Summary of the three included studies

Study designPopulationExposuresOutcomesStatistical methodsKey findings
INMA study [4]Cohort study641 mother–child pairs from Spain9 phthalate metabolites (MEP, MiBP, MnBP, MCMHP, MBzP, MEHHP, MEOHP, MECPP, MEHP) in the urine of gestating womenLung function of children: FVC, FEV1 and FEV1/FVC at ages 4, 7, 9 and 11 yearsFor each phthalate, linear regression for each study visit and mixed linear regression with a random intercept for subject for overall childhood
Phthalate metabolites mixture effect assessed using a WQS regression
Gestational exposure to phthalates was associated with children's lower FVC and FEV1, especially in early childhood
RHINESSA study [5]Retrospective cohort study3428 adults from Norway and Sweden (mean age 28 years)Air pollution (NO2, PM10, PM2.5, black carbon, O3) and greenness (NDVI) at residential address averaged across susceptibility windows: 0–10 years, 10–18 years, lifetime, and year before study participationPhysician-diagnosed asthma
Asthma attack
Current rhinitis
LLN lung function (FEV1, FVC and FEV1/FVC)
Logistic regression for asthma attack, rhinitis and LLN lung function
Conditional logistic regression with a matched case–control design for physician-diagnosed asthma
Air pollutants in different susceptibility windows were associated with increased risk of asthma attacks, rhinitis and LLN lung function
Greenness was not associated with asthma or rhinitis, but was a risk factor for LLN lung function
NutriNet-Santé study [9]Cross-sectional analysis from a web-based cohort study20 833 adults from France (mean age 56 years)Exposome (87 factors) covered four domains: socioeconomic, external environment, early-life environment, lifestyle-anthropometricAsthma symptom score
Asthma control
ExWAS followed by a latent class model within each exposome domain
Negative binomial (asthma symptom score) and logistic regressions (asthma control) per exposome domain
Three early-life and one lifestyle exposure profiles were associated with increased risk of asthma

MEP: mono-ethyl phthalate; MiBP: mono-iso-butyl phthalate; MnBP: mono-n-butyl phthalate; MCMHP: mono-2-carboxymethyl hexyl phthalate; MBzP: mono-benzyl phthalate; MEHHP: mono-(2-ethyl-5-hydroxyhexyl) phthalate; MEOHP: mono-(2-ethyl-5-oxohexyl) phthalate; MECPP: mono-(2-ethyl-5-carboxypentyl) phthalate; MEHP: mono-(2-ethyl-hexyl) phthalate; FVC: forced vital capacity; FEV1: forced expiratory volume in 1 s; WQS: weighted quantile sum; NO2: nitrogen dioxide; PMx: particulate matter with aerodynamic diameter <x μm; O3: ozone; NDVI: normalised difference vegetation index; LLN: lower limit of normal; ExWAS: exposome-wide association study.