Air pollution exposure and lung function in children: the ESCAPE project.
BACKGROUND
There is evidence for adverse effects of outdoor air pollution on lung function of children. Quantitative summaries of the effects of air pollution on lung function, however, are lacking due to large differences among studies.


OBJECTIVE
We aimed to study the association between residential exposure to air pollution and lung function in five European birth cohorts with a standardized exposure assessment following a common protocol.


METHODS
As part of the European Study of Cohorts for Air Pollution Effects (ESCAPE) we analyzed data from birth cohort studies situated in Germany, Sweden, the Netherlands, and the United Kingdom that measured lung function at 6-8 years of age (n = 5,921). Annual average exposure to air pollution [nitrogen oxides (NO2, NOx), mass concentrations of particulate matter with diameters < 2.5, < 10, and 2.5-10 μm (PM2.5, PM10, and PMcoarse), and PM2.5 absorbance] at the birth address and current address was estimated by land-use regression models. Associations of lung function with estimated air pollution levels and traffic indicators were estimated for each cohort using linear regression analysis, and then combined by random effects meta-analysis.


RESULTS
Estimated levels of NO2, NOx, PM2.5 absorbance, and PM2.5 at the current address, but not at the birth address, were associated with small decreases in lung function. For example, changes in forced expiratory volume in 1 sec (FEV1) ranged from -0.86% (95% CI: -1.48, -0.24%) for a 20-μg/m3 increase in NOx to -1.77% (95% CI: -3.34, -0.18%) for a 5-μg/m3 increase in PM2.5.


CONCLUSIONS
Exposure to air pollution may result in reduced lung function in schoolchildren.
Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
Ulrike
U
Gehring
Olena
O
Gruzieva
Raymond M
RM
Agius
Rob
R
Beelen
Adnan
A
Custovic
Josef
J
Cyrys
Marloes
M
Eeftens
Claudia
C
Flexeder
Elaine
E
Fuertes
Joachim
J
Heinrich
Barbara
B
Hoffmann
Johan C
JC
de Jongste
Marjan
M
Kerkhof
Claudia
C
Klümper
Michal
M
Korek
Anna
A
Mölter
Erica S
ES
Schultz
Angela
A
Simpson
Dorothea
D
Sugiri
Magnus
M
Svartengren
Andrea
A
von Berg
Alet H
AH
Wijga
Göran
G
Pershagen
Bert
B
Brunekreef
D000393:Air Pollutants / Q000032:analysis / Q000633:toxicity*; D002648:Child; D015331:Cohort Studies; D004781:Environmental Exposure / Q000032:analysis*; D004784:Environmental Monitoring / Q000379:methods / Q000706:statistics & numerical data*; D005060:Europe; D006801:Humans; D009589:Nitrogen Oxides / Q000633:toxicity; D010316:Particle Size; D012044:Regression Analysis; D012129:Respiratory Function Tests; D012143:Respiratory Physiological Phenomena / Q000187:drug effects*
D000393:Air Pollutants; D009589:Nitrogen Oxides