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Asthma incidence in children growing up close to traffic: a registry-based birth cohort

Lindgren, Anna LU ; Stroh, Emilie LU ; Björk, Jonas LU and Jakobsson, Kristina LU (2013) In Environmental Health 12.
Abstract
Background: Recent reviews conclude an association between traffic-related pollution and incidence of asthma in children, but not all studies agree. Studies have almost exclusively relied on parental-reported symptoms or parental-reported diagnoses of asthma and wheeze. Our aim was to investigate if traffic exposure is associated with higher incidence of early onset asthma, using registry-based outcome data. Methods: We investigated a birth cohort in southern Sweden, consisting of N = 26 128 children with outcome and exposure data (born July 2005-2010). Of these children, N = 7898 had additional covariate information. The cohort was followed to the end of 2011. Traffic intensity, and dispersion-modeled concentrations of NOX (100x100 m... (More)
Background: Recent reviews conclude an association between traffic-related pollution and incidence of asthma in children, but not all studies agree. Studies have almost exclusively relied on parental-reported symptoms or parental-reported diagnoses of asthma and wheeze. Our aim was to investigate if traffic exposure is associated with higher incidence of early onset asthma, using registry-based outcome data. Methods: We investigated a birth cohort in southern Sweden, consisting of N = 26 128 children with outcome and exposure data (born July 2005-2010). Of these children, N = 7898 had additional covariate information. The cohort was followed to the end of 2011. Traffic intensity, and dispersion-modeled concentrations of NOX (100x100 m grid), at residential addresses, were linked with registry data on dispensed asthma medication (the Swedish Prescribed Drug Register), and hospital and primary health care diagnoses of bronchiolitis, obstructive bronchitis and asthma (The Scania Health Care Register). Covariate information was obtained from questionnaires distributed to parents at Child Health Care-centre visits, eight months after birth. Cox proportional hazards regression was used for the statistical analyses. Results: Living in close proximity to a road with >= 8640 cars/day (compared to 0-8640 cars/day), was not associated with higher incidence of first purchase of inhaled beta(2)-agonist (adjusted hazard ratio (adj.HR) = 0.9, 95% CI: 0.8-1.0); third year purchase of inhaled beta(2)-agonist (adj.HR = 0.7, 95% CI: 0.6-0.9); bronchiolitis (adj.HR = 0.7, 95% CI: 0.6-0.9), obstructive bronchitis (adj.HR = 1.0, 95% CI: 0.9-1.2), or asthma (adj.HR = 0.7, 95% CI: 0.6-0.9). Similar results were found for inhaled corticosteroids, and in relation to NOX. Conclusions: Traffic-related exposure was not associated with higher incidence of asthma medication, or diagnoses of asthma, bronchiolitis, or obstructive bronchitis, in children 0-6 years in southern Sweden. This may depend on the low levels of traffic pollution in the area, mainly well below the WHO-guideline for NO2. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Air pollution, Asthma, Bronchitis, Children, Environmental, Epidemiology, GIS, Nitrogen oxides, Roadway proximity, Traffic
in
Environmental Health
volume
12
publisher
BioMed Central
external identifiers
  • wos:000329115500001
  • scopus:84887892818
ISSN
1476-069X
DOI
10.1186/1476-069X-12-91
language
English
LU publication?
yes
id
43129872-59dc-4446-99ca-349284e6b98c (old id 4261700)
date added to LUP
2014-02-10 12:15:17
date last changed
2019-04-10 02:19:29
@article{43129872-59dc-4446-99ca-349284e6b98c,
  abstract     = {Background: Recent reviews conclude an association between traffic-related pollution and incidence of asthma in children, but not all studies agree. Studies have almost exclusively relied on parental-reported symptoms or parental-reported diagnoses of asthma and wheeze. Our aim was to investigate if traffic exposure is associated with higher incidence of early onset asthma, using registry-based outcome data. Methods: We investigated a birth cohort in southern Sweden, consisting of N = 26 128 children with outcome and exposure data (born July 2005-2010). Of these children, N = 7898 had additional covariate information. The cohort was followed to the end of 2011. Traffic intensity, and dispersion-modeled concentrations of NOX (100x100 m grid), at residential addresses, were linked with registry data on dispensed asthma medication (the Swedish Prescribed Drug Register), and hospital and primary health care diagnoses of bronchiolitis, obstructive bronchitis and asthma (The Scania Health Care Register). Covariate information was obtained from questionnaires distributed to parents at Child Health Care-centre visits, eight months after birth. Cox proportional hazards regression was used for the statistical analyses. Results: Living in close proximity to a road with >= 8640 cars/day (compared to 0-8640 cars/day), was not associated with higher incidence of first purchase of inhaled beta(2)-agonist (adjusted hazard ratio (adj.HR) = 0.9, 95% CI: 0.8-1.0); third year purchase of inhaled beta(2)-agonist (adj.HR = 0.7, 95% CI: 0.6-0.9); bronchiolitis (adj.HR = 0.7, 95% CI: 0.6-0.9), obstructive bronchitis (adj.HR = 1.0, 95% CI: 0.9-1.2), or asthma (adj.HR = 0.7, 95% CI: 0.6-0.9). Similar results were found for inhaled corticosteroids, and in relation to NOX. Conclusions: Traffic-related exposure was not associated with higher incidence of asthma medication, or diagnoses of asthma, bronchiolitis, or obstructive bronchitis, in children 0-6 years in southern Sweden. This may depend on the low levels of traffic pollution in the area, mainly well below the WHO-guideline for NO2.},
  articleno    = {91},
  author       = {Lindgren, Anna and Stroh, Emilie and Björk, Jonas and Jakobsson, Kristina},
  issn         = {1476-069X},
  keyword      = {Air pollution,Asthma,Bronchitis,Children,Environmental,Epidemiology,GIS,Nitrogen oxides,Roadway proximity,Traffic},
  language     = {eng},
  publisher    = {BioMed Central},
  series       = {Environmental Health},
  title        = {Asthma incidence in children growing up close to traffic: a registry-based birth cohort},
  url          = {http://dx.doi.org/10.1186/1476-069X-12-91},
  volume       = {12},
  year         = {2013},
}