Randomized Controlled Trial

. 2018 Mar 27;17(1):27.

doi: 10.1186/s12940-018-0370-5.

Childhood fish oil supplementation modifies associations between traffic related air pollution and allergic sensitisation

Anna L Hansell^{1

2}, Ioannis Bakolis^{3

4

5}, Christine T Cowie^{6

7

8}, Elena G Belousova⁸, Kitty Ng⁸, Christina Weber-Chrysochoou⁸, Warwick J Britton⁹, Stephen R Leeder¹⁰, Euan R Tovey⁸, Karen L Webb^{10

11}, Brett G Toelle^{8

12}, Guy B Marks^{7

8

13}

Affiliations

¹ MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK. a.hansell@imperial.ac.uk.
² Public Health and Primary Care Directorate, Imperial College Healthcare NHS Trust, London, UK. a.hansell@imperial.ac.uk.
³ MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK.
⁴ Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK.
⁵ Centre for Implementation Science, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK.
⁶ South West Sydney Clinical School, UNSW Australia, Sydney, NSW, Australia.
⁷ Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.
⁸ Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia.
⁹ Centenary Institute of Cancer Medicine & Cell Biology, University of Sydney, Sydney, NSW, Australia.
¹⁰ School of Public Health and Menzies Centre for Health Policy, University of Sydney, Sydney, NSW, Australia.
¹¹ Nutrition Policy Institute, University of California, College of Agriculture and Natural Resources, Berkeley, California, USA.
¹² Sydney Local Health District, Sydney, NSW, Australia.
¹³ Department of Respiratory Medicine, Liverpool Hospital, Liverpool, NSW, Australia.

PMID: 29587831
PMCID: PMC5870687
DOI: 10.1186/s12940-018-0370-5

Randomized Controlled Trial

Childhood fish oil supplementation modifies associations between traffic related air pollution and allergic sensitisation

Anna L Hansell et al. Environ Health. 2018.

. 2018 Mar 27;17(1):27.

doi: 10.1186/s12940-018-0370-5.

Authors

Affiliations

¹ MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK. a.hansell@imperial.ac.uk.
² Public Health and Primary Care Directorate, Imperial College Healthcare NHS Trust, London, UK. a.hansell@imperial.ac.uk.
³ MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK.
⁴ Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK.
⁵ Centre for Implementation Science, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK.
⁶ South West Sydney Clinical School, UNSW Australia, Sydney, NSW, Australia.
⁷ Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.
⁸ Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia.
⁹ Centenary Institute of Cancer Medicine & Cell Biology, University of Sydney, Sydney, NSW, Australia.
¹⁰ School of Public Health and Menzies Centre for Health Policy, University of Sydney, Sydney, NSW, Australia.
¹¹ Nutrition Policy Institute, University of California, College of Agriculture and Natural Resources, Berkeley, California, USA.
¹² Sydney Local Health District, Sydney, NSW, Australia.
¹³ Department of Respiratory Medicine, Liverpool Hospital, Liverpool, NSW, Australia.

PMID: 29587831
PMCID: PMC5870687
DOI: 10.1186/s12940-018-0370-5

Abstract

Background: Studies of potential adverse effects of traffic related air pollution (TRAP) on allergic disease have had mixed findings. Nutritional studies to examine whether fish oil supplementation may protect against development of allergic disease through their anti-inflammatory actions have also had mixed findings. Extremely few studies to date have considered whether air pollution and dietary factors such as fish oil intake may interact, which was the rationale for this study.

Methods: We conducted a secondary analysis of the Childhood Asthma Prevention Study (CAPS) birth cohort, where children were randomised to fish oil supplementation or placebo from early life to age 5 years. We examined interactions between supplementation and TRAP (using weighted road density at place of residence as our measure of traffic related air pollution exposure) with allergic disease and lung function outcomes at age 5 and 8 years.

Results: Outcome information was available on approximately 400 children (~ 70% of the original birth cohort). Statistically significant interactions between fish oil supplementation and TRAP were seen for house dust mite (HDM), inhalant and all-allergen skin prick tests (SPTs) and for HDM-specific interleukin-5 response at age 5. Adjusting for relevant confounders, relative risks (RRs) for positive HDM SPT were RR 1.74 (95% CI 1.22-2.48) per 100 m local road or 33.3 m of motorway within 50 m of the home for those randomised to the control group and 1.03 (0.76-1.41) for those randomised to receive the fish oil supplement. The risk differential was highest in an analysis restricted to those who did not change address between ages 5 and 8 years. In this sub-group, supplementation also protected against the effect of traffic exposure on pre-bronchodilator FEV₁/FVC ratio.

Conclusions: Results suggest that fish oil supplementation may protect against pro-allergic sensitisation effects of TRAP exposure. Strengths of this analysis are that supplementation was randomised and independent of TRAP exposure, however, findings need to be confirmed in a larger experimental study with the interaction investigated as a primary hypothesis, potentially also exploring epigenetic mechanisms. More generally, studies of adverse health effects of air pollution may benefit from considering potential effect modification by diet and other factors.

Trial registration: Australia New Zealand Clinical Trial Registry. www.anzctr.org.au Registration: ACTRN12605000042640 , Date: 26th July 2005. Retrospectively registered, trial commenced prior to registry availability.

Keywords: Air pollution; Allergic sensitisation; Birth cohort; Children; Fish oil; Lung function; PUFAs.

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Conflict of interest statement

Ethics approval and consent to participate

Informed written consent was given by the parents of participating children and the study was approved by the Human Research Ethics Committees of the University of Sydney, Children’s Hospital at Westmead, and by Sydney South West Area Health Services.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

**Fig. 1**
Flow-chart of CAPS study participants with respect to original randomisation

See this image and copyright information in PMC

References

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Childhood fish oil supplementation modifies associations between traffic related air pollution and allergic sensitisation

Affiliations

Childhood fish oil supplementation modifies associations between traffic related air pollution and allergic sensitisation

Authors

Affiliations

Abstract

Conflict of interest statement

Ethics approval and consent to participate

Consent for publication

Competing interests

Publisher’s Note

Figures

References

Publication types

MeSH terms

Substances

Associated data

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Molecular Biology Databases

Miscellaneous