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Hu Y, Gu J, Wu D, Wang X, Lü H, Yu G. Short-Term Effects of Ambient Air Pollutants on Outpatient Visits for Childhood Allergic Diseases in Shanghai, China. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (SCIENCE) 2024; 29:979-994. [DOI: 10.1007/s12204-022-2454-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 08/04/2021] [Indexed: 01/05/2025]
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2
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Chua RXY, Tay MJY, Ooi DSQ, Siah KTH, Tham EH, Shek LPC, Meaney MJ, Broekman BFP, Loo EXL. Understanding the Link Between Allergy and Neurodevelopmental Disorders: A Current Review of Factors and Mechanisms. Front Neurol 2021; 11:603571. [PMID: 33658968 PMCID: PMC7917177 DOI: 10.3389/fneur.2020.603571] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 12/30/2020] [Indexed: 12/17/2022] Open
Abstract
Both allergic diseases and neurodevelopmental disorders are non-communicable diseases (NCDs) that not only impact on the quality of life and but also result in substantial economic burden. Immune dysregulation and inflammation are typical hallmarks in both allergic and neurodevelopmental disorders, suggesting converging pathophysiology. Epidemiological studies provided convincing evidence for the link between allergy and neurodevelopmental diseases such as attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Possible factors influencing the development of these disorders include maternal depression and anxiety, gestational diabetes mellitus, maternal allergic status, diet, exposure to environmental pollutants, microbiome dysbiosis, and sleep disturbances that occur early in life. Moreover, apart from inflammation, epigenetics, gene expression, and mitochondrial dysfunction have emerged as possible underlying mechanisms in the pathogenesis of these conditions. The exploration and understanding of these shared factors and possible mechanisms may enable us to elucidate the link in the comorbidity.
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Affiliation(s)
- Regena Xin Yi Chua
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Michelle Jia Yu Tay
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Delicia Shu Qin Ooi
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Kewin Tien Ho Siah
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Division of Gastroenterology & Hepatology, University Medicine Cluster, National University Hospital, Singapore, Singapore
| | - Elizabeth Huiwen Tham
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore.,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Lynette Pei-Chi Shek
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore.,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Michael J Meaney
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore.,Ludmer Centre for Neuroinformatics and Mental Health and Department of Psychiatry, McGill University, Montréal, QC, Canada
| | - Birit F P Broekman
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore.,Department of Psychiatry, Onze Lieve Vrouwe Gasthuis and Amsterdam University Medical Centre, VU University Medical Center, Amsterdam, Netherlands
| | - Evelyn Xiu Ling Loo
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
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3
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Deng S, Huang D, Wang W, Yan H, Li S, Xiang H. Associations of gestational and the first year of life exposure to ambient air pollution with childhood eczema in Hubei, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:23842-23849. [PMID: 31209757 DOI: 10.1007/s11356-019-05633-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 05/29/2019] [Indexed: 05/22/2023]
Abstract
Whether exposure to air pollution is associated with the increased incidence of childhood eczema is controversial. Only a few previous researches about the relationship between gestational and early-life exposures to ambient air pollutants and childhood eczema were conducted in China, and there is a lack of studies in Hubei province. This study aimed to explore the associations between air pollution exposure in gestation and the first year of life and childhood eczema. From November to December 2017, a total of 3383 children aged 3-6 years were recruited from 12 kindergartens in Hubei, China; 3167 were included in the final analysis. Parent-reported data involved with childhood eczema was inquired by questionnaire, and the concentrations of NO2, PM2.5, and PM10 were acquired from air quality monitoring stations which were the nearest to the twelve kindergartens. A binary logistic regression model was used to evaluate the associations of period-mean concentrations of individual pollutant exposure with childhood eczema. Of the 3167 children, 848 (26.8%) had a history of doctor-diagnosed eczema. After adjusting for the covariates, high levels of NO2, PM2.5, and PM10 exposures were significantly associated with a positive increase in risk of childhood eczema during the gestational period and the first year of life. In the gestational period, the estimate OR in the 3rd and 4th quartiles of NO2 was 1.256 and 1.496, respectively. During the first year of life, the estimate OR in the 3rd and 4th quartiles of NO2 was 1.371 and 1.335, respectively. Our study indicated that the gestational period and the first year of life exposures to high levels of ambient NO2, PM2.5, and PM10 were significantly associated with increased eczema among preschool children. Some effective measures of prevention and intervention could be developed for preschool children.
