Lung Function In Schoolchildren Research Articles

The link between early childhood lower airway symptoms, airway hyperresponsiveness, and school-age lung function

BackgroundThe role of early airway hyperresponsiveness (AHR) in the lung function of school-age children is currently unclear. ObjectiveTo conduct a prospective follow-up study of lung function in schoolchildren with a history of lower airway symptoms and AHR to methacholine in early childhood and to compare the findings to schoolchildren with no previous or current lung diseases. We also explored symptoms and markers of type 2 inflammation. MethodsIn 2004 to 2011, data on atopic markers, lung function, and AHR to methacholine were obtained from 193 symptomatic children under 3 years old. In 2016 to 2018, a follow-up sample of 84 children (median age, 11 years; IQR, 11-12) underwent measurements of atopic parameters, lung function, and AHR to methacholine. Moreover, in 2017 to 2018, 40 controls (median age, 11 years; IQR, 9-12) participated in the study. ResultsSchoolchildren with early childhood lower airway symptoms and increased AHR had more frequent blood eosinophilia than their peers without increased AHR and lower prebronchodilator forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity Z-scores than those without increased AHR and controls. Post-bronchodilator values were not significantly different between the two AHR groups. Atopy in early childhood (defined as atopic eczema and at least 1 positive skin prick test result) was associated with subsequent lung function and atopic markers, but not AHR. ConclusionIn symptomatic young children, increased AHR was associated with subsequent obstructive lung function, which appeared reversible by bronchodilation, and blood eosinophilia, indicative of type 2 inflammation.

Bronchial eosinophils, neutrophils, and CD8 + T cells influence asthma control and lung function in schoolchildren and adolescents with severe treatment-resistant asthma

Studies in adult severe treatment-resistant asthma (STRA) have demonstrated heterogeneous pathophysiology. Studies in the pediatric age group are still scarce, and few include bronchial tissue analysis. We investigated 6-18-year-old patients diagnosed with STRA in Sao Paulo, Brazil, by characterizing the different lung compartments and their correlations with asthma control and lung function. Inflammatory profiles of 13 patients with a confirmed diagnosis of STRA were analyzed using blood, induced sputum, bronchoalveolar lavage, viral and bacterial screens and endobronchial biopsy. Inflammatory cells, cytokines, and basement membrane thickening were tested for correlations with the asthma control test (ACT) and spirometry and plethysmography parameters. Endobronchial biopsy specimens from 11 patients were viable for analysis. All biopsies showed eosinophilic infiltration. Submucosal (SM) eosinophils and neutrophils were correlated with worse lung function (pre-BD FEV1), and SM neutrophils were correlated with fixed obstruction (post-BD FEV1). Intraepithelial (IE) neutrophils were positively correlated with lung function (pre-BD sGaw). CD8 + T cells had the highest density in the IE and SM layers and were positively correlated with ACT and negatively correlated with the cytokines IL1β, IL2, IL5, IL7, IL10, IL12, IL17, GCSF, MCP-1, INF-δ, and TNFα in sputum supernatant. The ASM chymase + mast cell density correlated positively with quality-of-life score (pAQLQ) and ACT. Eosinophils and SM neutrophils correlated with worse lung function, while IE neutrophils correlated with better lung function. Most importantly, CD8 + T cells were abundant in bronchial biopsies of STRA patients and showed protective associations, as did chymase + mast cells.

Associations between Short-Term Exposure to Particulate Matter and Ultrafine Particles with Lung Function in Schoolchildren from the German CorPuScula Study

