title: Intrauterine exposure to polycyclic aromatic hydrocarbons, fine particulate matter and early wheeze. Prospective birth cohort study in 4-year olds.
abstract: The main goal of the study was to determine the relationship between prenatal exposure to polycyclic aromatic hydrocarbons (PAHs) measured by PAH-DNA adducts in umbilical cord blood and early wheeze. The level of PAH-DNA adducts in the cord blood is assumed to reflect the cumulative dose of PAHs absorbed by the foetus over the prenatal period. The effect of prenatal PAH exposure on respiratory health measured by the incidence rate ratio (IRR) for the number of wheezing days in the subsequent 4 yr follow-up was adjusted for potential confounding factors such as personal prenatal exposure to fine particulate matter (PM(2.5)), environmental tobacco smoke (ETS), gender of child, maternal characteristics (age, education and atopy), parity and mould/dampness in the home. The study sample includes 339 newborns of non-smoking mothers 18-35 yr of age and free from chronic diseases, who were recruited from ambulatory prenatal clinics in the first or second trimester of pregnancy. The number of wheezing days during the first 2 yr of life was positively associated with prenatal level of PAH-DNA adducts (IRR = 1.69, 95%CI = 1.52-1.88), prenatal particulate matter (PM(2.5)) level dichotomized by the median (IRR = 1.38; 95%CI: 1.25-1.51), maternal atopy (IRR = 1.43; 95%CI: 1.29-1.58), mouldy/damp house (IRR = 1.43; 95%CI: 1.27-1.61). The level of maternal education and maternal age at delivery was inversely associated with the IRRs for wheeze. The significant association between frequency of wheeze and the level of prenatal environmental hazards (PAHs and PM(2.5)) was not observed at ages 3 or 4 yrs. Although the frequency of wheezing at ages 3 or 4 was no longer associated with prenatal exposure to PAHs and PM(2.5), its occurrence depended on the presence of wheezing in the first 2 yr of life, which nearly tripled the risk of wheezing in later life. In conclusion, the findings may suggest that driving force for early wheezing (<24 months of age) is different to those leading to later onset of wheeze. As we reported no synergistic effects between prenatal PAH (measured by PAH-DNA adducts) and PM(2.5) exposures on early wheeze, this suggests the two exposures may exert independent effects via different biological mechanism on wheeze.
authors.affiliation: Chair of Epidemiology and Preventive Medicine, Jagiellonian University, Medical College, Krakow, Poland. myjedryc@cyf-kr.edu.pl
authors.forename: Wieslaw A
authors.initials: WA
authors.lastname: Jedrychowski
authors.forename: Frederica P
authors.initials: FP
authors.lastname: Perera
authors.forename: Umberto
authors.initials: U
authors.lastname: Maugeri
authors.forename: Dorota
authors.initials: D
authors.lastname: Mrozek-Budzyn
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Mroz
authors.forename: Maria
authors.initials: M
authors.lastname: Klimaszewska-Rembiasz
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Flak
authors.forename: Susan
authors.initials: S
authors.lastname: Edwards
authors.forename: John
authors.initials: J
authors.lastname: Spengler
authors.forename: Ryszard
authors.initials: R
authors.lastname: Jacek
authors.forename: Agata
authors.initials: A
authors.lastname: Sowa
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D002675:Child, Preschool; D004522:Educational Status; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008423:Maternal Age; D018811:Maternal Exposure; D052638:Particulate Matter / Q000009:adverse effects*; D011044:Poland; D011084:Polycyclic Aromatic Hydrocarbons / Q000009:adverse effects*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000097:blood / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D011446:Prospective Studies; D012135:Respiratory Sounds; D012907:Smoking / Q000009:adverse effects
chemical_list: D052638:Particulate Matter; D011084:Polycyclic Aromatic Hydrocarbons
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