Gordian Mary Ellen, Haneuse Sebastien, Wakefield Jonathan
aInstitute for Circumpolar Health Studies, University of Alaska Anchorage, 3211 Providence Drive Diplomacy 404, Anchorage, AL 99508, USA.
J Expo Sci Environ Epidemiol. 2006 Jan;16(1):49-55. doi: 10.1038/sj.jea.7500436.
This study investigated whether proximity to traffic at residence location is associated with being diagnosed with asthma as a young child. A survey of parents of children (aged 5-7) in kindergarten and first-grade in 13 schools was completed in Anchorage, Alaska, and Geographical Information System (GIS) mapping was used to obtain an exposure measure based on traffic density within 100 m of the cross streets closest to the child's residence. Using the range of observed exposure values, a score of low, medium or high traffic exposure was assigned to each child. After controlling for individual level confounders, relative to the low referent group, relative risks (95% confidence intervals) of 1.40 (0.77, 2.55) and 2.83 (1.23,6.51) were obtained in the medium and high exposure groups, respectively. For the null hypothesis of no difference in risk, a significance level of 0.056 was obtained, which suggests that further investigation would be worthwhile. Children without a family history of asthma were more likely to have an asthma diagnosis if they resided in a high traffic area than children who had one or more parents with asthma. The relative risk for children without a family history of asthma is 2.43 (1.12, 5.28) for medium exposure and 5.43 (2.08, 13.74) for high exposure. For children with a family history of asthma, the relative risk is 0.66 (0.25, 1.74) for medium exposure and 0.67 (0.12, 3.69) for high exposure. The P-value for the overall "exposure-effect" (i.e. both main effects AND interaction terms) is 0.0097.
本研究调查了居住地点与交通的接近程度是否与幼儿被诊断为哮喘有关。在阿拉斯加安克雷奇的13所学校,对幼儿园和一年级的儿童(5 - 7岁)家长进行了一项调查,并使用地理信息系统(GIS)绘图,根据离孩子住所最近的交叉路口100米范围内的交通密度获得暴露量度。利用观察到的暴露值范围,为每个孩子分配低、中或高交通暴露分数。在控制了个体层面的混杂因素后,相对于低暴露参照组,中暴露组和高暴露组的相对风险(95%置信区间)分别为1.40(0.77,2.55)和2.83(1.23,6.51)。对于风险无差异的零假设,获得的显著性水平为0.056,这表明值得进一步调查。没有哮喘家族史的儿童如果居住在高交通区域,比有一个或多个患哮喘父母的儿童更有可能被诊断为哮喘。没有哮喘家族史的儿童,中暴露的相对风险为2.43(1.12,5.28),高暴露为5.43(2.08,13.74)。对于有哮喘家族史的儿童,中暴露的相对风险为0.66(0.25,1.74),高暴露为0.67(0.12, 3.69)。总体“暴露 - 效应”(即主效应和交互项)的P值为0.0097。