The effect of air pollution on lung development from 10 to 18 years of age.
BACKGROUND
Whether exposure to air pollution adversely affects the growth of lung function during the period of rapid lung development that occurs between the ages of 10 and 18 years is unknown.


METHODS
In this prospective study, we recruited 1759 children (average age, 10 years) from schools in 12 southern California communities and measured lung function annually for eight years. The rate of attrition was approximately 10 percent per year. The communities represented a wide range of ambient exposures to ozone, acid vapor, nitrogen dioxide, and particulate matter. Linear regression was used to examine the relationship of air pollution to the forced expiratory volume in one second (FEV(1)) and other spirometric measures.


RESULTS
Over the eight-year period, deficits in the growth of FEV(1) were associated with exposure to nitrogen dioxide (P=0.005), acid vapor (P=0.004), particulate matter with an aerodynamic diameter of less than 2.5 microm (PM(2.5)) (P=0.04), and elemental carbon (P=0.007), even after adjustment for several potential confounders and effect modifiers. Associations were also observed for other spirometric measures. Exposure to pollutants was associated with clinically and statistically significant deficits in the FEV(1) attained at the age of 18 years. For example, the estimated proportion of 18-year-old subjects with a low FEV(1) (defined as a ratio of observed to expected FEV(1) of less than 80 percent) was 4.9 times as great at the highest level of exposure to PM(2.5) as at the lowest level of exposure (7.9 percent vs. 1.6 percent, P=0.002).


CONCLUSIONS
The results of this study indicate that current levels of air pollution have chronic, adverse effects on lung development in children from the age of 10 to 18 years, leading to clinically significant deficits in attained FEV(1) as children reach adulthood.
Gauderman
W James
WJ
Department of Preventive Medicine, University of Southern California, Los Angeles 90089, USA. jimg@usc.edu
Avol
Edward
E
Gilliland
Frank
F
Vora
Hita
H
Thomas
Duncan
D
Berhane
Kiros
K
McConnell
Rob
R
Kuenzli
Nino
N
Lurmann
Fred
F
Rappaport
Edward
E
Margolis
Helene
H
Bates
David
D
Peters
John
J
D000293:Adolescent; D000393:Air Pollutants / Q000009:adverse effects* / Q000032:analysis; D000397:Air Pollution / Q000009:adverse effects*; D002140:California; D002648:Child; D004784:Environmental Monitoring; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects*; D006801:Humans; D016014:Linear Models; D008168:Lung / Q000187:drug effects* / Q000254:growth & development / Q000502:physiology; D008297:Male; D008450:Maximal Midexpiratory Flow Rate / Q000187:drug effects; D009585:Nitrogen Dioxide / Q000009:adverse effects / Q000032:analysis; D010126:Ozone / Q000009:adverse effects / Q000032:analysis; D010316:Particle Size; D011446:Prospective Studies; D012016:Reference Values; D013147:Spirometry; D011795:Surveys and Questionnaires; D014797:Vital Capacity / Q000187:drug effects
D000393:Air Pollutants; D010126:Ozone; D009585:Nitrogen Dioxide