Air pollution is associated with persistent peanut allergy in the first 10 years - 04/12/24

Doi : 10.1016/j.jaci.2024.08.018

Diego J. Lopez, PhD ^a, Caroline J. Lodge, PhD ^a,^b, Dinh S. Bui, PhD ^a, Nilakshi T. Waidyatillake, PhD ^a, John C. Su, PhD ^b,^c, Luke D. Knibbs, PhD ^d,^e, Rushani Wijesuriya, PhD ^b,^f, Kirsten P. Perrett, PhD ^b,^f,^g, Jennifer J. Koplin, PhD ^b,^h, Victoria X. Soriano, PhD ^b,^f, Kate Lycett, PhD ^b,ⁱ, Yichao Wang, PhD ^b,^f,ⁱ, Katie Allen, PhD ^b,^g, Suzanne Mavoa, PhD ^b,^j, Shyamali C. Dharmage, PhD ^a,^b, Adrian J. Lowe, PhD ^a,^b, Rachel L. Peters, PhD ^b,^f,^⁎
on behalf of the
HealthNuts investigators group
Noel Cranswick, Jo Smart, Jo Douglass, Anne-Louise Ponsonby, Mimi L.K. Tang, Lyle Gurrin, Melissa Wake, Jessica Oakley, Glend Isaraj, Najaf Dure

^a Allergy and Lung Health Unit, University of Melbourne, Melbourne, Australia
^b Murdoch Children’s Research Institute, Melbourne, Australia
^c Department of Dermatology, Monash University, Eastern Health, Melbourne, Australia
^d School of Public Health, University of Sydney, Sydney, Australia
^e Public Health Research Analytics and Methods for Evidence, Public Health Unit, Sydney Local Health District, Camperdown, Australia
^f Department of Paediatrics, University of Melbourne, Parkville, Australia
^g Department Allergy & Immunology, Royal Children’s Hospital, Melbourne, Australia
^h Child Health Research Centre, University of Queensland, Brisbane, Australia
ⁱ Centre for Social and Early Emotional Development (SEED), Deakin University, Geelong, Australia
^j Environment Protection Authority Victoria, Melbourne, Australia

^∗Corresponding author: Rachel L. Peters, PhD, Population Allergy, Murdoch Children’s Research Institute, The Royal Children’s Hospital, 50 Flemington Rd, Parkville, Victoria 3052 Australia.Population AllergyMurdoch Children’s Research InstituteThe Royal Children’s Hospital50 Flemington RdParkvilleVictoria3052Australia

Graphical abstract

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Abstract

Background

The role of air pollution in eczema and food allergy development remains understudied.

Objective

We aimed to assess whether exposure to air pollution is associated with eczema and food allergies in the first 10 years of life.

Methods

HealthNuts recruited a population-based sample of 1-year-old infants who were followed up at ages 4, 6, and 10 years. Annual average fine particulate matter (particulate matter with diameter of 2.5 μm or less, or PM_2.5) and nitrogen dioxide (NO₂) exposures were assigned to geocoded residential addresses. Eczema was defined by parent report. Oral food challenges to peanut, egg, and sesame were used to measure food allergy. Multilevel logistic regression models were fitted, and estimates were reported as adjusted odds ratios.

Results

Those exposed to high concentration of NO₂ (<10 ppb) at age 1 year had higher peanut allergy prevalence at ages 1 (adjusted odds ratio [95% confidence interval], 2.21 [1.40-3.48]) and 4 (2.29 [1.28-4.11]) years. High exposure to NO₂ at 6 years old were associated with higher peanut allergy prevalence at age 6 (1.34 [1.00-1.82] per 2.7 ppb NO₂ increase) years. Similarly, increased PM_2.5 at age 1 year was associated with peanut allergy at ages 4, 6, and 10 years (respectively, 1.27 [1.01-1.60], 1.27 [1.01-1.56], and 1.46 [1.05-2.04] per 1.2 μg/m PM_2.5 increase) years. We found that increased concentrations of NO₂ or PM_2.5 at age 1 year were associated with persistent peanut allergy at later ages. Little evidence of associations was observed with eczema or with egg allergy.

Conclusions

Early-life exposure to PM_2.5 and NO₂ was associated with peanut allergy prevalence and persistence. Policies aiming at reducing air pollution could potentially reduce presence and persistence of peanut allergy.

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Key words : Eczema, food allergy, air pollution

Abbreviations used : aOR, CALD, CI, IQR, IRSD, nDVI, NO₂, OFC, OR, PM_2.5/10, RMSE, SA2, sIgE, SPT

Plan

Methods

Study design and population

Confounding variables

Statistical analysis

Results

Discussion

The last 2 authors contributed equally to this article, and both should be considered senior author.

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Vol 154 - N° 6

P. 1489 - décembre 2024 Retour au numéro

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Air pollution is associated with persistent peanut allergy in the first 10 years - 04/12/24

Graphical abstract

Abstract

Background

Objective

Methods

Results

Conclusions

Plan

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