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Children's Health
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Exhaled Nitric Oxide in Children with Asthma and Short-Term PM2.5 Exposure
in Seattle Therese F. Mar,1 Karen Jansen,1 Kristen Shepherd,2 Thomas
Lumley,2 Timothy V. Larson,3 and Jane Q. Koenig1 1Department of Environmental Health and Occupational Sciences, 2Department
of Biostatistics, and 3Department of Civil and Environmental Engineering,
University of Washington, Seattle, Washington, USA Abstract The objective of this study was to evaluate associations between short-term (hourly) exposures to particulate matter with aerodynamic diameters < 2.5 µm (PM2.5) and the fractional concentration of nitric oxide in exhaled breath (FeNO) in children with asthma participating in an intensive panel study in Seattle, Washington. The exposure data were collected with tapered element oscillation microbalance (TEOM) PM2.5 monitors operated by the local air agency at three sites in the Seattle area. FeNO is a marker of airway inflammation and is elevated in individuals with asthma. Previously, we reported that offline measurements of FeNO are associated with 24-hr average PM2.5 in a panel of 19 children with asthma in Seattle. In the present study using the same children, we used a polynomial distributed lag model to assess the association between hourly lags in PM2.5 exposure and FeNO levels. Our model controlled for age, ambient NO levels, temperature, relative humidity, and modification by use of inhaled corticosteroids. We found that FeNO was associated with hourly averages of PM2.5 up to 10-12 hr after exposure. The sum of the coefficients for the lag times associated with PM2.5 in the distributed lag model was 7.0 ppm FeNO. The single-lag-model FeNO effect was 6.9 [95% confidence interval (CI) , 3.4 to 10.6 ppb] for a 1-hr lag, 6.3 (95% CI, 2.6 to 9.9 ppb ) for a 4-hr lag, and 0.5 (95% CI, -1.1 to 2.1 ppb) for an 8-hr lag. These data provide new information concerning the lag structure between PM2.5 exposure and a respiratory health outcome in children with asthma. Key words: airway inflammation, asthma, children, exhaled nitric oxide, particulate matter less than or equal to 2.5 µm, short-term exposure. Environ Health Perspect 113: 1791-1794 (2005) . doi:10.1289/ehp.7883 available via http://dx.doi.org/ [Online 8 August 2005]
Address correspondence to J.Q. Koenig, Department of Environmental Health and Occupational Sciences, Box 357234, Room F561a, University of Washington, Seattle, WA 98195-7234 USA. Telephone: (206) 543-2026. Fax: (206) 685-3990. E-mail: Jkoenig@u.washington.edu This work was funded by the U.S. Environmental Protection Agency (EPA) (CR82717701) , the Northwest Research Center for Particulate Air Pollution and Health (EPA grant CR827355) , and National Institute for Environmental Health Sciences grant P30 ES07033. This report has been subjected to agency review and approved for publication. Mention of trade names or commercial products does not constitute an endorsement or recommendation for use. The authors declare they have no competing financial interests. Received 21 December 2004 ; accepted 8 August 2005. |
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[References Listed in PubMed] References
Adamkiewicz G, Ebelt S, Syring M, Slater J, Schwartz J, Suh H, et al. 2004. Association between air pollution exposure and exhaled nitric oxide in an elderly panel. Thorax 58:242-245.
Bates CA, Silkoff PE. 2003. Exhaled nitric oxide in asthma: from bench to bedside. J Allergy Clin Immunol 111:256-262.
Beck-Ripp J, Griese M, Arenz S, Koering C, Pasqualoni B, Bufler P. 2002. Changes of exhaled nitric oxide during steroid treatment of childhood asthma. Eur Respir J 19:1015-1019.
Delfino R, Quintana P, Floro J, Gastanaga V, Samimi B, Kleinman M, et al. 2004. Associations of FEV1 in asthmatic children with personal and microenvironmental exposure to airborne particulate matter. Environ Health Perspect 112:932-941.
Delfino RJ, Zeigr RS, Seltzer JM, Street DH. 1998. Symptoms in pediatric asthmatics and air pollution: differences in effects by symptom severity, anti-inflammatory medication use, and particulate averaging time. Environ Health Perspect 106:751-761.
Deykin A, Halpern O, Massro AF, Draxen JM, Israel E. 1998. Expired nitric oxide after bronchoprovocation and repeated spirometry in patients with asthma. Am J Respir Crit Care Med 157:769-775.
Deykin A, Kharitonov SA. 2003. Nitric oxide. In: Asthma and COPD (Barnes P, Drazen J, Rennard S, Thomson N, eds). New York:Academic Press, 307-314.
Goodman PG, Dockery DW, Clancy L. 2004. Cause-specific mortality and the extended effects of particulate pollution and temperature exposure. Environ Health Perspect 112:179-185.
Jansen K, Koenig JQ, Larson TV, Fields C, Mar TF, Stewart J, et al. 2004. Nitric oxide in subjects with respiratory disease is associated with PM2.5 and black carbon in Seattle [Abstract]. Am J Respir Crit Care Med 169:A282.
Jones SL, Kittelson J, Cowan JO, Flannery EM, Hancox RJ, McLachlan CR, et al. 2001. The predictive values of exhaled nitric oxide measurements in assessing changes in asthma control. Am J Respir Crit Care Med 164:738-743.
Kharitonov SA, Barnes PJ. 2000. Clinical aspects of exhaled nitric oxide. Eur Respir J 16:781-792.
Koenig JQ, Jansen K, Mar TF, Lumley T, Kaufman J, Trenga CA, et al. 2003. Measurement of offline exhaled nitric oxide in a study of community exposure to air pollution. Environ Health Perspect 111:1625-1629.
Liu L-JS, Box M, Kalman D, Kaufman J, Koenig JQ, Larson T, et al. 2003. Exposure assessment of particulate matter for susceptible populations in Seattle, WA. Environ Health Perspect 111:909-918.
Ricciardolo FLM, Timmers MC, Sont JK, Folkerts G, Sterk PJ. 2003. Effect of bradykinin on allergen induced increase in exhaled nitric oxide in asthma. Thorax 58:840-845.
Schwartz J. 2000. The distributed lag between air pollution and daily death. Epidemiology 11:320-326.
Silvestri M, Sabatini F, Spallarossa D, Fregonese L, Battistini E, Biraghi MG, et al. 2001. Exhaled nitric oxide levels in non-allergic and allergic mono- or poly-sensitised children with asthma. Thorax 56:857-862.
Van Amsterdam JG, Nierkens S, Vos SG, Opperhuizen A, van Lovernen H, Steerenberg PA. 2000. Exhaled nitric oxide: a novel biomarker of adverse respiratory health effects in epidemiological studies. Arch Environ Health 55:418-423.
Van Amsterdam JG, Verlaan BPJ, van Lovernen H, Elzakker BGV, Vos SG, Opperhuizen A, et al. 1999. Air pollution is associated with increased level of exhaled nitric oxide in nonsmoking healthy subjects. Arch Environ Health 54:331-335.
Yates DH. 2001. Role of exhaled nitric oxide in asthma. Immunol Cell Biol 79:178-190. [CrossRef].
Zeidler MR, Kleerup EC, Tashkin DP. 2004. Exhaled nitric oxide in the assessment of asthma. Curr Opin Pulm Med 101:31-36.
Last Updated: February 10, 2006
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