Children's Respiratory Health Research Articles

The Effect of Being Born Moderate-to-Late Preterm on Lung Function and Respiratory Morbidity at 9 to 10 Years of Age.

Rationale: The effect of moderate-late preterm (MLP; 32 to 36 completed weeks' gestation) birth on childhood respiratory health is unclear. Objectives: To assess the effect of being born MLP, compared with being born at term (≥37 completed weeks' gestation), on lung function and respiratory morbidity at 9-10 years of age. Methods: Prospective cohort of children born MLP or at term at the Royal Women's Hospital, Victoria, Australia. Participants completed pre- and post-bronchodilator spirometry, DLCO, plethysmography, and multiple breath washout at 9-10 years of age. Parents completed the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Mean differences in z-scores of lung function outcomes and risk ratio (RR) for ISAAC outcomes between those born moderate-late preterm and those born at term were estimated using regression models with adjustment for potential confounding. Multiple imputation was used to handle missing data. Measurements and Main Results: 148 of 201 children born MLP and 120 of 201 term-born controls were assessed at 9-10 years. Compared with controls, children born moderate-late preterm had lower mean z-scores (mean difference, 95% confidence interval) for FEV1: -0.35, (-0.61, -0.08), FEV1/FVC: -0.29, (-0.58, -0.01), FEF25-75%: -0.33, (-0.62, -0.04) and DLCO: -0.24, (-0.45, -0.03). Participants born MLP had higher risk of experiencing asthma symptoms (RR, 95% CI: 1.52 [1.08, 2.14]). Conclusions: Children born MLP have lower lung function and increased risk of exhibiting asthma symptoms compared with term-born peers at 9-10 years. Such findings at the end of the first decade of life may portend adverse consequences for respiratory health in adulthood.

Daycare use of disinfectants and cleaning products and wheeze among children: Cross-sectional analyses in the French CRESPI cohort.

Evidence is mounting that domestic use of disinfectants and cleaning products (DCP), particularly in spray form, is associated with wheezing in children. Beyond the home environment, many children are also exposed to DCP in daycare. The links between daycare exposures to DCP and child respiratory health have never before been studied. Evaluate the associations between daycare DCP use and wheeze among children. This cross-sectional study draws upon the data at inclusion for 536 children (mean age: 22.3months; 47.4% female) of the French CRESPI cohort (108 daycares in the Paris region, 2019-2022). Exposure to DCP was evaluated using a barcode-scanning smartphone application with an embedded questionnaire. An exposure score was calculated as the sum of frequencies of use of DCP for each daycare. Child wheezing outcomes (ever wheeze since birth, recurrent wheeze (≥3 times since birth), and wheeze ever treated with inhaled corticosteroids (ICS)) were evaluated by parental questionnaire. Associations between daycare DCP exposure and wheezing outcomes were analyzed with Generalized Estimating Equations to account for a possible center effect, and adjusted for child age, parental smoking status, parental educational attainment, and daycare size. The prevalence of ever wheeze was 32.1%, that of recurrent wheeze 13.3%, and that of wheeze ever treated with ICS 14.5%. Above-median exposure scores (vs.≤median exposure scores) were associated with higher odds of wheeze ever treated with ICS (Odds Ratio=1.72, 95% Confidence Interval: 1.07-2.75) and ever wheeze (1.40, 0.98-2.00), but not with recurrent wheeze (1.35, 0.79-2.31). Relationships between specific DCP application modes and wheezing outcomes did not suggest a predominant role of specific modes. Given the observed association between daycare DCP use and wheeze in children, measures which limit child exposure to DCP in care settings should be considered.

Impact of climate change and air pollution on childhood respiratory health.

To assess the impact of climate change and air pollution on children's respiratory health. Narrative review of articles published in English, Portuguese, French, and Spanish in the last decade in the following databases: PubMed, Google Scholar, EMBASE, and SciELO. The keywords used in this search were: climate changes OR air pollution OR indoor pollutants OR wildfires AND human health OR children OR exposome. Increases in extreme weather events, such as heat waves, forest fires, floods, droughts, hurricanes, and dust storms, put children's respiratory system health at greater risk. The growing global increase in respiratory diseases in recent decades raises questions about the impact of environmental factors resulting from industrialization, urbanization, and climate change on the individual's exposome. Understanding it better is a key point for better treatment.

