Air Quality, Atmosphere & Health

, Volume 6, Issue 1, pp 47–56 | Cite as

Long-term exposure to air pollution and the incidence of asthma: meta-analysis of cohort studies

  • H. Ross Anderson
  • Graziella Favarato
  • Richard W. Atkinson
Article

Abstract

We quantified the association between long-term exposure to air pollution and the incidence of asthma by conducting a systematic review and meta-analysis of cohort studies. Incidence was defined as the incidence of diagnosed asthma or of new wheeze symptom between two assessments or, in birth cohorts followed up to 10 years of age, a lifetime prevalence estimate of asthma or wheeze symptom. We identified 17 cohorts (eight birth cohorts and nine child/adult cohorts) with a total of 99 population-based risk estimates. The studies were heterogeneous in their design and methods of measurement. Follow-up ranged from 3 to 23 years. Most studies were based on within-community exposure contrasts dominated by traffic pollution. Twelve of the cohorts reported at least one positive statistically significant association between air pollution and a measure of incidence. Of the total of 99 estimates, only a minority (29) were positive and statistically significant. Estimates for meta-analysis were chosen a priori using a protocol. For the 13 studies with estimates for nitrogen dioxide (NO2), the random effects odds ratio was 1.07 (95% CI 1.02 to 1.13) per 10 μg/m3. For five studies with estimates for particulate matter with aerodynamic diameter <2.5 μm (PM2.5), the random effects estimate was 1.16 (95% CI 0.98 to 1.37) per 10 μg/m3. These estimates were reduced in size and statistical significance by adjustment for publication bias but remained positive. The results are consistent with an effect of outdoor air pollution on asthma incidence. Future meta-analyses would benefit from greater standardisation of cohort methods.

Keywords

Air pollution Asthma incidence Cohort Epidemiology Meta-analysis Review 

Supplementary material

11869_2011_144_MOESM1_ESM.pdf (24 kb)
Online Resource 1Details of literature search (PDF 23 kb)
11869_2011_144_MOESM2_ESM.pdf (49 kb)
Online Resource 2Pollutant conversions and scaling factors (PDF 49 kb)
11869_2011_144_MOESM3_ESM.pdf (15 kb)
Online Resource 3Mapping of reported outcomes to categories for analysis (PDF 14 kb)
11869_2011_144_MOESM4_ESM.pdf (21 kb)
Online Resource 4Algorithms and rules for selecting estimates for meta-analysis (PDF 20 kb)
11869_2011_144_MOESM5_ESM.pdf (32 kb)
Online Resource 5Details of birth cohorts (PDF 31 kb)
11869_2011_144_MOESM6_ESM.pdf (30 kb)
Online Resource 6Details of child/adult cohorts (PDF 29 kb)
11869_2011_144_MOESM7_ESM.pdf (612 kb)
Online Resource 7Details of individual estimates by pollutant and cohort (PDF 612 kb)
11869_2011_144_MOESM8_ESM.pdf (137 kb)
Online Resource 8Cohort studies of air pollution and the incidence of asthma and wheeze symptom. Frequency of estimates and of their direction and statistical significance (PDF 136 kb)
11869_2011_144_MOESM9_ESM.pdf (79 kb)
Online Resource 9Publication bias analyses for the estimates selected for the main meta-analyses of NO2 and PM2.5. (PDF 79 kb)