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Affiliation(s)
- Shumin Deng
- School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Danqin Huang
- School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Wei Wang
- School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Hong Yan
- School of Health Sciences, Wuhan University, Wuhan, 430071, China.
| | - Shiyue Li
- School of Health Sciences, Wuhan University, Wuhan, 430071, China.
| | - Hao Xiang
- School of Health Sciences, Wuhan University, Wuhan, 430071, China
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4
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Maternal Exposure to Particulate Matter during Pregnancy and Adverse Birth Outcomes in the Republic of Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16040633. [PMID: 30795535 PMCID: PMC6406420 DOI: 10.3390/ijerph16040633] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 02/12/2019] [Accepted: 02/18/2019] [Indexed: 02/06/2023]
Abstract
Air pollution has become a global concern due to its association with numerous health effects. We aimed to assess associations between birth outcomes in Korea, such as preterm births and birth weight in term infants, and particulate matter < 10 µm (PM10). Records from 1,742,183 single births in 2010⁻2013 were evaluated. Mean PM10 concentrations during pregnancy were calculated and matched to birth data by registered regions. We analyzed the frequency of birth outcomes between groups using WHO criteria for PM10 concentrations with effect sizes estimated using multivariate logistic regression. Women exposed to PM10 > 70 µg/m³ during pregnancy had a higher rate of preterm births than women exposed to PM10 ≤ 70 µg/m³ (7.4% vs. 4.7%, P < 0.001; adjusted odds ratio (aOR) 1.570; 95% confidence interval (CI): 1.487⁻1.656). The rate of low birth weight in term infants increased when women were exposed to PM10 > 70 µg/m³ (1.9% vs. 1.7%, P = 0.278), but this difference was not statistically significant (aOR 1.060, 95% CI: 0.953⁻1.178). In conclusion, PM10 exposure > 70 µg/m³ was associated with preterm births. Further studies are needed to explore the pathophysiologic mechanisms and guide policy development to prevent future adverse effects on birth outcomes.
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5
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A Closer Look at the Bivariate Association between Ambient Air Pollution and Allergic Diseases: The Role of Spatial Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081625. [PMID: 30071675 PMCID: PMC6121458 DOI: 10.3390/ijerph15081625] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 07/22/2018] [Accepted: 07/30/2018] [Indexed: 12/14/2022]
Abstract
Although previous ecological studies investigating the association between air pollution and allergic diseases accounted for temporal or seasonal relationships, few studies address spatial non-stationarity or autocorrelation explicitly. Our objective was to examine bivariate correlation between outdoor air pollutants and the prevalence of allergic diseases, highlighting the limitation of a non-spatial correlation measure, and suggesting an alternative to address spatial autocorrelation. The 5-year prevalence data (2011⁻2015) of allergic rhinitis, atopic dermatitis, and asthma were integrated with the measures of four major air pollutants (SO₂, NO₂, CO, and PM10) for each of the 423 sub-districts of Seoul. Lee's L statistics, which captures how much bivariate associations are spatially clustered, was calculated and compared with Pearson's correlation coefficient for each pair of the air pollutants and allergic diseases. A series of maps showing spatiotemporal patterns of allergic diseases at the sub-district level reveals a substantial degree of spatial heterogeneity. A high spatial autocorrelation was observed for all pollutants and diseases, leading to significant dissimilarities between the two bivariate association measures. The local L statistics identifies the areas where a specific air pollutant is considered to be contributing to a type of allergic disease. This study suggests that a bivariate correlation measure between air pollutants and allergic diseases should capture spatially-clustered phenomenon of the association, and detect the local instability in their relationships. It highlights the role of spatial analysis in investigating the contribution of the local-level spatiotemporal dynamics of air pollution to trends and the distribution of allergic diseases.
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6
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Hong E, Lee S, Kim GB, Kim TJ, Kim HW, Lee K, Son BS. Effects of Environmental Air Pollution on Pulmonary Function Level of Residents in Korean Industrial Complexes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15050834. [PMID: 29695054 PMCID: PMC5981873 DOI: 10.3390/ijerph15050834] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 04/11/2018] [Accepted: 04/21/2018] [Indexed: 12/28/2022]
Abstract
This study aims to identify environmental air pollution adversely affecting pulmonary function among a community-based general population living in Korean industrial complexes. A total of 1963 residents participated in a pulmonary function test (PFT). The sample population consisted of an exposed group (n = 1487) living within a radius of 5 km of industrial complexes and a control group (n = 476) living over a radius of 10 km from the industrial complexes in Gwangyang and Yeosu cities. PFT results were calculated for each resident of the study population. On-site questionnaire surveys with face-to-face interviews were also conducted to collect more detailed information on personal lifestyles, medical history, exposure to air pollution, and respiratory disease and related symptoms. A total of 486 measured samples were collected by eight automated air-monitoring stations installed in four counties of Gwangyang and four counties of Yeosu in South Korea from January 2006 to February 2007. Mean levels of SO2 (0.012 ppm), CO (0.648 ppm), NO2 (0.02 ppm), O3 (0.034 ppm), and PM10 (43.07 μg/m3), collected within a radius of 5 km, were significantly higher than those collected over a radius of 10 km from Gwangyang and Yeosu industrial complexes. Prevalence odds ratio (OR) of abnormal pulmonary function in the exposed group of residents (<5 km) was elevated at 1.24 (95% CI 0.71–1.96), but not statistically significant (p > 0.05). In multiple linear regression analysis, forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) levels significantly declined as SO2, CO, and O3 levels increased when adjusting for age, sex, body mass index (BMI), alcohol, smoking, secondhand smoke, and respiratory disease and related symptoms (n = 1963) (p < 0.05). These results suggest that exposure to air pollution affects pulmonary function levels of residents living in Korean industrial complexes.
