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Air pollution hampers teenagers’ lung development
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     Specialist Registrar in Respiratory Medicine, Derriford Hospital, Plymouth, UK; iyazkhan@aol.com

    Gauderman WJ, Avol E, Gilliland F, et al. The effect of air pollution on lung development from 10 to 18 years of age. N Engl J Med 2004;351:1057–67[Abstract/Free Full Text]

    The Children’s Health Study recruited 1759 children from schools in Southern California and prospectively followed up these children from the age of 10 to 18 years, measuring lung function annually. FVC, FEV1, and maximal mid expiratory flow rate (MMEF) were used as markers of lung development. Air pollution monitoring stations were established in target areas that recorded pollution data continuously over the 8 years. Linear regression models were used to adjust for confounding variables and to determine the effects.

    The results showed a strong association between decreased lung function (FEV1) attained at the age of 18 years and pollutants like nitrogen dioxide (p = 0.005), acid vapour (p = 0.01), fine particulate matter PM2.5 (p = 0.002), and elemental carbon (p = 0.006). The effect of these pollutants was similar in both sexes and remained significant in children with no history of asthma or exposure to smoking. The authors noted that reduced lung function was a risk factor for complications and death during adulthood and later in life.

    The study did not provide a mechanism for air pollutant effect, although the authors have suggested airway inflammation. It is also interesting and somewhat in contrast with the previous studies that this study has not implicated ozone in having any health effect on lung development. However, the authors point out the need for caution in interpreting this particular finding.(A Khan)