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March 07, 2023
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Less air pollution leads to ‘better lung health’ from childhood to adulthood

Fact checked byKristen Dowd
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Lung function growth from childhood to early adulthood improved with less exposure to ambient air pollutants, according to study results published in European Respiratory Journal.

Erik Melén

“We know that air pollution exposure is bad for your lungs, and with our new results we see that measures to reduce exposure (individual or societal) actually pays off in terms of better lung health in young people,” Erik Melén, MD, PhD, professor in the department of clinical sciences and education at Karolinska Institutet in Sweden, told Healio.

Infographic showing for each 2.19 μg/m3 decrease in PM2.5, the lung function growth rate increased by:
Data were derived from Yu Z, et al. Eur Respir J. 2023;doi:10.1183/13993003.01783-2022.

Using BAMSE (Children, Allergy, Environment, Stockholm, Epidemiology), a Swedish prospective birth cohort, Melén and colleagues analyzed 1,509 individuals born between 1994 and 1996 with spirometry measurements at 8 years old (2002-2004) and either at 16 years (2011-2013) and/or 24 years old (2016-2019) to determine how ambient air pollution changes are related to lung function growth as children develop into adults.

With knowledge of participant home addresses, researchers estimated levels of air pollution for each of them through dispersion modelling. They evaluated levels of several pollutants including particulate matter measuring 2.5 m or less in diameter (PM2.5), PM measuring 10 m or less in diameter (PM10), black carbon (BC) and nitrogen oxides (NOX).

To find the link between the two factors, they used linear mixed-effect models.

Additionally, researchers accounted for covariates by using information the children gave them on questionnaires they took at each assessed age.

Of the total cohort, researchers assessed 3,837 spirometry measurements.

In terms of changes in air pollution, researchers found that median PM2.5 lessened from the time the individuals were aged 8 years (8.24 g/m3; interquartile range [IQR], 0.92) to when they were aged 24 years (5.21 g/m3; IQR, 0.67).

Researchers also observed reductions from 2002-2004 to 2016-2019 in PM10 (–7.64 g/m3 to –10.9 g/m3), BC (–0.19 g/m3 to –1.78 g/m3) and NOX (–44.4 g/m3 to –48.4 g/m3).

Improved FEV1 and FVC growth rates occurred with each IQR reduction of PM2.5, according to researchers. For each 2.19 g/m3 decrease, the lung function growth rate went up by 4.63 mL/year (95% CI, 1.64-7.61) for FEV1, and for FVC, it increased by 9.38 mL/year (95% CI, 4.76-14).

Decreases in the other pollutants also showed improved growth rates in FEV1 and FVC. Each decline of 1 g/m3 in PM10 was related to a mean growth rate increase of 0.72 mL/year (95% CI, –0.91 to 2.35) for FEV1 and of 2.77 mL/year (95% CI, 0.19-5.35) for FVC.

Each decline of 0.28 g/m3 in BC was linked to an increase of 2.8 mL/year (95% CI, 0.66-4.93) for FEV1 and of 5.59 mL/year (95% CI, 2.3-8.87) for FVC.

Lastly, each decline of 6.17 g/m3 in NOX was associated with an increase of 1.7 mL/year (95% CI, –0.16 to 3.57) for FEV1 and of 3.29 mL/year (95% CI, 0.35-6.23) for FVC.

To confirm these results, researchers adjusted for asthma, allergic sensitization, overweight, early-life air pollution exposure and antioxidant dietary intake, and found that the association observed above continued.

“I am surprised to see such clear positive health effects of reduced air pollution exposure given that Stockholm has relatively good air quality to start with,” Melén told Healio. “However, this is even more encouraging — even small improvements in air quality counts.”

For future studies, there are several possible areas to investigate, Melén said.

“It would be very useful to look at even higher resolution of the individual exposure patterns, eg, through smart devices that may capture exact levels (of many pollutants exposures) where you reside, and how individual-level exposure may change with time,” he told Healio.

Headshot Credit: Stefan Zimmerman

For more information:

Erik Melén, MD, PhD, can be reached at erik.melen@ki.se.

Reference: