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Pañella P, Casas M, Donaire-Gonzalez D, Garcia-Esteban R, Robinson O, Valentín A, Gulliver J, Momas I, Nieuwenhuijsen M, Vrijheid M, Sunyer J. Ultrafine particles and black carbon personal exposures in asthmatic and non-asthmatic children at school age. Indoor Air 2017; 27:891-899. [PMID: 28321937 DOI: 10.1111/ina.12382] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 03/13/2017] [Indexed: 06/06/2023]
Abstract
Traffic-related air pollution (TRAP) exposure during childhood is associated with asthma; however, the contribution of the different TRAP pollutants in each microenvironment (home, school, transportation, others) in asthmatic and non-asthmatic children is unknown. Daily (24-h) personal black carbon (BC), ultrafine particle (UFP), and alveolar lung-deposited surface area (LDSA) individual exposure measurements were obtained from 100 children (29 past and 21 current asthmatics, 50 non-asthmatics) aged 9±0.7 years from the INMA-Sabadell cohort (Catalonia, Spain). Time spent in each microenvironment was derived by the geolocation provided by the smartphone and a new spatiotemporal map-matching algorithm. Asthmatics and non-asthmatics spent the same amount of time at home (60% and 61%, respectively), at school (20% and 23%), on transportation (8% and 7%), and in other microenvironments (7% and 5%). The highest concentrations of all TRAPs were attributed to transportation. No differences in TRAP concentrations were found overall or by type of microenvironment between asthmatics and non-asthmatics, nor when considering past and current asthmatics, separately. In conclusion, asthmatic and non-asthmatic children had a similar time-activity pattern and similar average exposures to BC, UFP, and LDSA concentrations. This suggests that interventions should be tailored to general population, rather than to subgroups defined by disease.
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Affiliation(s)
- P Pañella
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - M Casas
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - D Donaire-Gonzalez
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Physical Activity and Sports Sciences Department, Fundació Blanquerna, Barcelona, Spain
| | - R Garcia-Esteban
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - O Robinson
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, Kensington, London, UK
| | - A Valentín
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - J Gulliver
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, Kensington, London, UK
| | - I Momas
- Faculté de Pharmacie de Paris, Laboratoire Santé Publique et Environnement, Université Paris Descartes, Paris, France
- Direction de l'Action Sociale de l'Enfance et de la Santé, Cellule Cohorte, Mairie de Paris, Paris, France
| | - M Nieuwenhuijsen
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - M Vrijheid
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - J Sunyer
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Casas L, Sunyer J, Tischer C, Gehring U, Wickman M, Garcia-Esteban R, Lehmann I, Kull I, Reich A, Lau S, Wijga A, Antó JM, Nawrot TS, Heinrich J, Keil T, Torrent M. Reply: To PMID 25858551. Allergy 2015; 70:1190-1191. [PMID: 26535423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- L Casas
- Centre for Environment and Health - Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
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Asselbergs IC, Eikenboom HC, Wartna JB, Koes BW, Casas L, Sunyer J, Tischer C, Gehring U, Wickman M, Garcia-Esteban R, Lehmann I, Kull I, Reich A, Lau S, Wijga A, Antó JM, Nawrot TS, Heinrich J, Keil T, Torrent M. Early-life house dust mite allergens, childhood mite sensitization, and respiratory outcomes. Allergy 2015; 70:1190-91. [DOI: 10.1111/all.12665] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- I. C. Asselbergs
- Department of General Practice; Erasmus MC; University Medical Center Rotterdam; Rotterdam Netherlands
| | - H. C. Eikenboom
- Department of General Practice; Erasmus MC; University Medical Center Rotterdam; Rotterdam Netherlands
| | - J. B. Wartna
- Department of General Practice; Erasmus MC; University Medical Center Rotterdam; Rotterdam Netherlands
| | - B. W. Koes
- Department of General Practice; Erasmus MC; University Medical Center Rotterdam; Rotterdam Netherlands
| | - L. Casas
- Centre for Environment and Health - Department of Public Health and Primary Care; KU Leuven; Leuven Belgium
- Centre for Research in Environmental Epidemiology (CREAL); Barcelona Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP); Barcelona Spain
| | - J. Sunyer
- Centre for Research in Environmental Epidemiology (CREAL); Barcelona Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP); Barcelona Spain
