Login Register Cart 0
Review Article

Influence of Ultrafine Particles Exposure on Asthma Exacerbation in Children: A Meta-Analysis

Author(s): Qinyuan Li, Qian Yi, Lin Tang, Siying Luo, Yuan Tang, Guangli Zhang and Zhengxiu Luo*

Volume 20, Issue 4, 2019

Page: [412 - 420] Pages: 9

DOI: 10.2174/1389450119666180829114252

Price: $65

conference banner
Abstract

Background: Air pollution is a major cause of asthma exacerbation. Most studies have shown that exposure to coarse and fine particulate matter is associated with asthma exacerbation. Ultrafine particles (UFPs, aerodynamic diameter ≤ 0.1 µm) are the smallest airborne particles, which are capable of penetrating deep into the lungs. Toxicological studies have suggested that exposure to UFPs may have serious effects on respiratory health. However, epidemiological evidence on the effects of UFPs exposure on asthma exacerbation in children remains unclear.

Objective: We conducted a meta-analysis to quantitatively assess the effects of exposure to UFPs on childhood asthma exacerbation.

Methods: We searched four databases for epidemiological studies published until March 20, 2018. Pooled Odds Ratios (OR) and 95% confidence intervals (95% CIs) per 10000 particles/cm3 were estimated using fixed-effect models. Subgroup analyses, sensitivity analyses, and Begg’s and Egger’s regression were also performed.

Results: Eight moderate–high quality studies with 51542 events in total satisfied the inclusion criteria. Exposure to UFPs showed a positive association with childhood asthma exacerbation [OR (95% CI): 1.070 (1.037, 1.104)], increased asthma-associated emergency department visits [OR (95% CI): 1.111 (1.055, 1.170)], and asthma-associated hospital admissions [OR (95% CI): 1.045 (1.004, 1.088)] and had a stronger association with childhood asthma exacerbation at long lags [OR (95% CI):1.060 (1.039, 1.082)]. A low heterogeneity and no publication bias were detected.

Conclusion: Exposure to UFPs may increase the risk of asthma exacerbation and may be strongly associated with childhood asthma exacerbation at long lags.

Keywords: Ultrafine particle, asthma, childhood, meta-analysis, exposure, risk factor.

