Parental Report of Indoor Air Pollution Is Associated with Respiratory Morbidities in Bronchopulmonary Dysplasia - 08/11/24

Doi : 10.1016/j.jpeds.2024.114241

Jessica L. Rice, DO, MHS ¹, Joseph M. Collaco, MD, PhD ^2,^⁎ , Michael C. Tracy, MD ³, Catherine A. Sheils, MD ⁴, Lawrence M. Rhein, MD, MPH ⁵, Antonia P. Popova, MD ⁶, Paul E. Moore, MD ⁷, Audrey N. Miller, MD ⁸, Winston M. Manimtim, MD ⁹, Khanh Lai, MD ¹⁰, Jacob A. Kaslow, MD ⁷, Lystra P. Hayden, MD, MMSc ⁴, Julie L. Fierro, MD ¹, Manvi Bansal, MD ¹¹, Eric D. Austin, MD, MSCI ⁷, Brianna Aoyama, MD ², Stamatia Alexiou, MD ¹, Gangaram Akangire, MD, MS ⁹, Amit Agarwal, MD ¹², Natalie Villafranco, MD ¹³, Roopa Siddaiah, MD ¹⁴, Joanne M. Lagatta, MD ¹⁵, Mehtap Haktanir Abul, MD ¹⁶, A. Ioana Cristea, MD, MS ¹⁷, Christopher D. Baker, MD ¹⁸, Steven H. Abman, MD ¹⁸, Sharon A. McGrath-Morrow, MD, MBA ¹
¹ Division of Pulmonary Medicine, Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA
² Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins University, Baltimore, MD
³ Division of Pediatric Pulmonary, Asthma and Sleep Medicine, Stanford University, Stanford, CA
⁴ Division of Pulmonary Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA
⁵ Neonatal-Perinatal Medicine/Pediatric Pulmonology, University of Massachusetts, Worcester, MA
⁶ Pediatric Pulmonology, University of Michigan, Ann Arbor, MI
⁷ Pulmonary Medicine, Vanderbilt University and Vanderbilt University Medical Center, Nashville, TN
⁸ Division of Neonatology, Nationwide Children's Hospital and Ohio State University, Columbus, OH
⁹ Division of Neonatology, Children's Mercy-Kansas City and University of Missouri Kansas City School of Medicine, Kansas City, MO
¹⁰ Division of Pediatric Pulmonary and Sleep Medicine, University of Utah, Salt Lake City, UT
¹¹ Pulmonology and Sleep Medicine, Children's Hospital of Los Angeles, Los Angeles, CA
¹² Division of Pulmonary Medicine, Arkansas Children's Hospital and University of Arkansas for Medical Sciences, Little Rock, AR
¹³ Pulmonary Medicine, Texas Children's Hospital and Baylor College of Medicine, Houston, TX
¹⁴ Pediatric Pulmonology, Penn State Health, Hershey, PA
¹⁵ Department of Pediatrics, Medical College of Wisconsin Milwaukee, WI
¹⁶ Department of Pediatrics, Brown University School of Medicine, Providence, RI
¹⁷ Division of Pediatric Pulmonology, Allergy and Sleep Medicine, Riley Children's Hospital and Indiana University, Indianapolis, IN
¹⁸ Section of Pulmonary and Sleep Medicine, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO

^∗Reprint requests: Joseph M. Collaco, MD, PhD, Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins University, 200 North Wolfe St, Baltimore, MD 21287.Eudowood Division of Pediatric Respiratory SciencesJohns Hopkins University, 200 North Wolfe StBaltimoreMD21287

Abstract

Objective

To determine the association between indoor air pollution and respiratory morbidities in children with bronchopulmonary dysplasia (BPD) recruited from the multicenter BPD Collaborative.

Study design

A cross-sectional study was performed among participants <3 years old in the BPD Collaborative Outpatient Registry. Indoor air pollution was defined as any reported exposure to tobacco or marijuana smoke, electronic cigarette emissions, gas stoves, and/or wood stoves. Clinical data included acute care use and chronic respiratory symptoms in the past 4 weeks.

Results

A total of 1011 participants born at a mean gestational age of 26.4 ± 2.2 weeks were included. Most (66.6%) had severe BPD. More than 40% of participants were exposed to ≥1 source of indoor air pollution. The odds of reporting an emergency department visit (OR, 1.7; 95% CI, 1.18-2.45), antibiotic use (OR, 1.9; 95% CI, 1.12-3.21), or a systemic steroid course (OR, 2.18; 95% CI, 1.24-3.84) were significantly higher in participants reporting exposure to secondhand smoke (SHS) compared with those without SHS exposure. Participants reporting exposure to air pollution (not including SHS) also had a significantly greater odds (OR, 1.48; 95% CI, 1.08-2.03) of antibiotic use as well. Indoor air pollution exposure (including SHS) was not associated with chronic respiratory symptoms or rescue medication use.

Conclusions

Exposure to indoor air pollution, especially SHS, was associated with acute respiratory morbidities, including emergency department visits, antibiotics for respiratory illnesses, and systemic steroid use.

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Keywords : Fine particulate matter, gas stoves, PM_2.5, secondhand smoke

Abbreviations : BPD, EPA, NO₂, PM_2.5, SHS

Plan

Air Pollution Exposures

Respiratory Morbidities Associated with Indoor Air Pollution

Discussion

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Article 114241- décembre 2024 Retour au numéro

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Parental Report of Indoor Air Pollution Is Associated with Respiratory Morbidities in Bronchopulmonary Dysplasia - 08/11/24

Abstract

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