Does exposure to air pollution increase the risk of acute care in young children with asthma? An Ontario, Canada study

To, Teresa; Zhu, Jingqin; Terebessy, Emilie; Zhang, Kimball; Fong, Ivy; Pinault, Lauren; Jerrett, Michael; Robichaud, Alain; Ménard, Richard; Donkelaar, Aaron van; Martin, Randall V.; Hystad, Perry; Brook, Jeffrey R.; Dell, Sharon D.; Stieb, Dave

doi:10.1016/j.envres.2021.111302

Cited by 18 publications

(12 citation statements)

References 26 publications

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“…Some, but not all, prior studies of general pediatric populations have identified childhood exposure to O 3 as a risk factor for asthma. 9,44–47 We found a consistently higher risk for both current wheeze and current asthma among children who had a history of infant bronchiolitis with higher exposure to O 3 . All estimated O 3 concentrations were below US Environmental Protection Agency (EPA) regulatory exposure limits, with similar variability to previous studies in North America.…”

Section: Discussionmentioning

confidence: 63%

“…Perhaps more importantly, concentrations of ambient NO 2 and O 3 are often negatively correlated owing to well-described atmospheric chemical reactions where NO 2 reacts and is consumed in the formation of ground-level O 3 . 49 Others have observed negative correlations between NO 2 and O 3 in epidemiologic analysis 46 as well as observed effect estimates of NO 2 and O 3 in opposite directions. 44,46,50 It is possible the lower risk observed with higher NO 2 exposure reflects a proxy for the adverse impact of O 3 exposure in our study, that is, the “protective” findings of higher NO 2 may be demonstrating lesser risk for areas with lower O 3 concentrations.…”

Section: Discussionmentioning

confidence: 98%

“…49 Others have observed negative correlations between NO 2 and O 3 in epidemiologic analysis 46 as well as observed effect estimates of NO 2 and O 3 in opposite directions. 44,46,50 It is possible the lower risk observed with higher NO 2 exposure reflects a proxy for the adverse impact of O 3 exposure in our study, that is, the “protective” findings of higher NO 2 may be demonstrating lesser risk for areas with lower O 3 concentrations. This is supported by our sensitivity analyses of mutual adjustment for PM 2.5 , NO 2 , and O 3 that resulted in a shift to null effect estimates for NO 2 whereas estimates for O 3 remain similar to the single-pollutant analysis.…”

Section: Discussionmentioning

confidence: 98%

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Role of Air Pollution in the Development of Asthma Among Children with a History of Bronchiolitis in Infancy

et al. 2023

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Background: Infants experiencing bronchiolitis are at increased risk for asthma, but few studies have identified modifiable risk factors. We assessed whether early life air pollution influenced child asthma and wheeze at age 4–6 years among children with a history of bronchiolitis in the first postnatal year. Methods: Children with caregiver-reported physician-diagnosed bronchiolitis were drawn from ECHO-PATHWAYS, a pooled longitudinal cohort from six US cities. We estimated their air pollution exposure from age 1 to 3 years from validated spatiotemporal models of fine particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3). Caregivers reported children’s current wheeze and asthma at age 4–6 years. We used modified Poisson regression to estimate relative risks (RR) and 95% confidence intervals (CI), adjusting for child, maternal, and home environmental factors. We assessed effect modification by child sex and maternal history of asthma with interaction models. Results: A total of 224 children had caregiver-reported bronchiolitis. Median (interquartile range) 2-year pollutant concentrations were 9.3 (7.8–9.9) µg/m3 PM2.5, 8.5 (6.4–9.9) ppb NO2, and 26.6 (25.6–27.7) ppb O3. RRs (CI) for current wheeze per 2-ppb higher O3 were 1.3 (1.0–1.7) and 1.4 (1.1–1.8) for asthma. NO2 was inversely associated with wheeze and asthma whereas associations with PM2.5 were null. We observed interactions between NO2 and PM2.5 and maternal history of asthma, with lower risks observed among children with a maternal history of asthma. Conclusion: Our results are consistent with the hypothesis that exposure to modest postnatal O3 concentrations increases the risk of asthma and wheeze among the vulnerable subpopulation of infants experiencing bronchiolitis.