- Hospital del Mar Medical Research Institute (IMIM); Barcelona Spain
- Universitat Pompeu Fabra (UPF); Barcelona Spain
| | - C. Tischer
- Helmholtz Zentrum München; German Research Centre for Environmental Health; Institute of Epidemiology I; Neuherberg Germany
| | - U. Gehring
- Division of Environmental Epidemiology; Institute for Risk Assessment Sciences; Utrecht University; Utrecht the Netherlands
| | - M. Wickman
- Department of Clinical Science and Education; Södersjukhuset; Karolinska Institutet; Stockholm Sweden
- Sach's Children's Hospital; Stockholm Sweden
| | - R. Garcia-Esteban
- Centre for Research in Environmental Epidemiology (CREAL); Barcelona Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP); Barcelona Spain
- Hospital del Mar Medical Research Institute (IMIM); Barcelona Spain
| | - I. Lehmann
- Institute for environmental medicine; Karolinska Institutet; Stockholm Sweden
- Department of Environmental Immunology; FZ-Helmholtz Centre for Environmental Research Leipzig; Leipzig Germany
| | - I. Kull
- Department of Clinical Science and Education; Södersjukhuset; Karolinska Institutet; Stockholm Sweden
- Sach's Children's Hospital; Stockholm Sweden
| | - A. Reich
- Institute of Social Medicine, Epidemiology and Health Economics; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - S. Lau
- Klinik für Pädiatrie m. S. Pneumologie und Immunologie; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - A. Wijga
- Centre for Nutrition, Prevention and Health Services; National Institute for Public Health and the Environment (RIVM); Bilthoven the Netherlands
| | - J. M. Antó
- Centre for Research in Environmental Epidemiology (CREAL); Barcelona Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP); Barcelona Spain
- Hospital del Mar Medical Research Institute (IMIM); Barcelona Spain
- Universitat Pompeu Fabra (UPF); Barcelona Spain
| | - T. S. Nawrot
- Centre for Environment and Health - Department of Public Health and Primary Care; KU Leuven; Leuven Belgium
- Centre for Environmental Sciences; Hasselt University; Hasselt Belgium
| | - J. Heinrich
- Helmholtz Zentrum München; German Research Centre for Environmental Health; Institute of Epidemiology I; Neuherberg Germany
- Comprehensive Pneumology Center Munich (CPC-M); German Center for Lung Research (DZL); Munich Germany
| | - T. Keil
- Institute of Social Medicine, Epidemiology and Health Economics; Charité - Universitätsmedizin Berlin; Berlin Germany
- Institute of Clinical Epidemiology and Biometry; University of Wuerzburg; Wuerzburg Germany
| | - M. Torrent
- Area de Salud de Menorca; IB-SALUT; Menorca Spain
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Casas L, Sunyer J, Tischer C, Gehring U, Wickman M, Garcia-Esteban R, Lehmann I, Kull I, Reich A, Lau S, Wijga A, Antó JM, Nawrot TS, Heinrich J, Keil T, Torrent M. Early-life house dust mite allergens, childhood mite sensitization, and respiratory outcomes. Allergy 2015; 70:820-7. [PMID: 25858551 DOI: 10.1111/all.12626] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Exposure to indoor allergens during early life may play a role in the development of the immune system and inception of asthma. OBJECTIVE To describe the house dust mite (HDM) allergen concentrations in bedroom dust during early life and to evaluate its associations with HDM sensitization, wheezing, and asthma, from birth to school age, in 5 geographically spread European birth cohorts. METHODS We included 4334 children from INMA-Menorca (Spain), BAMSE (Sweden), LISAplus and MAS (Germany), and PIAMA-NHS (the Netherlands). Dust samples were collected from bedrooms during early life and analyzed for Dermatophagoides pteronyssinus (Der p1) and Dermatophagoides farinae (Der f1). HDM concentrations were divided into four categories. Sensitization was determined by specific IgE. Wheezing and asthma information up to 8/10 years was collected through questionnaires. We performed mixed-effects logistic regression models and expressed associations as odds ratios with 95% confidence intervals. RESULTS House dust mite concentrations varied across cohorts. Mean allergen concentrations were highest in INMA-Menorca (geometric mean (GM) Der p1 = 3.3 μg/g) and LISAplus (GM Der f1 = 2.1 μg/g) and lowest in BAMSE (GM Der p1 = 0.1 μg/g, Der f1 = 0.3 μg/g). Moderate and high HDM concentrations were significantly (P-values < 0.05) associated with 50-90% higher prevalence of HDM sensitization. No significant associations were observed with respiratory outcomes. CONCLUSION Our study based on geographically spread regions, a large sample size, and a wide range of allergen concentration shows that HDM allergen concentrations vary across regions and that exposure during early life plays a role in the development of allergic sensitization but not in the development of respiratory outcomes.
