Breastfeeding as a modifier of the respiratory effects of air pollution in children

Guang Hui Dong, Zhengmin Qian, Miao Miao Liu, Da Wang, Wan Hui Ren, Shahida Bawa, John Fu, Jing Wang, Roger Lewis, Alan Zelicoff, Maayan Simckes, Edwin Trevathan

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: Breastfeeding and air pollution are both important factors for respiratory symptoms and asthma in children. Few studies have examined possible interaction between them on respiratory outcomes. METHODS: We studied 31,049 Chinese children, ages 2-14 years old, from 25 elementary schools and 50 kindergartens in the Seven Northeastern Cities during 2008-2009. Parents or guardians completed questionnaires about the children's histories of respiratory conditions, risk factors, and feeding methods. Three-year average concentrations of particles with an aerodynamic diameter ≤10 μm, sulfur dioxide, nitrogen dioxides, and ozone were calculated from monitoring stations in 25 study districts. We used two-level logistic regressions to examine the effects of exposure, controlling for covariates. RESULTS: Association of air pollution with childhood respiratory conditions was modified by breastfeeding. Compared with children who had been breastfed, those who were not exhibited consistently stronger effects of air pollution. Among non-breastfed children, odds ratios (ORs) per 10 μg/m increase in nitrogen dioxide were 1.40 (95% confidence interval = 1.19-1.64) for cough, 1.41 (1.16-1.71) for phlegm, 1.17 (1.00-1.36) for current wheeze, and 1.25 (1.07-1.46) for doctor-diagnosed asthma. For breastfed children, the ORs were 1.25 (1.09-1.43) for cough, 1.15 (0.99-1.34) for phlegm, 0.97 (0.87-1.08) for current wheeze, and 1.17 (1.05-1.32) for doctor-diagnosed asthma. Breastfeeding was more protective among younger children. Breastfeeding was also associated with reduced effects of passive smoke exposure in children. CONCLUSION: Breastfeeding is associated with smaller associations between air pollution and respiratory conditions in children, suggesting that breastfeeding reduces susceptibility to the respiratory effects of pollutants.

Original languageEnglish (US)
Pages (from-to)387-394
Number of pages8
JournalEpidemiology
Volume24
Issue number3
DOIs
StatePublished - May 1 2013

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Air Pollution
Breast Feeding
Nitrogen Dioxide
Asthma
Cough
Odds Ratio
Feeding Methods
Sulfur Dioxide
Ozone
Smoke
Parents
Logistic Models
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Epidemiology

Cite this

Dong, G. H., Qian, Z., Liu, M. M., Wang, D., Ren, W. H., Bawa, S., ... Trevathan, E. (2013). Breastfeeding as a modifier of the respiratory effects of air pollution in children. Epidemiology, 24(3), 387-394. https://doi.org/10.1097/EDE.0b013e3182877eb8
Dong, Guang Hui ; Qian, Zhengmin ; Liu, Miao Miao ; Wang, Da ; Ren, Wan Hui ; Bawa, Shahida ; Fu, John ; Wang, Jing ; Lewis, Roger ; Zelicoff, Alan ; Simckes, Maayan ; Trevathan, Edwin. / Breastfeeding as a modifier of the respiratory effects of air pollution in children. In: Epidemiology. 2013 ; Vol. 24, No. 3. pp. 387-394.
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abstract = "BACKGROUND: Breastfeeding and air pollution are both important factors for respiratory symptoms and asthma in children. Few studies have examined possible interaction between them on respiratory outcomes. METHODS: We studied 31,049 Chinese children, ages 2-14 years old, from 25 elementary schools and 50 kindergartens in the Seven Northeastern Cities during 2008-2009. Parents or guardians completed questionnaires about the children's histories of respiratory conditions, risk factors, and feeding methods. Three-year average concentrations of particles with an aerodynamic diameter ≤10 μm, sulfur dioxide, nitrogen dioxides, and ozone were calculated from monitoring stations in 25 study districts. We used two-level logistic regressions to examine the effects of exposure, controlling for covariates. RESULTS: Association of air pollution with childhood respiratory conditions was modified by breastfeeding. Compared with children who had been breastfed, those who were not exhibited consistently stronger effects of air pollution. Among non-breastfed children, odds ratios (ORs) per 10 μg/m increase in nitrogen dioxide were 1.40 (95{\%} confidence interval = 1.19-1.64) for cough, 1.41 (1.16-1.71) for phlegm, 1.17 (1.00-1.36) for current wheeze, and 1.25 (1.07-1.46) for doctor-diagnosed asthma. For breastfed children, the ORs were 1.25 (1.09-1.43) for cough, 1.15 (0.99-1.34) for phlegm, 0.97 (0.87-1.08) for current wheeze, and 1.17 (1.05-1.32) for doctor-diagnosed asthma. Breastfeeding was more protective among younger children. Breastfeeding was also associated with reduced effects of passive smoke exposure in children. CONCLUSION: Breastfeeding is associated with smaller associations between air pollution and respiratory conditions in children, suggesting that breastfeeding reduces susceptibility to the respiratory effects of pollutants.",
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Dong, GH, Qian, Z, Liu, MM, Wang, D, Ren, WH, Bawa, S, Fu, J, Wang, J, Lewis, R, Zelicoff, A, Simckes, M & Trevathan, E 2013, 'Breastfeeding as a modifier of the respiratory effects of air pollution in children', Epidemiology, vol. 24, no. 3, pp. 387-394. https://doi.org/10.1097/EDE.0b013e3182877eb8