References

  1. Abbey DE, Lebowitz MD, Mills PK, Petersen FF, Beeson WL, Burchette RJ (1995) Long-term ambient concentrations of particulates and oxidants and development of chronic disease in a cohort of nonsmoking California residents. Inhal Toxicol 7:19–34CrossRefGoogle Scholar
  2. Begg CB, Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics 50:1088–1101CrossRefGoogle Scholar
  3. Bennett CM, Simpson P, Raven J, Skoric B, Powell J, Wolfe R, Walters EH, Abramson MJ (2007) Associations between ambient PM2.5 concentrations and respiratory symptoms in Melbourne, 1998–2005. J Toxicol Environ Health A 70:1613–1618CrossRefGoogle Scholar
  4. Braback L, Forsberg B (2009) Does traffic exhaust contribute to the development of asthma and allergic sensitization in children: findings from recent cohort studies. Environ Health 8:17CrossRefGoogle Scholar
  5. Brauer M, Hoek G, Smit HA, de Jongste JC, Gerritsen J, Postma DS, Kerkhof M, Brunekreef B (2007) Air pollution and development of asthma, allergy and infections in a birth cohort. Eur Respir J 29:879–888CrossRefGoogle Scholar
  6. Clark NA, Demers PA, Karr CJ, Koehoorn M, Lencar C, Tamburic L, Brauer M (2010) Effect of early life exposure to air pollution on development of childhood asthma. Environ Health Perspect 118:284–290CrossRefGoogle Scholar
  7. Clougherty JE, Levy JI, Kubzansky LD, Ryan PB, Suglia SF, Canner MJ, Wright RJ (2007) Synergistic effects of traffic-related air pollution and exposure to violence on urban asthma etiology. Environ Health Perspect 115:1140–1146CrossRefGoogle Scholar
  8. Davies HT, Crombie IK, Tavakoli M (1998) When can odds ratios mislead? BMJ 316:989–991CrossRefGoogle Scholar
  9. Department of Health Committee on the Medical Effects of Air Pollutants (1995) Asthma and outdoor air pollution. HMSO, LondonGoogle Scholar
  10. DerSimonian R, Laird NM (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188CrossRefGoogle Scholar
  11. Duval S, Tweedie R (2000) A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics 56:455–463CrossRefGoogle Scholar
  12. Egger M, Davey SG, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315:629–634CrossRefGoogle Scholar
  13. Gehring U, Cyrys J, Sedlmeir G, Brunekreef B, Bellander T, Fischer P, Bauer CP, Reinhardt D, Wichmann HE, Heinrich J (2002) Traffic-related air pollution and respiratory health during the first 2 years of life. Eur Respir J 19:690–698CrossRefGoogle Scholar
  14. Gehring U, Wijga AH, Brauer M, Fischer P, de Jongste JC, Kerkhof M, Oldenwening M, Smit HA, Brunekreef B (2010) Traffic-related air pollution and the development of asthma and allergies during the first 8 years of life. Am J Respir Crit Care Med 181:596–603CrossRefGoogle Scholar
  15. Health Effects Institute (2010) HEI special report 17: traffic-related air pollution: a critical review of the literature on emissions, exposure, and health effects. Health Effects Institute, BostonGoogle Scholar
  16. Higgins JP, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21:1539–1558CrossRefGoogle Scholar
  17. Jacquemin B, Sunyer J, Forsberg B, Aguilera I, Briggs D, Garcia-Esteban R, Gotschi T, Heinrich J, Jarvholm B, Jarvis D, Vienneau D, Kunzli N (2009) Home outdoor NO2 and new onset of self-reported asthma in adults. Epidemiology 20:119–126CrossRefGoogle Scholar
  18. Jedrychowski W, Perera FR, Maugeri U, Mrozek-Budzyn D, Mroz E, Flak E, Edwards S, Spengler JD, Jacek R, Sowa A, Musial A (2009) Early wheezing phenotypes and severity of respiratory illness in very early childhood: study on intrauterine exposure to fine particle matter. Environ Int 35:877–884CrossRefGoogle Scholar
