Proximity to Major Roads and Risks of Childhood Recurrent Wheeze and Asthma in a Severe Bronchiolitis Cohort.

Rachel D Freid,Rebecca E Cash,Janice A Espinola,Zahra Aryan,Carlos A Camargo,Ying (Shelly) Qi,Ashley F Sullivan

doi:10.3390/ijerph18084197

Abstract

Air pollution exposures have been suggested as risk factors for childhood respiratory diseases. We investigated proximity to major roads, an indicator of air pollution exposure, and its associations with childhood recurrent wheeze and asthma. We used data from a multicenter prospective cohort study of 921 infants hospitalized for bronchiolitis and recruited from 14 U.S. states. Primary exposure was residential proximity to the nearest major road at birth through age 3 years. Residential distance from nearest major road was divided into four categories: <100, 100–200, 201–300, and >300 m. Outcomes were parent-reported recurrent wheeze by age 3 years and asthma by age 5 years. Associations between residential proximity to major roads and respiratory outcomes were investigated using multivariable Cox proportional hazards modeling and logistic regression, adjusted for confounders. Out of 920 participants with home address data, pooled estimates identified 241 (26%) participants resided within 300 m of a major road, 296 (32%) developed recurrent wheeze by age 3, and 235 out of 858 participants (27%) developed asthma by 5 years. Participants who resided close to a major road had the highest risk of recurrent wheeze (adjusted hazards ratio for <100 m, 1.59, 95%CI: 1.08–2.33) and asthma (adjusted odds ratio for 201–300 m, 1.62, 95%CI: 1.16–2.25), compared to those residing >300 m from a major road. Proximity to major roads is associated with increased risks of recurrent wheeze and asthma in young children.

Highlights

Respiratory problems in young children are highly prevalent and, in particular, recurrent wheeze and asthma are a significant worldwide public health issue [1,2,3,4,5]
Participant characteristics were similar across pooled proximity to major road categories, but non-Hispanic black participants were more likely to live within ≤200 m of a major road compared to other participants
Pooled proximity to primary roads had a similar distribution compared to major roads, with 34 (4%) located within

Summary

Introduction

Respiratory problems in young children are highly prevalent and, in particular, recurrent wheeze and asthma are a significant worldwide public health issue [1,2,3,4,5]. Wheezing episodes are common in young children and an estimated 50% experience at least 1 wheezing episode between the first year of life and age 6 years [4,6,7]. Asthma is the most common non-communicable disease and accounts for over 5 million respiratory illnesses in children [3,4,5,9]. A growing body of evidence suggests that both recurrent wheeze and asthma are multifactorial disorders, necessitating investigation into possible early-life influences with an important focus on environmental factors

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Discussion

Conclusion