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Affiliation(s)
- L. Casas
- Department of Public Health and Primary Care; Centre for Environment and Health; KU Leuven; Leuven Belgium
- Centre for Research in Environmental Epidemiology (CREAL); Barcelona Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP); Barcelona Spain
| | - J. Sunyer
- Centre for Research in Environmental Epidemiology (CREAL); Barcelona Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP); Barcelona Spain
- Hospital del Mar Medical Research Institute (IMIM); Barcelona Spain
- Universitat Pompeu Fabra (UPF); Barcelona Spain
| | - C. Tischer
- Helmholtz Zentrum München; German Research Centre for Environmental Health; Institute of Epidemiology I; Neuherberg Germany
| | - U. Gehring
- Division of Environmental Epidemiology; Institute for Risk Assessment Sciences; Utrecht University; Utrecht The Netherlands
| | - M. Wickman
- Department of Clinical Science and Education; Södersjukhuset; Karolinska Institutet; Stockholm Sweden
- Sach's Children's Hospital; Stockholm Sweden
- Institute for Environmental Medicine; Karolinska Institutet; Stockholm Sweden
| | - R. Garcia-Esteban
- Centre for Research in Environmental Epidemiology (CREAL); Barcelona Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP); Barcelona Spain
- Hospital del Mar Medical Research Institute (IMIM); Barcelona Spain
| | - I. Lehmann
- Department of Environmental Immunology; FZ-Helmholtz Centre for Environmental Research Leipzig; Leipzig Germany
| | - I. Kull
- Department of Clinical Science and Education; Södersjukhuset; Karolinska Institutet; Stockholm Sweden
- Sach's Children's Hospital; Stockholm Sweden
- Institute for Environmental Medicine; Karolinska Institutet; Stockholm Sweden
| | - A. Reich
- Institute of Social Medicine, Epidemiology and Health Economics; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - S. Lau
- Klinik für Pädiatrie m. S. Pneumologie und Immunologie; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - A. Wijga
- Centre for Nutrition, Prevention and Health Services; National Institute for Public Health and the Environment (RIVM); Bilthoven The Netherlands
| | - J. M. Antó
- Centre for Research in Environmental Epidemiology (CREAL); Barcelona Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP); Barcelona Spain
- Hospital del Mar Medical Research Institute (IMIM); Barcelona Spain
- Universitat Pompeu Fabra (UPF); Barcelona Spain
| | - T. S. Nawrot
- Department of Public Health and Primary Care; Centre for Environment and Health; KU Leuven; Leuven Belgium
- Centre for Environmental Sciences; Hasselt University; Hasselt Belgium
| | - J. Heinrich
- Helmholtz Zentrum München; German Research Centre for Environmental Health; Institute of Epidemiology I; Neuherberg Germany
- Comprehensive Pneumology Center Munich (CPC-M); German Center for Lung Research (DZL); Munich Germany
| | - T. Keil
- Institute of Social Medicine, Epidemiology and Health Economics; Charité - Universitätsmedizin Berlin; Berlin Germany
- Institute of Clinical Epidemiology and Biometry; University of Wuerzburg; Wuerzburg Germany
| | - M. Torrent
- Area de Salud de Menorca; IB-SALUT; Menorca Spain
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Casas L, Tischer C, Wouters IM, Valkonen M, Gehring U, Doekes G, Torrent M, Pekkanen J, Garcia-Esteban R, Hyvärinen A, Heinrich J, Sunyer J. Endotoxin, extracellular polysaccharides, and β(1-3)-glucan concentrations in dust and their determinants in four European birth cohorts: results from the HITEA project. Indoor Air 2013; 23:208-18. [PMID: 23176390 DOI: 10.1111/ina.12017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Accepted: 11/12/2012] [Indexed: 05/15/2023]
Abstract
