Abstract
Studies investigating the association between urinary Polycyclic Aromatic Hydrocarbons (PAHs) and asthma in children provided inhomogeneous results. We aimed to use Mediation Analysis to discover whether a link between urinary PAHs and lung function exists and if it might be ascribed to a direct or a symptom-mediated (indirect) effect in children with asthma. This single-center prospective study was conducted in Palermo, Italy, between March and July 2017 and involved 50 children with persistent mild-moderate asthma, aged 6–11 years. At each time visit (day 0, 30, 60, and 90), physical examination, spirometry, and urine collection for detection of urinary cotinine and PAHs were performed. A symptom score was computed. The sum of individually calculated molar mass of nine PAH metabolites (ΣPAH), naphthalene metabolites (ΣPAHn) and phenanthrene metabolites (ΣPAHp) were calculated. Three children withdrew from the study due to technical problems (n = 1) and adverse events (n = 2). PAHs indirect effects on FEV1 (ΣPAH: −0.011, p = 0.04; ΣPAHn: −0.011, p = 0.04; ΣPAHp: −0.012, p < 0.001) and FVC (ΣPAH: −0.012, p = 0.02; ΣPAHn: −0.0126, p = 0.02; ΣPAHp: −0.013, p < 0.001) were statistically significant. In conclusion, PAHs exposures have significant indirect (symptom-mediated) effects on lung function, emphasizing the role of PAHs-induced respiratory morbidity in decreasing lung function in children with asthma.
Highlights
Polycyclic aromatic hydrocarbons (PAHs) are a group of hydrocarbons originated from the incomplete combustion of tobacco, wood, coal, and fossil fuels [1]
Thirty-four per cent of children were females, 16% were exposed to Environmental Tobacco Smoke (ETS)
* Three children were lost to follow-up due to technical problems and lost to follow-up due to adverse events
Summary
Polycyclic aromatic hydrocarbons (PAHs) are a group of hydrocarbons originated from the incomplete combustion of tobacco, wood, coal, and fossil fuels [1]. Concentrations of both outdoor and indoor PAHs are significantly higher in the gaseous fraction (2-, 3-, and 4-ring PAHs) than in the particulate fraction (5- and 6-ring PAHs) [2]. PAHs may be adsorbed on inhaled particulate matter (PM) surface [3]. Their wide environmental distribution poses a potentially serious hazard for human exposure [4].
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