Early-life exposure to submicron particulate air pollution in relation to asthma development in Chinese preschool children

Abstract

Background: Emerging research suggested an association of early-life particulate air pollution exposure with development of asthma in childhood. However, the potentially differential effects of submicron particulate matter (PM; PM with aerodynamic diameter ≤1 μm [PM1]) remain largely unknown.

Objective: This study primarily aimed to investigate associations of childhood asthma and wheezing with in utero and first-year exposures to size-specific particles.

Methods: We conducted a large cross-sectional survey among 5788 preschool children aged 3 to 5 years in central China. In utero and first-year exposures to ambient PM1, PM with aerodynamic diameter less than or equal to 2.5 μm, and PM with aerodynamic diameter less than or equal to 10 μm at 1 × 1-km resolution were assessed using machine learning–based spatiotemporal models. A time-to-event analysis was performed to examine associations between residential PM exposures and childhood onset of asthma and wheezing.

Results: Early-life size-specific PM exposures, particularly during pregnancy, were significantly associated with increased risk of asthma, whereas no evident PM-wheezing associations were observed. Each 10-μg/m3 increase in in utero and first-year PM1 exposure was accordingly associated with an asthma’s hazard ratio in childhood of 1.618 (95% CI, 1.159-2.258; P = .005) and 1.543 (0.822-2.896; P = .177). Subgroup analyses suggest that short breast-feeding duration may aggravate PM-associated risk of childhood asthma. Each 10-μg/m3 increase in in utero exposure to PM1, for instance, was associated with a hazard ratio of 2.260 (1.393-3.666) among children with 0 to 5 months’ breast-feeding and 1.156 (0.721-1.853) among those longer breast-fed.

Conclusions: Our study added comparative evidence for increased risk of childhood asthma in relation to early-life PM exposures, highlighting stronger associations with ambient PM1 than with PM with aerodynamic diameter less than or equal to 2.5 μm and PM with aerodynamic diameter less than or equal to 10 μm.