Is smaller worse? New insights about associations of PM1 and respiratory health in children and adolescents

Mo Yang, Chu Chu, Michael S. Bloom, Shanshan Li, Gongbo Chen, Joachim Heinrich, Iana Markevych, Luke D. Knibbs, Gayan Bowatte, Shyamali C. Dharmage, Mika Komppula, Ari Leskinen, Maija Riitta Hirvonen, Marjut Roponen, Pasi Jalava, Si Quan Wang, Shao Lin, Xiao Wen Zeng, Li Wen Hu, Kang Kang LiuBo Yi Yang, Wen Chen, Yuming Guo, Guang Hui Dong

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53 Citations (Scopus)


Background and objectives: Little is known about PM1 effects on respiratory health, relative to larger size fractions (PM2.5). To address this literature gap, we assessed associations between PM1 exposure and asthmatic symptoms in Chinese children and adolescents, compared with PM2.5. Methods: A total of 59,754 children, aged 2–17 years, were recruited from 94 kindergartens, elementary and middle schools in the Seven Northeast Cities (SNEC) study, during 2012–2013. We obtained information on asthma and asthma-related symptoms including wheeze, persistent phlegm, and persistent cough using a standardized questionnaire developed by the American Thoracic Society. PM1 and PM2.5 concentrations were estimated using a spatial statistical model matched to the children's geocoded home addresses. To examine the associations, mixed models with school/kindergarten as random intercept were used, controlling for covariates. Results: Odds ratios (ORs) of doctor-diagnosed asthma associated with a 10-μg/m3 increase for PM1 and PM2.5 were 1.56 (95% CI: 1.46–1.66) and 1.50 (1.41–1.59), respectively, and similar pattern were observed for other outcomes. Interaction analyses indicated that boys and the individuals with an allergic predisposition may be vulnerable subgroups. For example, among children with allergic predisposition, the ORs for doctor diagnosed asthma per 10 μg/m3 increase in PM1 was 1.71 (95% CI: 1.60–1.83), which was stronger than in their counterparts (1.46; 1.37–1.56) (p for interaction < 0.05). Conclusions: This study indicated that long-term exposure to PM1 may increase the risk of asthma and asthma-related symptoms, especially among boys and those with allergic predisposition. Furthermore, these positive associations for PM1 were very similar to those for PM2.5.

Original languageEnglish
Pages (from-to)516-524
Number of pages9
JournalEnvironment International
Publication statusPublished - 1 Nov 2018


  • Allergic predisposition
  • Asthma
  • Children and adolescents
  • China
  • PM

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