RATIONALE: The heterogeneity of asthma phenotypes may explain inconsistencies in observed associations with environmental exposures. OBJECTIVES: To identify trajectories of childhood asthma and to characterize the potential impact of residential greenness and air pollution on asthma trajectory subgroups. METHODS: Linked administrative databases of medical visits were used to define the occurrence and recurrence of asthma over a 10-year follow-up period within a population-based birth cohort of more than 65,000 children. Group-based trajectory modeling was used to identify unique asthma trajectories. Weighted multinomial regression was used to assess the relationship between asthma trajectories and risk factors, including environmental exposures. MEASUREMENTS AND MAIN RESULTS: Group-based trajectory modeling distinguished four trajectories: one with no asthma representing 88.8% of the cohort, one with transient asthma (5.6% of the cohort), and two trajectories with chronic asthma with early (<1 yr; 1.5%) and late (<3 yr; 4.1%) onset during early childhood. These trajectories differed with respect to socioeconomic markers and modifiable risk factors, including maternal smoking and breastfeeding initiation. After accounting for sex, parity, breastfeeding, term birth weight, household income, maternal education, delivery mode, and smoking, an interquartile increase in nitrogen dioxide exposure increased the risk of membership in the early and late-onset chronic asthma trajectories, relative to subjects without asthma, by 50% and 20%, respectively (weighted risk ratio, 1.5 and 1.2; 95% confidence interval, 1.2-1.9 and 1.0-1.4). Greenness was not associated with any of the asthma trajectories. CONCLUSIONS: Traffic-related air pollution increased the probability of a chronic asthma trajectory.
RATIONALE: The heterogeneity of asthma phenotypes may explain inconsistencies in observed associations with environmental exposures. OBJECTIVES: To identify trajectories of childhood asthma and to characterize the potential impact of residential greenness and air pollution on asthma trajectory subgroups. METHODS: Linked administrative databases of medical visits were used to define the occurrence and recurrence of asthma over a 10-year follow-up period within a population-based birth cohort of more than 65,000 children. Group-based trajectory modeling was used to identify unique asthma trajectories. Weighted multinomial regression was used to assess the relationship between asthma trajectories and risk factors, including environmental exposures. MEASUREMENTS AND MAIN RESULTS: Group-based trajectory modeling distinguished four trajectories: one with no asthma representing 88.8% of the cohort, one with transient asthma (5.6% of the cohort), and two trajectories with chronic asthma with early (<1 yr; 1.5%) and late (<3 yr; 4.1%) onset during early childhood. These trajectories differed with respect to socioeconomic markers and modifiable risk factors, including maternal smoking and breastfeeding initiation. After accounting for sex, parity, breastfeeding, term birth weight, household income, maternal education, delivery mode, and smoking, an interquartile increase in nitrogen dioxide exposure increased the risk of membership in the early and late-onset chronic asthma trajectories, relative to subjects without asthma, by 50% and 20%, respectively (weighted risk ratio, 1.5 and 1.2; 95% confidence interval, 1.2-1.9 and 1.0-1.4). Greenness was not associated with any of the asthma trajectories. CONCLUSIONS: Traffic-related air pollution increased the probability of a chronic asthma trajectory.
Authors: Edith Chen; Gregory E Miller; Madeleine U Shalowitz; Rachel E Story; Cynthia S Levine; Robin Hayen; Hind Sbihi; Michael Brauer Journal: Pediatrics Date: 2017-03-09 Impact factor: 7.124
Authors: Gillian C Goobie; Mehdi Nouraie; Yingze Zhang; Daniel J Kass; Christopher J Ryerson; Christopher Carlsten; Kerri A Johannson Journal: Am J Respir Crit Care Med Date: 2020-11-01 Impact factor: 21.405
Authors: Anna Gref; Simon K Merid; Olena Gruzieva; Stéphane Ballereau; Allan Becker; Tom Bellander; Anna Bergström; Yohan Bossé; Matteo Bottai; Moira Chan-Yeung; Elaine Fuertes; Despo Ierodiakonou; Ruiwei Jiang; Stéphane Joly; Meaghan Jones; Michael S Kobor; Michal Korek; Anita L Kozyrskyj; Ashish Kumar; Nathanaël Lemonnier; Elaina MacIntyre; Camille Ménard; David Nickle; Ma'en Obeidat; Johann Pellet; Marie Standl; Annika Sääf; Cilla Söderhäll; Carla M T Tiesler; Maarten van den Berge; Judith M Vonk; Hita Vora; Cheng-Jian Xu; Josep M Antó; Charles Auffray; Michael Brauer; Jean Bousquet; Bert Brunekreef; W James Gauderman; Joachim Heinrich; Juha Kere; Gerard H Koppelman; Dirkje Postma; Christopher Carlsten; Göran Pershagen; Erik Melén Journal: Am J Respir Crit Care Med Date: 2017-05-15 Impact factor: 21.405
Authors: Susan M Tarlo; Jean-Luc Malo; Frédéric de Blay; Nicole Le Moual; Paul Henneberger; Dick Heederik; Monika Raulf; Christopher Carlsten; André Cartier Journal: Ann Am Thorac Soc Date: 2017-09
Authors: Matthew C Altman; Agustin Calatroni; Sima Ramratnam; Daniel J Jackson; Scott Presnell; Mario G Rosasco; Peter J Gergen; Leonard B Bacharier; George T O'Connor; Megan T Sandel; Meyer Kattan; Robert A Wood; Cynthia M Visness; James E Gern Journal: J Allergy Clin Immunol Date: 2021-03-10 Impact factor: 10.793
Authors: Leonard B Bacharier; Avraham Beigelman; Agustin Calatroni; Daniel J Jackson; Peter J Gergen; George T O'Connor; Meyer Kattan; Robert A Wood; Megan T Sandel; Susan V Lynch; Kei E Fujimura; Douglas W Fadrosh; Clark A Santee; Homer Boushey; Cynthia M Visness; James E Gern Journal: Am J Respir Crit Care Med Date: 2019-01-01 Impact factor: 30.528