"Perinatal Exposure to Traffic-Related Air Pollution and Atopy at 1 Year of Age in a Multi-Center Canadian Birth Cohort Study"

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ehp

ENVIRONMENTAL

HEALTH

PERSPECTIVES

http://www.ehponline.org

Perinatal Exposure to Traffic-Related Air Pollution and

Atopy at 1 Year of Age in a Multi-Center

Canadian Birth Cohort Study

Hind Sbihi, Ryan W. Allen, Allan Becker, Jeffrey R. Brook,

Piush Mandhane, James A. Scott, Malcolm R. Sears,

Padmaja Subbarao, Tim K. Takaro, Stuart E. Turvey,

and Michael Brauer

http://dx.doi.org/10.1289/ehp.1408700

Received: 15 May 2014

Accepted: 26 March 2015

Advance Publication: 31 March 2015

This article will be available in its final, 508-conformant form 2–4 months

after Advance Publication. If you need assistance accessing this article before

then, please contact ehp508@niehs.nih.gov. Our staff will work with you to

assess and meet your accessibility needs within 3 working days.

ehp

ENVIRONMENTAL

HEALTH

PERSPECTIVES

http://www.ehponline.org

Perinatal Exposure to Traffic-Related Air Pollution and

Atopy at 1 Year of Age in a Multi-Center

Canadian Birth Cohort Study

Hind Sbihi, Ryan W. Allen, Allan Becker, Jeffrey R. Brook,

Piush Mandhane, James A. Scott, Malcolm R. Sears,

Padmaja Subbarao, Tim K. Takaro, Stuart E. Turvey,

and Michael Brauer

http://dx.doi.org/10.1289/ehp.1408700

Received: 15 May 2014

Accepted: 26 March 2015

Advance Publication: 31 March 2015

This article will be available in its final, 508-conformant form 2–4 months

after Advance Publication. If you need assistance accessing this article before

then, please contact ehp508@niehs.nih.gov. Our staff will work with you to

assess and meet your accessibility needs within 3 working days.

Perinatal Exposure to Traffic-Related Air Pollution and Atopy at

1 Year of Age in a Multi-Center Canadian Birth Cohort Study

Hind Sbihi,

Ryan W. Allen,

Allan Becker,

Jeffrey R. Brook,

Piush Mandhane,

James A.

Scott,

Malcolm R. Sears,

Padmaja Subbarao,

Tim K. Takaro,

Stuart E. Turvey,

and Michael

Brauer

School of Population and Public Health, University of British Columbia, Vancouver, British

Columbia, Canada;

Faculty of Health Sciences, Simon Fraser University, Burnaby, British

Columbia, Canada;

Department of Immunology, Faculty of Medicine, University of Manitoba,

Winnipeg, Manitoba, Canada;

Air Quality Research Division, Environment Canada, Toronto,

Ontario, Canada;

Department of Pediatrics, Faculty of Medicine and Dentistry, University of

Alberta, Edmonton, Alberta, Canada;

Dalla Lana School of Public Health, University of

Toronto, Toronto, Ontario, Canada;

Department of Medicine, Faculty of Health Sciences,

McMaster University, Hamilton, Ontario, Canada;

Hospital for Sick Children, Department of

Paediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada;

Children’s Hospital and Child and Family Research Institute, Department of Paediatrics, Faculty

of Medicine, University of British Columbia, Vancouver, British Columbia, Canada

Address correspondence to Hind Sbihi, School of Population and Public Health, University of

British Columbia, 2206 East Mall, Vancouver BC, V6T 1Z3, Canada. Telephone: (1)604 822-

9608. E-mail:

hind.sbihi@ubc.ca

Running title: Atopy and perinatal exposure to traffic air pollution

Acknowledgments: The authors extend their gratitude to Diana Lefebvre and Joanne Duncan,

Research Managers for the CHILD study and to members of the CHILD Environmental Working

Group. Thank you to all participating families.

