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. 2025 Dec 23;10(1):e443.
doi: 10.1097/EE9.0000000000000443. eCollection 2026 Feb.

Individual and combined effects of indoor home exposures and ambient PM2.5 during early life on childhood asthma in us birth cohort studies

Akihiro Shiroshita  1 , Antonella Zanobetti  2 , Brent A Coull  3 , Patrick H Ryan  4   5 , Soma Datta  6 , Jeffrey Blossom  7 , Emily Oken  8 , James E Gern  9 , Heike Luttmann-Gibson  2 , Eneida A Mendonça  10 , Sima K Ramratnam  9 , Sheryl L Rifas-Shiman  8 , Joanne E Sordillo  8 , Veronica A Wang  2 , Paloma I Beamer  11 , Daniel J Jackson  9 , Christine C Johnson  12 , Gurjit K Khurana Hershey  4   13 , Fernando D Martinez  11 , Rachel L Miller  14 , Katherine Rivera-Spoljaric  15 , Edward M Zoratti  16 , Tina V Hartert  1   17   18 , Diane R Gold  2   19 ; ECHO Cohort Consortium
Collaborators, Affiliations

Individual and combined effects of indoor home exposures and ambient PM2.5 during early life on childhood asthma in us birth cohort studies

Akihiro Shiroshita et al. Environ Epidemiol. .

Abstract

Background: Children encounter multiple indoor and outdoor environmental exposures in early life. We assessed the independent effects of indoor home exposures and ambient particulate matter with an aerodynamic diameter ≤2.5 µm (PM2.5) on early childhood asthma diagnosis.

Methods: We included 6,413 children born 1987-2016 from nine United States prospective birth cohorts from the Environmental Influences on Child Health Outcomes consortium, with complete covariate and outcome data. Exposures were (1) average ambient PM2.5 levels during the first 3 years of life, and (2) indoor home exposures, including water damage/home dampness during infancy/childhood, dogs/cats at home during infancy, dust mite allergen during infancy/childhood. Asthma was defined as caregiver-reported or doctor-diagnosed asthma anytime from birth to age 5. We applied Cox proportional hazards models, adjusting for individual-level and neighborhood-level confounders. Cohort-specific effects were implemented as fixed effects.

Results: By age 5 years, 10.3%-50.3% of children had developed asthma across general-risk and high-risk cohorts. We found a significant detrimental association of PM2.5 and water damage/home dampness, and a protective association of dogs in the home with risk of childhood asthma, regardless of PM2.5 adjustment. The effect of having both water damage/home dampness and high PM2.5 on asthma diagnosis was greater than that of no water damage/home dampness and having low PM2.5 (hazard ratio: 1.95 [95% confidence interval = 1.19, 3.20]). There were no significant associations with household cats or dust mites.

Conclusion: Multiple early exposures, such as PM2.5, home dampness, and absence of dogs in the home, should be considered together as risk factors for childhood asthma.

Keywords: Air pollution; Asthma; Childhood asthma; PM2.5; Pets; Water damage/home dampness.

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Conflict of interest statement

A.Z. reported grants from the National Institutes of Health (NIH) during the conduct of the study and grants from the National Institute on Aging outside the submitted work. B.A.C. reported grants from NIH during the conduct of the study, and from Apple, Inc., outside the submitted work. P.H.R., C.C.J., R.L.M., D.R.G., and E.M.Z. reported grants from NIH during the conduct of the study. J.E.G. reported grants from NIH during the conduct of the study, personal fees from Arrowhead Pharmaceuticals, AstraZeneca, and Meissa Vaccines, Inc., and stock options for Meissa Vaccines, Inc. outside the submitted work. S.K.R. reported receiving consulting fees from Sanofi. P.I.B. reported grants from NIH during the conduct of the study and grants from NIH and the Environmental Protection Agency outside the submitted work. D.J.J. reported grants from NIH during the conduct of the study and grants and/or personal fees from Areteia, Astra Zeneca, Avillion, GlaxoSmithKline, Sanofi, Regeneron, Genentech, Pfizer, Upstream Bio, outside the submitted work. F.D.M. reported consultancy fees from OM PHARMA. T.V.H. reported grants from NIH and the World Health Organization during the conduct of the study and personal fees from the American Thoracic Society, speaker honorarium from the American Academy of Allergy, Asthma and Immunology, the Parker B. Francis Foundation Scientific Advisory Board, and Pfizer outside the submitted work. Other authors had nothing to disclose.

Figures

Figure 1.
Figure 1.
Flow diagram of participant selection. Among 7,484 infants from nine ECHO cohorts, we included 6,300 infants who had complete data for the covariates (infant sex, race and ethnicity, parental history of asthma, maternal education, and maternal smoking during pregnancy), neighborhood-level confounders (% population with low income and % Black population), and childhood asthma outcome. ECHO indicates Environmental Influences on Child Health Outcomes.
Figure 2.
Figure 2.
Geographical distribution of the included cohorts. CAS indicates Children’s Asthma Study; CCAAPS, Cincinnati Childhood Allergy and Air Pollution Study; CCCEH, Columbia Center for Children’s Environmental Health Cohort; COAST, Childhood Origins of Asthma study; EHAAS, The Epidemiology of Home Allergens and Asthma Study; IIS, Infant Immune Study; URECA, Urban Environment and Childhood Asthma study; WHEALS, Wayne County Health Environment Allergy and Asthma Longitudinal.
See this image and copyright information in PMC

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