Chronic effects of ambient air pollution on lung function among Chinese children

Gao, Yang; Chan, Emily Ying Yang; Li, Li Ping; He, Qingsong; Wong, Tze Wai

doi:10.1136/archdischild-2011-301541

Cited by 32 publications

(27 citation statements)

References 27 publications

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“…These studies provide strong evidence that short-term exposures to air pollution can increase airflow obstruction in asthmatic and non-asthmatic children, 20 and that long-term traffic pollution may increase incident asthma and reduce level of lung function in general populations of children. 2,21-24 There are fewer studies considering the effects of long-term exposures to pollution on lung function in asthmatic children, 1,2,20 and none that we know of evaluating long-term effects of pollution on lung function and AHR in asthmatic children in the context of a clinical trial.…”

Section: Discussionmentioning

confidence: 99%

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Ambient air pollution, lung function, and airway responsiveness in asthmatic children

Ierodiakonou

Zanobetti

Coull

et al. 2016

Journal of Allergy and Clinical Immunology

131

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Background Although ambient air pollution has been linked to reduced lung function in healthy children, longitudinal analyses of pollution effects in asthma are lacking. Objective To investigate pollution effects in a longitudinal asthma study and effect modification by controller medications. Methods We examined associations of lung function and methacholine responsiveness (PC20) with ozone, carbon monoxide (CO), nitrogen dioxide (NO2) and sulfur dioxide (SO2) levels in 1,003 asthmatic children participating in a 4-year clinical trial. We further investigated whether budesonide and nedocromil modified pollution effects. Daily pollutant concentrations were linked to zip/postal code of residence. Linear mixed models tested associations of within-subject pollutant concentrations with FEV1 and FVC %predicted, FEV1/FVC and PC20, adjusting for seasonality and confounders. Results Same-day and 1-week average CO levels were negatively associated with post-bronchodilator %predicted FEV1 (change(95%CI) per IQR: −0.33(−0.49, −0.16), −0.41(−0.62, −0.21), respectively) and FVC (−0.19(−0.25, −0.07), −0.25(−0.43, −0.07)). Longer-term four-month averages of CO were negatively associated with prebronchodilator %predicted FEV1 and FVC (−0.36(−0.62, −0.10), −0.21(−0.42, −0.01)). Four-month averaged CO and ozone levels were negatively associated with FEV1/FVC (p<0.05). Increased four-month average NO2 levels were associated with reduced post-bronchodilator FEV1 and FVC %predicted. Long-term exposures to SO2 were associated with reduced PC20 (%change(95%CI) per IQR:-6(-11,-1.5)). Treatment augmented the negative short-term CO effect on PC20. Conclusions Air pollution adversely influences lung function and PC20 in asthmatic children. Treatment with controller medications may not protect but worsens the CO effects on PC20. This clinical trial design evaluates modification of pollution effects by treatment without confounding by indication.

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Section: Discussionmentioning

confidence: 99%

“…2,20,21,23,56,57 In this study we measured daily pollutant concentrations to predict long-term (4-month (but also acute (same day) and intermediate (1-week)) effects on asthma severity in children. We acknowledge that exposure is at the zip/postal code rather than the residence level.…”

Section: Discussionmentioning

confidence: 99%

Ambient air pollution, lung function, and airway responsiveness in asthmatic children

Ierodiakonou

Zanobetti

Coull

et al. 2016

Journal of Allergy and Clinical Immunology

131

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“…Two studies of Chinese schoolchildren in 2013 and 2014, found long-term exposure to ambient air pollution was associated with a number of adverse effects, such as wheezing, cough or phlegm. Of interest was that PM 10 may be the most relevant pollutant associated with adverse effects as well as with impaired lung function [18, 19]. …”

