Heinrich Joachim, Hoelscher Bernd, Frye Christian, Meyer Ines, Pitz Mike, Cyrys Josef, Wjst Matthias, Neas Lucas, Wichmann H-Erich
GSF, National Research Center for Environment and Health Institute for Epidemiology, PO Box 1129, D-85758 Oberschleissheim, Germany.
Epidemiology. 2002 Jul;13(4):394-401. doi: 10.1097/00001648-200207000-00006.
Previous research on air pollution effects has found associations with chronic adverse health effects even at the relatively low levels of ambient particulates currently measured in most urban areas.
We assessed the impact of declines of total suspended particulates and sulfur dioxide in eastern Germany after reunification on the prevalence of nonallergic respiratory disorders in children. In the 1990s, particle mass (total suspended particulates) and sulfur dioxide declined, whereas number concentrations of nucleation-mode particles (10-30 nm) increased. In three study areas, questionnaires for 7,632 children between 5 and 14 years of age were collected in three phases: 1992-1993, 1995-1996, and 1998-1999.
Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for a 50-microg/m3 increment in total suspended particulates were 3.0 (CI = 1.7-5.3) for bronchitis, 2.6 (CI = 1.0-6.6) for sinusitis, and 1.9 (CI = 1.2-3.1) for frequent colds. The effect sizes for a 100-microg/m3 increment in sulfur dioxide were similar. The effect estimates for ambient total suspended particulates and sulfur dioxide were stronger among children not exposed to gas stove emissions, visible molds or dampness, cats, or environmental tobacco smoke.
The decreasing prevalence of nonallergic respiratory symptoms, along with improvements in ambient particle mass and sulfur dioxide (but not in nucleation-mode particles), indicates the reversibility of adverse health effects in children. This adds further evidence of a causal association between combustion-related air pollutants and childhood respiratory symptoms.
先前关于空气污染影响的研究发现，即使在目前大多数城市地区所测量的相对较低水平的环境颗粒物情况下，也与慢性不良健康影响存在关联。
我们评估了德国统一后东德地区总悬浮颗粒物和二氧化硫下降对儿童非过敏性呼吸道疾病患病率的影响。在20世纪90年代，颗粒物质量（总悬浮颗粒物）和二氧化硫下降，而成核模式颗粒（10 - 30纳米）的数量浓度增加。在三个研究区域，分三个阶段收集了7632名5至14岁儿童的问卷：1992 - 1993年、1995 - 1996年和1998 - 1999年。
总悬浮颗粒物每增加50微克/立方米，支气管炎的调整优势比（OR）和95%置信区间（CI）为3.0（CI = 1.7 - 5.3），鼻窦炎为2.6（CI = 1.0 - 6.6），频繁感冒为1.9（CI = 1.2 - 3.1）。二氧化硫每增加100微克/立方米的效应大小相似。在未接触燃气炉灶排放物、可见霉菌或潮湿、猫或环境烟草烟雾的儿童中，环境总悬浮颗粒物和二氧化硫的效应估计更强。
非过敏性呼吸道症状患病率的下降，以及环境颗粒物质量和二氧化硫（但不是成核模式颗粒）的改善，表明儿童不良健康影响具有可逆性。这进一步证明了与燃烧相关的空气污染物和儿童呼吸道症状之间存在因果关联。
