ORIGINAL ARTICLE

Respiratory health and individual estimated exposure to traffic-related air pollutants in a cohort of young children

V Morgenstern¹, A Zutavern^1,3, J Cyrys^1,4, I Brockow⁵, U Gehring¹, S Koletzko⁵, C P Bauer⁵, D Reinhardt³, H-E Wichmann^1,2, J Heinrich¹

¹ GSF National Research Center for Environment and Health, Institute of Epidemiology, Neuherberg, Germany
² Institute of Medical Data Management, Biometrics and Epidemiology, Ludwig-Maximilians University of Munich, Munich, Germany
³ Kinderklinik und Kinderpoliklinik im Dr v Hauner’schen Kinderspital, Munich, Germany
⁴ WZU, Environmental Science Center, University of Augsburg, Augsburg, Germany
⁵ Kinderklinik und Poliklinik der TU München, Munich, Germany; Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands

Correspondence to:
Dr J Heinrich
GSF, National Research Center for Environment and Health, Institute of Epidemiology, Ingolstaedter Landstrasse 1, D-85764 Neuherberg, Germany; joachim.heinrich{at}gsf.de

Objectives: To estimate long-term exposure to traffic-related air pollutants on an individual basis and to assess adverse health effects using a combination of air pollution measurement data, data from geographical information systems (GIS) and questionnaire data.

Methods: 40 measurement sites in the city of Munich, Germany were selected at which to collect particulate matter with a 50% cut-off aerodynamic diameter of 2.5 µm (PM_2.5) and to measure PM_2.5 absorbance and nitrogen dioxide (NO₂). A pool of GIS variables (information about street length, household and population density and land use) was collected for the Munich metropolitan area and was used in multiple linear regression models to predict traffic-related air pollutants. These models were also applied to the birth addresses of two birth cohorts (German Infant Nutritional Intervention Study (GINI) and Influence of Life-style factors on the development of the Immune System and Allergies in East and West Germany (LISA)) in the Munich metropolitan area. Associations between air pollution concentrations at birth address and 1-year and 2-year incidences of respiratory symptoms were analysed.

Results: The following means for the estimated exposures to PM_2.5, PM_2.5 absorbance and NO₂ were obtained: 12.8 µg/m³, 1.7x10^–5 m^–1 and 35.3 µg/m³, respectively. Adjusted odds ratios (ORs) for wheezing, cough without infection, dry cough at night, bronchial asthma, bronchitis and respiratory infections indicated positive associations with traffic-related air pollutants. After controlling for individual confounders, significant associations were found between the pollutant PM_2.5 and sneezing, runny/stuffed nose during the first year of life (OR 1.16, 95% confidence interval 1.01 to 1.34) Similar effects were observed for the second year of life. These findings are similar to those from our previous analysis that were restricted to a subcohort in Munich city. The extended study also showed significant effects for sneezing, running/stuffed nose. Additionally, significant associations were found between NO₂ and dry cough at night (or bronchitis) during the first year of life. The variable "living close to major roads" (<50 m), which was not analysed for the previous inner city cohort with birth addresses in the city of Munich, turned out to increase the risk of wheezing and asthmatic/spastic/obstructive bronchitis.

Conclusions: Effects on asthma and hay fever are subject to confirmation at older ages, when these outcomes can be more validly assessed.

Abbreviations: ATKIS, Authoritative Topographic-Cartographic Information System; GINI, German Infant Nutritional Intervention Study; GIS, geographical information system; LISA, Influence of Life-style factors on the development of the Immune System and Allergies in East and West Germany; RMSE, root mean squared error; TRAPCA, Traffic-Related Air Pollution and Childhood Asthma

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