Exercise-induced bronchoconstriction is associated with air humidity and particulate matter concentration in preschool children

Anna P. Tikkakoski; Antti Tikkakoski; Kalle Sipilä; Juho E. Kivistö; Heini Huhtala; Mika Kähönen; Jussi Karjalainen; Lauri Lehtimäki

doi:10.1002/ppul.26284

Exercise-induced bronchoconstriction is associated with air humidity and particulate matter concentration in preschool children

Anna P. Tikkakoski, Antti Tikkakoski, Kalle Sipilä, Juho E. Kivistö, Heini Huhtala, Mika Kähönen, Jussi Karjalainen, Lauri Lehtimäki

Health Sciences

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Abstract

Background: Long-term exposure to air pollution is connected to asthma morbidity in children. Exercise-induced bronchoconstriction (EIB) is common in asthma, and the free running test outdoors is an important method for diagnosing asthma in children. It is not known whether momentary air pollution exposure affects the results of outdoor exercise tests in children. Methods: We analyzed all reliable exercise challenge tests with impulse oscillometry in children (n = 868) performed between January 2012 and April 2015 at Tampere University Hospital. Pollutant concentrations (PM_2.5, NO₂, and O₃) at the time of the exercise test were collected from public registers. We compared the pollutant concentrations with the proportion and severity of EIB and adjusted the analyses for air humidity and pollen counts. Results: Pollution levels were rarely high (median PM_2.5 6.0 µg/m³, NO₂ 12.0 µg/m³, and O₃ 47.0 µg/m³). The relative change in resistance at 5 Hz after exercise did not correlate with O₃, NO₂ or PM_2.5 concentrations (p values 0.065−0.884). In multivariate logistic regression, we compared the effects of PM_2.5 over 10 µg/m³, absolute humidity (AH) over 10 g/m³ and alder or birch pollen concentration over 10 grains/m³. High (over 10 g/m³) AH was associated with decreased incidence (OR 0.31, p value 0.004), and PM_2.5 over 10 µg/m³ was associated with increased incidence (OR 1.69, p value 0.036) of EIB. Conclusions: Even low PM_2.5 levels may have an effect on EIB in children. Of the other properties of air, only AH was associated with the incidence of EIB.

Original language	English
Pages (from-to)	996-1003
Number of pages	8
Journal	Pediatric Pulmonology
Volume	58
Issue number	4
Early online date	2022
DOIs	https://doi.org/10.1002/ppul.26284
Publication status	Published - 2023
Publication type	A1 Journal article-refereed

Keywords

air pollution
air quality
asthma
exercise test
exercise-induced bronchoconstriction
impulse oscillometry
particulate matter
pulmonary Function Tests

Publication forum classification

Publication forum level 1

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Pulmonary and Respiratory Medicine
Physiology (medical)

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Tikkakoski et al EIB is associated
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Cite this

@article{a85eacabee2e43ceba33265a9a3f2a62,

title = "Exercise-induced bronchoconstriction is associated with air humidity and particulate matter concentration in preschool children",

abstract = "Background: Long-term exposure to air pollution is connected to asthma morbidity in children. Exercise-induced bronchoconstriction (EIB) is common in asthma, and the free running test outdoors is an important method for diagnosing asthma in children. It is not known whether momentary air pollution exposure affects the results of outdoor exercise tests in children. Methods: We analyzed all reliable exercise challenge tests with impulse oscillometry in children (n = 868) performed between January 2012 and April 2015 at Tampere University Hospital. Pollutant concentrations (PM2.5, NO2, and O3) at the time of the exercise test were collected from public registers. We compared the pollutant concentrations with the proportion and severity of EIB and adjusted the analyses for air humidity and pollen counts. Results: Pollution levels were rarely high (median PM2.5 6.0 µg/m3, NO2 12.0 µg/m3, and O3 47.0 µg/m3). The relative change in resistance at 5 Hz after exercise did not correlate with O3, NO2 or PM2.5 concentrations (p values 0.065−0.884). In multivariate logistic regression, we compared the effects of PM2.5 over 10 µg/m³, absolute humidity (AH) over 10 g/m³ and alder or birch pollen concentration over 10 grains/m³. High (over 10 g/m3) AH was associated with decreased incidence (OR 0.31, p value 0.004), and PM2.5 over 10 µg/m³ was associated with increased incidence (OR 1.69, p value 0.036) of EIB. Conclusions: Even low PM2.5 levels may have an effect on EIB in children. Of the other properties of air, only AH was associated with the incidence of EIB.",

keywords = "air pollution, air quality, asthma, exercise test, exercise-induced bronchoconstriction, impulse oscillometry, particulate matter, pulmonary Function Tests",

author = "Tikkakoski, {Anna P.} and Antti Tikkakoski and Kalle Sipil{\"a} and Kivist{\"o}, {Juho E.} and Heini Huhtala and Mika K{\"a}h{\"o}nen and Jussi Karjalainen and Lauri Lehtim{\"a}ki",

note = "Funding Information: This study was funded by grants from the Research Foundation of the Pulmonary Diseases, Ida Montin's Foundation, the Tampere Tuberculosis Foundation and the Foundation of the Finnish Antituberculosis Association. Publisher Copyright: {\textcopyright} 2022 Wiley Periodicals LLC.",

year = "2023",

doi = "10.1002/ppul.26284",

language = "English",

volume = "58",

pages = "996--1003",

journal = "Pediatric Pulmonology",

issn = "8755-6863",

publisher = "Wiley",

number = "4",

}

TY - JOUR

T1 - Exercise-induced bronchoconstriction is associated with air humidity and particulate matter concentration in preschool children

AU - Tikkakoski, Anna P.

