title: Intrauterine and early postnatal exposure to outdoor air pollution and lung function at preschool age.
abstract: BACKGROUND
  Effects of prenatal and postnatal exposure to air pollution on lung function at preschool age remain unexplored. We examined the association of exposure to air pollution during specific trimesters of pregnancy and postnatal life with lung function in preschoolers.
  
  
  METHODS
  Lung function was assessed with spirometry in preschoolers aged 4.5 years (n=620) participating in the INfancia y Medio Ambiente (INMA) cohort. Temporally adjusted land use regression (LUR) models were applied to estimate individual residential exposures to benzene and nitrogen dioxide (NO₂) during specific trimesters of pregnancy and early postnatal life (the first year of life). Recent and current (1 year and 1 week before lung function testing, respectively) exposures to NO₂ and nitrogen oxides (NOx) were also assessed.
  
  
  RESULTS
  Exposure to higher levels of benzene and NO₂ during pregnancy was associated with reduced lung function. FEV1 estimates for an IQR increase in exposures during the second trimester of pregnancy were -18.4 mL, 95% CI -34.8 to -2.1 for benzene and -28.0 mL, 95% CI -52.9 to -3.2 for NO₂. Relative risk (RR) of low lung function (<80% of predicted FEV1) for an IQR increase in benzene and NO₂ during the second trimester of pregnancy were 1.22, 95% CI 1.02 to 1.46 and 1.30, 95% CI 0.97 to 1.76, respectively. Associations for early postnatal, recent and current exposures were not statistically significant. Stronger associations appeared among allergic children and those of lower social class.
  
  
  CONCLUSIONS
  Prenatal exposure to residential traffic-related air pollution may result in long-term lung function deficits at preschool age.
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Morales
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Garcia-Esteban
authors.affiliation: Unit of Pediatric Pneumology and Allergy, Hospital de Sabadell, Corporació Sanitària Parc Taulí, Sabadell, Catalonia, Spain.
authors.forename: Oscar Asensio
authors.initials: OA
authors.lastname: de la Cruz
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Spain Health Research Institute Biodonostia, San Sebastian, Gipuzkoa, Spain Public Health Department of Gipuzkoa, San Sebastian, Gipuzkoa, Spain.
authors.forename: Mikel
authors.initials: M
authors.lastname: Basterrechea
authors.affiliation: Health Research Institute Biodonostia, San Sebastian, Gipuzkoa, Spain University of the Basque Country, Bilbao, Spain.
authors.forename: Aitana
authors.initials: A
authors.lastname: Lertxundi
authors.affiliation: Health Research Institute Biodonostia, San Sebastian, Gipuzkoa, Spain Department of Environment and Regional Planning, Basque Government, San Sebastian, Gipuzkoa, Spain.
authors.forename: Maria D Martinez López
authors.initials: MD
authors.lastname: de Dicastillo
authors.affiliation: Department of Pediatrics, Hospital de Zumárraga, San Sebastian, Gipuzkoa, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Zabaleta
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Sunyer
mesh_terms: D000328:Adult; D000393:Air Pollutants / Q000009:adverse effects*; D002675:Child, Preschool; D004781:Environmental Exposure / Q000009:adverse effects*; D004784:Environmental Monitoring; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects*; D011247:Pregnancy; D011264:Pregnancy Trimesters; D011297:Prenatal Exposure Delayed Effects / Q000175:diagnosis / Q000453:epidemiology*; D012129:Respiratory Function Tests; D012143:Respiratory Physiological Phenomena / Q000187:drug effects*; D013030:Spain / Q000453:epidemiology
chemical_list: D000393:Air Pollutants
keywords: Lung Physiology; Paediatric Lung Disaese; Respiratory Measurement