UNLABELLED Early-life exposure to microbial agents may play a protective role in asthma and allergies development. Geographical differences in the prevalence of these diseases exist, but the differences in early-life indoor microbial agent levels and their determinants have been hardly studied. We aimed to describe the early-life levels of endotoxin, extracellular polysaccharides (EPS), and β(1-3)-glucans in living room dust of four geographically spread European birth cohorts (LISA in Germany, PIAMA in the Netherlands, INMA in Spain, and LUKAS2 in Finland) and to assess their determinants. A total of 1572 dust samples from living rooms of participants were analyzed for endotoxin, Penicillium/Aspergillus EPS, and β(1-3)-glucans. Information on potential determinants was obtained through questionnaires. Concentrations of endotoxin, EPS, and β(1-3)-glucans were different across cohorts. Concentrations of endotoxin and EPS were respectively lower and higher in INMA than in other cohorts, while glucans were higher in LUKAS2. Season of sampling, dog ownership, dampness, and the number of people living at home were significantly associated with concentrations of at least one microbial agent, with heterogeneity of effect estimates of the determinants across cohorts. In conclusion, both early-life microbial exposure levels and exposure determinants differ across cohorts derived from diverse European countries. PRACTICAL IMPLICATIONS This study adds evidence of variability in the levels of indoor endotoxin, extracellular polysaccharide, and β(1-3)-glucans across four geographically spread European regions. Furthermore, we observed heterogeneity across regions in the effect of exposure determinants. We hypothesize that the variations observed in our study may play a role in the differences in asthma and allergies prevalences across countries.
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Affiliation(s)
- L Casas
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
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Antó JM, Sunyer J, Basagaña X, Garcia-Esteban R, Cerveri I, de Marco R, Heinrich J, Janson C, Jarvis D, Kogevinas M, Kuenzli N, Leynaert B, Svanes C, Wjst M, Gislason T, Burney P. Risk factors of new-onset asthma in adults: a population-based international cohort study. Allergy 2010; 65:1021-30. [PMID: 20132157 DOI: 10.1111/j.1398-9995.2009.02301.x] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The occurrence of new-onset asthma during adulthood is common, but there is insufficient understanding of its determinants including the role of atopy. OBJECTIVE To assess the risk factors for the development of new-onset asthma in middle-aged adults and to compare them according to atopy. METHODS A longitudinal analysis of 9175 young adults who participated in two surveys of the European Community Respiratory Health Survey (ECRHS) conducted 9 years apart. FINDINGS We observed 179 cases of new-onset asthma among 4588 participants who were free of asthma and reported at the beginning of the follow-up that they had never had asthma (4.5 per 1000 person-years). In a logistic regression, the following risk factors were found to increase the risk of new-onset asthma: female gender (OR: 1.97; 95% confidence interval (CI): 1.38, 2.81), bronchial hyperresponsiveness (3.25; 2.19, 4.83), atopy (1.55; 1.08, 2.21), FEV(1) < 100 % predicted (1.87; 1.34, 2.62), nasal allergy (1.98;1.39,2.84) and maternal asthma (1.91; 1.13; 3.21). Obesity, respiratory infections in early life and high-risk occupations increased the risk of new-onset asthma although we had limited power to confirm their role. Among the atopics, total IgE and sensitization to cat were independently related to the risk of new-onset asthma. The proportion of new-onset asthma attributable to atopy varied from 12% to 21%. CONCLUSION Adults reporting that they had never had asthma were at a substantial risk of new-onset asthma as a result of multiple independent risk factors including lung function. Atopy explains a small proportion of new-onset adult asthma.
