Impact of road proximity on infants and children with bronchopulmonary dysplasia

Abstract

Introduction Infants born prematurely are at high risk for morbidities, including lung disease (bronchopulmonary dysplasia [BPD]). Little is known regarding environmental factors that can impact outcomes in BPD. We sought to assess the role of traffic‐related air pollution (TRAP) on respiratory outcomes in BPD. Methods A total of 784 subjects were included from the Johns Hopkins BPD clinic. Caregivers completed questionnaires on environmental exposures and respiratory outcomes (acute care use and chronic symptoms). Distance to the nearest major roadway was derived from subjects’ geocoded residential addresses. Results Approximately half of the subjects (53.8%) lived within 500 m of a major roadway. Subjects who lived within 500 m of a major roadway were more likely to be non‐white (P = .006), have a lower estimated household income (P < .001) and live in more densely populated zip codes (P < .001) than those who lived further than 500 m away. For every 1 km increase in distance between residence and roadway, the likelihood of activity limitations decreased by 35% (P = .005). No differences in acute care use were seen with proximity to major roadways. Conclusions Proximity to a major roadway was associated with chronic respiratory symptoms, such as activity limitations (eg, dyspnea), and tended to be associated with nighttime symptoms as well. Self‐reported minorities and families with lower estimated household incomes may be more likely to be exposed to TRAP. Further research is necessary to define the effects of TRAP versus other sources of indoor and outdoor air pollution as well as to determine the best ways of combatting pollution‐related respiratory morbidities.

Differential Effect of School-Based Pollution Exposure in Children With Asthma Born Prematurely

“…Although we did not find a distinct effect on health-care utilization in our study, we confirm the adverse effect of pollutants on asthma symptoms and lung function on preterm children in excess of that of term children. These findings are in concert with a recent report by Collaco et al, 9 who found home proximity to roadways associated with symptoms but not health-care utilization in a cohort of patients with bronchopulmonary dysplasia. Our limited sample size and lack of characterization of degree of prematurity may have limited our ability to find other significant associations.…”

A Preconception Paternal Fish Oil Diet Prevents Toxicant-Driven New Bronchopulmonary Dysplasia in Neonatal Mice

“…Several studies have suggested that placental dysfunction precedes (and contributes to) the development of new BPD [21][22][23][24]. The onset and severity of developmental lung diseases, such as new BPD, have also been linked to exposure to pollution in humans and experimental animal models [25][26][27][28][29]. Our laboratory found that the offspring of male mice that were exposed to TCDD in utero were also susceptible to new BPD [29].…”

Bronchopulmonary dysplasia as a determinant of respiratory outcomes in adult life

“…Outdoor pollutants may include industrial sites, but more commonly traffic. A study of estimated traffic exposure in preterm infants demonstrated an association between proximity to a major roadway and chronic respiratory symptoms 78 . In adults increasing levels of traffic pollution are associated with a more rapid decline in FEV 1 79 .…”