Residential Area Characteristics Are Associated With Asthma Burden in Children.

Wheezing illnesses, especially those triggered by rhinovirus infection, cause a major disease burden, and they often precede asthma. Environmental exposures are known to affect recurrence of wheezing. We investigated the relations of population density, greenness (forested areas), and socioeconomic factors of the living surroundings to the burden of asthma in children with prior bronchiolitis. Three hundred and ninety-four children, aged 0-24 months, with doctor-diagnosed bronchiolitis were enrolled in the MARC-30 Finland study. We assessed the children's early-life exposures to greenness and socioeconomic factors using time-series of Corine Land Cover data and Statistics Finland's grid data. We compared the living surroundings data to the prescription drug purchases and special asthma reimbursement benefits until the age 8 years; asthma data were from the Social Insurance Institution of Finland. Children living in sparsely populated areas had lighter asthma disease burden than children living in densely populated ones, with burden measured in median bronchodilator (50DDD [defined daily dose] vs. 104DDD, p = 0.02) and inhaled corticosteroid (0DDD vs. 123DDD, p = 0.04) purchases. In the subgroup of children with rhinovirus-induced bronchiolitis, children living in more forested areas developed asthma 10 months later than those with less forested areas (p = 0.04). Neighborhood socioeconomic characteristics were not associated with differences in asthma burden. Sparsely populated areas and forested environments seem to have a beneficial association with children's respiratory health. These findings warrant further studies on the protective health effects of greenness and the type of biodiversity around homes.

Respiratory Benefits of Multisetting Air Purification in Children

Particulate matter exposure has been linked to impaired respiratory health in children, but the respiratory benefits of air purification have not been fully elucidated. To assess the respiratory health outcomes among children exposed to multisetting air purification vs sham purification. This cluster randomized, double-blind, crossover trial was conducted among healthy school-aged children (10-12 years) in China from April to December 2021. Data were analyzed from December 2021 to July 2024. A multisetting (both in classrooms and bedrooms) air purification intervention compared with sham purification in a 2-stage intervention with more than 2 months (76 days) for each period and a washout period (88 days) to estimate the respiratory benefits of air purification. The primary outcomes were pulmonary function, airway inflammation markers, and metabolites in exhaled breath condensate (EBC) before and after the air purification intervention. Linear mixed-effects models were used to estimate the respiratory benefits of children related to air purification. Differential metabolites in EBC were identified using metabolomics analysis to explore their possible mediation roles. A total of 79 children (38 male [48%]; mean [SD] age, 10.3 [0.5] years) were included in the statistical analyses. During the study period, the mean (SD) concentration of outdoor fine particulate matter (PM2.5) at the school site was 32.53 (24.06) μg/m3. The time-weighted personal PM2.5 concentration decreased by 45.14% during the true air purification period (mean [SD], 21.49 [8.72] μg/m3) compared with the sham air purification period (mean [SD], 39.17 [14.25] μg/m3). Air purification improved forced expiratory volume in 1 second by 8.04% (95% CI, 2.15%-13.93%), peak expiratory flow by 16.52% (95% CI, 2.76%-30.28%), forced vital capacity (FVC) by 5.73% (95% CI, 0.48%-10.98%), forced expiratory flow at 25% to 75% of FVC by 17.22% (95% CI, 3.78%-30.67%), maximal expiratory flow at 75% of FVC by 14.60% (95% CI, 0.35%-28.85%), maximal expiratory flow at 50% of FVC by 17.86% (95% CI, 3.65%-32.06%), and maximal expiratory flow at 25% of FVC by 18.22% (95% CI, 1.73%-34.70%). Fractional exhaled nitric oxide in the true air purification group decreased by 22.38% (95% CI, 2.27%-42.48%). Several metabolites in EBC (eg, L-tyrosine and β-alanine) were identified to mediate the effect of air purification on respiratory health. This randomized clinical trial provides robust and holistic evidence that indoor air purification notably improved pulmonary health in children, highlighting the importance of intensified indoor air purification in regions with high air pollution levels. ClinicalTrials.gov Identifier: NCT04835337.