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Affiliation(s)
- Eunju Hong
- Department of Environmental Health Science, College of Natural Science, Soonchunhyang University, 22 Soonchunhyang-ro, Asan City, Chungnam 31538, Korea.
| | - Seokwon Lee
- Samsung Health Research Institute, Samsung Electronics Co. Ltd., 1 Samsungjeonja-ro, Hwaseong City, Gyeonggi-do 18448, Korea.
| | - Geun-Bae Kim
- Environmental Health Research Division, National Institute of Environment Research, 42 Hwangyeong-ro, Incheon City 22689, Korea.
| | - Tae-Jong Kim
- World Vertex Corp., ACE bldg., 401m 179, Baumoe-ro, Seocho-gu, Seoul 06744, Korea.
| | - Hyoung-Wook Kim
- Department of Environmental Health Science, College of Natural Science, Soonchunhyang University, 22 Soonchunhyang-ro, Asan City, Chungnam 31538, Korea.
| | - Kyoungho Lee
- Samsung Health Research Institute, Samsung Electronics Co. Ltd., 1 Samsungjeonja-ro, Hwaseong City, Gyeonggi-do 18448, Korea.
| | - Bu-Soon Son
- Department of Environmental Health Science, College of Natural Science, Soonchunhyang University, 22 Soonchunhyang-ro, Asan City, Chungnam 31538, Korea.
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7
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Malaquias MAS, Oyama LA, Jericó PC, Costa I, Padilha G, Nagashima S, Lopes-Pacheco M, Rebelatto CLK, Michelotto PV, Xisto DG, Brofman PRS, Rocco PRM, de Noronha L. Effects of mesenchymal stromal cells play a role the oxidant/antioxidant balance in a murine model of asthma. Allergol Immunopathol (Madr) 2018; 46:136-143. [PMID: 29174587 DOI: 10.1016/j.aller.2017.06.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 05/30/2017] [Accepted: 06/21/2017] [Indexed: 01/10/2023]
Abstract
Asthma is a heterogeneous disease characterised by chronic airway inflammation. One of the most devastating consequences of this inflammatory process is the generation of reactive oxygen and nitrogen species responsible for oxidative stress. The aim of this study is to analyse the efficiency of treatment with human bone marrow-derived mesenchymal stromal cells (hMSC) in maintaining the oxidative balance in a murine model of allergic asthma by quantifying nitrotyrosine in lung tissues. After confirmation of asthma in the experimental model, samples of lung parenchyma were submitted to immunohistochemical assessment. Intravenous administration of hMSC reduced the levels of nitrotyrosine in the ASTHMA-hMSC group compared to those in the ASTHMA-SAL group. In conclusion, therapeutic administration of hMSC had a beneficial effect on oxidative stress, reducing the levels of nitrotyrosine in lung tissues in a model of allergic asthma.
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Affiliation(s)
- M A S Malaquias
- Pathology Experimental Laboratory, School of Medicine, Pontifical Catholic University of Paraná, Curitiba, Brazil.
| | - L A Oyama
- Pathology Experimental Laboratory, School of Medicine, Pontifical Catholic University of Paraná, Curitiba, Brazil
| | - P C Jericó
- Pathology Experimental Laboratory, School of Medicine, Pontifical Catholic University of Paraná, Curitiba, Brazil
| | - I Costa
- Laboratory of Pulmonary Investigation, Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - G Padilha
- Laboratory of Pulmonary Investigation, Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - S Nagashima
- Pathology Experimental Laboratory, School of Medicine, Pontifical Catholic University of Paraná, Curitiba, Brazil
| | - M Lopes-Pacheco
- Laboratory of Pulmonary Investigation, Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - C L K Rebelatto
- Experimental Laboratory for Cell Culture, School of Medicine, Pontifical Catholic University of Paraná, Curitiba, Brazil
| | - P V Michelotto
- Experimental Laboratory for Cell Culture, School of Medicine, Pontifical Catholic University of Paraná, Curitiba, Brazil
| | - D G Xisto
- Laboratory of Pulmonary Investigation, Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - P R S Brofman
- Experimental Laboratory for Cell Culture, School of Medicine, Pontifical Catholic University of Paraná, Curitiba, Brazil
| | - P R M Rocco
- Laboratory of Pulmonary Investigation, Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - L de Noronha
- Pathology Experimental Laboratory, School of Medicine, Pontifical Catholic University of Paraná, Curitiba, Brazil
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8
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Prunicki M, Stell L, Dinakarpandian D, de Planell-Saguer M, Lucas RW, Hammond SK, Balmes JR, Zhou X, Paglino T, Sabatti C, Miller RL, Nadeau KC. Exposure to NO 2, CO, and PM 2.5 is linked to regional DNA methylation differences in asthma. Clin Epigenetics 2018; 10:2. [PMID: 29317916 PMCID: PMC5756438 DOI: 10.1186/s13148-017-0433-4] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 12/12/2017] [Indexed: 12/30/2022] Open
Abstract
