Abstract
BackgroundPediatric allergic diseases are a major public health concern, and previous studies have suggested that exposure to traffic-related air pollution (TRAP) exposure is a risk factor. These studies have typically assessed TRAP exposure using traffic measures, such as distance to major roads, or by modeling air pollutant concentrations; however inconsistent associations with pediatric allergic diseases have often been found. Using road proximity and density, we previously found an association between TRAP and atopic eczema among approximately 15,000 children living in Seoul, Korea, heavily populated and highly polluted city in which traffic is a major emission source. We aimed to conduct a parallel analysis using modeled air pollution concentrations and thus examine the consistency of the association. Specifically, we examined the associations of individual-level annual-average concentrations of NO2, PM10, and PM2.5 with symptoms and diagnoses of three pediatric allergic diseases including asthma, allergic rhinitis, and atopic eczema.MethodsThe study population included 14,614 children from the Seoul Atopy Friendly School Project Survey in Seoul, Korea, in 2010. To assess individual exposures to TRAP among these children, we predicted annual-average concentrations of NO2, PM10, and PM2.5 at the children’s home addresses in 2010 using universal kriging and land use regression models along with regulatory air quality monitoring data and geographic characteristics. Then, we estimated odds ratios (ORs) of the three allergic diseases for interquartile increases in air pollution concentrations after adjusting for individual risk factors in mixed effects logistic regression.ResultsSymptoms and diagnoses of atopic eczema symptoms showed an association with NO2 (OR = 1.07, 95% confidence interval = 1.02–1.13; 1.08, 1.03–1.14) and PM10 (1.06, 1.01–1.12; 1.07, 1.01–1.13). ORs of PM2.5 were positive but not statistically significant (1.01, 0.95–1.07; 1.04, 0.98–1.10). No association was found between asthma and allergic rhinitis, although PM2.5 showed a marginal association with allergic rhinitis.ConclusionsOur consistent findings regarding the association between TRAP and the prevalence of atopic eczema using traffic measures and surrogate air pollutants suggested the effect of TRAP on children’s health. Follow-up studies should elucidate the causal link, to support subsequent policy considerations and minimize adverse health effects in children.
Highlights
Pediatric allergic diseases are a major public health concern, and previous studies have suggested that exposure to traffic-related air pollution (TRAP) exposure is a risk factor
We aimed to investigate the association between exposure to TRAP and the prevalence of three pediatric allergic diseases using individual-level concentrations of three traffic-related air pollutants among about 15,000 children living in Seoul, Korea and to compare the results with those obtained from the analyses based on traffic measures in our previous study
Allergic diseases We identified children with current and doctor-diagnosed allergic disorders for asthma, allergic rhinitis, and atopic eczema based on the questionnaire of the Seoul Atopy Friendly School Project Survey, translated from the International Study of Asthma and Allergies in Children (ISAAC) questionnaire [36]
Summary
Pediatric allergic diseases are a major public health concern, and previous studies have suggested that exposure to traffic-related air pollution (TRAP) exposure is a risk factor. These studies have typically assessed TRAP exposure using traffic measures, such as distance to major roads, or by modeling air pollutant concentrations; inconsistent associations with pediatric allergic diseases have often been found. We examined the associations of individual-level annual-average concentrations of NO2, PM10, and PM2.5 with symptoms and diagnoses of three pediatric allergic diseases including asthma, allergic rhinitis, and atopic eczema. Pediatric allergic diseases, including asthma, allergic rhinitis, and atopic eczema, are major public health concerns, owing to their adverse physical and psychological effects, which result in a social and economic burden [1]. NO2 can modify immune responses to various allergens [15, 16] possibly by acting as an adjuvant, leading to sensitization or potentiation of inflammatory effects on an allergen challenge as discussed in a previous study [17]
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