Breastfeeding as a modifier of the respiratory effects of air pollution in children. / Dong, Guang Hui; Qian, Zhengmin; Liu, Miao Miao; Wang, Da; Ren, Wan Hui; Bawa, Shahida; Fu, John; Wang, Jing; Lewis, Roger; Zelicoff, Alan; Simckes, Maayan; Trevathan, Edwin.

In: Epidemiology, Vol. 24, No. 3, 01.05.2013, p. 387-394.

Research output: Contribution to journalArticle

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T1 - Breastfeeding as a modifier of the respiratory effects of air pollution in children

AU - Dong, Guang Hui

AU - Qian, Zhengmin

AU - Liu, Miao Miao

AU - Wang, Da

AU - Ren, Wan Hui

AU - Bawa, Shahida

AU - Fu, John

AU - Wang, Jing

AU - Lewis, Roger

AU - Zelicoff, Alan

AU - Simckes, Maayan

AU - Trevathan, Edwin

PY - 2013/5/1

Y1 - 2013/5/1

N2 - BACKGROUND: Breastfeeding and air pollution are both important factors for respiratory symptoms and asthma in children. Few studies have examined possible interaction between them on respiratory outcomes. METHODS: We studied 31,049 Chinese children, ages 2-14 years old, from 25 elementary schools and 50 kindergartens in the Seven Northeastern Cities during 2008-2009. Parents or guardians completed questionnaires about the children's histories of respiratory conditions, risk factors, and feeding methods. Three-year average concentrations of particles with an aerodynamic diameter ≤10 μm, sulfur dioxide, nitrogen dioxides, and ozone were calculated from monitoring stations in 25 study districts. We used two-level logistic regressions to examine the effects of exposure, controlling for covariates. RESULTS: Association of air pollution with childhood respiratory conditions was modified by breastfeeding. Compared with children who had been breastfed, those who were not exhibited consistently stronger effects of air pollution. Among non-breastfed children, odds ratios (ORs) per 10 μg/m increase in nitrogen dioxide were 1.40 (95% confidence interval = 1.19-1.64) for cough, 1.41 (1.16-1.71) for phlegm, 1.17 (1.00-1.36) for current wheeze, and 1.25 (1.07-1.46) for doctor-diagnosed asthma. For breastfed children, the ORs were 1.25 (1.09-1.43) for cough, 1.15 (0.99-1.34) for phlegm, 0.97 (0.87-1.08) for current wheeze, and 1.17 (1.05-1.32) for doctor-diagnosed asthma. Breastfeeding was more protective among younger children. Breastfeeding was also associated with reduced effects of passive smoke exposure in children. CONCLUSION: Breastfeeding is associated with smaller associations between air pollution and respiratory conditions in children, suggesting that breastfeeding reduces susceptibility to the respiratory effects of pollutants.

AB - BACKGROUND: Breastfeeding and air pollution are both important factors for respiratory symptoms and asthma in children. Few studies have examined possible interaction between them on respiratory outcomes. METHODS: We studied 31,049 Chinese children, ages 2-14 years old, from 25 elementary schools and 50 kindergartens in the Seven Northeastern Cities during 2008-2009. Parents or guardians completed questionnaires about the children's histories of respiratory conditions, risk factors, and feeding methods. Three-year average concentrations of particles with an aerodynamic diameter ≤10 μm, sulfur dioxide, nitrogen dioxides, and ozone were calculated from monitoring stations in 25 study districts. We used two-level logistic regressions to examine the effects of exposure, controlling for covariates. RESULTS: Association of air pollution with childhood respiratory conditions was modified by breastfeeding. Compared with children who had been breastfed, those who were not exhibited consistently stronger effects of air pollution. Among non-breastfed children, odds ratios (ORs) per 10 μg/m increase in nitrogen dioxide were 1.40 (95% confidence interval = 1.19-1.64) for cough, 1.41 (1.16-1.71) for phlegm, 1.17 (1.00-1.36) for current wheeze, and 1.25 (1.07-1.46) for doctor-diagnosed asthma. For breastfed children, the ORs were 1.25 (1.09-1.43) for cough, 1.15 (0.99-1.34) for phlegm, 0.97 (0.87-1.08) for current wheeze, and 1.17 (1.05-1.32) for doctor-diagnosed asthma. Breastfeeding was more protective among younger children. Breastfeeding was also associated with reduced effects of passive smoke exposure in children. CONCLUSION: Breastfeeding is associated with smaller associations between air pollution and respiratory conditions in children, suggesting that breastfeeding reduces susceptibility to the respiratory effects of pollutants.

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