Trace metal exposure is associated with increased exhaled nitric oxide in asthmatic children

Background: Children with asthma experience increased susceptibility to airborne pollutants. Exposure to traffic and industrial activity have been positively associated with exacerbation of symptoms as well as emergency room visits and hospitalisations. The effect of trace metals contained in fine particulate matter (aerodynamic diameter 2. 5 mu m and lower, PM2.5) on acute health effects amongst asthmatic children has not been well investigated. The objective of this panel study in asthmatic children was to determine the association between personal daily exposure to ambient trace metals and airway inflammation, as measured by fractional exhaled nitric oxide (FeNO). Methods: Daily concentrations of trace metals contained on PM2.5 were determined from personal samples (n = 217) collected from 70 asthmatic school aged children in Montreal, Canada, over ten consecutive days. FeNO was measured daily using standard techniques. Results: A positive association was found between FeNO and children's exposure to an indicator of vehicular non-tailpipe emissions (8.9 % increase for an increase in the interquartile range (IQR) in barium, 95 % confidence interval (CI): 2.8, 15.4) as well as exposure to an indicator of industrial emissions (7.6 % increase per IQR increase in vanadium, 95 % CI: 0.1, 15.8). Elevated FeNO was also suggested for other metals on the day after the exposure: 10.3 % increase per IQR increase in aluminium (95 % CI: 4.2, 16.6) and 7.5 % increase per IQR increase in iron (95 % CI: 1.5, 13.9) at a 1-day lag period. Conclusions: Exposures to ambient PM2.5 containing trace metals that are markers of traffic and industrial-derived emissions were associated in asthmatic children with an enhanced FeNO response.