Effects of air pollution on exhaled nitric oxide in children: Results from the GINIplus and LISAplus studies (original) (raw)
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The effect of ambient air pollution on exhaled nitric oxide in the Children's Health Study
European Respiratory Journal, 2011
We assessed the effect of daily variations in ambient air pollutants on exhaled nitric oxide fraction (FeNO) using data from a cohort of school children with large differences in air pollutant exposures from the Children's Health Study. Based on a cohort of 2,240 school children from 13 Southern Californian communities, cumulative lagged average regression models were fitted to determine the association between FeNO and ambient air pollution levels from central site monitors with lags of up to 30 days prior to FeNO testing. Daily 24-h cumulative lagged averages of particles with a 50% cutoff aerodynamic diameter of 2.5 mm (PM2.5; over 1-8 days) and particles with a 50% cutoff aerodynamic diameter of 10 mm (PM10; over 1-7 days), as well as 10:00-18:00 h cumulative lagged average of O 3 (over 1-23 days) were significantly associated with 17.42% (p,0.01), 9.25% (p,0.05) and 14.25% (p,0.01) higher FeNO levels over the interquartile range of 7.5 mg?m-3 , 12.97 mg?m-3 and 15.42 ppb, respectively. The effects of PM2.5, PM10 and O 3 were higher in the warm season. The particulate matter effects were robust to adjustments for effects of O 3 and temperature and did not vary by asthma or allergy status. In summary, short-term increases in PM2.5, PM10 and O 3 were associated with airway inflammation independent of asthma and allergy status, with PM10 effects significantly higher in the warm season.
Longitudinal effects of air pollution on exhaled nitric oxide: the Children's Health Study
Occupational and Environmental Medicine, 2014
OBJECTIVES-To assess the effects of long-term variations in ambient air pollutants on longitudinal changes in exhaled nitric oxide (FeNO), a potentially useful biomarker of eosinophilic airway inflammation, based on data from the southern California Children's Health Study. METHODS-Based on a cohort of 1,211 schoolchildren from 8 Southern California communities with FeNO measurements in 2006/07 and 2007/08, regression models adjusted for short-term effects of air pollution were fitted to assess the association between changes in annual long-term exposures and changes in FeNO. RESULTS-Increases in annual average concentrations of 24-hr average NO 2 and PM 2.5 (scaled to the interquartile range (IQR) of 1.8 ppb and 2.4 μg/m 3 , respectively) were associated with a 2.29 ppb (CI=[0.36,4.21]; p =0.02) and a 4.94 ppb (CI=[1.44,8.47]; p = 0.005) increase in FeNO, respectively, after adjustments for short term effects of the respective pollutants. In contrast, changes in annual averages of PM 10 and O 3 were not significantly associated with changes in FeNO. These findings did not differ significantly by asthma status. CONCLUSIONS-Changes in annual average exposure to current levels of ambient air pollutants are significantly associated with changes in FeNO levels in children, independent of short-term exposures and asthma status. Use of this biomarker in population-based epidemiologic research has great potential for assessing the impact of changing real world mixtures of ambient air pollutants on children's respiratory health.
International Archives of Occupational and Environmental Health, 2002
Objectives: The aim of the study was to investigate whether the level of exhaled nitric oxide (eNO) provides a more sensitive measure to assess adverse pulmonary effects of air pollution than conventional lung function indices. Method: The nonselected cohort studied consisted of 68 children (aged 10-11 years) living in an urban environment. For 7 weeks respiratory complaints were reported daily by these children in a diary, and lung function measures and eNO levels were determined in the children once a week on days with various level of air pollution. Results: During the study the increase in the levels of the various air pollutants was positively associated with eNO (6% to 31% increase; P<0.05) but not with lung function measures. In contrast to the lung function measures, the prevalence of respiratory symptoms such as ''sore throat'', ''runny nose'', ''having a cold'', and ''sick at home'' were positively associated with the level of eNO measured in the following week. Conclusions: Though clinically very meaningful, functional pulmonary measures appear to be too course to detect relatively mild clinical symptoms in response to exposure to air pollution. In an epidemiological setting the increase in eNO may represent a more suitable measure to assess such adverse effects.
