Abstract
BackgroundWhile several studies suggest that traffic-related air pollutants are detrimental for respiratory health, few studies have examined relationships between residential proximity to a major roadway and asthma control in children. Furthermore, a major limitation of existing research is reliance on self-reported outcomes. We therefore determined the spatial relationship between the distance from a major roadway and clinical, physiologic and inflammatory features of asthma in a highly characterized sample of asthmatic children 6–17 years of age across a wide range of severities. We hypothesized that a closer residential proximity to a major roadway would be associated with increased respiratory symptoms, altered pulmonary function and a greater magnitude of airway and systemic inflammation.Methodology/Principal Findings224 children 6–17 years with confirmed asthma completed questionnaires and underwent spirometry, plethysmography, exhaled nitric oxide determination, exhaled breath condensate collection and venipuncture. Residential distance from a major roadway was determined by mapping the geographic coordinates of the residential address in Geographic Information System software. The distance between the home address and the nearest major roadway was calculated according to the shortest distance between the two points (i.e., “as the crow flies”). Asthmatic children living in closer proximity to a major roadway had an increased frequency of wheezing associated with increased medication requirements and more hospitalizations even after controlling for potential confounders. These children also had increased airway resistance, increased airway inflammation reflected by a lower breath condensate pH, and higher plasma EGF concentrations.Conclusions/SignificanceThese findings suggest that closer residential proximity to a major roadway is associated with poorer asthma control in school-age children. Assessment of residential proximity to major roadways may be useful in the clinical evaluation of asthma in children.
Highlights
Asthma is a complicated disorder associated with variable airway inflammation and airflow limitation in response to specific triggers
More recent studies have revealed increased respiratory symptoms in asthmatic children residing in close proximity to a major roadway [13,14] which correlated with the magnitude of vehicle emissions [14]
Another strength is the inclusion of only asthmatic children, since asthma medications and other key variables in the medical history may confound the spatial relationship between roadway proximity and asthma control [21,22]
Summary
Asthma is a complicated disorder associated with variable airway inflammation and airflow limitation in response to specific triggers. More recent studies have revealed increased respiratory symptoms in asthmatic children residing in close proximity to a major roadway [13,14] which correlated with the magnitude of vehicle emissions [14] These studies suggest that the increased burden of traffic-related air pollutants associated with a close residential proximity to a major roadway may be an important factor in asthma pathogenesis in children. While several studies suggest that traffic-related air pollutants are detrimental for respiratory health, few studies have examined relationships between residential proximity to a major roadway and asthma control in children. We hypothesized that a closer residential proximity to a major roadway would be associated with increased respiratory symptoms, altered pulmonary function and a greater magnitude of airway and systemic inflammation
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