Abstract
Background: Traffic-related pollution is associated with the onset of asthma and the development of different phenotypes of asthma. Few studies have investigated the association between traffic proximity and late-onset of asthma (LOA) and early-onset asthma (EOA). This study was conducted to investigate the associations of LOA phenotypes with a function of the distance between residence and heavy traffic roads (HTRs).Methods: The study group consisted of 280 patients who were (LOA: 78.4%) recruited consecutively from a pay-for-performance asthma program to clarify the patient characteristics and proximity to HTRs within 1,000 m from their residences between EOA and LOA in three urban centers in Taiwan. The subsequent analysis focused on patients with LOA (n = 210) linking phenotypes and distance to HTRs.Results: Subjects with LOA tended to be older than those with EOA and had shorter asthma duration, poorer lung function, lower atopy, and less exposure to fumes or dust at home. Patients with LOA were more likely than those with EOA to live within 900 m of two or more HTRs (14.3 vs. 3.4%, p = 0.02). Among patients with LOA, minimum distance to an HTR was negatively associated with numbers of specific IgE as well as positively associated with the age of onset and body weight significantly. A higher proportion of patients with atopy (26.3 vs. 20.6%, p = 0.001. odds ratio [OR]: 2.82) and anxiety/depression (21.0 vs. 18.1%, p = 0.047. OR: 1.81) and a trend of lower proportion of patients with obese (5.7 vs. 12.4%, p = 0.075) were found to be living within 900 m from HTRs.Conclusions: Late-onset of asthma (LOA) tended to live in areas of higher HTR density compared to EOAs. Among patients with LOA living close to HTRs, the interaction between traffic-related pollution, allergy sensitization, and mood status were the factors associated with asthma onset early. Obesity may be the factor for later onset who live far from HTRs.
Highlights
Traffic-related pollution is associated with the onset of asthma and the development of different phenotypes of asthma
We examined patient characteristics in order to identify factors significantly associated with traffic proximity in Late-onset of asthma (LOA)
As for allergic biomarkers, immunoglobulin E (IgE) levels were significantly higher in the early-onset asthma (EOA) group than in the LOA group
Summary
Traffic-related pollution is associated with the onset of asthma and the development of different phenotypes of asthma. Few studies have investigated the association between traffic proximity and late-onset of asthma (LOA) and early-onset asthma (EOA). Early-onset asthma (EOA) and late-onset asthma (LOA) can be viewed as two distinct phenotypes, based on the categorization of disease entities according to underlying mechanisms or endotypes, such as risk factors, remission rates, co-morbidities, and gene expression profiles [2,3,4]. The risk factors of EOA include single nucleotide polymorphisms on chromosome 17q21, atopic status, rhinovirus infection, and exposure to traffic-related air pollution (TRAP) [8,9,10,11,12]. Proximity to traffic has been linked to an elevated risk of asthma [12, 14,15,16]
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