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Affiliation(s)
- J M Antó
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona.
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Künzli N, Bridevaux PO, Liu LJS, Garcia-Esteban R, Schindler C, Gerbase MW, Sunyer J, Keidel D, Rochat T. Traffic-related air pollution correlates with adult-onset asthma among never-smokers. Thorax 2009; 64:664-70. [PMID: 19359271 DOI: 10.1136/thx.2008.110031] [Citation(s) in RCA: 105] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Traffic-related pollution is associated with the onset of asthma in children. Its effect on adult-onset asthma is poorly investigated. The SAPALDIA cohort study was used to investigate associations between the 11-year change (1991-2002) in home outdoor traffic-related particulate matter up to 10 microm in diameter (TPM(10)) and the incidence of asthma. METHODS Never-smokers without asthma at baseline aged 18-60 years in 1991 were eligible for inclusion in the study. Subjects reporting doctor-diagnosed asthma at follow-up were considered incident cases. TPM(10) at baseline and follow-up was predicted and interpolated to subjects' place of residence by dispersion models using emission and meteorological data. Cox proportional hazard models for time to asthma onset were adjusted (age, gender, baseline atopy, body mass index, bronchial reactivity, maternal allergies). RESULTS Of 2725 never-smokers, 41 reported asthma onset in 2002. Home outdoor TPM(10) concentrations improved during the interval (mean -0.6; range -9 to +7.2; IQR 0.6 microg/m(3)). The incidence of asthma was associated with a change in TPM(10). The hazard ratio (1.30; 95% CI 1.05 to 1.61) per 1 microg/m(3) change in TPM(10) (IQR) was not sensitive to further adjustments (education, workplace exposure, passive smoking, parental asthma or allergies, random area effects, lung function or co-pollutants such as regional, secondary, total PM(10) or proximity to busy roads). CONCLUSION The data suggest a role for traffic-related pollution in adult-onset asthma. Space, time and source-specific individual assignment of exposure to traffic-related pollution is a key strength of SAPALDIA. It may explain why findings were statistically significant despite the limited number of new cases. As traffic-related pollution prevails, the finding may be of substantial public health relevance.
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Affiliation(s)
- N Künzli
- Center for Research in Environmental Epidemiology, C Doctor Aiguader 88, Barcelona, Spain.
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Chatzi L, Torrent M, Romieu I, Garcia-Esteban R, Ferrer C, Vioque J, Kogevinas M, Sunyer J. Mediterranean diet in pregnancy is protective for wheeze and atopy in childhood. Thorax 2008; 63:507-13. [PMID: 18198206 DOI: 10.1136/thx.2007.081745] [Citation(s) in RCA: 178] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Dietary intake of specific nutrients or food groups during pregnancy could play a role in the risk of asthma and atopy in offspring, but specific dietary patterns have not been implicated. The authors evaluated the impact of maternal (during pregnancy) and child adherence to a Mediterranean diet on asthma and atopy in childhood. METHODS Women presenting for antenatal care at all general practices in Menorca, a Mediterranean island in Spain, over a 12 month period starting in mid-1997 were recruited. 460 children were included in the analysis after 6.5 years of follow-up. Maternal dietary intake during pregnancy and children's dietary intake at age 6.5 years were assessed by food frequency questionnaires, and adherence to a Mediterranean diet was evaluated by a priori defined scores. During follow-up, parents completed questionnaires on the child's respiratory and allergic symptoms. Children underwent skin prick tests with six common aeroallergens. RESULTS The prevalence rates of persistent wheeze, atopic wheeze and atopy at age 6.5 years were 13.2%, 5.8% and 17.0%, respectively. One-third (36.1%) of mothers had a low quality Mediterranean diet during pregnancy according to the Mediterranean Diet Score, while the rest had a high score. A high Mediterranean Diet Score during pregnancy (at two levels, using "low" score as the reference) was found to be protective for persistent wheeze (OR 0.22; 95% CI 0.08 to 0.58), atopic wheeze (OR 0.30; 95% CI 0.10 to 0.90) and atopy (OR 0.55; 95% CI 0.31 to 0.97) at age 6.5 years after adjusting for potential confounders. Childhood adherence to a Mediterranean diet was negatively associated with persistent wheeze and atopy although the associations did not reach statistical significance. CONCLUSION These results support a protective effect of a high level of adherence to a Mediterranean diet during pregnancy against asthma-like symptoms and atopy in childhood.
