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Indoor Air Pollution Sources and Respiratory Symptoms in Bronchopulmonary Dysplasia

Jessica L Rice1, Sharon A McGrath-Morrow1, Joseph M Collaco1

  • 1Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.

The Journal of Pediatrics
|May 18, 2020
PubMed

Insights

Indoor air pollution from combustion sources increases hospitalization risk for infants with bronchopulmonary dysplasia (BPD). Secondhand smoke exposure is linked to chronic respiratory symptoms, but air purifiers may help mitigate these effects.

Area of Science:

  • Pediatric Pulmonology
  • Environmental Health
  • Public Health

Background:

  • Infants and children with bronchopulmonary dysplasia (BPD) are at high risk for respiratory complications.
  • Indoor air pollution is a potential environmental risk factor affecting respiratory health in vulnerable pediatric populations.
  • Understanding the specific indoor air pollutants and their impact on BPD patients is crucial for developing targeted interventions.

Purpose of the Study:

  • To investigate the association between indoor air pollution exposure and respiratory health outcomes in infants and children diagnosed with BPD.
  • To identify specific indoor air pollutants, including secondhand smoke and combustion sources, that may exacerbate respiratory morbidity in this population.
  • To explore the potential protective effects of air purifiers in mitigating the adverse respiratory effects of indoor air pollution.

Main Methods:

  • A cohort of 244 subjects from the Johns Hopkins Bronchopulmonary Dysplasia registry was analyzed.
  • Parents completed a detailed environmental exposure questionnaire assessing secondhand smoke and indoor combustion sources.
  • Respiratory symptoms and healthcare utilization data were collected to evaluate acute and chronic respiratory outcomes.

Main Results:

  • Three-quarters of infants were exposed to indoor combustion sources, correlating with increased hospitalization risk for those on home respiratory support.
  • Secondhand smoke exposure, though less prevalent, was associated with chronic symptoms like activity limitation and nocturnal cough.
  • Air purifier use was found to attenuate the negative impact of secondhand smoke on activity limitation.

Conclusions:

  • Exposure to indoor air pollution from combustible sources significantly increases respiratory morbidity in infants with BPD.
  • Indoor air pollution represents a modifiable risk factor for respiratory health in infants and children suffering from BPD.
  • Public health strategies should focus on reducing indoor air pollution to improve respiratory outcomes in high-risk pediatric populations.
Abstract

Keywords:
chronic lung disease of prematuritycombustionhome environmentnitrogen dioxideparticulate matterpremature birthsecondhand smoke

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