Childhood Exposure to Air Pollution as a Potential Contributor of Chronic Non-Respiratory Inflammatory Disorders: A Longitudinal Prospective Cohort Study in Hamilton, Canada

Caroline Barakat-Haddad, Susan Elliott, David Pengelly

Department of Anthropology, University of Toronto Scarborough, Toronto, Canada.
Department of Medicine, McMaster University, Hamilton, Canada.
Faculty of Applied Health Sciences, University of Waterloo, Waterloo, Canada.

DOI: 10.4236/jep.2013.48091                

Abstract

This study examines the relationship between childhood exposure to air pollution and diagnosis with chronic non-respiratory health outcomes in adulthood. This prospective cohort study uses data collected in the 1970/1980s from 395 children, including exposure to air pollution. Over thirty years later, a survey collected data on various health outcomes, including diagnosis with arthritis, high blood pressure, long-term skin conditions, and hay fever allergies. Logistic regression modeling was performed to examine the relative contribution of childhood exposure to air pollution on chronic non-respiratory health outcomes in adulthood. Childhood exposure to SO₂ emerged as a significant predictor of arthritis (OR = 2.73, 95% CI 1.20 - 6.18) and high blood pressure (OR = 2.82, 95% CI 1.23 - 6.47). Other significant predictors include respiratory symptoms during childhood, family income during childhood and adulthood, property tenure, employment status, residential exposures, life events, physical activity, and body mass index. Childhood exposure to air pollution did not emerge as a significant predictor of long-term skin conditions or hay fever allergies. Findings contribute to the debate on the health effects of air pollution, indicating that the health impacts of childhood exposure to air pollution may include chronic inflammatory disorders in adulthood.

Keywords

Air Pollution; Health Development; Hay Fever; Arthritis; Hypertension; Skin Diseases

