Abstract for the 2018 HEI Annual Conference
Impact of Exposure to Air Pollution on Asthma: a Multi-Exposure Assessment
Marie Pedersen1;2, Zorana J Andersen,1 Anne-Marie N Andersen,1 Xavier Basagaña,3 Hans Bisgaard,4 Jørgen Brandt,5 Esben Budtz-Jørgensen,1 Klaus Bønnelykke,4 Leslie Stayner,5 Matthias Ketzel,6 Bert Brunekreef,7 Steffen Loft.1
1 University of Copenhagen, Department of Public Health, Copenhagen, Denmark; 2 Danish Cancer Society Research Center, Copenhagen, Denmark; 3 Barcelona Institute of Global Health, Barcelona, Spain; 4 Gentofte hospital, Pediatric Asthma Center, Copenhagen, Denmark; 5 University of Illinois at Chicago, School of Public Health Chicago, USA; 6 Aarhus University, Department of Environmental Science, Roskilde, Denmark; 7 Utrecht University, Institute for Risk Assessment Sciences, Utrecht, the Netherlands.
Asthma is the most common chronic disease in children. There is evidence that exposure to ambient air pollution from motor vehicle emissions not only exacerbates existing asthma, but also contributes to the development of asthma. Asthma has a multifactorial etiology, which is still not well understood, as multiple factors starting from fetal life may be involved. Some of these factors may be correlated, share sources and pathways resulting in joint effects that are greater than additive. Thus, the potential for confounding and effect modification of the ambient air pollution exposure effects on asthma is very high. The role of early-life exposure to ambient air pollution on the asthma pandemic remains poorly understood due to the lack of large birth cohort studies with sufficient long follow-up and assessment of multiple exposures.
Our aim is to test the hypothesis that early-life exposure to air pollution from multiple sources have individual and joint effects on risk of development of asthma in children and adolescents. Furthermore, we seek to determine the mechanistic basis for these effects by studying changes in lung function, inflammation, immunological markers and airway DNA methylation.
Unique material on individual health, home, neighborhood and personal characteristics from National registers will be used for prospective studies of all children and adolescents born in Denmark since 1997 (N»1,150,000) together with detailed questionnaire data from the Danish National Birth Cohort (N»90,000) and measurements of lung function and biomarkers from the COPenhagen Prospective Studies on Asthma in Childhood (N»1,000). Nitrogen dioxide, nitrogen dioxides, particulate matter (PM10 and PM2.5 from all sources and from wood stoves), carbon monoxide, elemental carbon, black carbon, organic carbon, ozone, sulphur dioxide and ammonium will be estimated at home addresses by applying air pollution dispersion models. Register and questionnaire data on asthma incidence (i.e. hospitalization, medicine prescriptions, and doctor-diagnosis), home characteristics and neighborhood will be evaluated. Confounding and effect modification by personal characteristics and exposures will be considered. Traditional and advanced statistical methods will be used. These complementary studies offer unique opportunities to better understand the role of specific sources of air pollution on asthma development and the mechanisms of asthma causation. This information will be useful to better target strategies for protection of health, to understand and to reduce the risk associated with different sources of air pollution. The findings may have profound implications for public health, given the large burden associated with asthma and the ubiquity of air pollution exposure worldwide.
Poster by Pedersen et al, 2018 HEI Annual Conference