短期暴露于气态污染物对儿童哮喘住院率的影响：一项双向病例交叉分析
Effect of short-term exposure to gaseous pollution on asthma hospitalisation in children: a bi-directional case-crossover analysis.
作者信息
Lin M, Chen Y, Burnett R T, Villeneuve P J, Krewski D
机构信息
Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
出版信息
J Epidemiol Community Health. 2003 Jan;57(1):50-5. doi: 10.1136/jech.57.1.50.
STUDY OBJECTIVE
Assess associations between short-term exposure to gaseous pollutants and asthma hospitalisation among boys and girls 6 to12 years of age.
DESIGN
A bi-directional case-crossover analysis was used. Conditional logistic regression models were fitted to the data for boys and girls separately. Exposures averaged over periods ranging from one to seven days were used to assess the effects of gaseous pollutants on asthma hospitalisation. Estimated relative risks for asthma hospitalisation were calculated for an incremental exposure corresponding to the interquartile range in pollutant levels, adjusted for daily weather conditions and concomitant exposure to particulate matter.
SETTING
Toronto, Ontario, Canada.
PARTICIPANTS
A total of 7319 asthma hospitalisations for children 6 to 12 years of age (4629 for boys and 2690 for girls) in Toronto between 1981 and 1993.
MAIN RESULTS
A significant acute effect of carbon monoxide on asthma hospitalisation was found in boys, and sulphur dioxide showed significant effects of prolonged exposure in girls. Nitrogen dioxide was positively associated with asthma admissions in both sexes. The lag time for certain gaseous pollutant effects seemed to be shorter in boys (around two to three days for carbon monoxide and nitrogen dioxide), as compared with girls (about six to seven days for sulphur dioxide and nitrogen dioxide). The effects of gaseous pollutants on asthma hospitalisation remained after adjustment of particulate matter. The data showed no association between ozone and asthma hospitalisation in children.
CONCLUSIONS
The study showed positive relations between gaseous pollutants (carbon monoxide, sulphur dioxide, and nitrogen dioxide) at comparatively low levels and asthma hospitalisation in children, using bi-directional case-crossover analyses. Though, the effects of certain specific gaseous pollutants were found to vary in boys and girls.
研究目的
评估6至12岁男孩和女孩短期暴露于气态污染物与哮喘住院之间的关联。
设计
采用双向病例交叉分析。分别对男孩和女孩的数据拟合条件逻辑回归模型。使用一至七天期间的平均暴露量来评估气态污染物对哮喘住院的影响。针对污染物水平四分位间距对应的增量暴露计算哮喘住院的估计相对风险，并根据每日天气状况和同时暴露于颗粒物的情况进行调整。
地点
加拿大安大略省多伦多市。
参与者
1981年至1993年期间，多伦多市共有7319例6至12岁儿童哮喘住院病例（男孩4629例，女孩2690例）。
主要结果
发现一氧化碳对男孩哮喘住院有显著急性影响，二氧化硫对女孩有显著的长期暴露影响。二氧化氮与两性的哮喘入院均呈正相关。某些气态污染物影响的滞后时间在男孩中似乎较短（一氧化碳和二氧化氮约为两至三天），而在女孩中较长（二氧化硫和二氧化氮约为六至七天）。调整颗粒物后，气态污染物对哮喘住院的影响依然存在。数据显示臭氧与儿童哮喘住院之间无关联。
结论
该研究采用双向病例交叉分析表明，相对低水平的气态污染物（一氧化碳、二氧化硫和二氧化氮）与儿童哮喘住院之间存在正相关关系。不过，发现某些特定气态污染物的影响在男孩和女孩中有所不同。
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