Early-Life Ozone Exposure and Childhood Allergic Rhinitis: Critical Exposure Windows, Exposure-Response Relationships, and Protective Modifiers

Childhood allergic rhinitis (AR) is associated with ozone (O3) exposure, yet the sensitive exposure window (SEW) remains unclear. This multicenter survey of 38,176 children aged 3–6 years across 7 Chinese cities (2019–2020) estimated satellite-based individual maximum daily 8 h average O3 exposure. The SEW and its exposure–response (E–R) relationship were assessed. Doctor-diagnosed AR prevalence was 11.9%. Average O3 exposure from prenatal to AR onset ranged from 67.5 to 76.7 μg/m3. The critical SEW was identified as infancy, specifically 30–38 weeks postnatal (7.5–9.5 months). Per interquartile range (IQR) (10.1 μg/m3) increase in O3, the adjusted odds ratio was 1.29 (95% CI: 1.22–1.36), independent of PM2.5. The E–R relationship was nonlinear, J-shaped, and threshold-free. The SEW effect was stronger in southern cities and mitigated by ≥6 months of exclusive breastfeeding. In conclusion, O3 significantly increases AR risk, with 7.5–9.5 months postnatal being a critical SEW, especially in exclusive breastfeeding <6 months and southern regions.

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Publication Details

Journal
Environment & Health
Published
2025-11-25
DOI
https://doi.org/10.1021/envhealth.5c00319
Citations
1
Primary Topic
Air Quality and Health Impacts
Type
article
Field-Weighted Citation Impact
1.20
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article

Early-Life Ozone Exposure and Childhood Allergic Rhinitis: Critical Exposure Windows, Exposure-Response Relationships, and Protective Modifiers

Chan Lu, Xia Meng, Zafar Fatmi, Dan Norbäck et al.
1 citations
Environment & Health
Air Quality and Health Impacts
1.20
article

Early-Life Ozone Exposure and Childhood Allergic Rhinitis: Critical Exposure Windows, Exposure-Response Relationships, and Protective Modifiers

Chan Lu, Xia Meng, Zafar Fatmi, Dan Norbäck, Magnus Svartengren, Zhiping Niu, Yanyi Xu, Erjia Ge, Tippawan Prapamontol, Xiaohong Zheng, Zhuohui Zhao, Xin Zhang, Tingting Wang, Jing Wei, Ling Zhang, Tianyi Chen, Zhiwei Liu, Wei Yu
article en
1 citations

Abstract

Childhood allergic rhinitis (AR) is associated with ozone (O3) exposure, yet the sensitive exposure window (SEW) remains unclear. This multicenter survey of 38,176 children aged 3–6 years across 7 Chinese cities (2019–2020) estimated satellite-based individual maximum daily 8 h average O3 exposure. The SEW and its exposure–response (E–R) relationship were assessed. Doctor-diagnosed AR prevalence was 11.9%. Average O3 exposure from prenatal to AR onset ranged from 67.5 to 76.7 μg/m3. The critical SEW was identified as infancy, specifically 30–38 weeks postnatal (7.5–9.5 months). Per interquartile range (IQR) (10.1 μg/m3) increase in O3, the adjusted odds ratio was 1.29 (95% CI: 1.22–1.36), independent of PM2.5. The E–R relationship was nonlinear, J-shaped, and threshold-free. The SEW effect was stronger in southern cities and mitigated by ≥6 months of exclusive breastfeeding. In conclusion, O3 significantly increases AR risk, with 7.5–9.5 months postnatal being a critical SEW, especially in exclusive breastfeeding <6 months and southern regions.

Environment & Health
Uppsala University (SE), Karachi Medical and Dental College (PK), Central South University (CN), University of Maryland Center for Environmental Science (US), Chongqing University (CN), Shanxi University (CN), Shanghai Jiao Tong University (CN), University of Toronto (CA), Fudan University (CN), Dow University of Health Sciences (PK), International Peace Maternity & Child Health Hospital (CN), Research and Production Association Typhoon (RU), Faculty of Public Health (GB), Public Health Ontario (CA), National Science and Technology Council (TW), Shanghai Meteorological Bureau (CN), Shanghai University of Medicine and Health Sciences (CN), Shanxi University of Traditional Chinese Medicine (CN), Earth System Science Interdisciplinary Center (US), Wuhan University of Science and Technology (CN), Chiang Mai University (TH), University of Maryland, College Park (US), Southeast University (CN)
Openalex Percentile: Top 16%
Air Quality and Health Impacts
1.20
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