Background DNA methylation of CpG sites on genetic loci has been linked to increased risk of asthma in children exposed to elevated ambient air pollutants (AAPs). Further identification of specific CpG sites and the pollutants that are associated with methylation of these CpG sites in immune cells could impact our understanding of asthma pathophysiology. In this study, we sought to identify some CpG sites in specific genes that could be associated with asthma regulation (Foxp3 and IL10) and to identify the different AAPs for which exposure prior to the blood draw is linked to methylation levels at these sites. We recruited subjects from Fresno, California, an area known for high levels of AAPs. Blood samples and responses to questionnaires were obtained (n = 188), and in a subset of subjects (n = 33), repeat samples were collected 2 years later. Average measures of AAPs were obtained for 1, 15, 30, 90, 180, and 365 days prior to each blood draw to estimate the short-term vs. long-term effects of the AAP exposures. Results Asthma was significantly associated with higher differentially methylated regions (DMRs) of the Foxp3 promoter region (p = 0.030) and the IL10 intronic region (p = 0.026). Additionally, at the 90-day time period (90 days prior to the blood draw), Foxp3 methylation was positively associated with NO2, CO, and PM2.5 exposures (p = 0.001, p = 0.001, and p = 0.012, respectively). In the subset of subjects retested 2 years later (n = 33), a positive association between AAP exposure and methylation was sustained. There was also a negative correlation between the average Foxp3 methylation of the promoter region and activated Treg levels (p = 0.039) and a positive correlation between the average IL10 methylation of region 3 of intron 4 and IL10 cytokine expression (p = 0.030). Conclusions Short-term and long-term exposures to high levels of CO, NO2, and PM2.5 were associated with alterations in differentially methylated regions of Foxp3. IL10 methylation showed a similar trend. For any given individual, these changes tend to be sustained over time. In addition, asthma was associated with higher differentially methylated regions of Foxp3 and IL10. Electronic supplementary material The online version of this article (10.1186/s13148-017-0433-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mary Prunicki
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, CA 94305 USA.,Department of Medicine, Stanford University, Stanford, CA 94305 USA
| | - Laurel Stell
- Department of Biomedical Data Science, Stanford University, Stanford, CA 94305 USA
| | - Deendayal Dinakarpandian
- Department of Medicine, Stanford University, Stanford, CA 94305 USA.,Center for Biomedical Informatics Research, Stanford University, Stanford, CA 94305 USA
| | | | | | - S Katharine Hammond
- School of Public Health, University of California, Berkeley, Berkeley, CA 94720 USA
| | - John R Balmes
- School of Public Health, University of California, Berkeley, Berkeley, CA 94720 USA.,Department of Medicine, University of California, San Francisco, San Francisco, CA 94143 USA
| | - Xiaoying Zhou
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, CA 94305 USA.,Department of Medicine, Stanford University, Stanford, CA 94305 USA
| | - Tara Paglino
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, CA 94305 USA.,Department of Medicine, Stanford University, Stanford, CA 94305 USA
| | - Chiara Sabatti
- Department of Biomedical Data Science, Stanford University, Stanford, CA 94305 USA.,Department of Statistics, Stanford University, Stanford, CA 94305 USA
| | - Rachel L Miller
- Department of Medicine, Columbia University, New York, NY 10032 USA
| | - Kari C Nadeau
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, CA 94305 USA.,Department of Medicine, Stanford University, Stanford, CA 94305 USA.,Division of Pulmonary and Critical Care Medicine, Department of Medicine, Stanford University, Stanford University School of Medicine, 269 Campus Drive, CCSR 3215, MC 5366, Stanford, CA 94305-5101 USA
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9
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Lee JY, Leem JH, Kim HC, Lamichhane DK, Hwang SS, Kim JH, Park MS, Jung DY, Ko JK, Kwon HJ, Hong SJ. Effects of traffic-related air pollution on susceptibility to infantile bronchiolitis and childhood asthma: A cohort study in Korea. J Asthma 2017; 55:223-230. [PMID: 29257909 DOI: 10.1080/02770903.2017.1313270] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE This study examined the role of exposure to traffic-related air pollution (TRAP) on susceptibility to asthma in children with past episodes of bronchiolitis. METHODS The baseline data included 2,627 school children aged 6-14 years who had participated in the longitudinal follow-up survey of the Children's Health and Environmental Research of Korea. Lifetime wheezing, past episodes of bronchiolitis, and doctor-diagnosed asthma were evaluated using an International Study of Asthma and Allergies in Childhood questionnaire. We used generalized linear regression with binomial distribution to calculate the relative risk (RR) between TRAP, assessed by proximity to a main road and the total length of roads, and asthma. RESULTS Compared with the subjects who had less than 100 m of road length within 200-m radius from their home, those with more than 500 m of road length had significantly increased odds for infantile bronchiolitis (adjusted OR [aOR]: 1.57, 95% confidence interval [CI]: 1.01-2.42). Positive exposure-response relationships were found between residential proximity to the main road and asthma (aOR: 1.79, 95% CI: 1.05-3.06; <75 m vs. >700 m from a main road, P for the trend = 0.02). Closer residential proximity to the main road (<75 m) and bronchiolitis combined increased the risks of newly diagnosed asthma (adjusted RR: 3.62, 95% CI: 1.07-12.26) compared with those without bronchiolitis and living ≥ 75 m away from the main road. CONCLUSIONS TRAP appeared to be associated with an increased asthma among children with bronchiolitis, indicating the importance of modifying effects of bronchiolitis in asthma pathogenesis.