Breathing in danger: unveiling cooking fuel transitions in India and alarming effect of household air pollution on under-five children’s health

Abstract Air pollution in households is a prime contributor to health issues in developing countries, as in the case of India. According to the latest National Family Health Survey Report 2022, more than half of India’s rural population and 41 per cent overall still depend on solid or unclean fuel combustions, which may reflect in future health hazards. Thus, it is crucial to understand the issue empirically. To that end, the study traces the transitional pattern of unclean cooking fuel users towards clean fuel over the last 30 years using responses from all five National Family Health Survey rounds. Further, the study uses an adjusted probit model to analyse the determinants that lead to the choice of cooking fuel in a household and a logistic model to examine the association between the choice made and the respiratory health of children under five. The empirical results show that the number of households using unclean fuel has declined over the years, with a slightly higher decline in the last five years. Moreover, it also shows that poverty status and place of residence significantly influence cooking fuel choice. Additionally, children residing in households that use clean fuels are less likely to suffer respiratory infections. In conclusion, the present study provides strong evidence to ameliorate the existing policies in a way that exhorts clean energy use. The authors propose pro-poor, pro-rural policies to expedite the clean energy transition, benefitting the most vulnerable households.

Is an antioxidant-rich or a pro-inflammatory diet during pregnancy associated with allergic and respiratory multimorbidity in children from the ELFE birth cohort?

The antioxidant capacity and the inflammatory potential of diet during pregnancy may represent a prevention opportunity for allergic and respiratory diseases. We aimed to investigate the associations between the antioxidant and the inflammatory potential of maternal diet in the last 3 months of pregnancy with allergic and respiratory diseases in children. Analyses were performed on 9679 mother–child pairs from the ELFE birth cohort. The dietary total antioxidant capacity (DTAC), without coffee, was estimated with the Trolox equivalent antioxidant capacity (TEAC), the total radical trapping antioxidant parameter (TRAP) and the ferric reducing-antioxidant power (FRAP). The inflammatory potential of the maternal diet was assessed by the energy-adjusted dietary inflammatory index (E-DII). Allergic and respiratory diseases in children up to 5·5 years were considered jointly through five allergic and respiratory multimorbidity clusters (‘asymptomatic’ - reference, ‘early wheeze without asthma’, ‘asthma only’, ‘allergies without asthma’ and ‘multi-allergic’). Multinomial logistic regressions were performed and adjusted for main confounders. A diet with a higher antioxidant potential was associated with a lower risk of belonging to the ‘early wheeze without asthma’ cluster (aOR (95 % CI) = 0·95 (0·90, 0·99) per sd of TEAC score). A higher E-DII was associated with a higher risk of belonging to the ‘asthma only’ cluster (aOR (95 % CI) = 1·09 (1·00, 1·19) per sd). No association was found with the ‘allergies without asthma’ or ‘multi-allergic’ clusters. An antioxidant-rich diet during pregnancy was associated with better respiratory health, while a pro-inflammatory diet was associated with poorer respiratory health in children up to 5·5 years, though the associations were weak.

Long-Term Exposure to Nitrogen Dioxide and Ozone and Respiratory Health in Children.

