Chronic PM2.5 exposure and risk of infant bronchiolitis and otitis media clinical encounters

- This study uses a unique birth cohort-hospitalization data linkage and individual level satellite based air pollution exposure.
- Little association with regional air pollution and infant bronchiolitis risk was detected.
- Study found consistent association with local measure of traffic related air pollution and infant bronchiolitis risk.
- There was limited evidence of an association with traffic related air pollution and otitis media risk.

Chronic particulate matter less than 2.5 μm in diameter (PM2.5) exposure can leave infants more susceptible to illness. Our objective is to estimate associations of the chronic PM2.5 exposure with infant bronchiolitis and otitis media (OM) clinical encounters. We obtained all first time bronchiolitis (n = 18,029) and OM (n = 40,042) clinical encounters among children less than 12 and 36 months of age, respectively, diagnosed from 2001 to 2009 and two controls per case matched on birthdate and gestational age from the Pregnancy to Early Life Longitudinal data linkage system in Massachusetts. We applied conditional logistic regression to estimate odds ratios (OR) and confidence intervals (CI) per 2-μg/m3 increase in lifetime average satellite based PM2.5 exposure. Effect modification was assessed by age, gestational age, frequency of clinical encounter, and income. We examined associations between residential distance to roadways, traffic density, and infant bronchiolitis and OM risk. PM2.5 was not associated with infant bronchiolitis (OR = 1.02, 95% CI = 1.00, 1.04) and inversely associated with OM (OR = 0.97, 95% CI = 0.95, 0.99). There was no evidence of effect modification. Compared to infants living near low traffic density, infants residing in high traffic density had elevated risk of bronchiolitis (OR = 1.23, 95% CI = 1.14, 1.31) but not OM (OR = 0.98, 95% CI = 0.93, 1.02) clinical encounter. We did not find strong evidence to support an association between early-life long-term PM2.5 exposure and infant bronchiolitis or OM. Bronchiolitis risk was increased among infants living near high traffic density.