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Early-Life Exposure to Air Pollution and Childhood Asthma Cumulative Incidence in the ECHO CREW Consortium.
Zanobetti, Antonella; Ryan, Patrick H; Coull, Brent A; Luttmann-Gibson, Heike; Datta, Soma; Blossom, Jeffrey; Brokamp, Cole; Lothrop, Nathan; Miller, Rachel L; Beamer, Paloma I; Visness, Cynthia M; Andrews, Howard; Bacharier, Leonard B; Hartert, Tina; Johnson, Christine C; Ownby, Dennis R; Khurana Hershey, Gurjit K; Joseph, Christine L M; Mendonça, Eneida A; Jackson, Daniel J; Zoratti, Edward M; Wright, Anne L; Martinez, Fernando D; Seroogy, Christine M; Ramratnam, Sima K; Calatroni, Agustin; Gern, James E; Gold, Diane R.
Afiliación
  • Zanobetti A; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
  • Ryan PH; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio.
  • Coull BA; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
  • Luttmann-Gibson H; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
  • Datta S; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
  • Blossom J; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
  • Brokamp C; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
  • Lothrop N; Center for Geographic Analysis, Harvard University, Cambridge, Massachusetts.
  • Miller RL; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio.
  • Beamer PI; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
  • Visness CM; Asthma and Airways Disease Research Center, University of Arizona, Tucson.
  • Andrews H; Department of Community, Environment, and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson.
  • Bacharier LB; Division of Clinical Immunology, Icahn School of Medicine at Mount Sinai, New York, New York.
  • Hartert T; Asthma and Airways Disease Research Center, University of Arizona, Tucson.
  • Johnson CC; Department of Community, Environment, and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson.
  • Ownby DR; Rho Inc, Federal Research Operations, Durham, North Carolina.
  • Khurana Hershey GK; Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York.
  • Joseph CLM; Monroe Carell Jr Children's Hospital at Vanderbilt, Division of Pediatric Allergy, Immunology, and Pulmonary Medicine, Nashville, Tennessee.
  • Mendonça EA; Vanderbilt University School of Medicine, Division of Allergy, Pulmonary, and Critical Care Medicine, Nashville, Tennessee.
  • Jackson DJ; Department of Public Health Sciences, Henry Ford Health, Detroit, Michigan.
  • Zoratti EM; Division of Allergy and Immunology, Augusta University, Augusta, Georgia.
  • Wright AL; Cincinnati Children's Hospital, Division of Asthma Research, Cincinnati, Ohio.
  • Martinez FD; Department of Public Health Sciences, Henry Ford Health, Detroit, Michigan.
  • Seroogy CM; Department of Pediatrics, Indiana University, Indianapolis.
  • Ramratnam SK; Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison.
  • Calatroni A; Department of Medicine, Henry Ford Health, Detroit, Michigan.
  • Gern JE; Asthma and Airways Disease Research Center, University of Arizona, Tucson.
  • Gold DR; Division of Pulmonary and Sleep Medicine, Department of Pediatrics, College of Medicine, University of Arizona, Tucson.
JAMA Netw Open ; 7(2): e240535, 2024 Feb 05.
Article en En | MEDLINE | ID: mdl-38416497
ABSTRACT
Importance Exposure to outdoor air pollution contributes to childhood asthma development, but many studies lack the geographic, racial and ethnic, and socioeconomic diversity to evaluate susceptibility by individual-level and community-level contextual factors.

Objective:

To examine early life exposure to fine particulate matter (PM2.5) and nitrogen oxide (NO2) air pollution and asthma risk by early and middle childhood, and whether individual and community-level characteristics modify associations between air pollution exposure and asthma. Design, Setting, and

Participants:

This cohort study included children enrolled in cohorts participating in the Children's Respiratory and Environmental Workgroup consortium. The birth cohorts were located throughout the US, recruited between 1987 and 2007, and followed up through age 11 years. The survival analysis was adjusted for mother's education, parental asthma, smoking during pregnancy, child's race and ethnicity, sex, neighborhood characteristics, and cohort. Statistical analysis was performed from February 2022 to December 2023. Exposure Early-life exposures to PM2.5 and NO2 according to participants' birth address. Main Outcomes and

Measures:

Caregiver report of physician-diagnosed asthma through early (age 4 years) and middle (age 11 years) childhood.

Results:

Among 5279 children included, 1659 (31.4%) were Black, 835 (15.8%) were Hispanic, 2555 (48.4%) where White, and 229 (4.3%) were other race or ethnicity; 2721 (51.5%) were male and 2596 (49.2%) were female; 1305 children (24.7%) had asthma by 11 years of age and 954 (18.1%) had asthma by 4 years of age. Mean values of pollutants over the first 3 years of life were associated with asthma incidence. A 1 IQR increase in NO2 (6.1 µg/m3) was associated with increased asthma incidence among children younger than 5 years (HR, 1.25 [95% CI, 1.03-1.52]) and children younger than 11 years (HR, 1.22 [95% CI, 1.04-1.44]). A 1 IQR increase in PM2.5 (3.4 µg/m3) was associated with increased asthma incidence among children younger than 5 years (HR, 1.31 [95% CI, 1.04-1.66]) and children younger than 11 years (OR, 1.23 [95% CI, 1.01-1.50]). Associations of PM2.5 or NO2 with asthma were increased when mothers had less than a high school diploma, among Black children, in communities with fewer child opportunities, and in census tracts with higher percentage Black population and population density; for example, there was a significantly higher association between PM2.5 and asthma incidence by younger than 5 years of age in Black children (HR, 1.60 [95% CI, 1.15-2.22]) compared with White children (HR, 1.17 [95% CI, 0.90-1.52]). Conclusions and Relevance In this cohort study, early life air pollution was associated with increased asthma incidence by early and middle childhood, with higher risk among minoritized families living in urban communities characterized by fewer opportunities and resources and multiple environmental coexposures. Reducing asthma risk in the US requires air pollution regulation and reduction combined with greater environmental, educational, and health equity at the community level.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Asma / Contaminación del Aire Límite: Child / Child, preschool / Female / Humans / Male / Pregnancy Idioma: En Revista: JAMA Netw Open Año: 2024 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Asma / Contaminación del Aire Límite: Child / Child, preschool / Female / Humans / Male / Pregnancy Idioma: En Revista: JAMA Netw Open Año: 2024 Tipo del documento: Article