Abstract
Introduction We investigated if long-term household air pollution (HAP) is associated with asthma and lung function decline in middle-aged adults, and whether these associations were modified by glutathione S-transferase (GST) gene variants, ventilation and atopy.
Materials and methods Prospective data on HAP (heating, cooking, mould and smoking) and asthma were collected in the Tasmanian Longitudinal Health Study (TAHS) at mean ages 43 and 53 years (n=3314). Subsamples had data on lung function (n=897) and GST gene polymorphisms (n=928). Latent class analysis was used to characterise longitudinal patterns of exposure. Regression models assessed associations and interactions.
Results We identified seven longitudinal HAP profiles. Of these, three were associated with persistent asthma, greater lung function decline and % reversibility by age 53 years compared with the “Least exposed” reference profile for those who used reverse-cycle air conditioning, electric cooking and no smoking. The “All gas” (OR 2.64, 95% CI 1.22–5.70), “Wood heating/smoking” (OR 2.71, 95% CI 1.21–6.05) and “Wood heating/gas cooking” (OR 2.60, 95% CI 1.11–6.11) profiles were associated with persistent asthma, as well as greater lung function decline and % reversibility. Participants with the GSTP1 Ile/Ile genotype were at a higher risk of asthma or greater lung function decline when exposed compared with other genotypes. Exhaust fan use and opening windows frequently may reduce the adverse effects of HAP produced by combustion heating and cooking on current asthma, presumably through increasing ventilation.
Conclusions Exposures to wood heating, gas cooking and heating, and tobacco smoke over 10 years increased the risks of persistent asthma, lung function decline and % reversibility, with evidence of interaction by GST genes and ventilation.
Abstract
Long-term exposure to household air pollution (gas, wood smoke, tobacco smoke and their combinations) is linked to adverse respiratory health in middle age, particularly for those with GST risk variants and living in poorly ventilated houses https://bit.ly/3ammfKu
Footnotes
This article has an editorial commentary: https://doi.org/10.1183/13993003.03520-2020
This article has supplementary material available from erj.ersjournals.com
Author contributions: The authors alone are responsible for the content and writing of the article. S.C. Dharmage, E.H. Walters, M.J. Abramson, G.G. Giles and J.L. Perret were all involved with acquiring funding, data collection and/or establishing study directions and protocols. X. Dai led the analysis and interpretation of the data with support from S.C. Dharmage, C.J. Lodge, A.J. Lowe and D.S. Bui. X. Dai wrote the initial draft of the manuscript, which was critically revised for important content by all the authors. All authors approved the final version of the article.
Conflict of interest: X. Dai has nothing to disclose.
Conflict of interest: D.S. Bui has nothing to disclose.
Conflict of interest: J.L. Perret reports grants from the National Health and Medical Research Council of Australia and Asthma Foundation, during the conduct of the study; grants from Boehringer Ingelheim, outside the submitted work.
Conflict of interest: A.J. Lowe reports grants from the National Health and Medical Research Council of Australia, during the conduct of the study.
Conflict of interest: P.A. Frith has nothing to disclose.
Conflict of interest: G. Bowatte has nothing to disclose.
Conflict of interest: P.S. Thomas has nothing to disclose.
Conflict of interest: G.G. Giles has nothing to disclose.
Conflict of interest: G.S. Hamilton has nothing to disclose.
Conflict of interest: H. Tsimiklis has nothing to disclose.
Conflict of interest: J. Hui has nothing to disclose.
Conflict of interest: J. Burgess has nothing to disclose.
Conflict of interest: A.K. Win has nothing to disclose.
Conflict of interest: M.J. Abramson reports grants from Pfizer and Boehringer Ingelheim, personal fees for consultancy from Sanofi, outside the submitted work.
Conflict of interest: E.H. Walters has nothing to disclose.
Conflict of interest: S.C. Dharmage has nothing to disclose.
Conflict of interest: C.J. Lodge has nothing to disclose.
Support statement: The TAHS is supported by grants from the National Health and Medical Research Council (NHMRC) of Australia, under the NHMRC grant scheme (299901, 1021275) and NHMRC European collaborative grant scheme (1101313) as part of ALEC (Aging Lungs in European Cohorts funded by the European Union's Horizon 2020 research and innovation programme under grant agreement number 633212), the Victorian, Queensland and Tasmanian Asthma Foundations, the Clifford Craig Medical Research Trust, the Royal Hobart Hospital Research Foundation, the University of Melbourne, Helen Macpherson Smith Trust, and GlaxoSmithKline.
- Received March 9, 2020.
- Accepted August 7, 2020.
- Copyright ©ERS 2021
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