AU - Tikkakoski, Antti

AU - Sipilä, Kalle

AU - Kivistö, Juho E.

AU - Huhtala, Heini

AU - Kähönen, Mika

AU - Karjalainen, Jussi

AU - Lehtimäki, Lauri

N1 - Funding Information: This study was funded by grants from the Research Foundation of the Pulmonary Diseases, Ida Montin's Foundation, the Tampere Tuberculosis Foundation and the Foundation of the Finnish Antituberculosis Association. Publisher Copyright: © 2022 Wiley Periodicals LLC.

PY - 2023

Y1 - 2023

N2 - Background: Long-term exposure to air pollution is connected to asthma morbidity in children. Exercise-induced bronchoconstriction (EIB) is common in asthma, and the free running test outdoors is an important method for diagnosing asthma in children. It is not known whether momentary air pollution exposure affects the results of outdoor exercise tests in children. Methods: We analyzed all reliable exercise challenge tests with impulse oscillometry in children (n = 868) performed between January 2012 and April 2015 at Tampere University Hospital. Pollutant concentrations (PM2.5, NO2, and O3) at the time of the exercise test were collected from public registers. We compared the pollutant concentrations with the proportion and severity of EIB and adjusted the analyses for air humidity and pollen counts. Results: Pollution levels were rarely high (median PM2.5 6.0 µg/m3, NO2 12.0 µg/m3, and O3 47.0 µg/m3). The relative change in resistance at 5 Hz after exercise did not correlate with O3, NO2 or PM2.5 concentrations (p values 0.065−0.884). In multivariate logistic regression, we compared the effects of PM2.5 over 10 µg/m³, absolute humidity (AH) over 10 g/m³ and alder or birch pollen concentration over 10 grains/m³. High (over 10 g/m3) AH was associated with decreased incidence (OR 0.31, p value 0.004), and PM2.5 over 10 µg/m³ was associated with increased incidence (OR 1.69, p value 0.036) of EIB. Conclusions: Even low PM2.5 levels may have an effect on EIB in children. Of the other properties of air, only AH was associated with the incidence of EIB.

AB - Background: Long-term exposure to air pollution is connected to asthma morbidity in children. Exercise-induced bronchoconstriction (EIB) is common in asthma, and the free running test outdoors is an important method for diagnosing asthma in children. It is not known whether momentary air pollution exposure affects the results of outdoor exercise tests in children. Methods: We analyzed all reliable exercise challenge tests with impulse oscillometry in children (n = 868) performed between January 2012 and April 2015 at Tampere University Hospital. Pollutant concentrations (PM2.5, NO2, and O3) at the time of the exercise test were collected from public registers. We compared the pollutant concentrations with the proportion and severity of EIB and adjusted the analyses for air humidity and pollen counts. Results: Pollution levels were rarely high (median PM2.5 6.0 µg/m3, NO2 12.0 µg/m3, and O3 47.0 µg/m3). The relative change in resistance at 5 Hz after exercise did not correlate with O3, NO2 or PM2.5 concentrations (p values 0.065−0.884). In multivariate logistic regression, we compared the effects of PM2.5 over 10 µg/m³, absolute humidity (AH) over 10 g/m³ and alder or birch pollen concentration over 10 grains/m³. High (over 10 g/m3) AH was associated with decreased incidence (OR 0.31, p value 0.004), and PM2.5 over 10 µg/m³ was associated with increased incidence (OR 1.69, p value 0.036) of EIB. Conclusions: Even low PM2.5 levels may have an effect on EIB in children. Of the other properties of air, only AH was associated with the incidence of EIB.

KW - air pollution

KW - air quality

KW - asthma

KW - exercise test

KW - exercise-induced bronchoconstriction

KW - impulse oscillometry

KW - particulate matter

KW - pulmonary Function Tests

U2 - 10.1002/ppul.26284

DO - 10.1002/ppul.26284

M3 - Article

C2 - 36530015

AN - SCOPUS:85145331218

SN - 8755-6863

VL - 58

SP - 996

EP - 1003

JO - Pediatric Pulmonology

JF - Pediatric Pulmonology

IS - 4

ER -

Exercise-induced bronchoconstriction is associated with air humidity and particulate matter concentration in preschool children

Abstract

Keywords

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