Open access
Research Article
6 April 2010

Childhood Incident Asthma and Traffic-Related Air Pollution at Home and School

Publication: Environmental Health Perspectives
Volume 118, Issue 7
Pages 1021 - 1026



Traffic-related air pollution has been associated with adverse cardiorespiratory effects, including increased asthma prevalence. However, there has been little study of effects of traffic exposure at school on new-onset asthma.


We evaluated the relationship of new-onset asthma with traffic-related pollution near homes and schools.


Parent-reported physician diagnosis of new-onset asthma (n = 120) was identified during 3 years of follow-up of a cohort of 2,497 kindergarten and first-grade children who were asthma- and wheezing-free at study entry into the Southern California Children’s Health Study. We assessed traffic-related pollution exposure based on a line source dispersion model of traffic volume, distance from home and school, and local meteorology. Regional ambient ozone, nitrogen dioxide (NO2), and particulate matter were measured continuously at one central site monitor in each of 13 study communities. Hazard ratios (HRs) for new-onset asthma were scaled to the range of ambient central site pollutants and to the residential interquartile range for each traffic exposure metric.


Asthma risk increased with modeled traffic-related pollution exposure from roadways near homes [HR 1.51; 95% confidence interval (CI), 1.25–1.82] and near schools (HR 1.45; 95% CI, 1.06–1.98). Ambient NO2 measured at a central site in each community was also associated with increased risk (HR 2.18; 95% CI, 1.18–4.01). In models with both NO2 and modeled traffic exposures, there were independent associations of asthma with traffic-related pollution at school and home, whereas the estimate for NO2 was attenuated (HR 1.37; 95% CI, 0.69–2.71).


Traffic-related pollution exposure at school and homes may both contribute to the development of asthma.

Supplementary Material

File (0901232cha_suppl.pdf)


