Lung Function Growth in Children with Long-Term Exposure to Air Pollutants in Mexico City

Instituto Nacional de Salud Publica, 655 Avenida Universidad, Col. Santa Maria Ahuacatitlán, Cuernavaca, Morelos 62508, México.
American Journal of Respiratory and Critical Care Medicine (Impact Factor: 13). 09/2007; 176(4):377-84. DOI: 10.1164/rccm.200510-1678OC
Source: PubMed


Although short-term exposure to air pollution has been associated with acute, reversible lung function decrements, the impact of long-term exposure has not been well established.
To evaluate the association between long-term exposure to ozone (O(3)), particulate matter less than 10 mum in diameter (PM(10)), and nitrogen dioxide (NO(2)) and lung function growth in Mexico City schoolchildren.
A dynamic cohort of 3,170 children aged 8 years at baseline was followed from April 23, 1996, through May 19, 1999. The children attended 39 randomly selected elementary schools located near 10 air quality monitoring stations and were visited every 6 months. Statistical analyses were performed using general linear mixed models.
After adjusting for acute exposure and other potential confounding factors, deficits in FVC and FEV(1) growth over the 3-year follow-up period were significantly associated with exposure to O(3), PM(10), and NO(2). In multipollutant models, an interquartile range (IQR) increase in mean O(3) concentration (IQR, 11.3 ppb) was associated with an annual deficit in FEV(1) of 12 ml in girls and 4 ml in boys, an IQR range (IQR, 36.4 microg/m(3)) increase in PM(10) with an annual deficit in FEV(1) of 11 ml in girls and 15 ml in boys, and an IQR range (IQR, 12.0 ppb) increase in NO(2) with an annual deficit in FEV(1) of 30 ml in girls and 25 ml in boys.
We conclude that long-term exposure to O(3), PM(10), and NO(2) is associated with a deficit in FVC and FEV(1) growth among schoolchildren living in Mexico City.

