Background: Few studies have investigated traffic-related air pollution as a risk factor for respiratory infections during early childhood.
Objectives: We aimed to investigate the association between air pollution and pneumonia, croup, and otitis media in 10 European birth cohorts—BAMSE (Sweden), GASPII (Italy), GINIplus and LISAplus (Germany), MAAS (United Kingdom), PIAMA (the Netherlands), and four INMA cohorts (Spain)—and to derive combined effect estimates using meta-analysis.
Methods: Parent report of physician-diagnosed pneumonia, otitis media, and croup during early childhood were assessed in relation to annual average pollutant levels [nitrogen dioxide (NO2), nitrogen oxide (NOx), particulate matter ≤ 2.5 μm (PM2.5), PM2.5 absorbance, PM10, PM2.5–10 (coarse PM)], which were estimated using land use regression models and assigned to children based on their residential address at birth. Identical protocols were used to develop regression models for each study area as part of the ESCAPE project. Logistic regression was used to calculate adjusted effect estimates for each study, and random-effects meta-analysis was used to calculate combined estimates.
Results: For pneumonia, combined adjusted odds ratios (ORs) were elevated and statistically significant for all pollutants except PM2.5 (e.g., OR = 1.30; 95% CI: 1.02, 1.65 per 10-μg/m3 increase in NO2 and OR = 1.76; 95% CI: 1.00, 3.09 per 10-μg/m3 PM10). For otitis media and croup, results were generally null across all analyses except for NO2 and otitis media (OR = 1.09; 95% CI: 1.02, 1.16 per 10-μg/m3).
Conclusion: Our meta-analysis of 10 European birth cohorts within the ESCAPE project found consistent evidence for an association between air pollution and pneumonia in early childhood, and some evidence for an association with otitis media.
1Institute of Epidemiology I, Helmholtz Zentrum München, German Research Centre for Environmental Health, Munich, Germany; 2Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; 3Centre for Epidemiology, Institute of Population Health, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, United Kingdom; 4School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada; 5IUF-Leibniz Research Institute for Environmental Medicine, University of Düsseldorf, Düsseldorf, Germany; 6Air Quality & Sustainable Nanotechnology, IUTA (Institut für Energie-und Umwelttechnik e.V.), Duisburg, Germany; 7Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; 8Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain; 9Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; 10Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; 11Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children’s Hospital, and 12GRIAC (Groningen Research Institute of Asthma and COPD), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; 13Department of Pediatrics, Division of Respiratory Medicine, Erasmus University Medical Center/Sophia Children’s Hospital, Rotterdam, the Netherlands; 14Institute of Epidemiology II, Helmholtz Zentrum München, German Research Centre for Environmental Health, Munich, Germany; 15Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; 16Institute of Inflammation and Repair, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, United Kingdom; 17Department of Epidemiology, Lazio Regional Health Service ASL RME (Dipartimento di epidemiologia ASL Roma E), Rome, Italy; 18Centre of Public Health Research (CSISP), Valencia, Spain; 19Department of Preventive Medicine, University of Oviedo, Asturias, Spain; 20BioDonostia Health Research Institute, Donostia, Spain; 21Department of Public Health and Preventive Medicine, University of Basque Country, Bilbão, Spain; 22Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain; 23Pompeu Fabra University, Department of Experimental and Health Sciences, Barcelona, Catalonia, Spain
Recommended Citation:
Elaina A. MacIntyre,1 Ulrike Gehring,2 Anna Mölter,et al. Air Pollution and Respiratory Infections during Early Childhood: An Analysis of 10 European Birth Cohorts within the ESCAPE Project[J]. Environmental Health Perspectives,2014-01-01,Volume 122(Issue 1):107