Air Pollution and Respiratory Infections during Early Childhood: An Analysis of 10 European Birth Cohorts within the ESCAPE Project

Elaina A. MacIntyre, Ulrike Gehring, Anna Moelter, Elaine Fuertes, Claudia Kluemper, Ursula Kraemer, Ulrich Quass, Barbara Hoffmann, Mireia Gascon, Bert Brunekreef, Gerard H. Koppelman, Rob Beelen, Gerard Hoek, Matthias Birk, Johan C. de Jongste, H. A. Smit, Josef Cyrys, Olena Gruzieva, Michal Korek, Anna BergstromRaymond M. Agius, Frank de Vocht, Angela Simpson, Daniela Porta, Francesco Forastiere, Chiara Badaloni, Giulia Cesaroni, Ana Esplugues, Ana Fernandez-Somoano, Aitana Lerxundi, Jordi Sunyer, Marta Cirach, Mark J. Nieuwenhuijsen, Goran Pershagen, Joachim Heinrich*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

164 Citations (Scopus)


BACKGROUND: Few studies have investigated traffic-related air pollution as a risk factor for respiratory infections during early childhood.

OBJECTIVES: We aimed to investigate the association between air pollution and pneumonia, croup, and otitis media in 10 European birth cohorts-BAMSE (Sweden), GASPII (Italy), GINIplus and LISAplus (Germany), MAAS (United Kingdom), PIAMA (the Netherlands), and four INMA cohorts (Spain)-and to derive combined effect estimates using meta-analysis.

Methods: Parent report of physician-diagnosed pneumonia, otitis media, and croup during early childhood were assessed in relation to annual average pollutant levels [nitrogen dioxide (NO2), nitrogen oxide (NOx), particulate matter

RESULTS: For pneumonia, combined adjusted odds ratios (ORs) were elevated and statistically significant for all pollutants except PM2.5 (e. g., OR = 1.30; 95% CI: 1.02, 1.65 per 10-mu g/m(3) increase in NO2 and OR = 1.76; 95% CI: 1.00, 3.09 per 10-mu g/m(3) PM10). For otitis media and croup, results were generally null across all analyses except for NO2 and otitis media (OR = 1.09; 95% CI: 1.02, 1.16 per 10-mu g/m(3)).

CONCLUSION: Our meta-analysis of 10 European birth cohorts within the ESCAPE project found consistent evidence for an association between air pollution and pneumonia in early childhood, and some evidence for an association with otitis media.

Original languageEnglish
Pages (from-to)107-113
Number of pages7
JournalEnvironmental Health Perspectives
Issue number1
Publication statusPublished - Jan 2014


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