• Prashant Bharadwaj, Zivin Joshua Graff JG 1 Department of Economics, University of California San Diego, La Jolla, California., Jamie T Mullins, and Matthew Neidell.
• 1 Department of Economics, University of California San Diego, La Jolla, California.
• Am. J. Respir. Crit. Care Med. 2016 Dec 15; 194 (12): 1475-1482.

RationaleLittle is known about the long-term effects of air pollution exposure and the root causes of asthma. We use exposure to intense air pollution from the 1952 Great Smog of London as a natural experiment to examine both issues.ObjectivesTo determine whether exposure to extreme air pollution in utero or soon after birth affects asthma development later in life.MethodsThis was a natural experiment using the unanticipated pollution event by comparing the prevalence of asthma between those exposed to the Great Smog in utero or the first year of life with those conceived well before or after the incident and those residing outside the affected area at the time of the smog.Measurements And Main ResultsPrevalence of asthma during childhood (ages 0-15) and adulthood (ages >15) is analyzed for 2,916 respondents to the Life History portion of the English Longitudinal Study on Aging born from 1945 to 1955. Exposure to the Great Smog in the first year of life increases the likelihood of childhood asthma by 19.87 percentage points (95% confidence interval [CI], 3.37-36.38). We also find suggestive evidence that early-life exposure led to a 9.53 percentage point increase (95% CI, -4.85 to 23.91) in the likelihood of adult asthma and exposure in utero led to a 7.91 percentage point increase (95% CI, -2.39 to 18.20) in the likelihood of childhood asthma.ConclusionsThese results are the first to link early-life pollution exposure to later development of asthma using a natural experiment, suggesting the legacy of the Great Smog is ongoing.

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