« Previous Next »
Graphical Abstract

[1]
Bateman ED, Hurd SS, Barnes PJ, et al. Global strategy for asthma management and prevention: GINA executive summary. Eur Respir J 2008; 31: 143-78.
[2]
Halonen JI, Lanki T, Yli-Tuomi T, Kulmala M, Tiittanen P, Pekkanen J. Urban air pollution, and asthma and COPD hospital emergency room visits. Thorax 2008; 63: 635-41.
[3]
O’Connor GT, Neas L, Vaughn B, et al. Acute respiratory health effects of air pollution on children with asthma in US inner cities. J Allergy Clin Immunol 2008; 121: 1133-9.e1.
[4]
Nel A, Xia T, Mädler L, Li N. Toxic potential of materials at the nanolevel. Science 2006; 311: 622-7.
[5]
Li N, Georas S, Alexis N, et al. A work group report on ultrafine particles (American Academy of Allergy, Asthma & Immunology): Why ambient ultrafine and engineered nanoparticles should receive special attention for possible adverse health outcomes in human subjects. J Allergy Clin Immunol 2016; 138: 386-96.
[6]
Gauderman WJ, Urman R, Avol E, et al. Association of improved air quality with lung development in children. N Engl J Med 2015; 372: 905-13.
[7]
Andersen ZJ, Loft S, Ketzel M, et al. Ambient air pollution triggers wheezing symptoms in infants. Thorax 2008; 63: 710-6.
[8]
Andersen ZJ, Wahlin P, Raaschou-Nielsen O, Ketzel M, Scheike T, Loft S. Size distribution and total number concentration of ultrafine and accumulation mode particles and hospital admissions in children and the elderly in Copenhagen, Denmark. Occup Environ Med 2008; 65: 458-66.
[9]
Evans KA, Halterman JS, Hopke PK, Fagnano M, Rich DQ. Increased ultrafine particles and carbon monoxide concentrations are associated with asthma exacerbation among urban children. Environ Res 2014; 129: 11-9.
[10]
Iskandar A, Andersen ZJ, Bonnelykke K, Ellermann T, Andersen KK, Bisgaard H. Coarse and fine particles but not ultrafine particles in urban air trigger hospital admission for asthma in children. Thorax 2012; 67: 252-7.
[11]
Samoli E, Atkinson RW, Analitis A, et al. Differential health effects of short-term exposure to source-specific particles in London, U.K. Environ Int 2016; 97: 246-53.
[12]
Tiittanen P, Timonen KL, Ruuskanen J, Mirme A, Pekkanen J. Fine particulate air pollution, resuspended road dust and respiratory health among symptomatic children. Eur Respir J 1999; 13: 266-73.
[13]
Clifford S, Mazaheri M, Salimi F, Ezz WN, Yeganeh B, Low-Choy S, et al. Effects of exposure to ambient ultrafine particles on respiratory health and systemic inflammation in children. Environ Int 2018; 114: 167-80.
[14]
Heinzerling A, Hsu J, Yip F. Respiratory Health Effects of Ultrafine Particles in Children: A Literature Review. Water Air Soil Pollut 2016; 227: pii: 32.
[15]
Moher D, Liberati A, Tetzlaff J, Altman DG. PRISMA Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 2009; 339: b2535.
[16]
Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of observational studies in epidemiology (MOOSE) group. JAMA 2000; 283: 2008-12.
[17]
Wells GA, Shea B, O’Connell D, et al. The Newcastle–Ottawa Scale (NOS) for assessing the quality of non-randomized studies in Meta-Analysis2000. Available from.http://www.ohri.ca/ programs/clinical_epidemiology/oxford.asp
[18]
Mustafic H, Jabre P, Caussin C, et al. Main air pollutants and myocardial infarction: a systematic review and meta-analysis. JAMA 2012; 307: 713-21.
[19]
Rostom A, Dubé C, Cranney A, et al. Rockville (MD): Agency for Healthcare Research and Quality (US); (Evidence Reports/ Technology Assessments, No. 104.) Appendix D. Quality Assessment Forms. Celiac Disease 2004.https:// www.ncbi.nlm.nih.gov/books/NBK35156/
[20]
Samoli E, Andersen ZJ, Katsouyanni K, et al. Exposure to ultrafine particles and respiratory hospitalisations in five European cities. Eur Respir J 2016; 48: 674-82.
[21]
Stafoggia M, Schneider A, Cyrys J, et al. Association between short-term exposure to ultrafine particles and mortality in eight European urban areas. Epidemiology 2017; 28: 172-80.
[22]
Anderson H, Atkinson R, Peacock J, Marston L, Konstantinou K. Meta-analysis of time-series studies and panel studies of Particulate Matter (PM) and ozone (O3). Report of a WHO Task group 2004; 1-68.
[23]
Atkinson RW, Kang S, Anderson HR, Mills IC, Walton HA. Epidemiological time series studies of PM 2.5 and daily mortality and hospital admissions: A systematic review and meta-analysis. Thorax 2014; 69: 660-5.
[24]