  19. Jerrett M, Shankardass K, Berhane K, Gauderman WJ, Kunzli N, Avol E, Gilliland F, Lurmann F, Molitor JN, Molitor JT, Thomas DC, Peters J, McConnell R (2008) Traffic-related air pollution and asthma onset in children: a prospective cohort study with individual exposure measurement. Environ Health Perspect 116:1433–1438CrossRefGoogle Scholar
  20. Kerigan ATG (1986) A three-year cohort study of the role of environmental factors in the respiratory health of children in Hamilton, Ontario. Epidemiologic survey design, methods, and description of cohort. Am Rev Respir Dis 133:987–993Google Scholar
  21. Kramer U, Sugiri D, Ranft U, Krutmann J, von Berg A, Berdel D, Behrendt H, Kuhlbusch T, Hochadel M, Wichmann HE, Heinrich J (2009) Eczema, respiratory allergies, and traffic-related air pollution in birth cohorts from small-town areas. J Dermatol Sci 56:99–105CrossRefGoogle Scholar
  22. Kunzli N, Bridevaux PO, Liu LJS, Garcia-Esteban R, Schindler C, Gerbase MW, Sunyer J, Keidel D, Rochat T (2009) Traffic-related air pollution correlates with adult-onset asthma among never-smokers. Thorax 64:664–670CrossRefGoogle Scholar
  23. Mann SLW (1992) Accumulation of factors influencing respiratory illness in members of a national birth cohort and their offspring. J Epidemiol Community Health 46:286–292CrossRefGoogle Scholar
  24. McConnell R, Berhane K, Gilliland F, London SJ, Islam T, Gauderman WJ, Avol E, Margolis HG, Peters JM (2002) Asthma in exercising children exposed to ozone: a cohort study. Lancet 359:386–391CrossRefGoogle Scholar
  25. McConnell R, Islam T, Shankardass K, Jerrett M, Lurmann F, Gilliland F, Gauderman J, Avol E, Kunzli N, Yao L, Peters J, Berhane K (2010) Childhood incident asthma and traffic-related air pollution at home and school. Environ Health Perspect 118:1021–1026CrossRefGoogle Scholar
  26. McDonnell WF, Abbey DE, Nishino N, Lebowitz MD (1999) Long-term ambient ozone concentration and the incidence of asthma in nonsmoking adults: the AHSMOG study. Environ Res 80:110–121CrossRefGoogle Scholar
  27. Miller RL, Garfinkel R, Horton M, Camann D, Pereral FP, Whyatt RM, Kinney PL (2004) Polycyclic aromatic hydrocarbons, environmental tobacco smoke, and respiratory symptoms in an inner-city birth cohort. Chest 126:1071–1078CrossRefGoogle Scholar
  28. Miyake Y, Tanaka K, Fujiwara H, Mitani Y, Ikemi H, Sasaki S, Ohya Y, Hirota Y (2010) Residential proximity to main roads during pregnancy and the risk of allergic disorders in Japanese infants: The Osaka Maternal and Child Health Study. Pediatr Allergy Immunol 21:22–28CrossRefGoogle Scholar
  29. Modig L, Jarvholm B, Ronnmark E, Nystrom L, Lundback B, Andersson C, Forsberg B, Modig L, Jarvholm B, Ronnmark E, Nystrom L, Lundback B, Andersson C, Forsberg B (2006) Vehicle exhaust exposure in an incident case–control study of adult asthma. Eur Respir J 28:75–81CrossRefGoogle Scholar
  30. Modig L, Toren K, Janson C, Jarvholm B, Forsberg B (2009) Vehicle exhaust outside the home and onset of asthma among adults. Eur Respir J 33:1261–1267CrossRefGoogle Scholar
  31. Morgenstern V, Zutavern A, Cyrys J, Brockow I, Gehring U, Koletzko S, Bauer CP, Reinhardt D, Wichmann HE, Heinrich J (2007) Respiratory health and individual estimated exposure to traffic-related air pollutants in a cohort of young children. Occup Environ Med 64:8–16CrossRefGoogle Scholar
  32. Nordling E, Berglind N, Melen E, Emenius G, Hallberg J, Nyberg F, Pershagen G, Svartengren M, Wickman M, Bellander T (2008) Traffic-related air pollution and childhood respiratory symptoms, function and allergies. Epidemiology 19:401–408CrossRefGoogle Scholar
  33. Oftedal B, Nystad W, Brunekreef B, Nafstad P (2009) Long-term traffic-related exposures and asthma onset in schoolchildren in Oslo, Norway. Environ Health Perspect 117:839–844Google Scholar
