Early-life exposure to PM2.5 and risk of acute asthma clinical encounters among children in Massachusetts: a case-crossover analysis.
Environ Health
; 17(1): 20, 2018 02 21.
Article
em En
| MEDLINE
| ID: mdl-29466982
ABSTRACT
BACKGROUND:
Associations between ambient particulate matter < 2.5 µm (PM2.5) and asthma morbidity have been suggested in previous epidemiologic studies but results are inconsistent for areas with lower PM2.5 levels. We estimated the associations between early-life short-term PM2.5 exposure and the risk of asthma or wheeze clinical encounters among Massachusetts children in the innovative Pregnancy to Early Life Longitudinal (PELL) cohort data linkage system.METHODS:
We used a semi-bidirectional case-crossover study design with short-term exposure lags for asthma exacerbation using data from the PELL system. Cases included children up to 9 years of age who had a hospitalization, observational stay, or emergency department visit for asthma or wheeze between January 2001 and September 2009 (n = 33,387). Daily PM2.5 concentrations were estimated at a 4-km resolution using satellite remote sensing, land use, and meteorological data. We applied conditional logistic regression models to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CI). We also stratified by potential effect modifiers.RESULTS:
The median PM2.5 concentration among participants was 7.8 µg/m3 with an interquartile range of 5.9 µg/m3. Overall, associations between PM2.5 exposure and asthma clinical encounters among children at lags 0, 1 and 2 were close to the null value of OR = 1.0. Evidence of effect modification was observed by birthweight for lags 0, 1 and 2 (p < 0.05), and season of clinical encounter for lags 0 and 1 (p < 0.05). Children with low birthweight (LBW) (< 2500 g) had increased odds of having an asthma clinical encounter due to higher PM2.5 exposure for lag 1 (OR 1.08 per interquartile range (IQR) increase in PM2.5; 95% CI 1.01, 1.15).CONCLUSION:
Asthma or wheeze exacerbations among LBW children were associated with short-term increases in PM2.5 concentrations at low levels in Massachusetts.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Asma
/
Sons Respiratórios
/
Poluentes Atmosféricos
/
Material Particulado
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Prevalence_studies
/
Risk_factors_studies
Limite:
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
/
Newborn
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Environ Health
Assunto da revista:
SAUDE AMBIENTAL
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Estados Unidos