The impact of prenatal ambient air pollution exposure on childhood asthma development

Abstract

Overview of the topic: Asthma is an inflammatory and allergic disease whereby its diagnosis rate has been increasing over the years, especially amongst children. There are a vast number of predisposing factors contributing to this condition, such as air pollution, however the extent of which prenatal exposure of air pollution contributes to childhood asthma development still needs further evidence-based research.

Research question: Does prenatal exposure to ambient air pollution contribute to childhood asthma development? PEO elements: Population (P): Children. Exposure (E): Prenatal exposure to air pollution. Outcome (O): Asthma development. Methods of appraisal used: The key terms for each PEO element were generated and search tools were used for the combination of these search terms. Limiters were also applied, and the search was conducted in five databases. The Prisma Flow Diagram (Moher, Liberati, Tetzlaff & Altman, 2009) was used to present the research process, where irrelevant articles were excluded according to the inclusion and exclusion criteria. One systematic review and meta-analysis, one case-control study, and three retrospective cross-sectional studies were the final key studies to be appraised. The Critical Appraisal Skills Programme (CASP) (Appendix 1-3) was used for the critical appraisal of these five studies. Results and conclusions: Although there were inconsistencies amongst results due to the study’s methodological weaknesses, the evidence-based research did demonstrate statistically significant associations with asthma development for gestational period exposure to air pollutants NO2 and SO2 across all studies, except for one. Implications and recommendations: The high-risk group of pregnant mothers exposed to air pollution needs to be established, and this could be achieved by using a health risk assessment tool in order for proactive measures to take place. Health care professionals (HCPs) working both in hospital and community-based settings need to be trained and equipped with evidence-based knowledge on this matter, along with evidence-based guidelines and protocols in order to teach their patients preventive measures on reducing their health hazard. Further research would opt conducting more culture-specific investigations, as these local findings would help in the generation of new plans and public policies.