Zhang S, Li G, Tian L, Guo Q, Pan X. Short-term exposure to air pollution and morbidity of COPD and asthma in East Asian area: A systematic review and meta-analysis. Environ Res 2016; 148: 15-23.
[25]
Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0. Cochrane Database Syst Rev 2008; 5: S38.
[26]
Seagroatt V, Stratton I. Bias in meta-analysis detected by a simple, graphical test. Test had 10% false positive rate. BMJ 1998; 316: 470.
[27]
Duval S, Tweedie R. A nonparametric “Trim and Fill” method of accounting for publication bias in meta-analysis. J Am Stat Assoc 2000; 95: 89-98.
[28]
Particles HR. P on U Understanding the health effects of ambient ultrafine particles. Health Effects Institute 2013; p. 122.
[29]
Kadoya C, Lee B-W, Ogami A, et al. Analysis of pulmonary surfactant in rat lungs after inhalation of nanomaterials: Fullerenes, nickel oxide and multi-walled carbon nanotubes. Nanotoxicology 2016; 10: 194-203.
[30]
Kendall M, Brown L, Trought K. Molecular adsorption at particle surfaces: a PM toxicity mediation mechanism. Inhal Toxicol 2004; 16: 99-105.
[31]
Yeh H-C, Muggenburg BA, Harkema JR. In vivo deposition of inhaled ultrafine particles in the respiratory tract of rhesus monkeys. Aerosol Sci Technol 1997; 27: 465-70.
[32]
Li N, Xia T, Nel AE. The role of oxidative stress in ambient particulate matter-induced lung diseases and its implications in the toxicity of engineered nanoparticles. Free Radic Biol Med 2008; 44: 1689-99.
[33]
Araujo JA, Nel AE. Particulate matter and atherosclerosis: Role of particle size, composition and oxidative stress. Part Fibre Toxicol 2009; 6: 24.
[34]
Chan JKW, Kodani SD, Charrier JG, et al. Age-specific effects on rat lung glutathione and antioxidant enzymes after inhaling ultrafine soot. Am J Respir Cell Mol Biol 2013; 48: 114-24.
[35]
Chen EY, Garnica M, Wang Y-C, Mintz AJ, Chen C-S, Chin W-C. A mixture of anatase and rutile TiO2 nanoparticles induces histamine secretion in mast cells. Part Fibre Toxicol 2012; 9: 2.
[36]
Wang X, Podila R, Shannahan JH, Rao AM, Brown JM. Intravenously delivered graphene nanosheets and multiwalled carbon nanotubes induce site-specific Th2 inflammatory responses via the IL-33/ST2 axis. Int J Nanomedicine 2013; 8: 1733-48.
[37]
Nel AE, Diaz-Sanchez D, Ng D, Hiura T, Saxon A. Enhancement of allergic infla mmation by the interaction between diesel exhaust particles and the immune system. J Allergy Clin Immunol 1998; 102: 539-54.
[38]
Merrifield A, Schindeler S, Jalaludin B, Smith W. Health effects of the September 2009 dust storm in Sydney, Australia: Did emergency department visits and hospital admissions increase? Environ Health 2013; 12: 32.
[39]
Taj T, Malmqvist E, Stroh E, Oudin Åström D, Jakobsson K, Oudin A. Short-term associations between air pollution concentrations and respiratory health-comparing primary health care visits, hospital admissions, and emergency department visits in a multi-municipality study. Int J Environ Res Public Health 2017; 14: pii: E587.
[40]
Ferin J, Oberdörster G, Penney DP. Pulmonary retention of ultrafine and fine particles in rats. Am J Respir Cell Mol Biol 1992; 6: 535-42.
[41]
Stölzel M, Breitner S, Cyrys J, et al. Daily mortality and particulate matter in different size classes in Erfurt, Germany. J Expo Sci Environ Epidemiol 2007; 17: 458-67.
[42]
Alessandrini F, Schulz H, Takenaka S, et al. Effects of ultrafine carbon particle inhalation on allergic inflammation of the lung. J Allergy Clin Immunol 2006; 117: 824-30.
[43]
Schaumann F, Frömke C, Dijkstra D, et al. Effects of ultrafine particles on the allergic inflammation in the lung of asthmatics: Results of a double-blinded randomized cross-over clinical pilot study. Part Fibre Toxicol 2014; 11: 39.
[44]
Wichmann HE, Spix C, Tuch T, et al. Daily mortality and fine and ultrafine particles in Erfurt, Germany part I: Role of particle number and particle mass. Res Rep Health Eff Inst 2000; 5-86.
[45]
Benor S, Alcalay Y, Domany KA, et al. Ultrafine particle content in exhaled breath condensate in airways of asthmatic children. J Breath Res 2015; 9: 026001.
[46]
Kim J-L, Elfman L, Wieslander G, Ferm M, Torén K, Norbäck D. Respiratory Health among Korean Pupils in Relation to Home, School and Outdoor Environment. J Korean Med Sci 2011; 26: 166-73.

Rights & Permissions Print Cite
Article Metrics
73
5
1
Wayfinder Image
World Antimicrobial Awareness Week
World Prematurity Day
© 2024 Bentham Science Publishers | Privacy Policy