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Affiliation(s)
- Ji-Young Lee
- a Department of Social and Preventive Medicine, College of Medicine , Inha University , Incheon , Korea.,b Department of Occupational and Environmental Medicine , Ewha Womans University College of Medicine , Seoul , Korea
| | - Jong-Han Leem
- a Department of Social and Preventive Medicine, College of Medicine , Inha University , Incheon , Korea.,c Department of Occupational and Environmental Medicine , College of Medicine, Inha University , Incheon , Korea
| | - Hwan-Cheol Kim
- a Department of Social and Preventive Medicine, College of Medicine , Inha University , Incheon , Korea.,c Department of Occupational and Environmental Medicine , College of Medicine, Inha University , Incheon , Korea
| | - Dirga Kumar Lamichhane
- a Department of Social and Preventive Medicine, College of Medicine , Inha University , Incheon , Korea
| | - Seung-Sik Hwang
- a Department of Social and Preventive Medicine, College of Medicine , Inha University , Incheon , Korea
| | - Jeong-Hee Kim
- d Department of Pediatrics, College of Medicine , Inha University , Incheon , Korea
| | - Myung-Sook Park
- a Department of Social and Preventive Medicine, College of Medicine , Inha University , Incheon , Korea
| | - Dal-Young Jung
- a Department of Social and Preventive Medicine, College of Medicine , Inha University , Incheon , Korea
| | - Jung-Keun Ko
- a Department of Social and Preventive Medicine, College of Medicine , Inha University , Incheon , Korea
| | - Ho-Jang Kwon
- e Department of Preventive Medicine, College of Medicine , Dankook University , Cheonan , Korea
| | - Soo-Jong Hong
- f Department of Pediatrics, Asan Medical Center, College of Medicine , University of Ulsan , Seoul , Korea
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10
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Poddighe D, Gelardi M, Licari A, del Giudice MM, Marseglia GL. Non-allergic rhinitis in children: Epidemiological aspects, pathological features, diagnostic methodology and clinical management. World J Methodol 2016; 6:200-213. [PMID: 28074172 PMCID: PMC5183989 DOI: 10.5662/wjm.v6.i4.200] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 09/18/2016] [Accepted: 11/01/2016] [Indexed: 02/06/2023] Open
Abstract
Chronic rhinitis is a very common disease, as the prevalence in the general population resulted to be 40%. Allergic rhinitis has been considered to be the most frequent form of chronic rhinitis, as non-allergic rhinitis has been estimated to account for 25%. However, several evidences suggested that non-allergic rhinitis have been underrated, especially in children. In pediatrics, the diagnostic definition of non-allergic rhinitis has been often limited to the exclusion of an allergic sensitization. Actually, local allergic rhinitis has been often misdiagnosed as well as mixed rhinitis has not been recognized in most cases. Nasal cytology is a diagnostic procedure being suitable for routine clinical practice with children and could be a very useful tool to characterize and diagnose non-allergic rhinitis, providing important clues for epidemiological analysis and clinical management.
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11
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Liu W, Cai J, Huang C, Hu Y, Fu Q, Zou Z, Sun C, Shen L, Wang X, Pan J, Huang Y, Chang J, Zhao Z, Sun Y, Sundell J. Associations of gestational and early life exposures to ambient air pollution with childhood atopic eczema in Shanghai, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 572:34-42. [PMID: 27490301 DOI: 10.1016/j.scitotenv.2016.07.197] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 07/22/2016] [Accepted: 07/28/2016] [Indexed: 05/22/2023]
Abstract
Whether ambient air pollution is associated with childhood atopic eczema is controversial. In this paper, we selected 3358 preschool children who had not altered residences since pregnancy from a cross-sectional study during 2011-2012 in Shanghai, China, and obtained parent-reported data regarding childhood atopic eczema using an improved ISAAC questionnaire. We recorded daily concentrations of SO2, NO2, and PM10 throughout the child's lifetime (2006-2012), and calculated period-averaged concentrations for each district where the child lived to represent the child's exposure levels of these pollutants during different periods. In the multiple logistic regression analyses adjusted for potential confounders as well as for the other pollutants in the same periods, childhood atopic eczema was significantly associated with increments of NO2 in the approximate interquartile range (20μg/m3) during gestational period (adjusted OR, 95% CI for eczema lifetime-ever: 1.80, 1.29-2.49; for eczema in the year prior to the survey: 2.32, 1.57-3.43) and during the first year of life (2.00, 1.40-2.84; 2.16, 1.43-3.28). Exposure to elevated NO2 in the first two years, three years and total lifetime, as well as exposure to mixtures containing NO2 in each of these periods, were consistently associated with increased likelihood of childhood eczema. The highest odds ratios were found between exposure to a mixture of SO2 and NO2 during total lifetime (increment: 35μg/m3) and childhood eczema (adjusted OR, 95% CI: 2.80, 1.75-4.48; 3.50, 1.98-6.19). No significant associations were found between childhood eczema and ambient SO2 and PM10 individually or in mixtures. This study indicates that gestational and lifetime exposures to ambient NO2 are risk factors for atopic eczema in childhood. Exposure to ambient SO2 and PM10 may enhance the effect of NO2 exposure on childhood eczema.