Environmental Health Perspectives, 2006
BACKGROUND: Research has shown associations between pediatric asthma outcomes and airborne particulate matter (PM). The importance of particle components remains to be determined. METHODS: We followed a panel of 45 schoolchildren with persistent asthma living in Southern California. Subjects were monitored over 10 days with offline fractional exhaled nitric oxide (FE NO), a biomarker of airway inflammation. Personal active sampler exposures included continuous particulate matter < 2.5 µm in aerodynamic diameter (PM 2.5), 24-hr PM 2.5 elemental and organic carbon (EC, OC), and 24-hr nitrogen dioxide. Ambient exposures included PM 2.5 , PM 2.5 EC and OC, and NO 2. Data were analyzed with mixed models controlling for personal temperature, humidity and 10-day period. RESULTS: The strongest positive associations were between FE NO and 2-day average pollutant concentrations. Per interquartile range pollutant increase, these were: for 24 µg/m 3 personal PM 2.5 , 1.1 ppb FE NO [95% confidence interval (CI), 0.1-1.9]; for 0.6 µg/m 3 personal EC, 0.7 ppb FE NO (95% CI, 0.3-1.1); for 17 ppb personal NO 2 , 1.6 ppb FE NO (95% CI, 0.4-2.8). Larger associations were found for ambient EC and smaller associations for ambient NO 2. Ambient PM 2.5 and personal and ambient OC were significant only in subjects taking inhaled corticosteroids (ICS) alone. Subjects taking both ICS and antileukotrienes showed no significant associations. Distributed lag models showed personal PM 2.5 in the preceding 5 hr was associated with FE NO. In two-pollutant models, the most robust associations were for personal and ambient EC and NO 2 , and for personal but not ambient PM 2.5. CONCLUSION: PM associations with airway inflammation in asthmatics may be missed using ambient particle mass, which may not sufficiently represent causal pollutant components from fossil fuel combustion.
International Journal of Environmental Research and Public Health, 2021
The consequences of air pollution pose one of the most serious threats to human health, and especially impact children from large agglomerations. The measurement of nitric oxide concentration in exhaled air (FeNO) is a valuable biomarker in detecting and monitoring airway inflammation. However, only a few studies have assessed the relationship between FeNO and the level of air pollution. The study aims to estimate the concentration of FeNO in the population of children aged 8–9 attending the third grade of public primary schools in Krakow, as well as to determine the relationship between FeNO concentration and dust and gaseous air pollutants. The research included 4580 children aged 8–9 years who had two FeNO measurements in the winter–autumn and spring–summer periods. The degree of air pollution was obtained from the Regional Inspectorate of Environmental Protection in Krakow. The concentration of pollutants was obtained from three measurement stations located in different parts of...
Environmental Health Perspectives, 2011
Background: The fractional concentration of nitric oxide in exhaled air (Fe NO) potentially detects airway inflammation related to air pollution exposure. Existing studies have not yet provided conclusive evidence on the association of Fe NO with traffic-related pollution (TRP). oBjectives: We evaluated the association of Fe NO with residential TRP exposure in a large cohort of children. Methods: We related Fe NO measured on 2,143 children (ages 7-11 years) who participated in the Southern California Children's Health Study (CHS) to five classes of metrics of residential TRP: distances to freeways and major roads; length of all and local roads within circular buffers around the home; traffic densities within buffers; annual average line source dispersion modeled nitrogen oxides (NO x) from freeways and non freeway roads; and predicted annual average nitrogen oxide, nitrogen dioxide, and NO x from a model based on intracommunity sampling in the CHS. results: In children with asthma, length of roads was positively associated with Fe NO , with stronger associations in smaller buffers [46.7%; 95% confidence interval (CI), 14.3-88.4], 12.4% (95% CI,-8.8 to 38.4), and 4.1% (95% CI,-14.6 to 26.8) higher Fe NO for 100-, 300-, and 1,000-m increases in the length of all roads in 50-, 100-, and 200-m buffers, respectively. Other TRP metrics were not significantly associated with Fe NO , even though the study design was powered to detect exposures explaining as little as 0.4% of the variation in natural log-transformed Fe NO (R 2 = 0.004). conclusion: Length of road was the only indicator of residential TRP exposure associated with airway inflammation in children with asthma, as measured by Fe NO .