Fine particulate matter exposure during pregnancy and infancy and incident asthma

Chau-Ren Jung; Wei-Ting Chen; Yu-Hsin Tang; Bing-Fang Hwang

doi:10.1016/j.jaci.2019.03.024

Fine particulate matter exposure during pregnancy and infancy and incident asthma

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

Authors

Chau-Ren Jung¹, Wei-Ting Chen², Yu-Hsin Tang³, Bing-Fang Hwang⁴

Affiliations

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.

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

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 [PM_2.5]) exposure during pregnancy and infancy on asthma and identify vulnerable times to help elucidate possible mechanisms of the effects of PM_2.5 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 PM_2.5 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 PM_2.5 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 PM_2.5 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 PM_2.5 exposure of greater than 93 μg/m³ during pregnancy. Additionally, the HRs remained significant with postnatal exposure to PM_2.5 between 26 and 72 μg/m³ (range, 1.01-1.07 μg/m³), followed by a sharp increase in HRs at PM_2.5 exposure of greater than 73 μg/m³.

Conclusion: Both prenatal and postnatal exposures to PM_2.5 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.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Air Pollutants / adverse effects*
Asthma / epidemiology*
Child, Preschool
Female
Humans
Infant
Male
Maternal Exposure / adverse effects*
Particulate Matter / adverse effects*
Pregnancy
Prenatal Exposure Delayed Effects / epidemiology*
Proportional Hazards Models
Taiwan / epidemiology

Substances

Air Pollutants
Particulate Matter