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Available from: Teresa Fortoul, Oct 05, 2015
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    • "There is a strong evidence that especially increased air pollution with particulate matter (PM 10 and PM 2.5 ), and ozone (O 3 ), precipitates respiratory symptoms [1] [2] [3] [4] [5], and consequently emergency room visits and hospital admissions due to these symptoms [6] [7] [8] [9] [10]. Among the most susceptible population subgroups are children [3] [7] [11] [12] [13] [14] [15] [16] [17]. "
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    ABSTRACT: Aiming at assessing the feasibility of linkage of existing health and environmental data in Slovenia in the case of the Koper Municipality in identifying the grounded need for public health action, the objective of the study was to assess the association between consultations on the primary health care level due to asthma and daily ozone concentrations. An ecological time-trend study with a single day as a unit of observation was performed in 2012. Periods from April 1 through October 31 were observed in 2010 and 2011. The study population was children, aged 0-12 years, who visited the Community Health Centre Koper for asthma. Logistic regression was used in analysis. The results showed statistically significant association between daily occurrence of at least one consultation for asthma and ozone daily maximum 8-hr average concentration 70 μg/m 3 or exceeded, lag 4 days (OR=4.77; p=0.042). There is an evidence of association between increased ozone levels and daily occurrence of any consultation for asthma in Koper Municipality. The study opened many challenges for future research. If they are resolved, evidence-based approach to public health activities in the field of environmental health in the region and in Slovenia would be strongly improved on this basis thereof.
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    • "Epidemiological studies have consistently linked short-term peaks of PM with respiratory outcomes including morbidity and mortality of individuals with COPD. (Kelly and Fussell 2011) Greater long-term exposures to air pollution have also been associated with slowed lung growth in children (Avol et al. 2001; Gauderman et al. 2004; Rojas-Martinez et al. 2007) and more rapid decline in lung function in adults (Detels et al. 1991; Downs et al. 2007; Tashkin et al. 1994). Studies have similarly shown that greater longterm levels of PM and traffic-related air pollution are associated with higher incident and prevalent COPD (Andersen et al. 2011; Chen et al. 2005; Karakatsani et al. 2003; Lindgren et al. 2009; Schikowski et al. 2005; Sunyer 2001). "
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    ABSTRACT: Background: Air pollution is linked to low lung function and to respiratory events, yet little is known of associations with lung structure. Objectives: We examined associations of particulate matter (PM2.5, PM10) and nitrogen oxides (NOx) with percent emphysema-like lung on computed tomography (CT). Methods: The Multi-Ethnic Study of Atherosclerosis (MESA) recruited participants (45–84 years of age) in six U.S. states. Percent emphysema was defined as lung regions < –910 Hounsfield Units on cardiac CT scans acquired following a highly standardized protocol. Spirometry was also conducted on a subset. Individual-level 1- and 20-year average air pollution exposures were estimated using spatiotemporal models that included cohort-specific measurements. Multivariable regression was conducted to adjust for traditional risk factors and study location. Results: Among 6,515 participants, we found evidence of an association between percent emphysema and long-term pollution concentrations in an analysis leveraging between-city exposure contrasts. Higher concentrations of PM2.5 (5 μg/m3) and NOx (25 ppb) over the previous year were associated with 0.6 (95% CI: 0.1, 1.2%) and 0.5 (95% CI: 0.1, 0.9%) higher average percent emphysema, respectively. However, after adjustment for study site the associations were –0.6% (95% CI: –1.5, 0.3%) for PM2.5 and –0.5% (95% CI: –1.1, 0.02%) for NOx. Lower lung function measures (FEV1 and FVC) were associated with higher PM2.5 and NOx levels in 3,791 participants before and after adjustment for study site, though most associations were not statistically significant. Conclusions: Associations between ambient air pollution and percentage of emphysema-like lung were inconclusive in this cross-sectional study, thus longitudinal analyses may better clarify these associations with percent emphysema. Citation: Adar SD, Kaufman JD, Diez-Roux AV, Hoffman EA, D’Souza J, Stukovsky KH, Rich SS, Rotter JI, Guo X, Raffel LJ, Sampson PD, Oron AP, Raghunathan T, Barr RG. 2015. Air pollution and percent emphysema identified by computed tomography in the Multi-Ethnic Study of Atherosclerosis. Environ Health Perspect 123:144–151;
    Environmental Health Perspectives 10/2014; 123(2). DOI:10.1289/ehp.1307951 · 7.98 Impact Factor
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    • "However, results of these studies have been disparate and conclusions inconsistent . Whereas some studies reported associations with lung volume only (Raizenne et al. 1996; Rojas-Martinez et al. 2007; Sugiri et al. 2006), others reported associations with expiratory flow only (Avol et al. 2001; Oftedal et al. 2008). Some studies reported associations with both lung volume and flow (Gauderman et al. 2000; Horak et al. 2002; Schwartz 1989), whereas others reported no associations at all (Dockery et al. 1989; Hirsch et al. 1999; Neas et al. 1991; Nicolai et al. 2003). "
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    ABSTRACT: Background: Findings from previous studies on the effects of air pollution exposure on lung function during childhood have been inconsistent. A common limitation has been the quality of exposure data used, and few studies have modeled exposure longitudinally throughout early life. Objectives: We sought to study the long-term effects of exposure to particulate matter with an aerodynamic diameter ≤ 10 μm (PM10) and to nitrogen dioxide (NO2) on specific airway resistance (sRaw) and forced expiratory volume in 1 sec (FEV1) before and after bronchodilator treatment. Subjects were from the Manchester Asthma and Allergy Study (MAAS) birth cohort (n = 1,185). Methods: Spirometry was performed during clinic visits at ages 3, 5, 8, and 11 years. Individual-level PM10 and NO2 exposures were estimated from birth to 11 years of age through a microenvironmental exposure model. Longitudinal and cross-sectional associations were estimated using generalized estimating equations and multivariable linear regression models. Results: Lifetime exposure to PM10 and NO2 was associated with significantly less growth in FEV1 (percent predicted) over time, both before (-1.37%; 95% CI: -2.52, -0.23 for a 1-unit increase in PM10 and -0.83%; 95% CI: -1.39, -0.28 for a 1-unit increase in NO2) and after bronchodilator treatment (-3.59%; 95% CI: -5.36, -1.83 and -1.20%; 95% CI: -1.97, -0.43, respectively). We found no association between lifetime exposure and sRaw over time. Cross-sectional analyses of detailed exposure estimates for the summer and winter before 11 years of age and lung function at 11 years indicated no significant associations. Conclusions: Long-term PM10 and NO102 exposures were associated with small but statistically significant reductions in lung volume growth in children of elementary-school age.
    Environmental Health Perspectives 06/2013; 121(10). DOI:10.1289/ehp.1205961 · 7.98 Impact Factor
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