PracticeUpdate Conference Series: ERS 2018

Green SpaceNearHomeDuring Childhood Linked to Fewer Respiratory Problems inAdulthood Nearby access to green spaces reduces future respiratory problems. C hildren who have access to green spaces close to their homes have fewer respiratory problems, such as asthma and wheezing, in adulthood, reports an analysis of air pol- lution data in the Respiratory Health In Northern Europe, Spain and Australia (RHINESSA) study. “We will be conducting further analyses that include more centers taking part in RHINESSA. We also want to expand analyses to look at the effects of exposure to air pollution and greenness across generations.”

Dr. Kuiper and colleagues analyzed greenness data from 5415 participants aged 18–52 years, contributed by RHINESSA centers in Tartu, Estonia; Reykjavik, Iceland; Uppsala, Gothenburg, and Umea, Sweden; and Bergen, Norway. They also analyzed air pollution data from 4414 participants in Uppsala, Gothenburg, Umea, and Bergen. RHINESSA is a large international study that investigates lung health in children and adults in seven European countries and that collects information on residential greenness and air pollu- tion exposure from birth onward. The investigators looked at numbers of subjects who suffered from more than three respiratory symptoms, severe wheeze (in which the person experienced wheezing with breathlessness in the past year but did not have a cold), and late-onset asthma (after age 10 years). Respiratory symptoms included chest wheezing or whistling; breathlessness when wheezing; wheezing or whistling with- out a cold; tight chest on waking; being woken by an attack of shortness of breath; or by cough; asthma attack; or the need to take asthma medication.

Ingrid Nordeide Kuiper, MD, of the Haukeland University Hospital in Haukeland, Norway, said in an ERS press release, “These are preliminary results, but we found that exposure to greenness during childhood was associated with fewer respiratory symp- toms in adulthood. Exposure to air pollutants in childhood was associated with more respiratory symptoms in adulthood and with late-onset asthma. “We believe that our results,” she continued, “together with pre- vious results, will be of particular value for city planners and policymakers. With increasing population density in years to come it will be vital to include a decrease in air pollution expo- sure and an increase in access to green spaces in city plans and societal regulations. “We need to analyze these findings further before drawing any definite conclusions. However, it is likely that our findings will substantially expand our knowledge on the long-term effects of air pollution and greenness, enabling physicians, scientists and policymakers to see the importance of exposure to pollution and access to green spaces, and helping to improve public health,” noted Dr. Kuiper.

Uterine Exposure to Organochlorine Pesticides Linked to Poorer Lung Function Babies exposed to higher organochlorine levels in thewomb sufferworse lung function in childhood.

F or the first time, a link with objective meas- ures of lung strength and capacity has been demonstrated in relation to low-level uterine exposure to organochlorine compounds. This outcome of a study of pregnant mothers’ blood followed by pulmonary function testing of the child was reported at ERS 2018. Maribel Casas Sanahuja, DVM, PhD, of the Barcelona Institute for Global Health (ISGlobal), said in an ERS press release, “We already have evidence that exposure to environmental chem- icals including organochlorine compounds can have an impact on children’s health. Though this group of chemicals was banned in the 1970s, low (but detectable) levels are still present in pregnant women and in children. That means current popu- lations and future generations are still exposed to these compounds.”

She continued, “To reduce exposure to these chemicals, women of reproductive age can try to moderate their consumption of foods with high levels of organochlorine compounds, such as fatty meats and oily fish.” “We know,” she added, “that this group of chemicals can interfere with the body’s endocrine system and we also know that hormone receptors play an important role in fetal lung development, so this could be the mechanism for a link.” “Organochlorine compounds are thought to dis- rupt the endocrine system,” Dr. Casas Sanahuja noted, “and have been linked to a wide range of conditions. These include cardiovascular disorders, cancer, and low birth weight. The main source of exposure to organochlorine compounds is food, but fetuses and newborns can be exposed via the placenta and breastfeeding.”

Dr. Maribel Casas Sanahuja

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