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Affiliation(s)
- L Chatzi
- Department of Social Medicine, Faculty of Medicine, University of Crete, PO Box 2208, Heraklion, 71003, Crete, Greece.
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Sunyer J, Torrent M, Garcia-Esteban R, Ribas-Fitó N, Carrizo D, Romieu I, Antó JM, Grimalt JO. Early exposure to dichlorodiphenyldichloroethylene, breastfeeding and asthma at age six. Clin Exp Allergy 2007; 36:1236-41. [PMID: 17014430 DOI: 10.1111/j.1365-2222.2006.02560.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Our aims were to assess association of dichlorodiphenyldichloroethylene (DDE) with childhood asthma measured up to age 6 and the effect of DDE on the protective effect of breastfeeding on asthma. In addition, we attempted to assess the relevant time-window of DDE exposure (i.e. at birth or at 4 years). All women presenting for antenatal care in Menorca, Spain over a 12-month period beginning in mid-1997 were invited to take part in a longitudinal study that included a yearly visit. Four hundred eighty-two children were enrolled and 462 provided complete outcome data after 6.5 years of follow-up. Organochlorine compounds were measured in cord serum of 402 (83%) infants and in blood samples of 285 children aged 4. We defined asthma as the presence of wheezing at age 6 and during any preceding year or doctor-diagnosed asthma, and used skin prick test at age 6 to determine atopic status. Results At birth and 4 years of age, all children had detectable levels of DDE (median 1 ng/mL and 0.8 ng/mL, respectively). From birth to age 4, the mean DDE level among children with artificial feeding decreased by 72%, while among breastfed children it increased by 53%. Diagnosed asthma and persistent wheezing were associated with DDE at birth [odds ratio (OR) for an increase in 1 ng/mL, OR=1.18, 95% confidence interval (95% CI)=1.01-1.39 and OR=1.13, 95% CI=0.98-1.30, respectively], but not with DDE at 4 years. Neither breastfeeding nor atopy modified these associations (P>0.3). Breastfeeding protected against diagnosed asthma (OR=0.33, 95% CI=0.08-0.87) and wheezing (OR=0.53, 95% CI=0.34-0.82) in children with low and high DDE levels at birth. Conclusion In a community without known dichlorodiphenyltrichloroethane environmental releases, this study strengthens the evidence for an effect of DDE on asthma by measuring the disease at age 6 and does not support the hypothesis that DDE modifies the protective effect of breastfeeding on asthma.
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Affiliation(s)
- J Sunyer
- Centre de Recerca en Epidemiologia Ambiental, Institut Municipal Investigació Mèdica, Catalonia, Spain.
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Abstract
BACKGROUND There is growing evidence that n-3 fatty acids have anti-inflammatory properties and may modulate immune response. Dietary intake of these nutrients during pregnancy could play a role in the risk of asthma and atopy in the offspring. METHODS Using data from a cohort of women (n=462) enrolled during pregnancy and whose offspring were followed up to 6 years, we evaluated the impact of fish consumption during pregnancy on the incidence of atopy and asthma. Dietary intake was assessed by food frequency questionnaire (42 items) applied by an interviewer. RESULTS Thirty-four percent of infants had a medical diagnosis of eczema at age 1 year, 14.3% of the children were atopic [based on skin prick test (SPT) at 6 years], and 5.7% had atopic wheeze at age 6 years. After adjusting for potential confounding factors, fish intake during pregnancy was protective against the risk of eczema at age 1 year, a positive SPT for house dust mite at age 6 years and atopic wheeze at age 6 years [odds ratio (OR)=0.73 95% confidence interval (CI) 0.55-0.98, OR=0.68, 95% CI 0.46-1.01 and OR=0.55, 95% CI 0.31-0.96, respectively]. For an increase in fish intake from once per week to 2.5 times per week, the risk of eczema at age 1 year decreased by 37%, and the risk of positive SPT at age 6 years by 35%. Stratification by breastfeeding showed that fish intake was significantly related to a decrease risk in persistent wheeze among non-breastfed children (P for interaction<0.05). No protective effect was observed among breastfed children. CONCLUSION Our data suggest a protective effect of fish intake during pregnancy on the risk of atopy-related outcomes.
