Association between prenatal and childhood exposure to particulate matter and asthmatic symptoms in the children of the Cyprus MEDEA Cohort

Asthma is especially prevalent among children in the eastern Mediterranean, where desert dust storms worsen respiratory asthmatic symptoms. We examine the association between prenatal and childhood exposure to PM2.5 and PM10 and the development of ever and 12-month before interview asthma or asthmatic symptoms within the Mitigating the Health Effects of Desert Dust Storms Using Exposure-Reduction Approaches (MEDEA) cohort in Cyprus. The study included 3,773 MEDEA cohort children from Nicosia and Limassol. We used logistic regression to evaluate the association between prenatal exposure and ever outcomes, as well as 12-month exposure and 12-month outcomes. We adjusted for demographics, clinical characteristics, family history, season, year, temperature, and relative humidity. We examined effect measure modification (EMM) by age, sex, temperature, and BMI. For each prenatal 1 µg/m3 increase in PM10 levels, the odds of ever having wheezing increased by 3% (95% Confidence Intervals [CI]: 2%;4%), and ever having doctor-diagnosed asthma increased by 4% (95% CI: 2%;6%). There was no association between 12-month PM exposure and asthma or asthmatic symptoms during the year before the interview. Males had higher odds (odds ratio (OR): 1.04, 95% CI: 0.98, 1.11) of ever asthma than females (OR: 0.98, 95% CI: 0.90, 1.07). There was a positive interaction with temperature (p-value < 0.05). We show that prenatal exposure to PM increases the odds of having respiratory symptoms and asthma in children born in Nicosia and Limassol. Continued efforts are needed to identify vulnerable populations and develop strategies to reduce exposures and improve air quality.