Section: Pulmonary Heath Effectsmentioning

confidence: 99%

Pulmonary health effects of air pollution

Kurt

Zhang

Pinkerton

2016

Current Opinion in Pulmonary Medicine

367

212

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Purpose of the review Air pollution continues to be a major public health concern affecting nine out of ten individuals living in urban areas worldwide. Exposure to air pollution is the ninth leading risk factor for cardiopulmonary mortality. The aim of this review is to examine the current literature for the most recent updates on health effects of specific air pollutants and their impact on asthma, chronic obstructive pulmonary disease (COPD), lung cancer and respiratory infection. Recent findings A total of 53 publications were reviewed to establish new insights as to how air pollution is associated with pulmonary morbidity and mortality. Considerable past evidence suggests that air pollution is an important factor that enhances pulmonary disease, while also causing greater harm in susceptible populations, such as children, the elderly and those of low socio-economic status worldwide. Asthma, COPD, lung cancer and respiratory infections all seem to be exacerbated due to exposure to a variety of environmental air pollutants with the greatest effects due to particulate matter (PM), ozone and nitrogen oxides. New publications reviewed reaffirm these findings. Summary Continued vigilence will be essential to lessen the effects of air pollution on human health and pulmonary disease. Cooperation at a multi-national level will be required on the part of governments, industry, energy-based enterprises and the public working together to solve our air quality issues at the local, national and global level.

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“…However, to date, there is still limited research on the impact of wildfire smoke on vulnerable population groups, such as children (Jalaludin et al 2000;Künzli et al 2006;Mirabelli et al 2009). PM exposure on children, which is the main air constituent of wildfire smoke, has been associated in air pollution studies with deficits in lung function (Gao et al 2013;Gauderman et al 2004), increased respiratory illness and symptoms (Gruzieva et al 2013), increased school absences (Makino 2000;Peters et al 1997), and hospitalizations for respiratory disease (Iskandar et al 2012;Ostro et al 2009). Also, there is substantial and growing evidence that air pollution is a risk factor for increased mortality in infants and young children (Woodruff et al 2006).…”

Section: Introductionmentioning

confidence: 97%

Health effects of the 2012 Valencia (Spain) wildfires on children in a cohort study

Vicedo‐Cabrera

Íñiguez

Estarlich

et al. 2015

Environ Geochem Health

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In July 2012, two simultaneous wildfires burnt a big area in Valencia (Spain), where a birth cohort study (INMA) is being developed. The heavy smoke covered the whole INMA study area for several days. We aimed at evaluating the 2012 Valencia wildfire effects on the health of children enrolled in the INMA-Valencia cohort. Two weeks after the extinction of the wildfires, a phone survey was conducted and finally 460 individuals were enrolled. We considered a wildfire period (12-day interval when they were active) and a control period (12-day interval just before wildfires). Parents were asked about respiratory symptoms experienced during both periods, and during wildfires only about the preventive measures adopted and the perception of exposure, along with individual data collected through the different follow-up surveys of the cohort. Conditional logistic regression models were applied, and we included interaction terms for asthma/rhinitis and level of perception of exposure; 82.4 % perceived smoke smell outdoors, 40 % indoors and more than 90 % of the families observed the presence of ash. An adjusted odds ratio of 3.11 [95 % confidence interval 1.62-5.97] for itchy/watery eyes and 3.02 [1.41-6.44] for sore throat was obtained. Significant interaction terms for rhinitis and asthma in itchy/watery eyes and sneezing, and only asthma for sore throat were obtained. Exposure to wildfire smoke was associated with increased respiratory symptoms in this child population, particularly affecting susceptible individuals with asthma or rhinitis.

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Chronic effects of ambient air pollution on lung function among Chinese children

Abstract: Long-term exposure to higher ambient air pollution levels was associated with lower lung function in Chinese schoolchildren, especially among boys. Adverse effects were observed on large and small airways, with a stronger effect on the latter.

Cited by 32 publications

References 27 publications

Ambient air pollution, lung function, and airway responsiveness in asthmatic children

Ambient air pollution, lung function, and airway responsiveness in asthmatic children

Pulmonary health effects of air pollution

Health effects of the 2012 Valencia (Spain) wildfires on children in a cohort study

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