Eva Morales1, Raquel Garcia-Esteban1, Oscar Asensio de la Cruz2, Mikel Basterrechea3, Aitana Lertxundi4, Maria D Martinez López de Dicastillo5, Carlos Zabaleta6, Jordi Sunyer1. 1. Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Spain. 2. Unit of Pediatric Pneumology and Allergy, Hospital de Sabadell, Corporació Sanitària Parc Taulí, Sabadell, Catalonia, Spain. 3. CIBER Epidemiología y Salud Pública (CIBERESP), Spain Health Research Institute Biodonostia, San Sebastian, Gipuzkoa, Spain Public Health Department of Gipuzkoa, San Sebastian, Gipuzkoa, Spain. 4. Health Research Institute Biodonostia, San Sebastian, Gipuzkoa, Spain University of the Basque Country, Bilbao, Spain. 5. Health Research Institute Biodonostia, San Sebastian, Gipuzkoa, Spain Department of Environment and Regional Planning, Basque Government, San Sebastian, Gipuzkoa, Spain. 6. Department of Pediatrics, Hospital de Zumárraga, San Sebastian, Gipuzkoa, Spain.
Abstract
BACKGROUND: Effects of prenatal and postnatal exposure to air pollution on lung function at preschool age remain unexplored. We examined the association of exposure to air pollution during specific trimesters of pregnancy and postnatal life with lung function in preschoolers. METHODS: Lung function was assessed with spirometry in preschoolers aged 4.5 years (n=620) participating in the INfancia y Medio Ambiente (INMA) cohort. Temporally adjusted land use regression (LUR) models were applied to estimate individual residential exposures to benzene and nitrogen dioxide (NO₂) during specific trimesters of pregnancy and early postnatal life (the first year of life). Recent and current (1 year and 1 week before lung function testing, respectively) exposures to NO₂ and nitrogen oxides (NOx) were also assessed. RESULTS: Exposure to higher levels of benzene and NO₂ during pregnancy was associated with reduced lung function. FEV1 estimates for an IQR increase in exposures during the second trimester of pregnancy were -18.4 mL, 95% CI -34.8 to -2.1 for benzene and -28.0 mL, 95% CI -52.9 to -3.2 for NO₂. Relative risk (RR) of low lung function (<80% of predicted FEV1) for an IQR increase in benzene and NO₂ during the second trimester of pregnancy were 1.22, 95% CI 1.02 to 1.46 and 1.30, 95% CI 0.97 to 1.76, respectively. Associations for early postnatal, recent and current exposures were not statistically significant. Stronger associations appeared among allergic children and those of lower social class. CONCLUSIONS: Prenatal exposure to residential traffic-related air pollution may result in long-term lung function deficits at preschool age. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
BACKGROUND: Effects of prenatal and postnatal exposure to air pollution on lung function at preschool age remain unexplored. We examined the association of exposure to air pollution during specific trimesters of pregnancy and postnatal life with lung function in preschoolers. METHODS: Lung function was assessed with spirometry in preschoolers aged 4.5 years (n=620) participating in the INfancia y Medio Ambiente (INMA) cohort. Temporally adjusted land use regression (LUR) models were applied to estimate individual residential exposures to benzene and nitrogen dioxide (NO₂) during specific trimesters of pregnancy and early postnatal life (the first year of life). Recent and current (1 year and 1 week before lung function testing, respectively) exposures to NO₂ and nitrogen oxides (NOx) were also assessed. RESULTS: Exposure to higher levels of benzene and NO₂ during pregnancy was associated with reduced lung function. FEV1 estimates for an IQR increase in exposures during the second trimester of pregnancy were -18.4 mL, 95% CI -34.8 to -2.1 for benzene and -28.0 mL, 95% CI -52.9 to -3.2 for NO₂. Relative risk (RR) of low lung function (<80% of predicted FEV1) for an IQR increase in benzene and NO₂ during the second trimester of pregnancy were 1.22, 95% CI 1.02 to 1.46 and 1.30, 95% CI 0.97 to 1.76, respectively. Associations for early postnatal, recent and current exposures were not statistically significant. Stronger associations appeared among allergic children and those of lower social class. CONCLUSIONS: Prenatal exposure to residential traffic-related air pollution may result in long-term lung function deficits at preschool age. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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