Recent versus chronic fine particulate air pollution exposure as determinant of the retinal microvasculature in school children

Microvascular changes may represent an underlying mechanism through which exposure to fine particulate matter with a diameter ≤ 2.5µm (PM_2.5) contributes to age-related disease development. We investigated the effect of recent and chronic exposure to PM_2.5 on the microcirculation, exemplified by retinal vessel diameters, using repeated measurements in 8- to 12-year-old children.

221 children (49.1% girls; mean age 9.9 years) were examined repeatedly (25 one, 124 two, and 72 three times) adding up to 489 retinal vessel examinations. Same-day exposure to PM_2.5 was measured at school. In addition, recent (same and previous day) and chronic (yearly mean) exposure was modelled at the child's residence using a high-resolution interpolation model. Residential proximity to major roads was also assessed. Changes in retinal vessel diameters associated with recent and chronic exposures were estimated using mixed models, while adjusting for other known covariates such as sex, age, BMI, blood pressure and birth weight.

Each 10µg/m³ increment in same-day exposure to PM_2.5 measured at school was associated with 0.35µm (95% CI: 0.09-0.61µm) narrower retinal arterioles and 0.35µm (-0.03 to 0.73µm) wider venules. Children living 100m closer to a major road had 0.30µm (0.05-0.54µm) narrower arterioles.

Blood vessel diameters of the retinal microcirculation of healthy school-aged children respond to same-day PM_2.5 exposure. Furthermore, children living closer to major roads had smaller arteriolar diameters. Our results suggest that the microcirculation, with retinal microvasculature as a proxy in this study, is a pathophysiological target for air pollution in children.