McConnell Rob, Berhane Kiros, Yao Ling, Jerrett Michael, Lurmann Fred, Gilliland Frank, Künzli Nino, Gauderman Jim, Avol Ed, Thomas Duncan, Peters John
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA.
Environ Health Perspect. 2006 May;114(5):766-72. doi: 10.1289/ehp.8594.
Results from studies of traffic and childhood asthma have been inconsistent, but there has been little systematic evaluation of susceptible subgroups. In this study, we examined the relationship of local traffic-related exposure and asthma and wheeze in southern California school children (5-7 years of age). Lifetime history of doctor-diagnosed asthma and prevalent asthma and wheeze were evaluated by questionnaire. Parental history of asthma and child's history of allergic symptoms, sex, and early-life exposure (residence at the same home since 2 years of age) were examined as susceptibility factors. Residential exposure was assessed by proximity to a major road and by modeling exposure to local traffic-related pollutants. Residence within 75 m of a major road was associated with an increased risk of lifetime asthma [odds ratio (OR)=1.29; 95% confidence interval (CI), 1.01-1.86], prevalent asthma (OR=1.50; 95% CI, 1.16-1.95), and wheeze (OR=1.40; 95% CI, 1.09-1.78). Susceptibility increased in long-term residents with no parental history of asthma for lifetime asthma (OR=1.85; 95% CI, 1.11-3.09), prevalent asthma (OR=2.46; 95% CI, 0.48-4.09), and recent wheeze (OR=2.74; 95% CI, 1.71-4.39). The higher risk of asthma near a major road decreased to background rates at 150-200 m from the road. In children with a parental history of asthma and in children moving to the residence after 2 years of age, there was no increased risk associated with exposure. Effect of residential proximity to roadways was also larger in girls. A similar pattern of effects was observed with traffic-modeled exposure. These results indicate that residence near a major road is associated with asthma. The reason for larger effects in those with no parental history of asthma merits further investigation.
关于交通与儿童哮喘的研究结果并不一致,但对易感亚组的系统评估较少。在本研究中,我们调查了南加州学龄儿童(5至7岁)中与当地交通相关的暴露因素与哮喘及喘息之间的关系。通过问卷评估医生诊断的哮喘终生病史、现患哮喘和喘息情况。将哮喘家族史、儿童过敏症状史、性别和早期暴露情况(自2岁起居住在同一家庭)作为易感因素进行研究。通过与主要道路的距离以及对当地交通相关污染物暴露情况进行建模来评估居住暴露。居住在主要道路75米范围内与哮喘终生风险增加相关[比值比(OR)=1.29;95%置信区间(CI),1.01 - 1.86]、现患哮喘(OR = 1.50;95% CI,1.16 - 1.95)和喘息(OR = 1.40;95% CI,1.09 - 1.78)。对于无哮喘家族史的长期居民,其患哮喘终生风险(OR = 1.85;95% CI,1.11 - 3.09)、现患哮喘(OR = 2.46;95% CI,0.48 - 4.09)和近期喘息(OR = 2.74;95% CI,1.71 - 4.39)的易感性增加。主要道路附近较高的哮喘风险在距道路150 - 200米处降至背景水平。在有哮喘家族史的儿童以及2岁后搬至该住所的儿童中,暴露未增加风险。居住靠近道路对女孩的影响也更大。在交通暴露建模中也观察到了类似的影响模式。这些结果表明居住在主要道路附近与哮喘有关。无哮喘家族史者影响更大的原因值得进一步研究。