BACKGROUND AND AIM: Short-term exposure to particulate matter (PM) has been associated with impaired lung function, but exposure to ultrafine particles (UFP) has been less well examined in children. METHODS: We analyzed data from 50 schoolchildren (ages 6-10) at an elementary school from the German CorPuScula study conducted from 2001 to 2002. Spirometry (VC, FEV1, MEF25-75) and body plethysmography (specific airway resistance) were performed to assess lung function. PM exposure (diameter ≤10 µm; µg/m (PM10), diameter ≤2.5 µm; µg/m³ (PM2.5)) was measured at school over the full study period, and UFP exposure was measured for six months. Mean exposures during the day of examination (9-21h) as well as one- and two-day lags were assessed. Further, individual mean UFP (1- and 3-h), and PM10 (3-, 12- and 24-h) exposures before examination were calculated. Associations between short-term air pollution and lung function were assessed using generalized estimating equation models with an autoregressive correlation matrix, adjusted for day of the week, study day and physiological equivalent temperature index using splines. Two-pollutant models adjusted for centrally-monitored NO2 were performed. RESULTS:For PM, median PM10 levels were 17.4 µg/m³ (nobs=961, average of 20 tests/child). For UFP, median UFP concentration was 21,826 particles/mL (nobs=421, average of 8 tests/child). PM and UFP showed mixed associations with spirometry outcomes. For PM, we observed weak positive associations with airway resistance for 12-h and 24-h PM10 (e.g. 7.4 % [95% CI: 1.9%; 13.3%] increase in airway resistance per 24.9 µg/m³ increase in 12-h PM10) and weak inverse associations for the two-day lag. While results for 12-h and 24h PM10 before testing were robust to NO2 adjustment, inverse associations for two-day lags disappeared. For UFP, no associations with airway resistance were visible. CONCLUSIONS:We observed mixed results for spirometry outcomes. PM10 was associated with increased airway resistance. No associations were visible for UFPs. KEYWORDS: Short-term exposure, Particulate matter, Respiratory outcomes

Abnormal iron status is independently associated with reduced oscillometric lung function in schoolchildren.

Associations between anemia and allergic diseases have been reported, but the relationship of iron deficiency with airway dysfunction in children remains unclear. We aimed to investigate the relationship between abnormal iron parameters and lung function in schoolchildren. Four hundred and forty-five children (10-12years-old) from 11 elementary schools in were enrolled. The relationships of different iron parameters (hemoglobin, serum iron, transferrin saturation, and serum ferritin) with lung function evaluated by impulse oscillometry (airways resistanceat 5Hz [Rrs5], 10Hz [Rrs10], and the difference of Rrs5 and Rrs20 Hz [Rrs5-20]), and with exhaled nitric oxide (FeNO) were evaluated after adjustment for confounders including height, sex, and body mass index z-score, and for additional covariates that could affect airway function. Total airway dysfunction represented by Rrs5 was reduced in participants with low serum iron level (aβ: -0.13, 95% CI: -0.23 to -0.03, p=0.040) after adjustment for key confounders, but did not correlate with other iron profiles. Reduced oscillometric lung function recorded as Rrs5-20 was related with low serum iron and high serum ferritin, but the results were inconsistent after multiple comparisons. Associations were not observed with serum hemoglobin. Decreased serum iron level was related with airway dysfunction represented as oscillomteric Rrs5. Our results suggest a relationship of reduced lung function with abnormal iron status in children.

Linkage between Particulate Matter Properties and Lung Function in Schoolchildren: A Panel Study in Southern China.

While several scientific studies have linked PM2.5 to decreased lung function, there is still some degree of uncertainty regarding which particulate physicochemical properties are most harmful. We followed a panel of 57 healthy schoolchildren (857 person-days) to investigate the associations between a wide variety of PM2.5 and lung function in Heshan, China in 2016 for three periods. We monitored the daily concentrations of mass, chemical composition, size, number, surface area, and volume of particulate mixture. Associations of lung function with various particle metrics were estimated using generalized estimating equations and unconstrained distributed lag models. Random forest model was used to compare the relative importance of exposure metrics. Immediate (lag 0) associations of PM2.5 and carbonaceous aerosols with reduced FEV1 and MMEF, and accumulation-mode particles with FEV1 were found. Slightly delayed (lag 1, 2) effects on PEF were particularly prominent for Aitken-mode particles. Possible cumulative (lags 0-2) effects of PM2.5 and carbonaceous aerosols on PEF and Aitken-mode particles on FEV1, MMEF, and PEF were observed. This study provides comprehensive evidence that the physicochemical properties of particulate mixtures are associated with reduced lung function in children. Organic carbon (OC) may be an important risk factor for the decreased lung function related to PM exposure.

Short term seasonal effects of airborne fungal spores on lung function in a panel study of schoolchildren residing in informal settlements of the Western Cape of South Africa

