The Effect of Air Pollution on Lung Development from 10 to 18 Years of Age
W. James Gauderman, Ph.D., Edward Avol, M.S., Frank Gilliland, M.D., Ph.D., Hita Vora, M.S., Duncan Thomas, Ph.D., Kiros Berhane, Ph.D., Rob McConnell, M.D., Nino Kuenzli, M.D., Fred Lurmann, M.S., Edward Rappaport, M.S., Helene Margolis, Ph.D., David Bates, M.D., and John Peters, M.D.
Background Whether exposure to air pollution adversely affectsthe growth of lung function during the period of rapid lungdevelopment that occurs between the ages of 10 and 18 yearsis unknown.
Methods In this prospective study, we recruited 1759 children(average age, 10 years) from schools in 12 southern Californiacommunities and measured lung function annually for eight years.The rate of attrition was approximately 10 percent per year.The communities represented a wide range of ambient exposuresto ozone, acid vapor, nitrogen dioxide, and particulate matter.Linear regression was used to examine the relationship of airpollution to the forced expiratory volume in one second (FEV1)and other spirometric measures.
Results Over the eight-year period, deficits in the growth ofFEV1 were associated with exposure to nitrogen dioxide (P=0.005),acid vapor (P=0.004), particulate matter with an aerodynamicdiameter of less than 2.5 µm (PM2.5) (P=0.04), and elementalcarbon (P=0.007), even after adjustment for several potentialconfounders and effect modifiers. Associations were also observedfor other spirometric measures. Exposure to pollutants was associatedwith clinically and statistically significant deficits in theFEV1 attained at the age of 18 years. For example, the estimatedproportion of 18-year-old subjects with a low FEV1 (definedas a ratio of observed to expected FEV1 of less than 80 percent)was 4.9 times as great at the highest level of exposure to PM2.5as at the lowest level of exposure (7.9 percent vs. 1.6 percent,P=0.002).
Conclusions The results of this study indicate that currentlevels of air pollution have chronic, adverse effects on lungdevelopment in children from the age of 10 to 18 years, leadingto clinically significant deficits in attained FEV1 as childrenreach adulthood.
Source Information
From the Department of Preventive Medicine, University of Southern California, Los Angeles (W.J.G., E.A., F.G., H.V., D.T., K.B., R.M., N.K., E.R., J.P.); Sonoma Technology, Petaluma, Calif. (F.L.); Air Resources Board, State of California, Sacramento (H.M.); and the University of British Columbia, Vancouver, B.C., Canada (D.B.).
Address reprint requests to Dr. Gauderman at the Department of Preventive Medicine, University of Southern California, 1540 Alcazar St., Suite 220, Los Angeles, CA 90089, or at jimg{at}usc.edu.
Air Pollution and Lung Function
Lockwood A. H., Merkus P. J.F.M., Tetrault G. A., Gauderman W. J., Avol E., Gilliland F.
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N Engl J Med 2004;
351:2652-2653, Dec 16, 2004.
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