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	M. L. Bell and D. L. Davis, “Reassessment of the Lethal London Fog of 1952: Novel Indicators of Acute and Chronic Consequences of Acute Exposure to Air Pollution,” Environmental Health Perspectives, 109, Suppl. 3, 2001, pp. 389-394. doi:10.1289/ehp.01109s3389
[2]	J. Neidell and Matthew, “Air Pollution, Health, and Socio-Economic Status: The Effect of Outdoor Air Quality on Childhood Asthma,” Journal of Health Economics, Vol. 23, No. 6, 2004, pp. 1209-1236.
[3]	J. Schwartz, “Air Pollution and Children’s Health,” Pediatrics, Vol. 113, No. 4, 2004, pp. 1037-1043.
[4]	J. Gauderman, F. Gilliland, H. Vora, et al., “Association between Air Pollution and Lung Function Growth in Southern California Children. Results from a Second Cohort,” American Journal of Respiratory and Critical Care Medicine, Vol. 166, No. 1, 2002, pp. 76-84. doi:10.1164/rccm.2111021
[5]	J. Zhang, W. Hu, F. Wei, et al, “Children’s Respiratory Morbidity Prevalence in Relation to Air Pollution in Four Chinese Cities,” Environmental Health Perspectives, Vol. 110, No. 9, 2002, pp. 961-967. doi:10.1289/ehp.02110961
[6]	D. W. Dockery, J. Cunningham, A. I. Damokosh, et al., “Health Effects of Acid Aerosols on North American Children: Respiratory Symptoms,” Environmental Health Perspectives, Vol. 104, No. 5, 1996, pp. 500-505. doi:10.1289/ehp.96104500
[7]	M. Raizenne, M. Neas, I. Damokosh I, et al., “Health Effects of Acid Aerosols on North American Children: Pulmonary Function,” Environmental Health Perspectives, Vol. 104, No. 5, 1996, pp. 506-551.
[8]	D. Spengler, P. Koutrakis, W. Dockery, et al., “Health Effects of Acid Aerosols on North American Children: Air Pollution Exposures,” Environmental Health Perspectives, Vol. 105, No. 5, 1996, pp. 492-499.
[9]	J. Schwartz and N. Lucas, “Fine Particles Are More Strongly Associated than Coarse Particles with Acute Respiratory Health Effects in Schoolchildren,” Epidemiology, Vol. 11, No. 1, 2000, pp. 6-10.
[10]	D. Ward and J. Ayres, “Particulate Air Pollution and Panel Studies in Children: A Systematic Review,” Occupational and Environmental Medicine, Vol. 61, No. 4, 2004, p. e13
[11]	H. Pikhart, M. Bobak and P. Gorynski, “Outdoor Sulphur Dioxide and respiratory Symptoms in Czech and Polish School Children: A Small-Area Study (SAVIAH),” International Archives of Occupational and Environmental Health, Vol. 74, No. 8, 2001, pp. 574-578.
[12]	A. Pinter, P. Rudnai, E. Sarkany, et al., “Air Pollution and Children’s Respiratory Morbidity in the Tata Area, Hungary,” Central European Journal of Public Health, Vol. 4S, 1996, pp. 17-20.
[13]	J. Sanchez, I. Romieu, S. Ruiz, et al., “Efectos Agudos de las Particulasrespirables y del Dioxido de Azufresobre la Saludrespiratoria en Ninos del Area industrial de Puchuncavi, Chile,” Revista Panamericana de Salud Pública, Vol. 6, No. 6, pp. 1999, 384-391.
[14]	N. Künzli and I. B. Tager, “Air Pollution: From Lung to Heart,” Swiss Medical Weekly, Vol. 135, No. 47-48, 2005, pp. 697-702.
[15]	A. Blomberg, “Airway Inflammatory and Antioxidant Responses to Oxidative and Particulate Air Pollutants— Experimental Exposure Studies in Humans,” Clinical & Experimental Allergy, Vol. 30, No. 3, 2000, pp. 310-317.
[16]	S. F. Van Eden and J. C. Hogg, “Systemic Inflammatory Response Induced by Particulate Matter Air Pollution: The Importance of Bone-Marrow Stimulation,” Journal of Toxicology and Environmental Health, Part A, Vol. 65, No. 20, 2002, pp. 1597-1613.
[17]	A. Baeza-Squiban, V. Bonvallot, S. Boland, et al., “Airborne Particles Evoke an Inflammatory Response on Human Airway Epithelium. Activation of Transcription Factors,” Cell Biology and Toxicology, Vol. 15, No. 6, 1999, pp. 375-380.
[18]	W. MacNee and K. Donaldson, “Mechanism of Lung Injury Caused by PM10 and Ultra Fine Particles with Special Reference to COPD,” European Respiratory Journal, Vol. 21, No. 47S-51S, 2003, p. S40.
[19]	A. Zeka, J. R. Sullivan, P. S. Vokonas, et al., “Inflammatory Markers and Particulate Air Pollution: Characterizing the Pathway to Disease,” International Journal of Epidemiology, Vol. 35, No. 5, 2006, pp. 1347-1354.
[20]	A. Campbell, M. Oldham, A. Becaria, et al., “Particulate Matter in Polluted Air May Increase Biomarkers of Inflammation in Mouse Brain,” Neurotoxicology, Vol. 26, No. 1, 2005, pp. 133-140.
[21]	L. Calderon-Garciduenas, R. R. Maronpot, R. Torres-Jardon, et al., “DNA Damage in Nasal and Brain Tissues of Canines Exposed to Air Pollutants Is Associated with Evidence of Chronic Brain Inflammation and Neurodegeneration,” Toxicologic Pathology, Vol. 31, No. 5, 2003, pp. 524-538. doi:10.1080/01926230390226645
