Abstract
Few birth cohort studies have examined the role of traffic-related air pollution (TRAP) in the development of infantile atopic dermatitis (AD), but none have investigated the role of preventive factors such as green spaces. The aim of this study was to investigate whether exposure to nitrogen dioxide (NO2) and particulate matter with an aerodynamic diameter of <10 μm (PM10) during pregnancy is associated with increased risk of development of AD in 6-month-old children and also to examine how this association changes with residential green space. This study used prospective data from 659 participants of the Mothers and Children’s Environmental Health study. Subjects were geocoded to their residential addresses and matched with air pollution data modeled using land-use regression. Information on infantile AD was obtained by using a questionnaire administered to the parents or guardians of the children. The association between infantile AD and exposure to NO2 and PM10 was determined using logistic regression models. We assessed the effects of residential green spaces using stratified analyses and by entering product terms into the logistic regression models. The risk of infantile AD significantly increased with an increase in air pollution exposure during the first trimester of pregnancy. The adjusted odds ratio (OR) and 95% confidence interval (CI) were 1.219 (1.023–1.452) per 10 μg/m3 increase in PM10 and 1.353 (1.027–1.782) per 10 ppb increase in NO2. An increase in the green space within 200 m of residence was associated with a decreased risk of AD (OR = 0.996, 95% CI: 0.993–0.999). The stratified analysis of residential green space revealed stronger associations between infantile AD and PM10 and NO2 exposure during the first trimester in the areas in the lower tertiles of green space. This study indicated that exposure to TRAP during the first trimester of pregnancy is associated with infantile AD. Less residential green space may intensify the association between TRAP exposure and infantile AD.
Highlights
Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects as many as 10–30% of children [1,2] with a typical onset during infancy
To assess the combined effect of traffic-related air pollution (TRAP) and green space, we conducted a stratified analysis in which we examined the association between exposure to PM10 and NO2 during different windows of pregnancy and childhood AD according to the level of green space
Prenatal exposure to TRAP, especially in the first trimester of pregnancy, and low residential green space are both associated with an increased risk of AD at 6 months of age
Summary
Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects as many as 10–30% of children [1,2] with a typical onset during infancy. Several epidemiological studies have reported that exposure to ambient air pollutants increases the risk of AD or exacerbates AD symptoms in children [7,8]. Studies regarding prenatal exposure to air pollution and the development of AD are limited [9,10,11,12,13,14,15,16,17,18]. Most of these studies reported that exposures to ambient air pollutants during pregnancy increase the risk of AD in childhood
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