Abstract
Background: Evidence for an association between traffic-related particulate matter (PM) and pneumonia in early childhood was found by the ESCAPE project. Which, if any, specific particle matter (PM) constituent(s) are primarily responsible for this adverse health outcome is unknown. Aim: Using a standardized approach, we aimed to assess the association between PM constituents and pneumonia during the first years of life in seven birth cohort studies: BAMSE (Sweden), GASPII (Italy), GINI and LISA (Germany), INMA (Spain), MAAS (The United Kingdom) and PIAMA (The Netherlands). Methods: Concentrations of eight PM constituents (copper, iron, potassium, nickel, sulfur, silicon, vanadium, and zinc), each respectively derived from particles with aerodynamic diameters less than 10µg/m³(PM10) and 2.5µg/m³ (PM2.5), were calculated using land-use regression models developed from a common protocol as part of the TRANSPHORM project. Constituent concentrations were individually assigned to each child's birth address (Ntotal=15,775). Logistic regression models assessed cohort-specific associations between parental report of physician-diagnosed pneumonia during the first two years of life (three for MAAS) and each constituent. Models were adjusted for relevant host and environmental covariates and for total PM10 or PM2.5, depending on the origin of the constituent. Random-effects meta-analysis was used to obtain combined estimates. Results: Pneumonia was associated with zinc derived from PM10 (1.53 [1.04, 2.25] per 20ng/m³ increase) and potassium derived from PM2.5 (1.78 [1.07, 2.97] per 50ng/m³ increase) in the fully adjusted models.. Estimates for zinc derived from PM2.5 were elevated but non-significant (1.31 [0.98, 1.75] per 10ng/m³ increase). Conclusions: Results from a multi-center analysis of seven European birth cohorts indicate that zinc and potassium derived from traffic-related PM increase the risk of pneumonia in the first years of life. Zinc has been associated with tire wear.
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