[22]	L. Calderon-Garciduenas, W. Reed, R. R. Maronpot, et al., “Brain Inflammation and Alzheimer’s-Like Pathology in Individuals Exposed to Severe Air Pollution,” Toxicologic Pathology, Vol. 32, No. 6, 2004, pp. 650-658. doi:10.1080/01926230490520232
[23]	P. Poursafa and R. Kelishadi, “Air Pollution, Platelet Activation and Atherosclerosis,” Inflammation & Allergy-Drug Targets, Vol. 9, No. 5, 2010, pp. 387-392. doi:10.2174/187152810793937982
[24]	M. L. Scapellato and M. Lotti, “Short-Term Effects of Particulate Matter; an Inflammatory Mechanism?” Critical Reviews in Toxicology, Vol. 37, No. 6, 2007, pp. 461-487.
[25]	M. Lotti, I. Olivato and L. Bergamo, “Inflammation and Short-Term Cardiopulmonary Effects of Particulate Matter,” Nanotoxicology, Vol. 3, No. 1, 2009, pp. 27-32. doi:10.1080/17435390802538763
[26]	S. A. Ritz, “Air Pollution as a Potential Contributor to the ‘Epidemic’ of Autoimmune Disease,” Medical Hypotheses, Vol. 74, No. 1, 2010, pp. 110-117. doi:10.1016/j.mehy.2009.07.033
[27]	G. G. Kaplan, J. Hubbard, J. Korzenik, et al., “The Inflammatory Bowel Diseases and Ambient Air Pollution: A Novel Association,” The American Journal of Gastroenterology, Vol. 105, No. 11, 2010, pp. 2412-2419.
[28]	A. Iannuzzi, M. C. Verga, M. Renis, et al., “Air Pollution and Carotid Arterial Stiffness in Children,” Cardiology in the Young, Vol. 20, No. 2, 2010, pp. 186-190.
[29]	P. Pousafa, R. Kelishadi, A. Lahijansadeh, et al., “The Relationship of Air Pollution and Surrogate Markers of Endothelial Dysfunction in a Population-Based Sample of Children,” BMC Public Health, Vol. 11, 2011, pp. 115-122. doi:10.1186/1471-2458-11-115
[30]	P. Poursafa, R. Kelishadi, F. Moattar, et al., “Genetic Variation in the Association of Air Pollutants with a Biomarker of Vascular Injury in Children and Adolescents in Isfahan, Iran,” Journal of International Medical Research, Vol. 16, No. 6, 2011, pp. 733-740.
[31]	C. Freire, R. Ramos, R. Puertas, et al., “Association of Traffic-Related Air Pollution with Cognitive Development in Children,” Journal of Epidemiology & Community Health, Vol. 64, No. 3, 2010, pp. 223-228. doi:10.1136/jech.2008.084574
[32]	S. Q. Wang, J. L. Zhang, X. D. Zeng, et al., “Association of Traffic-Related Air Pollution with Children’s Neurobehavioral Functions in Quanzhou, China,” Environmental Health Perspectives, Vol. 117, No. 10, 2009, 1612-1618.
[33]	J. C. Chen and J. Schwartz, “Neurobehavioral Effects of Ambient Air Pollution on Cognitive Performance in US Adults,” Neurotoxicology, Vol. 30, No. 2, 2009, pp. 231-239. doi:10.1016/j.neuro.2008.12.011
[34]	M. Nikolic, A. Nikic and A. Stankovic, “Effects of Air Pollution on Red Blood Cells in Children,” Polish Journal of Environmental Studies, Vol. 17, No. 2, 2008, pp. 267-271.
[35]	R Kelishadi and P Poursafa, “Obesity and Air Pollution: Global Risk Factors for Pediatric Non-Alcoholic Fatty Liver Disease,” Hepatitis Monthly, Vol. 11, No. 10, 2011, pp. 794-802.
[36]	R. Kelishadi, N. Mirghaffari, P. Poursafa and S. Gidding, “Lifestyle and Environmental Factors Associated with Inflammation, Oxidative Stress and Insulin Resistance in Children,” Atherosclerosis, Vol. 203, No. 1, 2009, pp. 311-319. doi:10.1016/j.atherosclerosis.2008.06.022
[37]	C. Barakat-Haddad, S. Elliott and D. Pengelly, “Health Impacts of Air Pollution: A Life Course Approach for Examining Predictors of Respiratory Health in Adulthood,” Annals of Epidemiology, Vol. 22, No. 4, 2012, pp. 239-249. doi:10.1016/j.annepidem.2012.02.010
[38]	C. Barakat-Haddad, S. Elliott and D. Pengelly, “Does Chronic Exposure to Air Pollution in Childhood Impact Long-Term Respiratory Health?” Professional Geographer, Vol. 64, No. 3, 2012, pp. 1-18. doi:10.1080/00330124.2011.609775
[39]	A. Kerigan, C. Goldsmith and D. Pengelly, “A Three-Year Cohort Study of the Role of Environmental Factors in the Respiratory Health of Children in Hamilton, Ontario,” The American Review of Respiratory Disease, Vol. 133, No. 6, 1986, pp. 987-993.
[40]	D. Pengelly, A. Kerigan and C. H. Goldsmith, “Sensitivity of Children with Asthma to Chronic Low-Level Sulphur Dioxide Exposure,” Proceedings of the 8th World Clean Air Congress 1989, The Hague, 11-15 September 1989.
[41]	D. Pengelly, C. H. Goldsmith, A. T. Kerigan, et al., “The Hamilton Study: Estimating Exposure to Ambient Suspended Particles,” JAPCA, Vol. 37, No. 12, 1987, pp. 1421-1428. doi:10.1080/08940630.1987.10466337
[42]	C. Barakat-Haddad, S. Elliott, J. Eyles, et al., “Predictors of Locating Children Participants in Epidemiological Studies 20 Years after Last Contact: Internet Resources Facilitating Longitudinal Research,” European Journal of Epidemiology, Vol. 24, No. 8, 2009, pp. 397-405. doi:10.1007/s10654-009-9364-5
[43]	C. A. Donald and J. E. Ware, “The Measurement of Social Support,” Research in Community and Mental Health, Vol. 4, 1984, pp. 325-370.