Further evaluation of the impact of long-term exposure to the gaseous air pollutants nitrogen dioxide (NO2) and ozone (O3) on child lung function, and of NO2 or O3 on eosinophilic airway inflammation, is needed. To determine whether NO2 and O3 are associated with lung function and FeNO in children. We measured lung function (FEV1 and FVC) at mid-childhood (mean age 7.9 years, n=703), early teens (13.2 years, n=976), and mid-teen (17.6 years, n=624) study visits, and fractional exhaled nitric oxide (FeNO) at the early and mid-teen study visits in Project Viva, a cohort of mother-child pairs in the Boston, MA area. Long-term exposure to NO2 and O3 was estimated at home address using geospatial models. We examined associations of home address NO2 and O3 exposure and proximity to roadway with lung function and FeNO using linear regression models, adjusting for age, sex, height, weight, season, relative humidity, temperature, parental smoking, and measures of socioeconomic status. We examined for effect modification of the mid-teen associations by blood eosinophil level, physical activity, aeroallergen sensitization, and parental atopy. Median exposure to NO2 was 33.1 ppb (interquartile range [IQR] 10.4 ppb) and to O3 was 35.3 ppb (IQR 3.4) in the first year of life. Exposure to NO2 was associated with lower FEV1 and FVC across all age groups and exposure time intervals: e.g. an IQR increment of NO2 exposure from birth through the early teen visit was associated with 189.9 mL lower FEV1 (95% CI -273.3, -106.5) at the mid-teen visit. Lifetime NO2 exposure at was associated with higher FeNO at the early teen visit: e.g. 16.2% higher FeNO [95% CI 7.1-26.4%) per IQR of lifetime NO2 through the early teen visit. O3 exposure was not associated with lung function or FeNO. Aeroallergen sensitization (measured in a subset of participants) modified associations of NO2 and O3 with FeNO. Exposure to NO2 was associated with lower lung function and higher FeNO among generally healthy children and teenagers. As NO2 exposure levels were within the annual EPA standard, these findings suggest a need to reduce exposure to this pollutant to optimize child respiratory health.

Socio-economic gradients in urban green space access and respiratory health

Abstract Background This study investigates social disparities as one of the drivers influencing the access to green spaces and exposure to natural environments, potentially exacerbating disparities in respiratory health in children. Methods Longitudinal ELSPAC birth cohort study data included 4384 complete case participants born in cities of Brno and Znojmo, examined throughout the years 1990-2010. Estimates on socio-economic status (SES) scores of children’s parents and their education were used as socio-economical predictors. Tree cover density (TCD) calculated as mean canopy closure percentage in the individual walking distance neighbourhoods and the ownership and accessibility of a garden were used as indicators of green space accessibility. Multiple logistic regression models were employed to estimate odds ratios for predictors of respiratory health outcomes, controlling for several confounders. Results Parents’ SES was found to be positively associated with neighbourhood TCD, and this effect was even more pronounced for garden owners. Higher tree cover was then significantly negatively associated with development of acute bronchitis (OR 0.88, CI 95 % 0.84-0.94 for 1 SD of tree cover), while not having a garden (OR 1.81, CI 95 % 1.42-2.33) and living in area with lower tree cover (OR continuously decreasing from 1.88 to 1.68 for lowest and highest quartile respectively) was significantly associated with progression of acute bronchitis into chronic bronchitis in a fully adjusted model. Vice versa, higher tree cover was statistically significantly positively associated with development of allergic rhinitis (OR 1.09, CI 95 % 1.03-1.15), suggesting viability of the novel method of estimation of individual neighbourhood greenness. Conclusions The results suggest protective effect of access to urban green spaces against adverse respiratory outcomes in children. The socially uneven distribution of access emphasizes the importance of urban policies in promoting urban health. #NGEU Key messages • There is a significant protective effect of access to green spaces against respiratory diseases and their progression. • There’s an unequal, but varied distribution of access to green spaces, and social gradient in health, highlighting the importance of urban green space distributive politics.

Air quality disparities and respiratory health risks in critically polluted and relatively non-polluted areas: a prospective child health study.

Air pollution, a significant global health concern, notably impacts human well-being. Children, owing to their distinctive physiology and behavior, are particularly susceptible to its adverse effects. This prospective study examines air quality variations and respiratory risks in children residing in critically polluted areas (CPA) compared to relatively non-polluted areas (NPA), utilizing a prospective design to understand the impacts of air pollution on children's respiratory health, including measures like relative risk (RR) and attributable risk (AR). This prospective study tracked 739 students of 5th- 7th grade residing in CPA and NPA for one year, and measured the ambient and indoor air quality levels in both these areas. Throughout the study, based on the observed respiratory symptoms new episodes of upper and lower respiratory tract illnesses were recorded for each child on a weekly basis. Incidence rate, RR and AR for both the illnesses were compared. Statistical analysis was performed with SPSS 26.0. The study observes higher concentration for particulate matter and gaseous pollutants at CPA in comparison to NPA. Children living in CPA exhibited a notably greater weekly occurrence of both upper and lower respiratory tract illnesses compared to those in NPA, with RR of 1.26 (95% CI: 1.16-1.37) and 1.74 (95% CI: 1.34-2.27), respectively. The AR associated with air pollution for upper and lower respiratory tract illnesses among CPA students was found to be 20.7% and 42.7%, respectively. This research underscores the pressing need to address air pollution in critically polluted areas and its profound effects on children's respiratory health. Public health interventions, such as reducing emissions from industries and creating green spaces, should be prioritized. Furthermore, early respiratory health screening in schools within polluted areas could aid in the timely diagnosis and management of respiratory issues in children.