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Affiliation(s)
- Wei Liu
- School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China
| | - Jiao Cai
- School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China
| | - Chen Huang
- School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China.
| | - Yu Hu
- Tongji Architectural Design (Group) Company Limited (TJAD), Shanghai, China
| | - Qingyan Fu
- Shanghai Environmental Monitoring Center (SEMC), Shanghai, China
| | - Zhijun Zou
- School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China
| | - Chanjuan Sun
- School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China
| | - Li Shen
- R&B Technology (Shanghai) Company Limited, Shanghai, China
| | - Xueying Wang
- School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China
| | - Jun Pan
- Shanghai Environmental Monitoring Center (SEMC), Shanghai, China
| | - Yanmin Huang
- Shanghai Environmental Monitoring Center (SEMC), Shanghai, China
| | - Jing Chang
- School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China; Department of Thermal Energy and Power Engineering, Shandong Jiaotong University, Jinan, China
| | - Zhuohui Zhao
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Yuexia Sun
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Jan Sundell
- School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China; Department of Building Science, Tsinghua University, Beijing, China
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Chauhan B, Gupta M, Chauhan K. Role of antioxidants on the clinical outcome of patients with perennial allergic rhinitis. ALLERGY & RHINOLOGY (PROVIDENCE, R.I.) 2016; 7:74-81. [PMID: 27658183 PMCID: PMC5010436 DOI: 10.2500/ar.2016.7.0163] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Antioxidants have a preventive or therapeutic role in oxygen free radical-mediated cell and tissue damage. The study aimed to investigate the therapeutic effects of antioxidants and intranasal steroid fluticasone furoate (FF) on the clinical outcome of patients with perennial allergic rhinitis. METHODS Subjects with perennial allergic rhinitis (n = 61) were randomly divided into two groups, group A (n = 30) received FF and group B (n = 31) received FF with antioxidants for 6 weeks. Nasal and ocular symptoms were evaluated weekly by using a four-point categoric scale. The efficacy of the study drug was assessed based on the mean change from baseline of the total daytime nasal symptom scores, total nighttime nasal symptom scores, and the composite symptom scores. RESULTS The combined therapy (FF with antioxidants) resulted in marked improvements (p ≤ 0.05) in the mean total daytime nasal symptom scores, total nighttime nasal symptom scores, and composite symptom scores of subjects compared with ones treated with intranasal steroid (FF) alone, which highlighted the therapeutic effect of antioxidants in allergic rhinitis. CONCLUSION Significant improvement in clinical outcome was observed in subjects who received antioxidants along with FF. However, because this was an open-label study, the results must be interpreted with caution, and further double-blind, placebo-controlled, dose-ranging trials supplemented with different antioxidants together with intranasal steroids are suggested.
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Affiliation(s)
- Bhushan Chauhan
- From the Department of Ear, Nose and Throat, Gian Sagar Medical College and Hospital, Punjab, India, and
| | - Manish Gupta
- From the Department of Ear, Nose and Throat, Gian Sagar Medical College and Hospital, Punjab, India, and
| | - Komal Chauhan
- Department of Food Science and Technology, National Institute of Food Technology Entrepreneurship and Management, Kundli, Haryana, India
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Yang HJ, Lee SY, Suh DI, Shin YH, Kim BJ, Seo JH, Chang HY, Kim KW, Ahn K, Shin YJ, Lee KS, Lee CM, Oh SY, Kim H, Leem JH, Kim HC, Kim EJ, Lee JS, Hong SJ. The Cohort for Childhood Origin of Asthma and allergic diseases (COCOA) study: design, rationale and methods. BMC Pulm Med 2014; 14:109. [PMID: 24990471 PMCID: PMC4099383 DOI: 10.1186/1471-2466-14-109] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 06/19/2014] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND This paper describes the background, aim, and design of a prospective birth-cohort study in Korea called the COhort for Childhood Origin of Asthma and allergic diseases (COCOA). COCOA objectives are to investigate the individual and interactive effects of genetics, perinatal environment, maternal lifestyle, and psychosocial stress of mother and child on pediatric susceptibility to allergic diseases. METHODS/DESIGN The participants in COCOA represents a Korean inner-city population. Recruitment started on 19 November, 2007 and will continue until 31 December, 2015. Recruitment is performed at five medical centers and eight public-health centers for antenatal care located in Seoul. Participating mother-baby pairs are followed from before birth to adolescents. COCOA investigates whether the following five environmental variables contribute causally to the development and natural course of allergic diseases: (1) perinatal indoor factors (i.e. house-dust mite, bacterial endotoxin, tobacco smoking, and particulate matters 2.5 and 10), (2) perinatal outdoor pollutants, (3) maternal prenatal psychosocial stress and the child's neurodevelopment, (4) perinatal nutrition, and (5) perinatal microbiome. Cord blood and blood samples from the child are used to assess whether the child's genes and epigenetic changes influence allergic-disease susceptibility. Thus, COCOA aims to investigate the contributions of genetics, epigenetics, and various environmental factors in early life to allergic-disease susceptibility in later life. How these variables interact to shape allergic-disease susceptibility is also a key aim.The COCOA data collection schedule includes 11 routine standardized follow-up assessments of all children at 6 months and every year until 10 years of age, regardless of allergic-disease development. The mothers will complete multiple questionnaires to assess the baseline characteristics, the child's exposure to environmental factors, maternal pre- and post-natal psychological stress, and the child's neurodevelopment, nutritional status, and development of allergic and respiratory illnesses. The child's microbiome, genes, epigenetics, plasma cytokine levels, and neuropsychological status, the microbiome of the residence, and the levels of indoor and outdoor pollutants are measured by standard procedures. DISCUSSION The COCOA study will improve our understanding of how individual genetic or environmental risk factors influence susceptibility to allergic disease and how these variables interact to shape the phenotype of allergic diseases.
