Atopic Diseases, Allergic Sensitization, and Exposure to Traffic-Related Air Pollution in Children

Abstract

Morgenstern V, Zutavern A, Cyrys J, et al. Am J Respir Crit Care Med. 2008;177(12):1331–1337PURPOSE OF THE STUDY. To assess the relationship between exposure to traffic-related air pollutants and allergic disease outcomes in a prospective birth cohort during the first 6 years of life.METHODS. A birth cohort of 3061 children in the Munich, Germany, metropolitan area were followed with serial questionnaires of their parents inquiring about asthma, hay fever, and eczema. Specific immunoglobulin E against common allergens was determined at the age of 6 years. Air pollution measurements were made for particulate matter ≤2.5 μm in diameter and nitrogen dioxide. Distances between the children's street address and the nearest main road were noted. Outcomes of atopic disease and allergic sensitization were compared with the children's exposure to the pollutants.RESULTS. Positive associations were found between the distance to the nearest main road and asthma, hay fever, eczema, and sensitization, with the highest odds ratios (ORs) for children living <50 m from busy streets. For particulate matter ≤2.5 μm in diameter, statistically significant effects were found for asthma (OR: 1.56 [95% confidence interval [CI]: 1.03–2.37]), hay fever (OR: 1.59 [95% CI: 1.11–2.27]), and allergic sensitization to pollen (OR: 1.40 [95% CI: 1.20–1.64]). Nitrogen dioxide exposure was associated with eczema, whereas no association was found for allergic sensitization.CONCLUSIONS. The results provide strong evidence for the adverse effects of traffic-related air pollutants on atopic diseases and allergic sensitization.REVIEWER COMMENTS. Several previous studies suggested an association between exposure to air pollution and the development of atopic sensitization and disease. This study supports that connection, even adding a “dose-response” element in which the closer you live to a busy street, the more likely you are to develop allergic disease.