Childhood Air Pollution Exposure Associated with Self-reported Bronchitic Symptoms in Adulthood.

Rationale: Few studies have examined the effects of long-term childhood air pollution exposure on adult respiratory health, including whether childhood respiratory effects underlie this relation. Objectives: To evaluate associations between childhood air pollution exposure and self-reported adult bronchitic symptoms while considering child respiratory health in the Southern California Children's Health Study. Methods: Exposures to nitrogen dioxide (NO2), ozone, and particulate matter <2.5 μm and <10 μm in diameter (PM10) assessed using inverse-distance-squared spatial interpolation based on childhood (birth to age 17 yr) residential histories. Bronchitic symptoms (bronchitis, cough, or phlegm in the past 12 mo) were ascertained via a questionnaire in adulthood. Associations between mean air pollution exposure across childhood and self-reported adult bronchitic symptoms were estimated using logistic regression. We further adjusted for childhood bronchitic symptoms and asthma to understand whether associations operated beyond childhood respiratory health impacts. Effect modification was assessed for family history of asthma, childhood asthma, and adult allergies. Measurements and Main Results: A total of 1,308 participants were included (mostly non-Hispanic White [56%] or Hispanic [32%]). At adult assessment (mean age, 32.0 yr; standard deviation [SD], 4.7), 25% reported bronchitic symptoms. Adult bronchitic symptoms were associated with NO2 and PM10 childhood exposures. Odds ratios per 1-SD increase were 1.69 (95% confidence interval, 1.14-2.49) for NO2 (SD, 11.1 ppb) and 1.51 (95% confidence interval, 1.00-2.27) for PM10 (SD, 14.2 μg/m3). Adjusting for childhood bronchitic symptoms or asthma produced similar results. NO2 and PM10 associations were modified by childhood asthma, with greater associations among asthmatic individuals. Conclusions: Childhood NO2 and PM10 exposures were associated with adult bronchitic symptoms. Associations were not explained by childhood respiratory health impacts; however, participants with childhood asthma had stronger associations.

Air quality and wheeze symptoms in a rural children's cohort near a drying saline lake

BackgroundIn California, climate change and competing water demands are intensifying the desiccation of the Salton Sea, a large land-locked “sea” situated near the southeastern rural US-Mexico border region known as the Imperial Valley. MethodsTo examine the possible effects of living near a saline lake on children's respiratory health, we analyzed the relationship between respiratory health symptoms and ambient PM concentrations among a predominantly Latino/Hispanic cohort of 722 school age children. Guardians completed a survey of their child's wheeze and respiratory health symptoms over the past 12 months, adapted from the International Study of Asthma and Allergies in Childhood (ISAAC). Exposure to dust storm hours (hourly concentrations >150 μg/m3 for PM10) was estimated using a network of regulatory monitors. ResultsBetween 2017 and 2019, children were exposed to 98 to 395 dust event hours annually. We observed disparate effects for dust events and wheeze among children living near the Salton Sea. Every additional 100 dust storm hours per year among children living near the Sea (<11 km) was associated with a 9.5 percentage point increase in wheeze (95% CI: 3.5, 15.4), a 4.6 percentage point increase in bronchitic symptoms (95% CI: 0.18, 10.2) and a 6.7 percentage point increase in sleep disturbance due to wheeze (95% CI: 0.96, 12.4). Similarly, increases in PM10 were also associated with greater reported wheeze and bronchitic symptoms among those living near the Sea, compared to children living ≥11 km from the Sea. There was no association of dust storms or PM10 with wheeze or bronchitic symptoms among the children residing farther from the Sea. ConclusionWe observed stronger adverse impacts of PM10 and dust events on respiratory health among those living closer to the drying Salton Sea, compared to children living farther away. In this community of predominantly low-income residents of color, these impacts raise environmental justice concerns about the effects of the drying Salton Sea on public health.

