title: Effects of air pollution on exhaled nitric oxide in children: results from the GINIplus and LISAplus studies.
abstract: Most previous studies which have investigated the short-term effects of air pollution on airway inflammation, assessed by an increase of exhaled nitric oxide (eNO), have been conducted among asthmatic children. Few studies have considered this potential association among non-asthmatics. Furthermore, although both short- and long-term effects of air pollution on eNO had been reported separately, studies which include both are scarce. We explored associations between 24h NO2 and PM10 (particles with aerodynamic diameters below 10μm) mass with eNO in 1985 children (192 asthmatics and 1793 non-asthmatics) aged 10 years and accounted for the long-term effects of air pollution by adjusting for annual averages of NO2, PM10 mass, PM2.5 mass (particles with aerodynamic diameters below 2.5μm) and PM2.5 absorbance, using data from two German birth cohorts in Munich and Wesel. In total, robust associations between 24h NO2 and eNO were observed in both single-pollutant (percentage change: 18.30%, 95% confidence interval: 11.63-25.37) and two-pollutant models (14.62%, 6.71-23.11). The association between 24h PM10 mass and eNO was only significant in the single-pollutant model (9.59%, 4.80-14.61). The same significant associations were also observed in non-asthmatic children, while they did not reach significant levels in asthmatic children. Associations between annual averages of ambient air pollution (NO2, PM10 mass, PM2.5 mass and PM2.5 absorbance) and eNO were consistently null. In conclusion, significantly positive associations were observed between short-term ambient air pollution and eNO. No long-term effects of air pollution on eNO were found in this study.
authors.affiliation: Helmholtz Zentrum München, German Research Centre for Environmental Health, Institute of Epidemiology I, Neuherberg, Germany; Faculty of Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany.
authors.forename: Chuang
authors.initials: C
authors.lastname: Liu
authors.affiliation: Helmholtz Zentrum München, German Research Centre for Environmental Health, Institute of Epidemiology I, Neuherberg, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Flexeder
authors.affiliation: Helmholtz Zentrum München, German Research Centre for Environmental Health, Institute of Epidemiology I, Neuherberg, Germany; School of Population and Public Health, The University of British Columbia, Canada.
authors.forename: Elaine
authors.initials: E
authors.lastname: Fuertes
authors.affiliation: Helmholtz Zentrum München, German Research Centre for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany.
authors.forename: Josef
authors.initials: J
authors.lastname: Cyrys
authors.affiliation: Technical University of Munich, Department of Paediatrics, Munich, Germany.
authors.forename: Carl-Peter
authors.initials: CP
authors.lastname: Bauer
authors.affiliation: Ludwig-Maximilians-University of Munich, Dr. von Hauner Children's Hospital, Division of Paediatric Gastroenterology and Hepatology, Munich, Germany.
authors.forename: Sibylle
authors.initials: S
authors.lastname: Koletzko
authors.affiliation: IUF Leibniz Research Institute for Environmental Medicine and Medical Faculty, Heinrich-Heine-University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Barbara
authors.initials: B
authors.lastname: Hoffmann
authors.affiliation: Department of Pediatrics, Marien-Hospital Wesel, Wesel, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: von Berg
authors.affiliation: Helmholtz Zentrum München, German Research Centre for Environmental Health, Institute of Epidemiology I, Neuherberg, Germany. Electronic address: heinrich@helmholtz-muenchen.de.
authors.forename: Joachim
authors.initials: J
authors.lastname: Heinrich
mesh_terms: D000393:Air Pollutants / Q000633:toxicity*; D002648:Child; D015331:Cohort Studies; D004784:Environmental Monitoring; D045853:Exhalation; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D009569:Nitric Oxide / Q000032:analysis*; D010316:Particle Size
chemical_list: D000393:Air Pollutants; D009569:Nitric Oxide
keywords: Air pollution; Children's respiratory health; Environmental epidemiology; Exhaled nitric oxide; Long-term exposure; Short-term exposure