BackgroundThe individual effects of biological constituents of particulate matter (PM) such as fungal spores, on lung function in children are not well known. This study investigated the seasonal short-term effect of daily variation in Alternaria and Cladosporium fungal spores on lung function in schoolchildren. MethodsThis panel study evaluated 313 schoolchildren in informal settlements of the Western Cape of South Africa, exposed to spores of two commonly encountered fungi, Alternaria and Cladosporium species. The children provided forced-expiratory volume in 1-s (FEV1) and peak-expiratory flow (PEF) measurements thrice daily for two consecutive school-weeks in summer and winter. Daily PM10 levels, from a stationary ambient air quality monitor and fungal spore levels using spore traps were measured in each study area throughout the year. The effects of Alternaria and Cladosporium spores, on lung function were analysed for lag periods up to five-days, adjusting-for PM10, other pollen exposures, study area, and other host and meteorological factors. Same-day exposure-response curves were computed for both fungal species. ResultsThere was more variability in Alternaria spores level with noticeable peaks in summer. There were consistent lag-effects for Alternaria on PEF compared to Cladosporium, with the largest PEF deficit observed in winter (mean deficit: 13.78 L/min, 95%CI: 24.34 to −3.23 L/min) per 10spores/m3 increase in Alternaria spores on lag day-2. Although there were no observable lag-effects for Alternaria and Cladosporium on FEV1, same-day effects of Cladosporium spores on FEV1 was present across both seasons. Threshold effects of Alternaria on both PEF and FEV1 deficits were apparent at levels of 100 spores/m3, but could not be explored for Cladosporium beyond the levels observed during the study. ConclusionThe study provides evidence for the independent effects of daily exposure to ambient fungal spores of Alternaria and Cladosporium on lung function deficits, more especially in winter for PEF.

Indoor ozone and particulate matter modify the association between airborne endotoxin and schoolchildren's lung function

BackgroundTo date, the effect of household airborne pollutants on the association between airborne endotoxin and lung function of schoolchildren is unknown. ObjectivesThe objective of this study is to evaluate whether indoor air pollutants such as carbon monoxide (CO), carbon dioxide (CO2), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), particulate matter with aerodynamic diameter <10 and 2.5 μm (PM10, PM2.5) can modify the association between airborne endotoxin and school children's lung function in a heavy industrial city in Taiwan. MethodsWe recruited 120 elementary school-age children in Kaohsiung City, Taiwan. Aerosol samples were collected on a filter membrane for 24 h period and then analyzed for endotoxin. Air pollutants were measured for 24 h in living rooms while school children's lung function was measured. The modification of air pollutants on the relationship between airborne endotoxin and children's lung function was estimated after adjusting the gender, age, height, weight, and case-control status. ResultsWe found that both O3 and PM10 concentrations significantly modified the relationships between airborne endotoxin and school children's lung function. Among children living in homes with O3 ≥ 0.01 ppm or PM10 ≥ 62 μg/m3, airborne endotoxin was negatively associated with lung functions, whereas among those living in homes with O3 < 0.01 ppm or PM10 < 62 μg/m3, airborne endotoxin was positively associated with lung functions. ConclusionsThe indoor air pollutant concentration of O3 and PM10 modifies the association between airborne endotoxin and school children's lung function.

Association of ambient temperature with lung function of school children living in tropical climatic conditions.

Association of ambient temperature with lung function of school children living in tropical climatic conditions.

Effects of Short-term Exposure to Ambient Particulate Matter on the Lung Function of School Children in Dhaka, Bangladesh.

Ambient particulate pollution may adversely affect children's lung function. However, evidence on this association remains scarce in Asia despite this region having the greatest burden of disease due to air pollution. To investigate the effect of short-term exposure to ambient particulate matter (PM) on the lung function of school children in Dhaka city, Bangladesh. The possible seasonal modification of this association was also examined. A panel of 315 school children who were 9-16 years of age were recruited from three schools in and around Dhaka. Lung function was assessed using a spirometry test during the cool and warm seasons in 2013, yielding six measurements per child. Daily PM data were retrieved from nearby air monitoring stations. Linear mixed effects models were used to examine associations. Seasonal modification was examined by stratification. An inverse association was observed for the lung function parameters with PM2.5; peak expiratory flow (PEF) and forced expiratory volume within 1 second (FEV1) decreased with increasing PM2.5. The percent deviation from the personal median was -4.19% [95% confidence interval (CI): -5.72, -2.66] for PEF and -2.05% (95% CI: -2.92, -1.18) for FEV1 for a 20 µg/m increase in PM2.5 on the previous day. Results for PM10 were less consistent. The estimated effects of PM on lung functions were generally greater in the warm season. Short-term exposure to PM is associated with worse lung function in children living in highly polluted settings, with the strength of these adverse PM effects varying by season.