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 98%

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Role of Air Pollution in the Development of Asthma Among Children with a History of Bronchiolitis in Infancy

et al. 2023

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“…However, a subsequent study that examined the impact of PM 2.5 components on morbidity in children living with asthma found that sulphate was significantly associated with approximately 130% and 40% increases in risk per IQR increment in concentration for all-cause hospitalization and emergency department visits, respectively, after adjusting for potential confounding factors. [ 18 ] Following the same study cohort, this epidemiological study further examined ROS concentrations generated in the human respiratory tract in response to inhaled pollutants including Cu and Fe in PM 2.5 . We found that exposure to ROS at birth significantly increased the risk of asthma by 11%.…”

Section: Discussionmentioning

confidence: 99%

Does early life exposure to exogenous sources of reactive oxygen species (ROS) increase the risk of respiratory and allergic diseases in children? A longitudinal cohort study

Terebessy

Zhu

et al. 2022

Environ Health

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Background Excess reactive oxygen species (ROS) can cause oxidative stress damaging cells and tissues, leading to adverse health effects in the respiratory tract. Yet, few human epidemiological studies have quantified the adverse effect of early life exposure to ROS on child health. Thus, this study aimed to examine the association of levels of ROS exposure at birth and the subsequent risk of developing common respiratory and allergic diseases in children. Methods 1,284 Toronto Child Health Evaluation Questionnaire (T-CHEQ) participants were followed from birth (born between 1996 and 2000) until outcome, March 31, 2016 or loss-to-follow-up. Using ROS data from air monitoring campaigns and land use data in Toronto, ROS concentrations generated in the human respiratory tract in response to inhaled pollutants were estimated using a kinetic multi-layer model. These ROS values were assigned to participants’ postal codes at birth. Cox proportional hazards regression models, adjusted for confounders, were then used to estimate hazard ratios (HR) with 95% confidence intervals (CI) per unit increase in interquartile range (IQR). Results After adjusting for confounders, iron (Fe) and copper (Cu) were not significantly associated with the risk of asthma, allergic rhinitis, nor eczema. However, ROS, a measure of the combined impacts of Fe and Cu in PM2.5, was associated with an increased risk of asthma (HR = 1.11, 95% CI: 1.02–1.21, p < 0.02) per IQR. There were no statistically significant associations of ROS with allergic rhinitis (HR = 0.96, 95% CI: 0.88–1.04, p = 0.35) and eczema (HR = 1.03, 95% CI: 0.98–1.09, p = 0.24). Conclusion These findings showed that ROS exposure in early life significantly increased the childhood risk of asthma, but not allergic rhinitis and eczema.

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“…8,14 Prolonged exposure to the aforementioned pollutants results in adverse health effects in local communities, with a larger impact on vulnerable members with pre-existing conditions such as heart disease and asthma. 17 Long periods of exposure to these pollutants can worsen asthmatic symptoms, increase chances of genetic defects in unborn children, 18 impact adolescent health, 19 increase the risk of cardiovascular diseases, and cause organ failure. 9,14,20 Recent studies on the impacts of TRAP on cardiovascular health highlighted that even at lower levels, TRAP is a signicant contributor to pollution-induced diabetes mellitus, 21 myocardial infarction, 22 and cancer development in the respiratory tract.…”

Section: Introductionmentioning

confidence: 99%

Application of machine learning and statistical modeling to identify sources of air pollutant levels in Kitchener, Ontario, Canada

Mohammed

Adamescu

Neil

et al. 2022

Environ. Sci.: Atmos.

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Does exposure to air pollution increase the risk of acute care in young children with asthma? An Ontario, Canada study

Cited by 18 publications

References 26 publications

Role of Air Pollution in the Development of Asthma Among Children with a History of Bronchiolitis in Infancy

Role of Air Pollution in the Development of Asthma Among Children with a History of Bronchiolitis in Infancy

Does early life exposure to exogenous sources of reactive oxygen species (ROS) increase the risk of respiratory and allergic diseases in children? A longitudinal cohort study

Application of machine learning and statistical modeling to identify sources of air pollutant levels in Kitchener, Ontario, Canada

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