Polycyclic aromatic hydrocarbons, environmental tobacco smoke, and respiratory symptoms in an inner-city birth cohort.
OBJECTIVE
Several studies have found associations between diesel exposure, respiratory symptoms, and/or impaired pulmonary function. We hypothesized that prenatal exposure to airborne polycyclic aromatic hydrocarbons (PAH), important components of diesel exhaust and other combustion sources, may be associated with respiratory symptoms in young children. We also hypothesized that exposure to environmental tobacco smoke (ETS) may worsen symptoms beyond that observed to be associated with PAH alone.


METHODS
To test our hypotheses, we recruited 303 pregnant women from northern Manhattan believed to be at high risk for exposure to both PAH and ETS, collected 48-h personal PAH exposure measurements, and monitored their children prospectively.


RESULTS
By 12 months of age, more cough and wheeze were reported in children exposed to prenatal PAH in concert with ETS postnatally (PAH x ETS interaction odds ratios [ORs], 1.41 [p < 0.01] and 1.29 [p < 0.05], respectively). By 24 months, difficulty breathing and probable asthma were reported more frequently among children exposed to prenatal PAH and ETS postnatally (PAH x ETS ORs, 1.54 and 1.64, respectively [p < 0.05]).


CONCLUSIONS
Our results suggest that early exposure to airborne PAH and ETS can lead to increased respiratory symptoms and probable asthma by age 12 to 24 months. Interventions to lower the risk of respiratory disease in young children living in the inner city may need to address the importance of multiple environmental exposures.
Division of Pulmonary, Allergy, Critical Care Medicine, Department of Medicine, Columbia University College of Physicians and Surgeons, PH8C, 630 168th Street, New York, NY 10032, USA. rlm14@columbia.edu
Rachel L
RL
Miller
Robin
R
Garfinkel
Megan
M
Horton
David
D
Camann
Frederica P
FP
Perera
Robin M
RM
Whyatt
Patrick L
PL
Kinney
D000328:Adult; D001249:Asthma / Q000453:epidemiology; D015331:Cohort Studies; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D007223:Infant; D009519:New York City / Q000453:epidemiology; D011084:Polycyclic Aromatic Hydrocarbons; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011446:Prospective Studies; D012140:Respiratory Tract Diseases / Q000453:epidemiology*; D014028:Tobacco Smoke Pollution; D014505:Urban Population
D011084:Polycyclic Aromatic Hydrocarbons; D014028:Tobacco Smoke Pollution