Impact of road proximity on infants and children with bronchopulmonary dysplasia

Joseph M. Collaco, Michael Morrow, Jessica L. Rice, Sharon A. McGrath-Morrow

Research output: Contribution to journalArticlepeer-review


Introduction: Infants born prematurely are at high risk for morbidities, including lung disease (bronchopulmonary dysplasia [BPD]). Little is known regarding environmental factors that can impact outcomes in BPD. We sought to assess the role of traffic-related air pollution (TRAP) on respiratory outcomes in BPD. Methods: A total of 784 subjects were included from the Johns Hopkins BPD clinic. Caregivers completed questionnaires on environmental exposures and respiratory outcomes (acute care use and chronic symptoms). Distance to the nearest major roadway was derived from subjects’ geocoded residential addresses. Results: Approximately half of the subjects (53.8%) lived within 500 m of a major roadway. Subjects who lived within 500 m of a major roadway were more likely to be non-white (P =.006), have a lower estimated household income (P <.001) and live in more densely populated zip codes (P <.001) than those who lived further than 500 m away. For every 1 km increase in distance between residence and roadway, the likelihood of activity limitations decreased by 35% (P =.005). No differences in acute care use were seen with proximity to major roadways. Conclusions: Proximity to a major roadway was associated with chronic respiratory symptoms, such as activity limitations (eg, dyspnea), and tended to be associated with nighttime symptoms as well. Self-reported minorities and families with lower estimated household incomes may be more likely to be exposed to TRAP. Further research is necessary to define the effects of TRAP versus other sources of indoor and outdoor air pollution as well as to determine the best ways of combatting pollution-related respiratory morbidities.

Original languageEnglish (US)
Pages (from-to)369-375
Number of pages7
JournalPediatric pulmonology
Issue number2
StatePublished - Feb 1 2020


  • air pollution
  • bronchopulmonary dysplasia
  • chronic lung disease
  • environment
  • prematurity
  • preterm
  • road proximity
  • traffic

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine

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