Effect of Indoor Air Quality on Respiratory Health of Children: An MPPD Model Approach

Effect of Indoor Air Quality on Respiratory Health of Children: An MPPD Model Approach

Modifying Air Pollution Impacts on Child Respiratory Health: The Role of Breastfeeding and Residential Greenspace

Modifying Air Pollution Impacts on Child Respiratory Health: The Role of Breastfeeding and Residential Greenspace

Associations of environmental chemical exposures measured in personal silicone wristbands with sociodemographic factors, COVID-19 restrictions, and child respiratory health

BackgroundAlthough human biomonitoring of environmental chemicals has been considered a gold standard, these methods can be costly, burdensome, and prone to unwanted sources of variability that may cause confounding. Silicone wristbands have recently emerged as innovative passive samplers for measuring personal exposures. MethodsIn a pilot study from 2019 to 2021 involving 55 children aged 5–9 years in Seattle and Yakima, Washington, we utilized silicone wristbands to explore associations of sociodemographic variables and COVID-19-related restrictions, including school closures, with exposures to numerous chemicals including brominated and organophosphate ester (OPE) flame retardants, polychlorinated biphenyls, polycyclic aromatic hydrocarbons (PAHs), phthalates, and pesticides. We additionally conducted the first analysis testing silicone wristband chemicals as predictors of child wheeze, individually and in mixtures via logistic weighted quantile sum regression (WQS). ResultsAmong 109 semi-volatile organic compounds measured, we detected 40 in >60% of wristbands worn by children continuously for an average of 5 days. Chemicals were generally positively correlated, especially within the same class. Male sex and increasing age were linked with higher exposures across several chemical classes; Hispanic/Latino ethnicity was linked with higher exposures to some phthalates and OPEs. COVID-19 restrictions were associated with lower wristband concentrations of brominated and triaryl OPE flame retardants. Each one-decile higher WQS exposure index was suggestively associated with 2.11-fold [95% CI: 0.93–4.80] higher odds of child wheeze. Risk of child wheeze was higher per 10-fold increase in the PAH chrysene (RR = 1.93[1.07–3.49]), the pesticide cis-permethrin (3.31[1.23–8.91]), and di-isononyl phthalate (DINP) (5.40[1.22–24.0]) ConclusionsOur identification of demographic factors including sex, age, and ethnicity associated with chemical exposures may aid efforts to mitigate exposure disparities. Lower exposures to flame retardants during pandemic restrictions corroborates prior evidence of higher levels of these chemicals in school versus home environments. Future research in larger cohorts is needed to validate these findings.

Bilirubin metabolism in early life and respiratory health during preschool age: A combined analysis of two independent birth cohorts.

