Air Pollution Exposure and Lung Function in Children: The ESCAPE Project

Abstract

Background: There is evidence for adverse effects of outdoor air pollution on lung function of children. Quantitative summaries of the effects of air pollution on lung function, however, are lacking due to large differences among studies.Objectives: We aimed to study the association between residential exposure to air pollution and lung function in five European birth cohorts with a standardized exposure assessment following a common protocol.Methods: As part of the European Study of Cohorts for Air Pollution Effects (ESCAPE) we analyzed data from birth cohort studies situated in Germany, Sweden, the Netherlands, and the United Kingdom that measured lung function at 6–8 years of age (n = 5,921). Annual average exposure to air pollution [nitrogen oxides (NO2, NOx), mass concentrations of particulate matter with diameters < 2.5, < 10, and 2.5–10 μm (PM2.5, PM10, and PMcoarse), and PM2.5 absorbance] at the birth address and current address was estimated by land-use regression models. Associations of lung function with estimated air pollution levels and traffic indicators were estimated for each cohort using linear regression analysis, and then combined by random effects meta-analysis.Results: Estimated levels of NO2, NOx, PM2.5 absorbance, and PM2.5 at the current address, but not at the birth address, were associated with small decreases in lung function. For example, changes in forced expiratory volume in 1 sec (FEV1) ranged from –0.86% (95% CI: –1.48, –0.24%) for a 20-μg/m3 increase in NOx to –1.77% (95% CI: –3.34, –0.18%) for a 5-μg/m3 increase in PM2.5.Conclusions: Exposure to air pollution may result in reduced lung function in schoolchildren.Citation: Gehring U, Gruzieva O, Agius RM, Beelen R, Custovic A, Cyrys J, Eeftens M, Flexeder C, Fuertes E, Heinrich J, Hoffmann B, de Jongste JC, Kerkhof M, Klümper C, Korek M, Mölter A, Schultz ES, Simpson A, Sugiri D, Svartengren M, von Berg A, Wijga AH, Pershagen G, Brunekreef B. 2013. Air pollution exposure and lung function in children: the ESCAPE project. Environ Health Perspect 121:1357–1364; http://dx.doi.org/10.1289/ehp.1306770

Long-term particulate matter exposure: Attributing health effects to individual PM components

“…The same was true for pediatric pneumonia, low birth weight, and lung cancer incidence Pedersen et al, 2013;Raaschou-Nielsen et al, 2013). Lung function in children was associated with both PM 2.5 and PM 2.5 absorbance (Gehring et al, 2013). Cerebrovascular events, nonmalignant respiratory deaths, prevalence and incidence of chronic obstructive pulmonary disease (COPD), and allergic sensitization measures were not significantly associated with any PM measure Dimakopoulou et al, 2014;Gruzieva et al, 2014;Schikowski et al, 2014).…”

“…The ESCAPE studies considered a wide range of health endpoints, including mortality by several cause categories Dimakopoulou et al, 2014;Wang et al, 2014), several morbidity measures MacIntyre et al, 2014;Raaschou-Nielsen et al, 2013;Schikowski et al, 2014;Stafoffia et al, 2014;Fuertes et al, 2014), physiological measures (Fuks et al, 2014;Gehring et al, 2013;Gruzieva et al, 2014), and reproductive measures (Pederen et al, 2013). The results from these studies varied according to the endpoint studied, with cardiovascular endpoints generally showing a significant association with PM 2.5 mass, but not with PM 2.5 absorbance .…”

A systematic review of early life factors which adversely affect subsequent lung function

“…The seminal paper on lung growth and pollution showed adverse effects on lung development in children 10 to 18 years old leading to clinically significant deficits in attained FEV 1 as they reached adulthood. [70] In addition, 2 large paediatric [71,72] and one adult study [73] have identified small deficits in lung function associated with exposure to particulate matter.…”

Realising car-free developments within compact cities

“…First, it is the reduced environmental harm, particularly in terms of a reduction of greenhouse gas emissions, other harmful local air pollutants, traffic noise and the 'urban heat island' effects. As shown by the large-scale European Study of Cohorts for Air Pollution Effects Project in Europe, vehicular traffic gives rise to local air pollutants, notably particulate matters (PM), that contribute to various respiratory and cardiovascular disease incidences, especially among young children (Beelen et al, 2014;Cesaroni et al, 2014;Eeftens et al, 2012aEeftens et al, , 2012bGehring et al, 2013;MacIntyre et al, 2014;Raaschou-Nielsen et al, 2013). Sundvor et al (2012: p. 254) reported that 'the range of the traffic contribution to urban PM concentrations in Europe ranges from 9-53% for PM 10 and 9-66% for PM 2·5 with an average of 39% and 43% at traffic sites, respectively and a higher range for NO 2 of over 80%'.…”