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J Allergy Clin Immunol. 2019 Jun;143(6):2254-2262.e5. doi: 10.1016/j.jaci.2019.03.024. Epub 2019 Apr 5.

Fine particulate matter exposure during pregnancy and infancy and incident asthma.

Author information

1
Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan; Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, Tsukuba, Japan.
2
Department of Atmospheric Sciences, National Taiwan University, Taipei, Taiwan.
3
Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan.
4
Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan; Department of Occupational Therapy, College of Medical and Health Science, Asia University, Taichung, Taiwan. Electronic address: bfhwang@mail.cmu.edu.tw.

Abstract

BACKGROUND:

Lung development is a multistage process from conception to the postnatal period, disruption of which by air pollutants can trigger later respiratory morbidity.

OBJECTIVE:

We sought to evaluate the effects of weekly average fine particulate matter (particulate matter with an aerodynamic diameter less than 2.5 μm [PM2.5]) exposure during pregnancy and infancy on asthma and identify vulnerable times to help elucidate possible mechanisms of the effects of PM2.5 on asthma symptoms.

METHODS:

A birth cohort study including 184,604 children born during 2004-2011 in Taichung City was retrieved from the Taiwan Maternal and Child Health Database and followed until 2014. A daily satellite-based hybrid model was applied to estimate PM2.5 exposure for each subject. A Cox proportional hazard model combined with a distributed lag nonlinear model was used to evaluate the associations of asthma with PM2.5 exposure during pregnancy and infancy.

RESULTS:

The birth cohort contained 34,336 asthmatic patients, and the mean age of children given a diagnosis of asthma was 3.39 ± 1.78 years. Increased exposure to PM2.5 during gestational weeks 6 to 22 and 9 to 46 weeks after birth were significantly associated with an increased incidence of asthma. The exposure-response relationship indicated that the hazard ratio (HR) of asthma increased steeply at PM2.5 exposure of greater than 93 μg/m3 during pregnancy. Additionally, the HRs remained significant with postnatal exposure to PM2.5 between 26 and 72 μg/m3 (range, 1.01-1.07 μg/m3), followed by a sharp increase in HRs at PM2.5 exposure of greater than 73 μg/m3.

CONCLUSION:

Both prenatal and postnatal exposures to PM2.5 were associated with later development of asthma. The vulnerable time windows might be within early gestation and midgestation and infancy.

KEYWORDS:

Asthma; air pollution; birth cohort; particulate matter with an aerodynamic diameter less than 2.5 μm; postnatal; prenatal; vulnerable time windows

PMID:
30959062
DOI:
10.1016/j.jaci.2019.03.024

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