Bilirubin has antioxidant properties, and elevated levels within the normal range have been associated with improved lung function and decreased risk of asthma in adults, but studies of young children are scarce. Here, we investigate associations between bilirubin in early life and respiratory health endpoints during preschool age in two independent birth cohorts. Bilirubin metabolites were assessed at ages 0.5, 1.5, and 6 years in COPSAC2010 (Copenhagen Prospective Studies on Asthma in Childhood 2010) and ages 1, 3, and 6 years in the VDAART (The Vitamin D Antenatal Asthma Reduction Trial) cohort. Meta-analyses were done to summarize the relationship between levels of bilirubin metabolites and asthma, infections, lung function, and allergic sensitization until age 6 across the cohorts. Interaction with the glucuronosyltransferase family 1 member A1 (UGT1A) genotype encoding for an enzyme in the bilirubin metabolism was explored, and metabolomics data were integrated to study underlying mechanisms. Increasing bilirubin (Z,Z) at ages 1.5-3 years was associated with an increased risk of allergic sensitization (adjusted relative risk [aRR]= 1.85 [1.20-2.85], p= 0.005), and age 6 bilirubin (Z,Z) also showed a trend of association with allergic sensitization at age 6 (aRR= 1.31 [0.97-1.77], p= 0.08), which showed significant interaction for the age 6 bilirubin (Z,Z)xUGT1A genotype. Further, increasing bilirubin (E,E), bilirubin (Z,Z), and biliverdin at ages 1.5-3 years was associated with a lower forced expiratory volume at age 6 (aRRrange= 0.81-0.91, p<0.049) but without a significant interaction with the UGT1A genotype (pinteractions>0.05). Network analysis showed a significant correlation between bilirubin metabolism and acyl carnitines. There were no associations between bilirubin metabolites and the risk of asthma and infections. Bilirubin metabolism in early life may play a role in childhood respiratory health, particularly in children with specific UGT1A genotypes. The Lundbeck Foundation (Grant no R16-A1694), The Ministry of Health (Grant no 903516), Danish Council for Strategic Research (Grant no 0603-00280B), and The Capital Region Research Foundation have provided core support to the COPSAC research center. This project has received funding from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation programme (grant agreement No. 946228). The Vitamin D Antenatal Asthma Reduction Trial (VDDART, ClinicalTrials.gov identifier: NCT00920621) was supported by grant U01HL091528 from NHLBI, U54TR001012 from the National Centers for Advancing Translational Sciences (NCATS). Metabolomics work by VDAART was supported by the National Heart, Lung, and Blood Institute (NHLBI) grant R01HL123915 and R01HL141826. S.T.W. was supported by R01HL091528 from the NHLBI, UG3OD023268 from Office of The Director, National Institute of Health, and P01HL132825 from the NHLBI.

Possible relationship between respiratory diseases and urinary concentrations of polycyclic aromatic hydrocarbon metabolites - a pilot study.

This study investigates the potential relationship between exposure to polycyclic aromatic hydrocarbons (PAHs), specifically monohydroxylated metabolites (OH-PAHs), in urine, and the prevalence of respiratory diseases in 2-year-old children residing in two locations within the Czech Republic - České Budějovice (control location) and the historically contaminated mining district of Most. Despite current air quality and lifestyle similarities between the two cities, our research aims to uncover potential long-term health effects, building upon previous data indicating distinctive patterns in the Most population. A total of 248 urine samples were analysed for the presence of 11 OH-PAHs. Employing liquid-liquid extraction with ethyl acetate and clean-up through dispersive solid-phase extraction, instrumental analysis was conducted using ultra-high performance liquid chromatography coupled with tandem mass spectrometry. The incidence of respiratory diseases was assessed through questionnaires administered by paediatricians. The concentrations of OH-PAHs were elevated in urine samples from 2-year-olds in Most compared to those from České Budějovice. The incidence of respiratory diseases showed statistically significant higher levels of OH-PAHs in children from Most, together with a higher incidence of influenza. This association underlines the impact of environmental PAH exposure on children's respiratory health. It suggests that elevated urinary OH-PAH levels indicate an increased risk of developing respiratory diseases in the affected population. Further studies are needed to clarify the possible long-term health effects and to contribute to sound public health strategies.

The association between COVID-19 vaccine/infection and new-onset asthma in children - based on the global TriNetX database.