  34. Patel MM, Hoepner L, Garfinkel R, Chillrud S, Reyes A, Quinn JW, Perera F, Miller RL, Patel MM, Hoepner L, Garfinkel R, Chillrud S, Reyes A, Quinn JW, Perera F, Miller RL (2009) Ambient metals, elemental carbon, and wheeze and cough in New York City children through 24 months of age. Am J Respir Crit Care Med 180:1107–1113CrossRefGoogle Scholar
  35. Pierse N, Rushton L, Harris RS, Kuehni CE, Silverman M, Grigg J (2006) Locally generated particulate pollution and respiratory symptoms in young children. Thorax 61:216–220CrossRefGoogle Scholar
  36. Ryan PH, LeMasters GK, Biagini J, Bernstein D, Grinshpun SA, Shukla R, Wilson K, Villareal M, Burkle J, Lockey J (2005) Is it traffic type, volume, or distance? Wheezing in infants living near truck and bus traffic. J Allergy Clin Immunol 116:279–284CrossRefGoogle Scholar
  37. Ryan PH, LeMasters GK, Biswas P, Levin L, Hu S, Lindsey M, Bernstein DI, Lockey J, Villareal M, Khurana Hershey GK, Grinshpun SA (2007) A comparison of proximity and land use regression traffic exposure models and wheezing in infants. Environ Health Perspect 115:278–284CrossRefGoogle Scholar
  38. Salam MT, Islam T, Gilliland FD (2008) Recent evidence for adverse effects of residential proximity to traffic sources on asthma. Curr Opin Pulm Med 14:3–8CrossRefGoogle Scholar
  39. Scarlett JF, Griffiths JM, Strachan DP, Anderson HR (1995) Effect of ambient levels of smoke and sulphur dioxide on the health of a national sample of 23 years old subjects in 1981. Thorax 50:764–768CrossRefGoogle Scholar
  40. Schindler C, Keidel D, Gerbase MW, Zemp E, Bettschart R, Brandli O, Brutsche MH, Burdet L, Karrer W, Knopfli B, Pons M, Rapp R, Bayer-Oglesby L, Kunzli N, Schwartz J, Liu LJ, Ackermann-Liebrich U, Rochat T, SAPALDIA Team (2009) Improvements in PM10 exposure and reduced rates of respiratory symptoms in a cohort of Swiss adults (SAPALDIA). Am J Respir Crit Care Med 179:579–587CrossRefGoogle Scholar
  41. Shima M, Adachi M (2000) Effect of outdoor and indoor nitrogen dioxide on respiratory symptoms in schoolchildren. Int J Epidemiol 29:862–870CrossRefGoogle Scholar
  42. Shima M, Nitta Y, Ando M, Adachi M (2002) Effects of air pollution on the prevalence and incidence of asthma in children. Arch Environ Health 57:529–535CrossRefGoogle Scholar
  43. Shima M, Nitta Y, Adachi M (2003) Traffic-related air pollution and respiratory symptoms in children living along trunk roads in Chiba Prefecture, Japan. J Epidemiol 13:108–119CrossRefGoogle Scholar
  44. Sterne JA, Gavaghan D, Egger M (2000) Publication and related bias in meta-analysis: power of statistical tests and prevalence in the literature. J Clin Epidemiol 53:1119–1129CrossRefGoogle Scholar
  45. Strachan DP, Butland BK, Anderson HR (1996) Incidence and prognosis of asthma and wheezing illness from early childhood to age 33 in a national British cohort. BMJ 312:1195–1199CrossRefGoogle Scholar
  46. Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 283:2008–2012CrossRefGoogle Scholar
  47. WHO (2000) Evaluation and use of epidemiological evidence for environmental health risk assessment. EUR/00/5020369. WHO Regional Office for Europe, CopenhagenGoogle Scholar
  48. WHO European Centre for Environment and Health (2005) Effects of air pollution on children’s health and development—a review of the evidence. WHO Regional Office for Europe, BonnGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • H. Ross Anderson
    • 1
  • Graziella Favarato
    • 1
  • Richard W. Atkinson
    • 1
  1. 1.MRC-HPA Centre for Environment and Health, Division of Population Health Sciences and EducationSt George’s, University of LondonLondonUK

Personalised recommendations