Appatova AS, Ryan PH, Lemasters GK, Gruinshpun SA. 2008. Proximal exposure of public schools and students to major roadways: a nationwide US survey. J Environ Plann Manage 51:631-646.
Asher MI, Keil U, Anderson HR, Beasley R, Crane J, Martinez Fet al. 1995. International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods. Eur Respir J 8(3):483-491
Benson P. 1989. Caline4—A Dispersion Model for Predicting Air Pollution Concentration Near Roadways Sacramento California Department of Transportation, Office of Transportation Laboratory.
Braman SS. 2006. The global burden of asthma. Chest 130(suppl 1):4S-12S
Brauer M, Hoek G, Smit HA, de Jongste JC, Gerritsen J, Postma DSet al. 2007. Air pollution and development of asthma, allergy and infections in a birth cohort. Eur Respir J 29(5):879-888
Briggs DJ, de Hoogh C, Gulliver J, Wills J, Elliott P, Kingham Set al. 2000. A regression-based method for mapping traffic-related air pollution: application and testing in four contrasting urban environments. Sci Total Environ 253(1–3):151-167
Burr ML. 1992. Diagnosing asthma by questionnaire in epidemiological surveys [Editorial]. Clin Exp Allergy 22(5):509-510
Eder W, Ege MJ, von Mutius E. 2006. The asthma epidemic. N Engl J Med 355(21):2226-2235
Gauderman WJ, Avol E, Lurmann F, Kuenzli N, Gilliland F, Peters Jet al. 2005. Childhood asthma and exposure to traffic and nitrogen dioxide. Epidemiology 16(6):737-743
Gauderman WJ, Vora H, McConnell R, Berhane K, Gilliland F, Thomas Det al. 2007. Effect of exposure to traffic on lung development from 10 to 18 years of age: a cohort study. Lancet 369(9561):571-577
Gehring U, Cyrys J, Sedlmeir G, Brunekreef B, Bellander T, Fischer Pet al. 2002. Traffic-related air pollution and respiratory health during the first 2 yrs of life. Eur Respir J 19(4):690-698
Gehring U, Wijga AH, Brauer M, Fischer P, de Jongste JC, Kerkhof Met al. 2009. Traffic-related air pollution and the development of asthma and allergies during the first 8 years of life. Am J Respir Crit Care Med 181(6):596-603
Gilbert NL, Woodhouse S, Stieb DM, Brook JR. 2003. Ambient nitrogen dioxide and distance from a major highway. Sci Total Environ 312(1–3):43-46
Green RS, Smorodinsky S, Kim JJ, McLaughlin R, Ostro B. 2004. Proximity of California public schools to busy roads. Environ Health Perspect 112(1):61-66
Hastie TJ, Tibshirani RJ. 1990. Generalized Additive Models London Chapman & Hall.
Heinrich J, Wichmann HE. 2004. Traffic related pollutants in Europe and their effect on allergic disease. Curr Opin Allergy Clin Immunol 4(5):341-348
Islam T, Berhane K, McConnell R, Gauderman WJ, Avol E, Peters JMet al. 2009. Glutathione-S-transferase (GST) P1, GSTM1, exercise, ozone and asthma incidence in school children. Thorax 64(3):197-202
Islam T, McConnell R, Gauderman WJ, Avol E, Peters JM, Gilliland FD. 2008. Ozone, oxidant defense genes, and risk of asthma during adolescence. Am J Respir Crit Care Med 177(4):388-395
Janssen NA, Brunekreef B, van Vliet P, Aarts F, Meliefste K, Harssema Het al. 2003. The relationship between air pollution from heavy traffic and allergic sensitization, bronchial hyperresponsiveness, and respiratory symptoms in Dutch schoolchildren. Environ Health Perspect 111:1512-1518
Jerrett M, Shankardass K, Berhane K, Gauderman WJ, Künzli N, Avol Eet al. 2008. Traffic-related air pollution and asthma onset in children: a prospective cohort study with individual exposure measurement. Environ Health Perspect 116:1433-1438
Kim JJ, Huen K, Adams S, Smorodinsky S, Hoats A, Malig Bet al. 2008. Residential traffic and children’s respiratory health. Environ Health Perspect 116:1274-1279
Kim S, Shen S, Sioutas C. 2002. Size distribution and diurnal and seasonal trends of ultrafine particles in source and receptor sites of the Los Angeles basin. J Air Waste Manag Assoc 52(3):297-307
Kim JJ, Smorodinsky S, Lipsett M, Singer BC, Hodgson AT, Ostro B. 2004. Traffic-related air pollution near busy roads: the East Bay Children’s Respiratory Health Study. Am J Respir Crit Care Med 170(5):520-526
Kramer U, Koch T, Ranft U, Ring J, Behrendt H. 2000. Traffic-related air pollution is associated with atopy in children living in urban areas. Epidemiology 11(1):64-70
Krewski D, Jerrett M, Burnett RT, Ma R, Hughes E, Shi Yet al. 2009. Extended follow-up and spatial analysis of the American Cancer Society study linking particulate air pollution and mortality. Res Rep Health Eff Inst 140:5-114
Kunzli N, McConnell R, Bates D, Bastain T, Hricko A, Lurmann Fet al. 2003. Breathless in Los Angeles: the exhausting search for clean air. Am J Public Health 93(9):1494-1499
Li N, Hao M, Phalen RF, Hinds WC, Nel AE. 2003. Particulate air pollutants and asthma. A paradigm for the role of oxidative stress in PM-induced adverse health effects. Clin Immunol 109(3):250-265
Ma R, Krewski D, Burnett RT. 2003. Random effects Cox models: a Poisson modeling approach. Biometrika 90:157-169.
Martinez FD, Wright AL, Taussig LM, Holberg CJ, Halonen M, Morgan WJ. 1995. Asthma and wheezing in the first six years of life. The Group Health Medical Associates. N Engl J Med 332(3):133-138
McConnell R, Berhane K, Gilliland F, London SJ, Islam T, Gauderman WJet al. 2002. Asthma in exercising children exposed to ozone: a cohort study. Lancet 359(9304):386-391
McConnell R, Berhane K, Yao L, Jerrett M, Lurmann F, Gilliland Fet al. 2006. Traffic, susceptibility, and childhood asthma. Environ Health Perspect 114:766-772
Moorman JE, Rudd RA, Johnson CA, King M, Minor P, Bailey Cet al. 2007. National surveillance for asthma—United States, 1980–2004. MMWR Surveill Summ 56(8):1-54
Morgenstern V, Zutavern A, Cyrys J, Brockow I, Koletzko S, Kramer Uet al. 2008. Atopic diseases, allergic sensitization, and exposure to traffic-related air pollution in children. Am J Respir Crit Care Med 177(12):1331-1337
Ning Z, Geller MD, Moore KF, Sheesley R, Schauer JJ, Sioutas C. 2007. Daily variation in chemical characteristics of urban ultrafine aerosols and inference of their sources. Environ Sci Technol 41(17):6000-6006
Nordling E, Berglind N, Melen E, Emenius G, Hallberg J, Nyberg Fet al. 2008. Traffic-related air pollution and childhood respiratory symptoms, function and allergies. Epidemiology 19(3):401-408
Oftedal B, Nystad W, Brunekreef B, Nafstad P. 2009. Long-term traffic-related exposures and asthma onset in schoolchildren in Oslo, Norway. Environ Health Perspect 117:839-844
Peters JM, Avol E, Navidi W, London SJ, Gauderman WJ, Lurmann Fet al. 1999. A study of twelve Southern California communities with differing levels and types of air pollution. I. Prevalence of respiratory morbidity. Am J Respir Crit Care Med 159(3):760-767
Ross Z, English PB, Scalf R, Gunier R, Smorodinsky S, Wall Set al. 2006. Nitrogen dioxide prediction in southern California using land use regression modeling: potential for environmental health analyses. J Expo Sci Environ Epidemiol 16(2):106-114
Ryan PH, LeMasters G, Biagini J, Bernstein D, Grinshpun SA, Shukla Ret al. 2005. Is it traffic type, volume, or distance? Wheezing in infants living near truck and bus traffic. J Allergy Clin Immunol 116(2):279-284
Salam MT, Gauderman WJ, McConnell R, Lin PC, Gilliland FD. 2007a. Transforming growth factor-β1 C-509T polymorphism, oxidant stress, and early-onset childhood asthma. Am J Respir Crit Care Med 176(12):1192-1199
Salam MT, Islam T, Gilliland FD. 2008. Recent evidence for adverse effects of residential proximity to traffic sources on asthma. Curr Opin Pulm Med 14(1):3-8
Salam MT, Lin PC, Avol EL, Gauderman WJ, Gilliland FD. 2007b. Microsomal epoxide hydrolase, glutathione S-transferase P1, traffic and childhood asthma. Thorax 62(12):1050-1057
Samet JM. 1987. Epidemiologic approaches for the identification of asthma. Chest 91(6 suppl):74S-78S
Sarnat JA, Holguin F. 2007. Asthma and air quality. Curr Opin Pulm Med 13(1):63-66
Shankardass K, McConnell R, Jerrett M, Milam J, Richardson J, Berhane K. 2009. Parental stress increases the effect of air pollution on childhood asthma incidence. Proc Natl Acad Sci USA 106:12406-12411
Shima M, Nitta Y, Ando M, Adachi M. 2002. Effects of air pollution on the prevalence and incidence of asthma in children. Arch Environ Health 57(6):529-535
van Vliet P, Knape M, de Hartog J, Janssen N, Harssema H, Brunekreef B. 1997. Motor vehicle exhaust and chronic respiratory symptoms in children living near freeways. Environ Res 74(2):122-132
Wang LY, Zhong Y, Wheeler L. 2005. Direct and indirect costs of asthma in school-age children [Abstract]. Prev Chronic Dis 2(1):A11
Xue J, McCurdy T, Spengler J, Ozkaynak H. 2004. Understanding variability in time spent in selected locations for 7–12-year old children. J Expo Anal Environ Epidemiol 14(3):222-233
Zhu Y, Hinds WC, Kim S, Sioutas C. 2002. Concentration and size distribution of ultrafine particles near a major highway. J Air Waste Manag Assoc 52(9):1032-1042