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Affiliation(s)
- Hyeon-Jong Yang
- Department of Pediatrics, Soonchunhyang University School of Medicine, Seoul, Korea
| | - So-Yeon Lee
- Department of Pediatrics, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Youn Ho Shin
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Byoung-Ju Kim
- Department of Pediatrics, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Ju-Hee Seo
- Department of Pediatrics, Korean Cancer Center Hospital, Seoul, Korea
| | - Hyoung Yoon Chang
- Department of Pediatrics, Childhood Asthma Atopy Center, Research Center for Standardization of Allergic Diseases, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, 760, Korea
| | - Kyung Won Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Kangmo Ahn
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yee-Jin Shin
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung-Sook Lee
- Department of Rehabilitation, Hanshin University, Osan, Korea
| | - Cheol Min Lee
- Institute of Environmental and Industrial Medicine, Hanyang University, Seoul, Korea
| | - Se-Young Oh
- Department of Food and Nutrition, College of Human Ecology, Kyung Hee University, Seoul, Korea
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Jong-Han Leem
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Korea
| | - Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Korea
| | - Eun-Jin Kim
- Allergy TF, Department of Immunology and Pathology, Korea National Institute of Health, Osong Health Technology Administration Complex, 187 Osongsaengmyeong 2-ro, Yeonjae-ri, Osong-eup, Cheongwon, 363-951, Korea
| | - Joo-Shil Lee
- Allergy TF, Department of Immunology and Pathology, Korea National Institute of Health, Osong Health Technology Administration Complex, 187 Osongsaengmyeong 2-ro, Yeonjae-ri, Osong-eup, Cheongwon, 363-951, Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Research Center for Standardization of Allergic Diseases, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, 760, Korea
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Elshabrawy WO, Ismail HAS, Hassanein KM. The impact of environmental and agricultural pollutants on the prevalence of allergic diseases in people from Qassim, KSA. Int J Health Sci (Qassim) 2014; 8:21-31. [PMID: 24899876 DOI: 10.12816/0006068] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND There are multiple environmental factors that influence a sensitized (IgE antibody positive) patient's predisposition to manifest allergic symptoms following allergen exposure. The majority of allergens are known to induce morbidity with chronic symptoms such as rhinitis, pruritis, dermatitis and urticaria. AIM To study the impact of environmental and agricultural pollutants with different pollens on the immunological, hematological and biochemical markers and to determine the prevalence of sensitization to allergens among exposed individuals as well as to identify the eliciting allergens. SUBJECTS AND METHODS Ninety six highly exposed individuals to environmental and agricultural pollution in addition to 20 as controls were selected. A solid phase enzyme-linked immunosorbent assay and the EUROLINE test kit were used for the quantitative determination of total IgE concentration and semi-quantitative in vitro assay of human IgE antibodies to some of the inhalant, ingestant and contactant allergens in serum samples, respectively. Percentage and absolute eosinophil counts and biochemical parameters were analyzed. RESULTS Thirteen (13.5%) out of the 96 studied highly exposed subjects were manifesting allergic symptoms. Higher significant total serum IgE levels and absolute eosinophil counts in groups 1 and 3 of the highly exposed individuals compared to the control group were found (p1=0.00, p3=0.001 and p1=0.016, p3=0.028, respectively). Higher sensitization with inhalant Timothy grass, Aspergillus fumigatus, Der. Farinae and Olive; ingestant Egg yolk, Mango, Strawberry and Codfish and with contactant Latex/plastic and Crude oil was found in the studied groups compared with the controls. CONCLUSION The present data suggest that the highly exposed subjects to pollution are at high risk of developing an allergy. For the screening of those with suspected allergen sensitization, the determination of specific IgE antibodies is a suitable marker of type I allergy.