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Affiliation(s)
- I Romieu
- National Institute of Public Health, Cuernavaca, Mexico.
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11
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Abstract
BACKGROUND Definition of asthma as a continuous score is a promising tool for population studies that has not yet been fully evaluated. OBJECTIVE We assessed (i) the predictive ability of an asthma score against the occurrence of different asthma-related outcomes and (ii) the risk factors identified when using an asthma score. METHODS The European Community Respiratory Health Study II included subjects from the general population randomly studied during 1991-1993 who were followed up in the years 1998-2001, from 29 centres in 14 countries. A total of 8956 subjects were included. The asthma score consisted of a simple sum of the positive answers to five respiratory symptoms. RESULTS Asthma score at baseline showed a linear relationship with incidence of asthma, the occurrence of asthma attacks, use of asthma medication and bronchial reactivity at the end of the follow-up. Asthma score at the end of follow-up was associated with known risk factors at baseline such as IgE to grass, rhinitis or body mass index, in addition to passive smoking in men [average score ratio (RR) = 1.30; 95% confidence interval (CI) 1.09-1.50] or changes in body mass index (RR = 1.27; 95% CI 1.05-1.27, per each kg/m(2)). CONCLUSION The asthma score had good predictive ability against outcomes related with asthma and also good ability to detect risk factors. This encourages the use of the score as a measure of asthma in epidemiological studies on aetiology of asthma.
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Affiliation(s)
- J Sunyer
- Medical Research Institute (IMIM), Universitat Pompeu Fabra (UPF), Barcelona, Spain
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12
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Sunyer J, Jarvis D, Gotschi T, Garcia-Esteban R, Jacquemin B, Aguilera I, Ackerman U, de Marco R, Forsberg B, Gislason T, Heinrich J, Norbäck D, Villani S, Künzli N. Chronic bronchitis and urban air pollution in an international study. Occup Environ Med 2006; 63:836-43. [PMID: 16847030 PMCID: PMC2078017 DOI: 10.1136/oem.2006.027995] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES The chronic effects of urban air pollution are not well known. The authors' aim was to investigate the association between the prevalence and new onset of chronic bronchitis and urban air pollution. METHODS Subjects from the general population randomly selected for the European Community Respiratory Health Survey (ECRHS I) during 1991-93 in 21 centres in 10 countries were followed up from the years 2000 to 2002 (n = 3232 males and 3592 females; average response rate = 65.3%). PM2.5 and elements, with the same equipment at centre level, and home outdoor NO2 in 1634 individuals were measured. Hierarchical models were used. RESULTS The prevalence and new onset of chronic phlegm during follow up were 6.9% and 4.5%, respectively, 5.3% in males and 3.5% in females. Smoking, rhinitis, poor education, and low social class were associated with (prevalence and new onset of) chronic phlegm in both genders, and occupational exposures in males and traffic intensity (adjusted odds ratio for constant traffic, OR = 1.86; 95% CI 1.24 to 2.77) as well as home outdoor NO2 (OR > 50 microg/m3v < 20 microg3 = 2.71; 95% CI 1.03 to 7.16) among females. PM2.5 and S content at centre level did not show any association with prevalence or new onset of chronic phlegm. Similar results were obtained with chronic productive cough. CONCLUSION Individual markers of traffic at household level such as reported intensity and outdoor NO2 were risk factors for chronic bronchitis among females.
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Affiliation(s)
- J Sunyer
- Centre de Recerca en Epidemiologia Ambiental, Institut Municipal Investigació Mèdica, Barcelona, Spain.
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