Information & Authors


Published In

Environmental Health Perspectives
Volume 118Issue 7July 2010
Pages: 1021 - 1026
PubMed: 20371422


Received: 22 July 2009
Accepted: 22 March 2010
Published online: 6 April 2010


  1. air pollution
  2. asthma
  3. child
  4. epidemiology
  5. vehicular traffic



Rob McConnell [email protected]
University of Southern California, Los Angeles, California, USA
Talat Islam
University of Southern California, Los Angeles, California, USA
Ketan Shankardass
St. Michael’s Hospital, Toronto, Ontario, Canada
Michael Jerrett
University of California, Berkeley, California, USA
Fred Lurmann
Sonoma Technology, Inc, Petaluma, California, USA
Frank Gilliland
University of Southern California, Los Angeles, California, USA
Jim Gauderman
University of Southern California, Los Angeles, California, USA
Ed Avol
University of Southern California, Los Angeles, California, USA
Nino Künzli
Swiss Tropical and Public Health Institute, Basel and University of Basel, Switzerland
Ling Yao
United Health Group, City of Hope Hospital Medical Center, Los Angeles, California, USA
John Peters
University of Southern California, Los Angeles, California, USA
Kiros Berhane
University of Southern California, Los Angeles, California, USA


Address correspondence to R. McConnell, Department of Preventive Medicine, USC Keck School of Medicine, 1540 Alcazar St., CHP 236, Los Angeles, CA 90033 USA. Telephone: (323) 442-1096. Fax: (323) 442-3272. E-mail: [email protected]
F.L. is employed by Sonoma Technology, Inc, (Petaluma, CA). The other authors declare they have no actual or potential competing interests.

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