Abstract Rational EImprovement in neonatal survival has led to a greater prevalence of bronchopulmonary dysplasia (BPD). Neonatal predictors of long-term respiratory health outcomes in children with BPD only account for 8-40% of later lung function. Emerging data has shown that radon exposure in children is associated with asthma prevalence and reduced lung function in children with asthma. We hypothesized that residential radon exposure in early childhood would be associated with increased asthma diagnosis and reduced lung function in school-aged children with BPD. Methods This was a secondary analysis of the Air quality, Environment and Respiratory Outcomes in Bronchopulmonary Dysplasia (AEROBPD) study; a prospective cohort study of children aged 6-12 years, with a known diagnosis of BPD. Exposure was annualized average residential radon (Rn); generated time weighted geo-spatial estimates from all home addresses lived since birth. Participant addresses were coded to ZIP code, and monthly estimates of Zip-Code Tabulation Area (ZCTA) residential Rn were derived using a previously validated model. Primary outcomes were asthma prevalence (physician diagnosis) and lung function (Forced Expiratory Volume in the 1st second (FEV1) z-score) measured with spirometry. Secondary outcomes were Forced Vital Capacity (FVC), FEV1/FVC and unscheduled healthcare utilization in the last 12 months. Logistic and linear regression models were used to explore the associations between radon exposure and outcomes. Interaction by BPD severity was tested. Significance was set at the two-sided 0.05 level. Results A total of 147 children, mean (SD) age of 8.4 (2.4) years, 56% male, were included. Average lifetime basement radon level of participants was 65.4(17.3) Bq/m3 (mean SD), while average baseline level in the first year of life was 63.9 (18.2) Bq/m3 (mean SD). There was no significant association between radon levels and all outcomes after adjusting for age, sex, gestational age, birth weight, BMI, race, ethnicity, family income, and BPD severity. (Table 1) BPD severity was significantly associated with lower lung function (FEV1 z score) β=-0.57; 95% CI: -1.01 to -0.14; p = 0.011, however, there was no effect modification of the radon – lung function relationship by BPD severity interaction β= -0.007; 95CI: -0.034 – 0.02; p = 0.6. Conclusion Early childhood exposure to modeled radon may not be an independent risk factor for asthma and lung function in school-aged children with BPD. Further studies with larger sample size or direct radon exposure assessment are needed to confirm these findings. This abstract is funded by: IA-1050758 American Lung Association Innovation Award
Akinbolagbe et al. (Fri,) studied this question.