The COVID-19 pandemic has underscored the importance of its potential long-term health effects, including its link to new-onset asthma in children. Asthma significantly impacts children's health, causing adverse outcomes and increased absenteeism. Emerging evidence suggests a potential association between COVID-19 infection and higher rates of new-onset asthma in adults, raising concerns about its impact on children's respiratory health. A retrospective cohort study design was employed, using electronic medical records from the TriNetX database, covering January 1, 2021, to December 31, 2022. Two cohorts of children aged 5 to 18 who underwent SARS-CoV-2 RT-PCR testing were analyzed: unvaccinated children with and without COVID-19 infection, and vaccinated children with and without infection. Propensity score matching was used to mitigate selection bias, and hazard ratio (HR) and 95% CI were calculated to assess the risk of new-onset asthma. Our study found a significantly higher incidence of new-onset asthma in COVID-19 infected children compared to uninfected children, regardless of vaccination status. In Cohort 1, 4.7% of COVID-19 infected children without vaccination developed new-onset asthma, versus 2.0% in their non-COVID-19 counterparts within a year (HR = 2.26; 95% CI = 2.158-2.367). For Cohort 2, COVID-19 infected children with vaccination showed an 8.3% incidence of new-onset asthma, higher than the 3.1% in those not infected (HR = 2.745; 95% CI = 2.521-2.99). Subgroup analyses further identified higher risks in males, children aged 5-12 years, and Black or African American children. Sensitivity analyses confirmed the reliability of these findings. The study highlights a strong link between COVID-19 infection and an increased risk of new-onset asthma in children, which is even more marked in those vaccinated. This emphasizes the critical need for ongoing monitoring and customized healthcare strategies to mitigate the long-term respiratory impacts of COVID-19 in children, advocating for thorough strategies to manage and prevent asthma amidst the pandemic.

Low-dose aspirin, maternal cardiometabolic health, and offspring respiratory health 9 to 14 years after delivery: Findings from the EAGeR Follow-up Study.

Accumulating evidence shows that peri-conceptional and in-utero exposures have lifetime health impacts for mothers and their offspring. We conducted a Follow-Up Study of the Effects of Aspirin in Gestation and Reproduction (EAGeR) trial with two objectives. First, we determined if women who enrolled at the Utah site (N = 1001) of the EAGeR trial (2007-2011, N = 1228) could successfully be contacted and agree to complete an online questionnaire on their reproductive, cardio-metabolic, and offspring respiratory health 9-14 years after original enrollment. Second, we evaluated if maternal exposure to low-dose aspirin (LDA) during pregnancy was associated with maternal cardio-metabolic health and offspring respiratory health. The original EAGeR study population included women, 18-40 years of age, who had 1-2 prior pregnancy losses, and who were trying to become pregnant. At follow-up (2020-2021), participants from the Utah cohort completed a 13-item online questionnaire on reproductive and cardio-metabolic health, and those who had a live birth during EAGeR additionally completed a 7-item questionnaire on the index child's respiratory health. Primary maternal outcomes included hypertension and hypercholesterolemia; primary offspring outcomes included wheezing and asthma. Sixty-eight percent (n = 678) of participants enrolled in the follow-up study, with 10% and 15% reporting maternal hypertension and hypercholesterolemia, respectively; and 18% and 10% reporting offspring wheezing and asthma. We found no association between maternal LDA exposure and hypertension (risk difference [RD] -0.001, 95% confidence interval [CI] -0.05, 0.04) or hypercholesterolemia (RD -0.01, 95% CI -0.06, 0.05) at 9-14 years follow-up. Maternal LDA exposure was not associated with offspring wheezing (RD -0.002, 95% CI -0.08, 0.08) or asthma (RD 0.13, 95% CI 0.11, 0.37) at follow-up. Findings remained robust after considering potential confounding and selection bias. We observed no association between LDA exposure during pregnancy and maternal cardiometabolic or offspring respiratory health.

Impact of Air Quality on Respiratory Health in Children in Mexico

Purpose: The aim of the study was to analyze the impact of air quality on respiratory health in children in Mexico. Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries. Findings: High air pollution levels in Mexico, largely from traffic and industry, worsen respiratory health in children. This includes higher rates of asthma, respiratory infections, and decreased lung function. Urban areas with limited healthcare access are hit hardest. Urgent action is needed, including stricter regulations and public health initiatives, to protect Mexican children's well-being. Unique Contribution to Theory, Practice and Policy: Environmental determinism theory, bronfenbrenner’s ecological systems theory &amp; health belief model (HBM) may be used to anchor future studies on analyze the impact of air quality on respiratory health in children in Mexico. Encourage pediatricians and healthcare providers to routinely discuss air quality issues during visits and provide guidance on minimizing exposure, especially in areas with known poor air quality. Policy initiatives should aim to reduce the emission of key pollutants identified in the research as harmful to children's respiratory health.