Eggleston Peyton A
Department of Pediatrics, School of Medicine, The Johns Hopkins University, CMCSC 1102, Baltimore, MD 21287-3923, USA.
Chest. 2007 Nov;132(5 Suppl):782S-788S. doi: 10.1378/chest.07-1906.
Poor, minority children living in US inner cities have increased rates of asthma morbidity and mortality. Factors that contribute to these increased rates are varied and complex, with current evidence suggesting that the environment is an important causative factor. Respiratory morbidity is often the result of allergens and air pollutants. Additionally, for children living in urban environments, underlying societal susceptibility factors specific to the inner city serve to increase asthma morbidity. Even though ambient pollutants have been declining in US cities, asthma morbidity and mortality rates have been increasing. Indoor pollutants are closely linked to increased asthma prevalence and morbidity. While the understanding of environmental influences is still relatively limited, we can say that indoor exposures are more important than ambient pollutants, and we know that bioaerosols containing allergenic proteins are especially important. Additionally, certain particulate aerosols and ozone cause inflammation individually and may act synergistically to enhance the acute and chronic IgE-mediated inflammation. The purpose of this article is to review the data relating exposure to environmental pollutants and airborne allergens, and the relationship of this exposure to asthma prevalence and morbidity in order to inform plans for public health programs to reduce an asthma burden.
生活在美国内陆城市的贫困少数族裔儿童哮喘发病率和死亡率有所上升。导致这些发病率上升的因素多种多样且复杂，目前的证据表明环境是一个重要的致病因素。呼吸道疾病往往是过敏原和空气污染物所致。此外，对于生活在城市环境中的儿童来说，内陆城市特有的潜在社会易感性因素会增加哮喘发病率。尽管美国城市中的环境污染物一直在减少，但哮喘发病率和死亡率却一直在上升。室内污染物与哮喘患病率和发病率的增加密切相关。虽然对环境影响的理解仍然相对有限，但我们可以说室内接触比环境污染物更重要，而且我们知道含有致敏蛋白的生物气溶胶尤为重要。此外，某些颗粒气溶胶和臭氧会单独引发炎症，并且可能协同作用以增强急性和慢性IgE介导的炎症。本文的目的是回顾有关接触环境污染物和空气传播过敏原的数据，以及这种接触与哮喘患病率和发病率之间的关系，以便为减轻哮喘负担的公共卫生项目计划提供参考。
