official American Thoracic Society Statement

Bhakta¹,

Bime²,

Kaminsky³

et al. 2023

Am J Respir Crit Care Med

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Current American Thoracic Society (ATS) standards promote the use of race and ethnicity-specific reference equations for pulmonary function test (PFT) interpretation. There is rising concern that the use of race and ethnicity in PFT interpretation contributes to a false view of fixed differences between races and may mask the effects of differential exposures. This use of race and ethnicity may contribute to health disparities by norming differences in pulmonary function. In the United States and globally, race serves as a social construct that is based on appearance and reflects social values, structures, and practices. Classification of people into racial and ethnic groups differs geographically and temporally. These considerations challenge the notion that racial and ethnic categories have biological meaning and question the use of race in PFT interpretation. The ATS convened a diverse group of clinicians and investigators for a workshop in 2021 to evaluate the use of race and ethnicity in PFT interpretation. Review of evidence published since then that challenges current practice and continued discussion concluded with a recommendation to replace race and ethnicity-specific equations with race-neutral average reference equations, which must be accompanied with a broader re-evaluation of how PFTs are used to make clinical, employment, and insurance decisions. There was also a call to engage key stakeholders not represented in this workshop and a statement of caution regarding the uncertain effects and potential harms of this change. Other recommendations include continued research and education to understand the impact of the change, to improve the evidence for the use of PFTs in general, and to identify modifiable risk factors for reduced pulmonary function.

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Section: Determinants Of Pulmonary Functionmentioning

confidence: 99%

“…Harmful early-life exposures affect lung growth health throughout life, including secondhand smoke, poor air quality, and infections ( 47 ). Undernutrition, as well as obesity, is associated with social determinants of health and reduced pulmonary function ( 47 , 48 ).…”

Section: Determinants Of Pulmonary Functionmentioning

confidence: 99%

Race and Ethnicity in Pulmonary Function Test Interpretation: An Official American Thoracic Society Statement

Bhakta¹,

Bime²,

Kaminsky³

et al. 2023

Am J Respir Crit Care Med

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show abstract

“…Additionally, children's respiratory and immune systems are still developing, and although inadequately understood, there are “critical windows” during which insults can have lasting impacts on development 23–25 . Indeed, the origins of many adult respiratory diseases are likely to be found during childhood, including gestation 26,27 . Further, children's airways are narrower than adults, such that bronchoconstriction and inflammation can produce earlier and more severe symptoms.…”

Section: Children Are More Susceptible To the Harmful Effects Of Ozonementioning

confidence: 99%

“…[23][24][25] Indeed, the origins of many adult respiratory diseases are likely to be found during childhood, including gestation. 26,27 Further, children's airways are narrower than adults, such that bronchoconstriction and inflammation can produce earlier and more severe symptoms.…”

Section: Children Are More Susceptible To the Harmful Effects Of Ozonementioning

confidence: 99%

Ozone and childhood respiratory health: A primer for US pediatric providers and a call for a more protective standard

Rosser

Balmes

2023

Pediatric Pulmonology

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Ground level ozone is a potent respiratory toxicant with decades of accumulated data demonstrating respiratory harms to children. Despite the ubiquity of ozone in the United States, impacting both urban and rural communities, the associated harms of exposure to this important air pollutant are often infrequently or inadequately covered during medical training including pulmonary specialization. Thus, many providers caring for children's respiratory health may have limited knowledge of the harms which may result in reduced discussion of ozone pollution during clinical encounters. Further, the current US air quality standard for ozone does not adequately protect children. In this nonsystematic review, we present basic background information for healthcare providers caring for children's respiratory health, review the US process for setting air quality standards, discuss the respiratory harms of ozone for healthy children and those with underlying respiratory disease, highlight the urgent need for a more protective ozone standard to adequately protect children's respiratory health, review impacts of climate change on ozone levels, and provide information for discussion in clinical encounters.

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“…Women and young children are particularly vulnerable to the harmful effects of indoor air pollution (IAP) as they spend more time indoors cooking, often with poor ventilation 2 . IAP and environmental tobacco smoke (ETS) are well described risk factors for childhood respiratory disease and impaired lung function 3 . Solid and alternate fuels emit a mixture of pollutants including particulate matter (PM) and volatile organic compounds (VOCs), all of which threaten respiratory health 3,4 …”

Section: Introductionmentioning

confidence: 99%

The impact of antenatal and postnatal indoor air pollution or tobacco smoke exposure on lung function at 3 years in an African birth cohort

Chaya,

Vanker,

Brittain

et al. 2023

Respirology

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Background and ObjectiveIndoor air pollution (IAP) and tobacco smoke exposure (ETS) are global health concerns contributing to the burden of childhood respiratory disease. Studies assessing the effects of IAP and ETS in preschool children are limited. We assessed the impact of antenatal and postnatal IAP and ETS exposure on lung function in a South African birth cohort, the Drakenstein Child Health Study.MethodsAntenatally enrolled mother–child pairs were followed from birth. Lung function measurements (oscillometry, multiple breath washout and tidal breathing) were performed at 6 weeks and 3 years. Quantitative antenatal and postnatal IAP (particulate matter [PM10], volatile organic compounds [VOC]) and ETS exposures were measured. Linear regression models explored the effects of antenatal and postnatal exposures on lung function at 3 years.ResultsFive hundred eighty‐four children had successful lung function testing, mean (SD) age of 37.3 (0.7) months. Exposure to antenatal PM10 was associated with a decreased lung clearance index (p < 0.01) and postnatally an increase in the difference between resistance at end expiration (ReE) and inspiration (p = 0.05) and decrease in tidal volume (p = 0.06). Exposure to antenatal VOC was associated with an increase in functional residual capacity (p = 0.04) and a decrease in time of expiration over total breath time (tE/tTOT) (p = 0.03) and postnatally an increase in respiratory rate (p = 0.05). High ETS exposure postnatally was associated with an increase in ReE (p = 0.03).ConclusionAntenatal and postnatal IAP and ETS exposures were associated with impairment in lung function at 3 years. Strengthened efforts to reduce IAP and ETS exposure are needed.

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Adverse early-life environmental exposures and their repercussions on adult respiratory health

Cited by 11 publications

References 65 publications

Race and Ethnicity in Pulmonary Function Test Interpretation: An Official American Thoracic Society Statement

Race and Ethnicity in Pulmonary Function Test Interpretation: An Official American Thoracic Society Statement

Ozone and childhood respiratory health: A primer for US pediatric providers and a call for a more protective standard

The impact of antenatal and postnatal indoor air pollution or tobacco smoke exposure on lung function at 3 years in an African birth cohort

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