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Affiliation(s)
- Walaa Othman Elshabrawy
- Department of Clinical Pathology, College of Medicine, Qassim University, KSA ; Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Egypt
| | | | - Khaled Mohamed Hassanein
- Department of Medical Microbiology and Immunology, College of Medicine, Qassim University, KSA ; Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Egypt
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Traffic-related air pollution is associated with airway hyperresponsiveness. J Allergy Clin Immunol 2014; 133:1763-5.e2. [DOI: 10.1016/j.jaci.2014.01.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Revised: 01/28/2014] [Accepted: 01/29/2014] [Indexed: 11/19/2022]
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16
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Kim HY, Shin YH, Han MY. Determinants of sensitization to allergen in infants and young children. KOREAN JOURNAL OF PEDIATRICS 2014; 57:205-10. [PMID: 25045361 PMCID: PMC4102681 DOI: 10.3345/kjp.2014.57.5.205] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Accepted: 03/12/2014] [Indexed: 12/20/2022]
Abstract
Atopic sensitization is a complex phenomenon that changes dynamically with age throughout childhood; its prevalence increases with age in young children. Additionally, with increasing age, the prevalence of sensitization to inhalant allergens and the prevalence of polysensitization to allergens increase. It is also well established that the development of atopic sensitization is the result of a complex interplay of genetic and environmental factors. However, there is considerable heterogeneity in the literature in terms of the effect of different environmental exposures in young children on the subsequent risk of atopic sensitization and allergic diseases. Previous studies on the relationship, in early life, between pet ownership, sex, exposure to secondhand smoke, exposure to traffic-related air pollution components, and atopic sensitization have yielded different results. Recent studies have highlighted the importance of gene-environment interactions, especially during early childhood, on the risk of subsequent atopic sensitization and allergic diseases. Therefore, pediatricians should consider the genetic and environmental determinants of atopic sensitization in infants and young children when diagnosing and treating patients with allergic diseases. Determining ways in which early exposure to these risk factors in young children may be reduced could be beneficial in preventing the likelihood of developing atopic sensitization.
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Affiliation(s)
- Hyeong Yun Kim
- Department of Pediatrics, Bundang JeSaeng General Hospital, Seongnam, Korea
| | - Youn Ho Shin
- Department of Pediatrics, CHA University School of Medicine, Seongnam, Korea
| | - Man Yong Han
- Department of Pediatrics, CHA University School of Medicine, Seongnam, Korea
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17
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Allergic diseases: the price of civilisational progress. Postepy Dermatol Alergol 2014; 31:77-83. [PMID: 25097472 PMCID: PMC4112251 DOI: 10.5114/pdia.2014.40936] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 09/26/2013] [Accepted: 09/28/2013] [Indexed: 12/22/2022] Open
Abstract
Atopic disorders are a major global health problem. The prevalence of asthma, allergic rhinitis and atopic dermatitis has been increasing over the last four decades, both in the industrialized and developing countries. It seems to be related to changes in the social structure, increasing industrialization, pollution and dietary changes. Many hypotheses link the allergy epidemic to stringent hygiene, dominance of a westernized lifestyle and an accelerated pace of life. Dietary antioxidants, lipids, sodium, vitamin D seem also to be implicated. We endeavour to review the most relevant theories with a special emphasis on the hygiene, antioxidative, lipid and air pollution hypotheses. It is however important to note that none of them explains all the aspects of unprecedented rise in the prevalence of allergic disorders. A complex interplay between host's immune response, invading pathogens, diversity of environmental factors and genetic background seems to be of a particular importance. Current allergy epidemic is multifactorial and basic and epidemiologic studies are warranted to further our understanding of this phenomenon.
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Kim BJ, Seo JH, Jung YH, Kim HY, Kwon JW, Kim HB, Lee SY, Park KS, Yu J, Kim HC, Leem JH, Lee JY, Sakong J, Kim SY, Lee CG, Kang DM, Ha M, Hong YC, Kwon HJ, Hong SJ. Air pollution interacts with past episodes of bronchiolitis in the development of asthma. Allergy 2013; 68:517-523. [PMID: 23347096 DOI: 10.1111/all.12104] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Exposure to ambient air pollution and bronchiolitis are risk factors for asthma. The aim of this study was to investigate the effect of air pollution on the development of asthma in children with past episodes of bronchiolitis. METHODS A prospective 2-year follow-up survey consisting of parental responses to the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire, and allergy evaluations were conducted in 1743 children with a mean age of 6.8 years. Recent 5-year exposure to air pollution was estimated using a geographic information system. RESULTS Higher exposure to ozone was associated with airway hyper-responsiveness (PC20 ≤ 16 mg/ml) at enrollment (odds ratio [OR] = 1.60, 95% CI [confidence interval] = 1.13-2.27) and with new episodes of wheezing during the 2-year period (OR = 1.92, 95% CI = 0.96-3.83). Past episodes of bronchiolitis were associated with both current wheezing and physician-diagnosed asthma. When the two factors were combined, the prevalence of bronchial hyper-reactivity (OR = 2.96, 95% CI = 1.41-6.24) and new wheezing (OR = 4.17, 95% CI = 0.89-19.66) as well as current wheezing and physician-diagnosed asthma was even greater (P for trend <0.05 for all). In children with both risk factors, lung function was significantly decreased, with atopic children being particularly vulnerable. CONCLUSION In children, the interaction between air pollution and past episodes of bronchiolitis resulted in a greater prevalence of asthma and pointed to an association with bronchial hyper-reactivity and decreased lung function. These results suggest mechanisms underlying the development of asthma.
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Affiliation(s)
- B J Kim
- Department of Pediatrics, Inje University Haeundae Paik Hospital, Busan, Korea
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