Table 1.

Summary of studies on long-term air pollution and lung function in healthy or population-based children published since 2018.

Reference	Population (location, cohort name)	Study design	Exposure focus	Exposure Assessment	Lung function Assessment	Results
Cai et al. 202044	5,276 children at age 8 years, 3,446 children at age 15 years (Avon in southwest England, ALSPAC)	Prospective birth cohort	Prenatal and childhood air pollution	PM10 during each trimester, 0–6 months, 7–12 months, and up to age 15 years	FEV1% predicted and FVC% predicted at ages 8 and 15 years	At age 8 years PM10 was associated with lower FEV1% predicted and FVC% predicted At age 15 years no observed adverse association with lung function
Usemann et al. 201963	232 children at age 6 years (Bern, Switzerland, BILD)	Prospective birth cohort	Low-to-moderate air pollution levels, from pregnancy until school-age	NO2, O3, PM10 during each pregnancy, 1st year of life, 6th year of life, and birth until follow-up	FEV1, FVC, FEV1/FVC ratio, and FEF25–75 measured at age 6 years	NO2 exposure during pregnancy and 1st year of life was associated with decreased FEV1 Null associations observed for O3 and PM10
He et al. 201966	2,942 children at age ~17.5 years (Hong Kong, “Children of 1997” cohort)	Prospective birth cohort	Prenatal and childhood air pollution	NO, NO2, PM10, and SO2 during pregnancy, age 0–2 years, and age 2–8 years	FEV1, FVC, FEF25–75, and FEV1/FVC ratio measured at age ~17.5 years	Higher NO and NO2 in utero, age 0–2 years and age 2–8 years were consistently associated with lower FEV1, FEV1/FVC and FEF25–75% in multi-pollutant analysis SO2 and PM10 were not associated with lung function
Milanzi et al. 201848	915 children for the age 8–16 years growth analysis, 721 for the age 16 years analysis (The Netherlands, PIAMA)	Prospective birth cohort	Air pollution exposure from birth	NO2, PM2.5, PM10, and PM coarse during preschool, primary school, and secondary school time windows	FEV1 and FVC measured at age 16, and FEV1 and FVC growth from ages 8 to 16 years based on repeated measures at ages 8, 12, and 16 years	Exposure during the preschool period was associated with reduced FEV1 growth for all pollutants No association with FVC growth, except for a positive association with PM2.5 Across pollutants and time periods, higher air pollution was associated with lower FEV1 at age 16 Inverse associations were also observed for FVC at age 16, but these were not statistically significant
Tsui et al. 201867	1,016 children age 6–15 years (Taiwan)	Nationwide, cross-sectional, school-based survey	Lifetime residential exposure to air pollution	PM10, O3, SO2, NO2, and CO during 1st year of life, age 2–6 years, and lifetime	FEV1, FVC, FEF25–75, and FEV1/FVC ratio measured once among children at mean age 11.9 years (standard deviation: 2.4)	Lifetime PM10 and O3 was associated with lower FEV1, FVC, and FEF25–75 NO2 was associated with FEV1 and FVC in all exposure windows examined CO showed some association with lower lung function SO2 was not associated with lung function
Bougas et al. 201864	788 children age 8–9 years (Paris, France, PARIS)	Prospective birth cohort	Traffic-related air pollution	NOx during each trimester and entire pregnancy, 1st year of life, and lifetime	FEV1, FVC, and FEF25–75 measured at age 8–9 years	Prenatal NOx exposure during the entire pregnancy was associated with a lower FEF25–75, but there were no significant associations with FEV1, FVC, or FEV1/FVC ratio Associations were similar for NOx exposure during the second trimester, but associations were null for the first and third trimester Null associations for 1st year of life and lifetime exposure
Bose et al. 201868	191 children age 5–8 years (Boston, USA, ACCESS)	Prospective birth cohort	Prenatal NO3-exposure	NO3- during pregnancy by gestational week	FEV1, FVC, FEF25–75, and FEV1/FVC ratio measured once among children at mean age 7.0 years (standard deviation: 0.89)	No statistically significant sensitive window was identified in the overall population Shape of the associations across gestation suggests an early window in pregnancy during which higher exposure to nitrates may be associated with reduced FEV1 Cumulative effect over entire gestation suggested an inverse association, but results were not statistically significant
Bergstra et al. 201865	424 children age 7–13 years (East Vlissingen in southwest of The Netherlands)	Cross-sectional study	Long-term air pollution from heavy industry	PM2.5 and NOx during prior five years	FVC, FEV1, PEF, FEF25–75, FEV1/FVC ratio measured once among children between the ages of 7 and 13 years	PM2.5 and NOx were associated with lower PEF Higher NOx was associated with lower FVC and FEV1

Abbreviations:

CO: Carbon monoxide

FEF_25–75: Forced expiratory flow at 25–75% of the pulmonary volume

FEV₁ : Forced expiratory volume in 1 second

FVC: Forced vital capacity

NO₂: Nitrogen dioxide

NO₃-: Nitrate

NOx: Nitrogen oxide

O₃: Ozone

PEF: Peak expiratory flow

PM₁₀: Particulate matter <10 μm

SO₂: Sulfur dioxide

PM_2.5: Particulate matter <2.5 μm