Pénard-Morand C, Charpin D, Raherison C, Kopferschmitt C, Caillaud D, Lavaud F, Annesi-Maesano I
INSERM U472, Epidemiology of Allergic and Respiratory Diseases, Villejuif, France.
Clin Exp Allergy. 2005 Oct;35(10):1279-87. doi: 10.1111/j.1365-2222.2005.02336.x.
The impact of air pollution on asthma and allergies still remains a debate.
Our cross-sectional study was intended to analyse the associations between long-term exposure to background air pollution and atopic and respiratory outcomes in a large population-based sample of schoolchildren.
Six thousand six hundred and seventy-two children aged 9-11 years recruited from 108 randomly schools in six French cities underwent a clinical examination including a skin prick test (SPT) to common allergens, exercise-induced bronchial reactivity (EIB) and skin examination for flexural dermatitis. The prevalence of asthma, allergic rhinitis (AR) and atopic dermatitis was assessed by a standardized health questionnaire completed by the parents. Three-year-averaged concentrations of air pollutants (NO2, SO2, PM10 and O3) were calculated at children' schools using measurements of background monitoring stations.
After adjusting for confounders, EIB, lifetime asthma and lifetime AR were found to be positively related to an increase in the exposure to SO2, PM10 and O3. The adjusted odds ratios (aOR) per increase of 5 microg/m3 of SO2 was 1.39 (95% confidence interval (CI)=1.15-1.66) for EIB and 1.19 (1.00-1.41) for lifetime asthma. The aOR for lifetime AR per increase of 10 microg/m3 of PM10 was 1.32 (CI=1.04-1.68). Moreover, SPT positivity was associated with O3 (aOR=1.34; CI=1.24-1.46). Associations with past year symptoms were consistent, even if not always statistically significant. Results persisted in long-term resident (current address for at least 8 years) children. However, no consistent positive association was found with NO2.
A moderate increase in long-term exposure to background ambient air pollution was associated with an increased prevalence of respiratory and atopic indicators in children.
空气污染对哮喘和过敏的影响仍存在争议。
我们的横断面研究旨在分析在一个以学校儿童为基础的大样本人群中，长期暴露于背景空气污染与特应性和呼吸道疾病结局之间的关联。
从法国六个城市的108所随机抽取的学校招募了6672名9至11岁的儿童，他们接受了临床检查，包括对常见变应原的皮肤点刺试验（SPT）、运动诱发支气管反应性（EIB）以及屈侧皮炎的皮肤检查。哮喘、过敏性鼻炎（AR）和特应性皮炎的患病率通过家长填写的标准化健康问卷进行评估。利用背景监测站的测量数据，计算儿童所在学校空气污染物（二氧化氮、二氧化硫、可吸入颗粒物10和臭氧）的三年平均浓度。
在对混杂因素进行调整后，发现EIB、终生哮喘和终生AR与二氧化硫、可吸入颗粒物10和臭氧暴露增加呈正相关。二氧化硫每增加5微克/立方米，EIB的调整优势比（aOR）为1.39（95%置信区间（CI）=1.15 - 1.66），终生哮喘的调整优势比为1.19（1.00 - 1.41）。可吸入颗粒物10每增加10微克/立方米，终生AR的aOR为1.32（CI = 1.04 - 1.68）。此外，SPT阳性与臭氧相关（aOR = 1.34；CI = 1.24 - 1.46）。与过去一年症状的关联是一致的，即使并非总是具有统计学意义。结果在长期居住（当前住址至少8年）的儿童中依然存在。然而，未发现与二氧化氮有一致的正相关。
长期暴露于背景环境空气污染的适度增加与儿童呼吸道和特应性指标患病率的增加相关。
