Early-Life Exposure to Ambient Air Pollution from Multiple Sources and Asthma Incidence in Children: A Nationwide Birth Cohort Study from Denmark

May 10, 2023Environmental health perspectives

Early Childhood Air Pollution from Various Sources Linked to New Cases of Asthma in Danish Children

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Abstract

6.1% of 1,060,154 children developed asthma during an average follow-up of 8.8 years.

Increased prenatal exposure to ambient air pollution is associated with a higher risk of asthma in children.
A hazard ratio of 1.06 indicates a notable increase in asthma risk for each interquartile range increase in prenatal nitrogen dioxide exposure.
For prenatal exposure to organic carbon, the hazard ratio was 1.08, suggesting a strong link to asthma development.
Postnatal exposure appears to maintain associations with asthma risk for most pollutants, although some adjustments may reduce the significance.
The observed associations were consistent even after accounting for socioeconomic status and focused on asthma cases after age 4.

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BACKGROUND: Ambient air pollution exposure has been associated with childhood asthma, but previous studies have primarily focused on prevalence of asthma and asthma-related outcomes and urban traffic-related exposures.

OBJECTIVE: We examined nationwide associations between pre- and postnatal exposure to ambient air pollution components and asthma incidence in children age 0-19 y.

METHODS: Asthma incidence was identified from hospital admission, emergency room, and outpatient contacts among all live-born singletons born in Denmark between 1998 and 2016. We linked registry data with monthly mean concentrations of particulate matter (PM) with aerodynamic diameter() and PM with aerodynamic diameter(), nitrogen dioxide (), nitrogen oxides, elemental carbon, and organic carbon (OC), sulfur dioxide, ozone, sulfate, nitrate, ammonium, secondary organic aerosols, and sea salt. Associations were estimated with Cox proportional hazard models using fixed prenatal exposure means and time-varying postnatal exposures. ≤ 2.5μ m PM2.5 ≤ 10μ m PM10NO2

RESULTS: Of the 1,060,154 children included, 6.1% had asthma during the mean follow-up period of 8.8 y. The risk of asthma increased with increasing prenatal exposure to all pollutants except forand sea salt. We also observed increased risk after restriction to asthma after age 4 y, after additional adjustment for area-specific socioeconomic status, and for postnatal exposure to most pollutants. The hazard ratio (HR) associated with an interquartile range increase of 2.4 andin prenatal exposure was 1.06 [95% confidence interval (CI): 1.04, 1.08] forand 1.04 (95% CI: 1.02, 1.05) for, respectively. This association withwas stable after adjustment for, whereas it attenuated forto 1.01 (95% CI: 0.99, 1.03) after adjustment for. For aincrease in prenatal OC exposure, for which biomass is an important source, the HR was 1.08 (95% CI: 1.06, 1.10), irrespective of adjustment for. O3 8.7 μ g m / 3PM2.5NO2PM2.5NO2NO2PM2.5 0.5 -/ μ g m3PM2.5

DISCUSSION: These findings suggest that early-life exposure to ambient air pollution from multiple sources contributes to asthma development. https://doi.org/10.1289/EHP11539.

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Early-Life Exposure to Ambient Air Pollution from Multiple Sources and Asthma Incidence in Children: A Nationwide Birth Cohort Study from Denmark

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