Article Text

Original article
Intrauterine and early postnatal exposure to outdoor air pollution and lung function at preschool age
  1. Eva Morales1,2,3,4,
  2. Raquel Garcia-Esteban1,2,3,4,
  3. Oscar Asensio de la Cruz5,
  4. Mikel Basterrechea4,6,7,
  5. Aitana Lertxundi6,8,
  6. Maria D Martinez López de Dicastillo6,9,
  7. Carlos Zabaleta10,
  8. Jordi Sunyer1,2,3,4
  1. 1Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain
  2. 2Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain
  3. 3Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain
  4. 4CIBER Epidemiología y Salud Pública (CIBERESP), Spain
  5. 5Unit of Pediatric Pneumology and Allergy, Hospital de Sabadell, Corporació Sanitària Parc Taulí, Sabadell, Catalonia, Spain
  6. 6Health Research Institute Biodonostia, San Sebastian, Gipuzkoa, Spain
  7. 7Public Health Department of Gipuzkoa, San Sebastian, Gipuzkoa, Spain
  8. 8University of the Basque Country, Bilbao, Spain
  9. 9Department of Environment and Regional Planning, Basque Government, San Sebastian, Gipuzkoa, Spain
  10. 10Department of Pediatrics, Hospital de Zumárraga, San Sebastian, Gipuzkoa, Spain
  1. Correspondence to Dr Eva Morales, Centre for Research in Environmental Epidemiology (CREAL), Parc de Recerca Biomèdica de Barcelona, Dr. Aiguader 88, Barcelona, Catalonia 08003, Spain; embarto{at}


Background Effects of prenatal and postnatal exposure to air pollution on lung function at preschool age remain unexplored. We examined the association of exposure to air pollution during specific trimesters of pregnancy and postnatal life with lung function in preschoolers.

Methods Lung function was assessed with spirometry in preschoolers aged 4.5 years (n=620) participating in the INfancia y Medio Ambiente (INMA) cohort. Temporally adjusted land use regression (LUR) models were applied to estimate individual residential exposures to benzene and nitrogen dioxide (NO2) during specific trimesters of pregnancy and early postnatal life (the first year of life). Recent and current (1 year and 1 week before lung function testing, respectively) exposures to NO2 and nitrogen oxides (NOx) were also assessed.

Results Exposure to higher levels of benzene and NO2 during pregnancy was associated with reduced lung function. FEV1 estimates for an IQR increase in exposures during the second trimester of pregnancy were −18.4 mL, 95% CI −34.8 to −2.1 for benzene and −28.0 mL, 95% CI −52.9 to −3.2 for NO2. Relative risk (RR) of low lung function (<80% of predicted FEV1) for an IQR increase in benzene and NO2 during the second trimester of pregnancy were 1.22, 95% CI 1.02 to 1.46 and 1.30, 95% CI 0.97 to 1.76, respectively. Associations for early postnatal, recent and current exposures were not statistically significant. Stronger associations appeared among allergic children and those of lower social class.

Conclusions Prenatal exposure to residential traffic-related air pollution may result in long-term lung function deficits at preschool age.

  • Lung Physiology
  • Paediatric Lung Disaese
  • Respiratory Measurement

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Supplementary materials

  • Supplementary Data

    This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

    Files in this Data Supplement:


    Files in this Data Supplement:

Linked Articles