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Traffic pollution is associated with early childhood aeroallergen sensitization
Christopher D Codispoti1, Grace K LeMasters2, Linda Levin2
1Department of Internal Medicine, Division of Immunology/Allergy, University of Cincinnati, Cincinnati, Ohio; Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio; Division of Immunology, Microbiology, and Allergy, Rush University Medical Center, Chicago, Illinois.
Insights
Diesel exhaust particle (DEP) exposure increases the risk of early aeroallergen sensitization in children. Skin prick test wheal size in early childhood predicts allergic rhinitis (AR) by age four.
Area of Science:
- Environmental Health
- Pediatric Allergy
- Epidemiology
Background:
- Limited prospective studies exist on diesel exhaust particle (DEP) exposure and early aeroallergen sensitization.
- The association between traffic exhaust exposure and allergic rhinitis (AR) at age four is not well-established.
Purpose of the Study:
- To investigate the link between infant traffic exhaust exposure and aeroallergen sensitization at age four.
- To determine if wheal area measurements from ages one to three predict AR at age four.
Main Methods:
- Infants from allergic families underwent annual skin prick tests for 15 aeroallergens.
- Diesel exhaust particle (DEP) exposure was estimated using air sampling and land use regression.
- Allergic rhinitis (AR) at age four was defined by positive skin tests and symptoms.
Main Results:
- High DEP exposure showed a trend towards increased aeroallergen sensitization at ages two and three.
- Wheal area increases at age two (timothy, Alternaria) and age three (fescue, dog, Penicillium) significantly predicted AR at age four.
Conclusions:
- Diesel exhaust particle (DEP) exposure appears to heighten the risk of developing aeroallergen sensitization early in life.
- Early aeroallergen skin test wheal size is a significant predictor of allergic rhinitis (AR) at age four.
Background:
No large, prospective, epidemiologic study has investigated the association between diesel exhaust particle (DEP) exposure and early aeroallergen sensitization and allergic rhinitis (AR) at 4 years of age.
Objective:
To determine how exposure to traffic exhaust during infancy is associated with aeroallergen sensitization and AR at 4 years of age and the predictive utility of the wheal area at 1 to 3 years of age on AR at 4 years of age.
Methods:
Infants born to aeroallergen sensitized parents were evaluated annually with skin prick tests to 15 aeroallergens with measurement of wheal areas. At 4 years of age, AR was defined as at least one positive aeroallergen skin prick test result and the presence of sneezing and a runny nose without a cold or flu. Infant (DEP) exposure was estimated using data from 27 air sampling monitors and a land use regression model.
Results:
Complete data were available for 634 children at 4 years of age. Prevalence of AR increased annually from 6.9% to 21.9%. A positive trend was observed for high DEP exposure and aeroallergen sensitization at 2 and 3 years of age (odds ratio, 1.40; 95% confidence interval, 0.97-2.0) and (odds ratio, 1.35; 95% confidence interval, 0.98-1.85) but not with AR. At 2 years of age, every 1-mm(2) increase in the wheal area of timothy and Alternaria significantly increased the odds of AR at 4 years of age. At 3 years of age, every 1-mm(2) increase in the wheal area of fescue, dog, and Penicillium significantly increased the odds of AR at 4 years of age.
Conclusion:
DEP exposure enhances the risk of early aeroallergen sensitization. Aeroallergen wheal area at 2 and 3 years of age is associated with AR at 4 years of age.
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