Fine particulate matter and wheezing illnesses in the first year of life.
BACKGROUND
Recent evidence implicates fine particulate matter (PM2.5), principally from vehicular exhaust, as a major cause of increased mortality and morbidity. However, there are limited data on the impact of PM2.5 on infant respiratory illnesses.


METHODS
We conducted a cohort study of 504 infants recruited at 4 months of age from primary health care units in southeastern Santiago, Chile. Project physicians followed infants through the first year of life via monthly check-ups and by appointments on demand. We obtained data for fine particulate matter, sulfur dioxide (SO2), and nitrogen dioxide (NO2) from the governmental monitoring network.


RESULTS
The most frequent diagnosis during follow-up was wheezing bronchitis, occurring 19.5 times per 100 infants per month. After adjusting for sex, socioeconomic level, family history of asthma, minimum temperature, and number of older siblings, we found that an increase of 10 microg/m of PM2.5 24-hour average was related to a 5% increase (95% confidence interval 0-9%) in the risk for wheezing bronchitis (1-day lag). This association was present for different lags, with a maximum observed for a 9-day lag (9%; 6-12%). No consistent association was detected with NO2 or SO2 ambient levels. Lower socioeconomic status and having older siblings were also associated with the risk of wheezing bronchitis. The association of PM2.5 and wheezing bronchitis was stronger among infants with a family history of asthma than among infants without.


CONCLUSIONS
Air pollution in the form of fine particulates, mostly from vehicular exhaust, may adversely affect infants' respiratory health with potential for chronic effects later in life.
Facultad de Medicina, Universidad de Chile, Santiago, Chile. ppino@med.uchile.cl
Paulina
P
Pino
Tomas
T
Walter
Manuel
M
Oyarzun
Rodrigo
R
Villegas
Isabelle
I
Romieu
D000393:Air Pollutants / Q000032:analysis; D016902:Air Pollution, Indoor / Q000032:analysis; D001991:Bronchitis / Q000453:epidemiology / Q000209:etiology*; D002677:Chile / Q000453:epidemiology; D015331:Cohort Studies; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D015999:Multivariate Analysis; D010316:Particle Size; D012135:Respiratory Sounds / Q000209:etiology*; D012307:Risk Factors; D012959:Socioeconomic Factors; D014028:Tobacco Smoke Pollution / Q000009:adverse effects* / Q000032:analysis
D000393:Air Pollutants; D014028:Tobacco Smoke Pollution