Short Term Seasonal Effect of Ambient Air Pollutants and Airborne Fungal Spores on the Lung Function of School Children in Western Cape, South Africa: A Panel Study

Short Term Seasonal Effect of Ambient Air Pollutants and Airborne Fungal Spores on the Lung Function of School Children in Western Cape, South Africa: A Panel Study

Air pollution and airway resistance at age 8\xa0years \u2013 the PIAMA birth cohort study

BackgroundAir pollution has been found to adversely affect children’s lung function. Forced expiratory volume in 1 s and forced vital capacity from spirometry have been studied most frequently, but measurements of airway resistance may provide additional information. We assessed associations of long-term air pollution exposure with airway resistance.MethodsWe measured airway resistance at age 8 with the interrupter resistance technique (Rint) in participants of the Dutch PIAMA birth cohort study. We linked Rint with estimated annual average air pollution concentrations [nitrogen oxides (NO2, NOx), PM2.5 absorbance (“soot”), and particulate matter < 2.5 μm (PM2.5), < 10 μm (PM10) and 2.5–10 μm (PMcoarse)] at the birth address and current home address (n = 983). Associations between air pollution exposure and interrupter resistance (Rint) were assessed using multiple linear regression adjusting for potential confounders.ResultsWe found that higher levels of NO2 at the current address were associated with higher Rint [adj. mean difference (95% confidence interval) per interquartile range increase in NO2: 0.018 (0.001, 0.035) kPa·s·L− 1]. Similar trends were observed for the other pollutants, except, PM10. No association was found between Rint and exposure at the birth address.ConclusionsOur results support the hypothesis that air pollution exposure is associated with a lower lung function in schoolchildren.

Oxidative stress, lung function and exposure to air pollutants in Mexican schoolchildren with and without asthma

To assess the association between the air pollutants exposure on markers of oxidative stress and lung function in schoolchildren with and without asthma from Salamanca and Leon Guanajuato, Mexico. We realized determinations of oxidative stress biomarkers and lung function tests in 314 schoolchildren. Information of air pollutants (O3, SO2, CO, PM2.5 and PM10) were obtained from monitoring stations and multiple linear regression models were run to assess the association. An increase of 0.09 pmol in conjugated dienes was observed by exposure to PM10 lag 1 in asthmatics from Salamanca (p<0.05). The exposure to O3 during the same day increased the concentration of Lipohydroperoxides in 4.38 nmol in asthmatics of Salamanca, as well as in 2.31 nmol by exposure to PM10 lag 2 (p<0.05). The forced vital capacity decreased by 138 and 203 ml in children without asthma, respectively, due to exposure to carbon monoxide (p<0.05). Exposure to air pollutants increase oxidative stress and decreased lung function in schoolchildren, with and without asthma.

Association between Allergic Scenario, Nutritional Status and Lung Function of School Children (10-14 years) in the Union Territory of Puducherry

Association between Allergic Scenario, Nutritional Status and Lung Function of School Children (10-14 years) in the Union Territory of Puducherry

Seasonal Modification In The Effect Of Short-Term Exposure To Ambient Fine Particulate Matter On The Lung Function Of School Children In Dhaka, Bangladesh

The objective of this study was to investigate the effect of short-term exposure to ambient particulate matter with an aerodynamic diameter less than 2.5 µm (PM2.5) on lung function and modification of this association by season in school children in Dhaka, the capital of Bangladesh. A panel of total of 314 school children, aged 9-16 years from 3 schools located within 1km of three existing continuous air monitoring stations inside and around Dhaka were recruited. Lung function was assessed repeatedly using spirometry test during winter and summer season in 2013, yielding a total of 6 measurements per child. Daily PM2.5 data were retrieved from nearby air monitoring stations. Linear mixed effects models adjusted for potential confounders were used to examine the effect of the PM2.5 on lung function. To assess the effect modification of season, stratified analyses was performed by dichotomizing winter and summer season and then, the p-value was calculated by a multiple comparison test. The mean PM2.5 level was 88µg/m3 during the total study period. PM2.5 concentration varied greatly between seasons, with higher values observed in winter than in summer. In both seasons, lung function parameters were negatively associated with a 20 µg/m3 increase of PM2.5 on the previous day. In summer, the negative effect of PM2.5 on lung function parameters was stronger than in winter. Specifically, for peak expiratory flow (PEF), there was a - 4.17 (95% CI, -5.69 to -2.65) decrease in winter and -10.92 (95% CI, -15.73 to -6.12) decrease in summer for a 20 µg/m3 increase in PM2.5 on the previous day. This difference in estimates was statistically significant (p

Impact of close-proximity air pollution on lung function in schoolchildren in the French West Indies

