TY - JOUR
T1 - Prenatal and Postnatal Household Air Pollution Exposures and Pneumonia Risk
T2 - Evidence From the Ghana Randomized Air Pollution and Health Study
AU - Kinney, Patrick L.
AU - Asante, Kwaku Poku
AU - Lee, Alison G.
AU - Ae-Ngibise, Kenneth A.
AU - Burkart, Katrin
AU - Boamah-Kaali, Ellen
AU - Twumasi, Mieks
AU - Gyaase, Stephaney
AU - Quinn, Ashlinn
AU - Oppong, Felix B.
AU - Wylie, Blair J.
AU - Kaali, Seyram
AU - Chillrud, Steven
AU - Yawson, Abena
AU - Jack, Darby W.
AU - Owusu-Agyei, Seth
N1 - Publisher Copyright:
© 2021 American College of Chest Physicians
PY - 2021/11
Y1 - 2021/11
N2 - Background: Nearly 40% of the world's population is exposed daily to household air pollution. The relative impact of prenatal and postnatal household air pollution exposure on early childhood pneumonia, a leading cause of mortality, is unknown. Research Question: Are prenatal or postnatal household air pollution, or both, associated with pneumonia risk in the first year of life? Study Design and Methods: The Ghana Randomized Air Pollution and Health Study enrolled 1,414 nonsmoking, pregnant women before 24 weeks’ gestation with prospective follow-up to the child's age of 1 year. We measured 72-h personal household air pollution exposures, indexed by carbon monoxide (CO), four times prenatally and three times postnatally. Weekly fieldworker surveillance identified ill-appearing children for physician pneumonia assessment. We used quasi-Poisson models to examine associations between prenatal and postnatal CO and physician-diagnosed pneumonia and severe pneumonia. Sex-specific effects were examined. Results: Of the 1,306 live births, 1,141 infants were followed up with 55,605 child-weeks of fieldworker surveillance. The estimated risk for pneumonia and severe pneumonia in the first year of life increased by 10% (relative risk [RR], 1.10; 95% CI, 1.04-1.16) and 15% (RR, 1.15; 95% CI, 1.03-1.28), respectively, per 1-part per million (ppm) increase in average prenatal CO exposure and by 6% (RR, 1.06; 95% CI, 0.99-1.13) per 1-ppm increase in average postnatal CO exposure. Sex-stratified analyses suggest that in girls, higher prenatal CO exposure was associated with pneumonia risk, while no association was seen in boys. Interpretation: Prenatal household air pollution exposure increased risk of pneumonia and severe pneumonia in the first year of life. Clean-burning interventions may be most effective when begun prenatally. Trial Registry: ClinicalTrials.gov; No.: NCT01335490; URL: www.clinicaltrials.gov
AB - Background: Nearly 40% of the world's population is exposed daily to household air pollution. The relative impact of prenatal and postnatal household air pollution exposure on early childhood pneumonia, a leading cause of mortality, is unknown. Research Question: Are prenatal or postnatal household air pollution, or both, associated with pneumonia risk in the first year of life? Study Design and Methods: The Ghana Randomized Air Pollution and Health Study enrolled 1,414 nonsmoking, pregnant women before 24 weeks’ gestation with prospective follow-up to the child's age of 1 year. We measured 72-h personal household air pollution exposures, indexed by carbon monoxide (CO), four times prenatally and three times postnatally. Weekly fieldworker surveillance identified ill-appearing children for physician pneumonia assessment. We used quasi-Poisson models to examine associations between prenatal and postnatal CO and physician-diagnosed pneumonia and severe pneumonia. Sex-specific effects were examined. Results: Of the 1,306 live births, 1,141 infants were followed up with 55,605 child-weeks of fieldworker surveillance. The estimated risk for pneumonia and severe pneumonia in the first year of life increased by 10% (relative risk [RR], 1.10; 95% CI, 1.04-1.16) and 15% (RR, 1.15; 95% CI, 1.03-1.28), respectively, per 1-part per million (ppm) increase in average prenatal CO exposure and by 6% (RR, 1.06; 95% CI, 0.99-1.13) per 1-ppm increase in average postnatal CO exposure. Sex-stratified analyses suggest that in girls, higher prenatal CO exposure was associated with pneumonia risk, while no association was seen in boys. Interpretation: Prenatal household air pollution exposure increased risk of pneumonia and severe pneumonia in the first year of life. Clean-burning interventions may be most effective when begun prenatally. Trial Registry: ClinicalTrials.gov; No.: NCT01335490; URL: www.clinicaltrials.gov
KW - household air pollution
KW - pneumonia
KW - prenatal and postnatal exposures
KW - sex-specific effects
UR - http://www.scopus.com/inward/record.url?scp=85118342064&partnerID=8YFLogxK
U2 - 10.1016/j.chest.2021.06.080
DO - 10.1016/j.chest.2021.06.080
M3 - Article
C2 - 34298005
AN - SCOPUS:85118342064
SN - 0012-3692
VL - 160
SP - 1634
EP - 1644
JO - Chest
JF - Chest
IS - 5
ER -