The prenatal and postnatal effects of air pollution on asthma in children with atopic dermatitis

Abstract

Objectives Air pollution is strongly associated with asthma, but has not been determined to induce new‐onset asthma development in children with atopic dermatitis (AD). Working Hypothesis To assess whether prenatal/postnatal exposure to air pollutants triggers new‐onset asthma development in children with AD. Study Design Retrospective cohort study. Patient‐subject Selection Data of patients <age 18 years diagnosed with eczema or AD between 2009 and 2019 were extracted from the multicenter Kaohsiung Medical University Hospital Research Database. Patients diagnosed with new‐onset asthma were in the asthma group and patients without asthma history were in the non‐asthma group. Methodology The monthly average concentration of air pollutants for 1, 3, and 5 years before the index date, and 3, 6, and 9 months prenatally were analyzed and further stratified by age, immunoglobulin (Ig) E, and the percentage of eosinophil and eosinophil cationic protein (ECP). Results Postnatal exposure to airborne particulate matter (PM2.5, PM10), sulfur dioxide (SO2), ozone (O3), carbon monoxide (CO), nitric oxide (NO), nitric dioxide (NO2), and NOx, and prenatal exposure to PM2.5, PM10, SO2, NO, and NOx were significantly higher in the asthma group than in the non‐asthma group. Patients having IgE above 100 IU/ml and ECP less than 24 ng/ml were significantly influenced by postnatal exposure to PM2.5 and PM10, especially CO, to develop asthma, and those having an eosinophil count >3% were significantly influenced by prenatal exposure to PM2.5, especially SO2, NO, and NO2. Conclusions Prenatal and postnatal exposure to air pollution have an association with asthma development in AD patients.

Pediatric pulmonology 2022 year in review: Asthma

“…The authors found that prenatal or postnatal exposure to airborne particulate matter (PM 2.5 and PM 10 ), sulfur dioxide (SO 2 ), and nitric oxide (NO) were associated with the development of new onset asthma in children with eczema. 17 Additionally, prenatal exposure to all air pollution had a strong relationship with elevated levels of serum eosinophils, whereas postnatal exposure to air pollution was significantly associated with elevated levels of immunoglobulin E (IgE). These findings support efforts to reduce exposures to air pollution during the prenatal period, to limit or prevent the development of asthma in childhood.…”

“…Based on retrospective review of local air pollutant levels before and after the patient's birth, they identified which pollutants had positive associations with development of asthma. The authors found that prenatal or postnatal exposure to airborne particulate matter (PM 2.5 and PM 10 ), sulfur dioxide (SO 2 ), and nitric oxide (NO) were associated with the development of new onset asthma in children with eczema 17 . Additionally, prenatal exposure to all air pollution had a strong relationship with elevated levels of serum eosinophils, whereas postnatal exposure to air pollution was significantly associated with elevated levels of immunoglobulin E (IgE).…”

EAACI guidelines on environmental science for allergy and asthma: The impact of short‐term exposure to outdoor air pollutants on asthma‐related outcomes and recommendations for mitigation measures

“…32 Epidemiological studies show associations between outdoor pollutants and new-onset asthma in children. 13,19,[32][33][34] Recent data from the Dutch Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort linked asthma incidence until age 20 years to estimated concentrations of NO 2 , PMs and PM 2.5 absorbance ('soot') at the residential address and showed that exposure to air pollution, especially from motorized traffic, early in life may have long-term consequences for asthma development, as it is associated with an increased risk of developing asthma through childhood and adolescence into early adulthood. 35 In addition to single air pollutants, exposure to TRAP as a mixture of different pollutants has negative effects on the lung, such as reduced lung function (especially expiratory flows in both children and adults) and asthma exacerbations.…”