BackgroundHigh levels of asthma prevalence and severity of respiratory symptoms have been found in the Caribbean but little is known about the impact of air pollution in these regions.This study aimed to describe air pollution and measure the associations with child lung function in Guadeloupe (French West Indies).MethodsData from 30 randomly chosen elementary schools (8–13 years old) were obtained using a standardized protocol adapted from the ISAAC2 study. We considered two health outcomes: peak expiratory flow (PEF) before running and the variation in peak expiratory flow (ΔPEF) after running. The associations between pollutants and outcomes were investigated using several air pollution exposure models: i) medium-term exposure to close-proximity pollution both indoor and outdoor for ozone (O3) and nitrogen dioxide (NO2) and ii) short- and medium-term exposure to background pollution for O3, NO2, sulphur dioxide (SO2) and small particulate matter (PM10).ResultsOf 1,463 children, 277 (16%) were found to have asthma. A 1-μg/m3 increase in medium-term exposure to outdoor close-proximity pollution by O3 was associated with a PEF decrease (β = −0.32; 95% CI: −0.61;-0.03). No association was found with NO2 regarding close-proximity pollution. The association between medium-term exposure to background pollution and PEF decrease was stronger in asthmatic children than in non-asthmatic children for O3. No reduction in PEF or ΔPEF was shown with NO2, SO2 and PM10 pollutants but a significant association was found between PM10 and PEF increase.ConclusionsOur results suggest that O3 could have an acute effect on child lung function in the Caribbean even at a low concentration (below the WHO guidelines). Further research in the Caribbean is needed to confirm these findings.

New BPD predicts lung function at school age: Follow-up study and meta-analysis.

New treatment practices have improved survival of preterm infants and decreased airway pathology in bronchopulmonary dysplasia (BPD). Our aim was to investigate whether preterm birth, BPD, and the severity of BPD predict lung function in school children that are born in surfactant era. We studied pulmonary function of 88 school-aged children born very preterm (gestational age <32 weeks) and paired them with 88 age- and sex-matched controls born at term. Spirometry and diffusion capacity were recorded. We also performed a meta-analysis covering the era of antenatal corticosteroid and surfactant treatment. BPD was defined as oxygen dependence for ≥ 28 days and it was severity-graded by oxygen requirement at 36 weeks postmenstrual age (mild, none; moderate, FiO2 = 0.22-0.29; severe, FiO2 ≥ 0.30). Preterm children had lower forced expiratory volume in 1 sec (FEV1 ) 86.4 ± 11.8 versus 94.9 ± 10.1 (mean % predicted ± SD; P < 0.001), and lower diffusion capacity (DLCO) 87.6 ± 13.9 versus 93.7 ± 12.0 (P = 0.005) compared with term controls. BPD group differed in both FEV1 (P = 0.037) and DLCO (P = 0.018) from those without BPD. For meta-analysis, search identified 210 articles. Together with present results, six articles met the inclusion criteria. FEV1 of no BPD, all BPD, and moderate to severe BPD groups differed from that in term controls by -7.4, -10.5, and -17.8%, respectively. According to meta-analysis and follow-up study, the adverse effects of prematurity on pulmonary function are still detectable in school-age. BPD was associated with reductions in both diffusion capacity and spirometry. New interventions are required to document a further decrease in the life-long consequences of prematurity.

Effect of Traffic-Related Air Pollution on Allergic Disease: Results of the Children's Health and Environmental Research.

PurposeThis study evaluated the relationship of living near to main roads to allergic diseases, airway hyperresponsiveness (AHR), allergic sensitization, and lung function in Korean children.MethodsA total of 5,443 children aged 6-14 years from 33 elementary schools in 10 cities during 2005-2006 were included in a baseline survey of the Children's Health and Environmental Research. We assessed association of traffic-related air pollution (TAP) exposure with the distance to the nearest main road, total road length of main roads and the proportion of the main road area within the 200-m home area.ResultsPositive exposure-response relationships were found between the length of the main road within the 200-m home area and lifetime wheeze (adjusted prevalence ratio [PR] for comparison of the longest to the shortest length categories=1.24; 95% CIs, 1.04-1.47; P for trend=0.022) and diagnosed asthma (PR=1.42; 95% CIs, 1.08-1.86; P for trend=0.011). Living less than 75 m from the main road was significantly associated with lifetime allergic rhinitis (AR), past-year AR symptoms, diagnosed AR, and treated AR. The distance to the main road (P for trend=0.001), the length of the main road (P for trend=0.041), and the proportion of the main road area (P for trend=0.006) had an exposure-response relationship with allergic sensitization. A strong inverse association was observed between residential proximity to the main load and lung function, especially FEV1, FEV1/FVC, and FEF25-75. The length of the main road and the proportion of the main road area were associated with reduced FEV1 in schoolchildren.ConclusionsThe results of this study suggest that exposure to traffic-related air pollution may be associated with increased risk of asthma, AR, and allergic sensitization, and with reduced lung function in schoolchildren.

