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Early childhood exposure to ambient air pollution is associated with increased risk of paediatric asthma: An administrative cohort study from Stockholm, Sweden
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.ORCID iD: 0000-0002-8965-4312
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.ORCID iD: 0000-0002-0159-6657
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
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2021 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 155, article id 106667Article in journal (Refereed) Published
Abstract [en]

Introduction: Asthma is a complex, heterogeneous disease and one of the most common chronic diseases among children. Exposure to ambient air pollution in early life and childhood may influence asthma aetiology, but it is uncertain which specific components of air pollution and exposure windows are of importance. The role of socioeconomic status (SES) is also unclear. The aims of the present study are, therefore, to investigate how various exposure windows of different pollutants affect risk-induced asthma in early life and to explore the possible effect SES has on that relationship.

Methods: The study population was constructed using register data on all singleton births in the greater Stockholm area between 2006 and 2013. Exposure to ambient black carbon (BC), fine particulate matter (PM2.5), primary organic carbon (pOC) secondary organic aerosols (SOA), secondary inorganic aerosols, and oxidative potential at the residential address was modelled as mean values for the entire pregnancy period, the first year of life and the first three years of life. Swedish national registers were used to define the outcome: asthma diagnosis assessed at hospital during the first six years of life. Hazard ratios (HRs) and their 95% confidence intervals (CIs) were modelled with Cox proportional hazards model with age as the underlying time-scale, adjusting for relevant potential confounding variables.

Results: An increased risk for developing childhood asthma was observed in association with exposure to PM2.5, pOC and SOA during the first three years of life. With an interquartile range increase in exposure, the HRs were 1.06 (95% CI: 1.01-1.10), 1.05 (95% CI: 1.02-1.09) and 1.02 (95% CI: 1.00-1.04), for PM2.5, pOC and SOA, respectively, in the fully adjusted models. Exposure during foetal life or the first year of life was not associated with asthma risk, and the other pollutants were not statistically significantly associated with increased risk. Furthermore, the increase in risk associated with PM2.5 and the components BC, pOC and SOA were stronger in areas with lower SES.

Conclusion: Our results suggest that exposure to air pollution during the first three years of life may increase the risk for asthma in early childhood. The findings further imply a possible increased vulnerability to air pollutionattributed asthma among low SES children.

Place, publisher, year, edition, pages
Elsevier, 2021. Vol. 155, article id 106667
Keywords [en]
Air pollution, Asthma, Pediatric asthma, Socio-economy, Environmental medicine
National Category
Occupational Health and Environmental Health
Identifiers
URN: urn:nbn:se:umu:diva-187363DOI: 10.1016/j.envint.2021.106667ISI: 000679253400005PubMedID: 34077855Scopus ID: 2-s2.0-85111037041OAI: oai:DiVA.org:umu-187363DiVA, id: diva2:1592989
Funder
NordForsk, 75007Swedish Research Council Formas, 2017-00898Available from: 2021-09-10 Created: 2021-09-10 Last updated: 2021-09-10Bibliographically approved

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Olsson, DavidForsberg, BertilBråbäck, LennartOudin, Anna

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