Exhaled Nitric Oxide in Children with Asthma and Short-Term PM(2.5) Exposure in Seattle

The objective of this study was to evaluate associations between short-term (hourly) exposures to particulate matter with aerodynamic diameters < 2.5 μm (PM(2.5)) and the fractional concentration of nitric oxide in exhaled breath (Fe(NO)) in children with asthma participating in an intensive panel study in Seattle, Washington. The exposure data were collected with tapered element oscillation microbalance (TEOM) PM(2.5) monitors operated by the local air agency at three sites in the Seattle area. Fe(NO) is a marker of airway inflammation and is elevated in individuals with asthma. Previously, we reported that offline measurements of Fe(NO) are associated with 24-hr average PM(2.5) in a panel of 19 children with asthma in Seattle. In the present study using the same children, we used a polynomial distributed lag model to assess the association between hourly lags in PM(2.5) exposure and Fe(NO) levels. Our model controlled for age, ambient NO levels, temperature, relative humidity, and modification by use of inhaled corticosteroids. We found that Fe(NO) was associated with hourly averages of PM(2.5) up to 10–12 hr after exposure. The sum of the coefficients for the lag times associated with PM(2.5) in the distributed lag model was 7.0 ppm Fe(NO). The single-lag-model Fe(NO) effect was 6.9 [95% confidence interval (CI), 3.4 to 10.6 ppb] for a 1-hr lag, 6.3 (95% CI, 2.6 to 9.9 ppb ) for a 4-hr lag, and 0.5 (95% CI, −1.1 to 2.1 ppb) for an 8-hr lag. These data provide new information concerning the lag structure between PM(2.5) exposure and a respiratory health outcome in children with asthma.