Traffic related air pollution and incidence of childhood asthma: results of the Vesta case-control study
- D Zmirou1,
- S Gauvin2,
- I Pin3,
- I Momas4,
- F Sahraoui5,
- J Just5,
- Y Le Moullec6,
- F Brémont7,
- S Cassadou8,
- P Reungoat4,
- M Albertini9,
- N Lauvergne9,
- M Chiron10,
- A Labbé11,
- Vesta investigators*
- 1Public Health Laboratory, School of Medicine, Nancy University, France
- 2Centre Scientifique et Technique du Bâtiment, Paris, France
- 3Department of Paediatrics, Grenoble University Hospital, France
- 4Public Health and Hygiene Laboratory, School of Pharmacy, Paris 5 University, France
- 5Department of Paediatrics, Paris University Hospital of Trousseau, France
- 6Hygiene Laboratory of the City of Paris, France
- 7Department of Paediatrics, Toulouse University Hospital, France
- 8Regional Health Observatory of Midi-Pyrénées, Toulouse, France
- 9Department of Paediatrics, Nice University Hospital, France
- 10INRETS, the French National Institute for Transport and Safety Research, Lyon, France
- 11Department of Paediatrics, Clermont-Ferrand University Hospital, France
- Correspondence to: Professor D Zmirou INSERM, Faculté de Médecine, 9 av de la Foret de Haye, BP 164-54505 Vandoeuvre-les-Nancy Cedex, France;
- Accepted 19 May 2003
Study objective: The Vesta project aims to assess the role of traffic related air pollution in the occurrence of childhood asthma.
Design and setting: Case-control study conducted in five French metropolitan areas between 1998 and 2000. A set of 217 pairs of matched 4 to 14 years old cases and controls were investigated. An index of lifelong exposure to traffic exhausts was constructed, using retrospective information on traffic density close to all home and school addresses since birth; this index was also calculated for the 0–3 years age period to investigate the effect of early exposures.
Main results: Adjusted on environmental tobacco smoke, personal and parental allergy, and several confounders, lifelong exposure was not associated with asthma. In contrast, associations before age of 3 were significant: odds ratios for tertiles 2 and 3 of the exposure index, relative to tertile 1, exhibited a positive trend (1.48 (95%CI = 0.7 to 3.0) and 2.28 (1.1 to 4.6)), with greater odds ratios among subjects with positive skin prick tests.
Conclusions: These results suggest that traffic related pollutants might have contributed to the asthma epidemic that has taken place during the past decades among children.
↵* A list of the other Vesta investigators is printed at the end of the paper.
Funding: this study was supported by the French Research Program on air pollution (Primequal-Predit), coordinated by the Ministry of Environment. It also received funds from ADEME (French Environment and Energy Agency) and from local authorities in the study sites (Rhône-Alpes and Midi-Pyrénées Regions, metropolitan authorities of Grenoble and Toulouse). Stéphanie GAUVIN received a doctoral grant by ADEME and Union Française des Industries Pétrolières (UFIP). Patrice REUNGOAT also received a doctoral grant from ADEME and INRETS.