Funding sources: The CHILD Study is funded by the Canadian Institutes of Health Research

(CIHR) and the Allergy, Genes and Environment (AllerGen) Network of Centres of Excellence.

H.S was funded by CIHR Banting and Best doctoral award. S.E. Turvey was supported by a

Clinical Research Scholar Award from the Michael Smith Foundation for Health Research and

the Aubrey J. Tingle Professorship in Pediatric Immunology. M. R. Sears holds the AstraZeneca

endowed Chair in Respiratory Epidemiology.

Competing financial interests: All authors declare no competing financial interests.

Abstract

Background: The role of traffic related air pollution (TRAP) exposure in the development of

allergic sensitization in children is unclear and few birth cohort studies have incorporated

spatiotemporal exposure assessment.

Objectives: To examine the association between TRAP and atopy in 1 year old children from an

ongoing national birth cohort study in four Canadian cities.

Methods: We identified 2477 children ≥ 1 year old with assessment of atopy for inhalant

(Alternaria, Der p, Der f, Cat, Dog, Cockroach) and food-related (milk, eggs, peanuts, soy)

allergens. Exposure to nitrogen dioxide (NO

) was estimated from city-specific land use

regression models accounting for residential mobility and temporal variability in ambient

concentrations. We used mixed models to examine associations between atopy and exposure

during pregnancy and the first year of life, including adjustment for covariates (maternal atopy,

SES, pets, mold, and nutrition). We also conducted analyses stratified by time-location patterns,

daycare attendance, and modeled home ventilation.

Results: Following spatiotemporal adjustment, TRAP exposure after birth increased the risk for

development of atopy to any allergens (adjusted OR per 10 µg/m

= 1.16; 95% CI: 1.00,

1.41), but not during pregnancy (aOR = 1.02; 95% CI: 0.86, 1.22). This association was stronger

among children not attending daycare (aOR = 1.61; 95% CI: 1.28, 2.01) compared to daycare

attendees (aOR = 1.05; 95% CI: 0.81, 1.28). Trends to increased risk were also found for food

(aOR = 1.17; 95% CI: 0.95, 1.47) and inhalant allergens aOR = 1.28; 95% CI: 0.93, 1.76).

Conclusion: Using refined exposure estimates that incorporated temporal variability and

residential mobility, traffic-related air pollution during the first year of life was associated with

atopy.

Introduction

The incidence of allergic diseases has increased sharply, especially for people living in urban

areas, which raises an important public health concern given the trend to urbanization worldwide

(D’Amato et al. 2010). While associations between exposure to air pollution derived from traffic

emissions and allergic exacerbations have been demonstrated, the potential role of traffic related

air pollution (TRAP) in the onset of allergic diseases is uncertain (Heinrich and Wichmann

2004).

Several epidemiological studies have reported associations between atopy or other allergic

phenotypes and exposure to some TRAP exposure surrogates, including nitrogen dioxide (NO

)

(Gruzieva et al. 2012; Janssen et al. 2003; Brauer et al. 2007; Morgenstern et al. 2008).

However, a number of other studies have not observed these positive associations (Gehring et al.

2010; Oftedal et al. 2007). Differences in TRAP exposure assessment approaches are one

possible explanation for these divergent findings.

Despite the importance of early life exposures in the development of allergy, information on the

effect of air pollution exposure, particularly during pregnancy, on allergic responses early in life

has rarely been assessed (Aguilera et al. 2013; Esplugues et al. 2011; Mortimer et al. 2008) and

birth cohort studies addressing this relationship are rare (Bråbäck and Forsberg 2009). Exposure

assessment methods have evolved from self-reported measures (e.g. proximity) (Janssen et al.

2003) to atmospheric dispersion (Oftedal et al. 2007) and land use regression (LUR) models

capturing within-city air pollution variations (Brauer et al. 2007; Gehring et al. 2010). Most LUR

models consider annual average concentrations which may over or under-estimate personal

exposures as traffic markers such as NO

are highly variable in time and space (Mölter et al.

2010). Recently the temporal specificity of LUR models has been improved by applying forward

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