Association between Exposure to Particulate Material from Mine Tailings and Lung Function in Schoolchildren, Chile

Background: One of the main productive activities in Chile is mine industry, inadequate disposal of its waste can affect the respiratory health of people exposed to Particulate Matter (PM) whose so...

High ambient Cladosporium spores were associated with reduced lung function in schoolchildren in a longitudinal study

BackgroundIn our previous longitudinal study, we found that exposure to current levels of ambient total fungal spores was related to a reduction of childhood lung function. However, the biological properties of various taxa of fungal spores varied greatly, as well as their health effects. In this study, we aimed to determine whether any specific fungal spores were responsible for observed changes in lung function. MethodsMeasurement of lung function was conducted for 100 elementary and middle-school students on 5–10 occasions from October 2007 to November 2009 in New Taipei City, Taiwan. During the week of each lung function measurement, continuous daily concentrations of fungal spores were measured from Sunday to Saturday. The counts of fungal spores belonging to specific taxa were identified. A mixed-effect model with repeated measurements was used to analyze the association of lung function and exposure to each specific taxon of fungal spores. Forward stepwise regression was applied to determine which specific fungal spores were the most closely related to lung function changes. The non-linear relationship was examined using a generalized additive model. The piecewise linear regression was then applied to determine the threshold value. ResultsA total of 824 measurements were obtained from 100 participants. Among all the species of fungal spores, only Cladosporium spores were found to be negatively associated with forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) one day later. This association was stronger than the one between the total spore counts and lung function. The threshold of exposure where lung function effect became observable was approximately 1500spores/m3. ConclusionThis study showed that ambient Cladosporium was most strongly associated with the observed lung function changes among schoolchildren. Replication of these preliminary findings in other geographic areas with different populations would be warranted.

Air Pollution Exposure and Lung Function in Children: The ESCAPE Project

Background: There is evidence for adverse effects of outdoor air pollution on lung function of children. Quantitative summaries of the effects of air pollution on lung function, however, are lacking due to large differences among studies.Objectives: We aimed to study the association between residential exposure to air pollution and lung function in five European birth cohorts with a standardized exposure assessment following a common protocol.Methods: As part of the European Study of Cohorts for Air Pollution Effects (ESCAPE) we analyzed data from birth cohort studies situated in Germany, Sweden, the Netherlands, and the United Kingdom that measured lung function at 6–8 years of age (n = 5,921). Annual average exposure to air pollution [nitrogen oxides (NO2, NOx), mass concentrations of particulate matter with diameters < 2.5, < 10, and 2.5–10 μm (PM2.5, PM10, and PMcoarse), and PM2.5 absorbance] at the birth address and current address was estimated by land-use regression models. Associations of lung function with estimated air pollution levels and traffic indicators were estimated for each cohort using linear regression analysis, and then combined by random effects meta-analysis.Results: Estimated levels of NO2, NOx, PM2.5 absorbance, and PM2.5 at the current address, but not at the birth address, were associated with small decreases in lung function. For example, changes in forced expiratory volume in 1 sec (FEV1) ranged from –0.86% (95% CI: –1.48, –0.24%) for a 20-μg/m3 increase in NOx to –1.77% (95% CI: –3.34, –0.18%) for a 5-μg/m3 increase in PM2.5.Conclusions: Exposure to air pollution may result in reduced lung function in schoolchildren.Citation: Gehring U, Gruzieva O, Agius RM, Beelen R, Custovic A, Cyrys J, Eeftens M, Flexeder C, Fuertes E, Heinrich J, Hoffmann B, de Jongste JC, Kerkhof M, Klümper C, Korek M, Mölter A, Schultz ES, Simpson A, Sugiri D, Svartengren M, von Berg A, Wijga AH, Pershagen G, Brunekreef B. 2013. Air pollution exposure and lung function in children: the ESCAPE project. Environ Health Perspect 121:1357–1364; http://dx.doi.org/10.1289/ehp.1306770