Early life environmental exposures and childhood respiratory health

Resumen

The high the prevalence and burden of asthma and other chronic respiratory diseases worldwide has raised concerns about the potential role of environmental exposures. However, the evidence is still inadequate. This Thesis is based on the hypothesis that being exposed to a harmful environment during prenatal life can have a long-term impact on disease later in life (the Developmental Origins of Health and Disease paradigm). The main aim of this doctoral Thesis was to investigate how early-life environmental stressors, particularly ubiquitous chemical pollutants and the urban environment, influence child’s respiratory health. In this Thesis we first reviewed the current evidence of the role of prenatal exposure to chemical pollutants, mainly organic pollutants, on child’s lung function. Then, we explored the associations of prenatal exposure to chemical pollutants, namely organochlorine compounds and bisphenols, on children’s respiratory health using 8 European population-based birth cohort studies. Last, we used a large longitudinal database, the Information System for Research in Primary Care, to establish a new birth cohort by linking electronic health records of parents and children. Results of this Thesis show that 1) Evidence on prenatal exposure to organic pollutants on childhood lung function, especially organochlorine compounds and bisphenols, is limited. 2) Prenatal exposure to p,p′-dichlorodiphenyldichloroethylene (p,p′-DDE) is prevalent and may decrease lung function during childhood. 3) Prenatal exposure to bisphenol A is prevalent and is associated with higher risk of wheeze and asthma among school-age girls. 4) The urban environment during pregnancy, mainly air pollution, road traffic noise, and availability of blue spaces can affect respiratory health in childhood. 5) We successfully linked the electronic health records of 719,858 children born from 2005 to 2018 to the electronic health records of at least one potential parent in the Information System for Research in Primary Care In conclusion, prenatal exposure to organochlorine compounds, bisphenol A and to exposures of the urban environment is prevalent and influences children’s respiratory health. This Thesis highlights that early identification of the environmental determinants of children’s respiratory health is of utmost importance, given their long-term effect on disease throughout life, and provides a new large birth cohort from the linkage of parent and children’s electronic health records.