Cumulative Early-Life Traffic-Related Air Pollution Exposure and Sleep Disturbance Consistent with Sleep Disordered Breathing among 12-Year-Old Children

Abstract

Background/Aim: Exposure to traffic-related air pollution (TRAP) may be linked to sleep disordered breathing. The aim of this study was to assess whether cumulative early-life exposure to TRAP is associated with loud snoring and frequent napping among 12-year-old children.Methods: We used data from the Cincinnati Childhood Allergy and Air Pollution Study, a prospective birth cohort study of children in the greater Cincinnati, Ohio metropolitan area. Annual average exposures to TRAP at residential addresses from birth to 12-years-old were estimated using a previously-validated land use regression model of elemental carbon attributable to traffic. TRAP was dichotomized as high versus low at the 75th percentile (0.41 µg/m3) based on the distribution at age 12 years. Parental report of frequency of their child snoring loudly and napping was categorized as <3 times per week versus ≥3 times per week. Using log-binomial regression, we estimated prevalence ratios (PR) of frequent loud snoring and napping among children with high versus low TRAP exposure. Models were adjusted for age, sex, race/ethnicity, annual household income, secondhand smoke expo-sure, and obesity status (95th body mass index percentile).Results: Among 313 children, the prevalence of frequent loud snoring was 10.0% and frequent napping was 12.0%. There was an over 2-fold higher prevalence of frequent snoring among children with high versus low TRAP exposure in the fully-adjusted model (PR:2.20, 95%Confidence Interval [CI]:1.10-4.40, p=0.025). There was over twice the prevalence of frequent napping among children with high versus low TRAP exposure in the unadjusted model (PR:2.48, 95%CI:1.38-4.46, p=0.002); however, this association was attenuated in the fully-adjusted model (PR:1.12, 95%CI:0.65-1.92, p=0.68).Conclusions: High levels of cumulative early-life TRAP exposure may contribute to symptoms consistent with sleep disordered breathing among children, which are both associated with a wide range of adverse human health effects including poor cardiometabolic health. More research is warranted.