Wilhelm Michelle, Meng Ying-Ying, Rull Rudolph P, English Paul, Balmes John, Ritz Beate
Department of Epidemiology and Center for Occupational and Environmental Health, School of Public Health, University of California, Los Angeles, California, USA.
Environ Health Perspect. 2008 Sep;116(9):1254-60. doi: 10.1289/ehp.10945.
Despite extensive evidence that air pollution affects childhood asthma, state-level and national-level tracking of asthma outcomes in relation to air pollution is limited.
Our goals were to evaluate the feasibility of linking the 2001 California Health Interview Survey (CHIS), air monitoring, and traffic data; estimate associations between traffic density (TD) or outdoor air pollutant concentrations and childhood asthma morbidity; and evaluate the usefulness of such databases, linkages, and analyses to Environmental Public Health Tracking (EPHT).
We estimated TD within 500 feet of residential cross-streets of respondents and annual average pollutant concentrations based on monitoring station measurements. We used logistic regression to examine associations with reported asthma symptoms and emergency department (ED) visits/hospitalizations.
Assignment of TD and air pollution exposures for cross-streets was successful for 82% of children with asthma in Los Angeles and San Diego, California, Counties. Children with asthma living in high ozone areas and areas with high concentrations of particulate matter < 10 microm in aerodynamic diameter experienced symptoms more frequently, and those living close to heavy traffic reported more ED visits/hospitalizations. The advantages of the CHIS for asthma EPHT include a large and representative sample, biennial data collection, and ascertainment of important socio-demographic and residential address information. Disadvantages are its cross-sectional design, reliance on parental reports of diagnoses and symptoms, and lack of information on some potential confounders.
Despite limitations, the CHIS provides a useful framework for examining air pollution and childhood asthma morbidity in support of EPHT, especially because later surveys address some noted gaps. We plan to employ CHIS 2003 and 2005 data and novel exposure assessment methods to re-examine the questions raised here.
尽管有大量证据表明空气污染会影响儿童哮喘，但州级和国家级层面针对与空气污染相关的哮喘结果的追踪却很有限。
我们的目标是评估将2001年加利福尼亚健康访谈调查（CHIS）、空气监测和交通数据相联系的可行性；估计交通密度（TD）或室外空气污染物浓度与儿童哮喘发病率之间的关联；并评估此类数据库、联系及分析对环境公共卫生追踪（EPHT）的有用性。
我们根据监测站的测量数据，估算了受访者居住街道交叉路口500英尺范围内的交通密度以及年平均污染物浓度。我们使用逻辑回归来研究与报告的哮喘症状以及急诊室（ED）就诊/住院情况之间的关联。
对于加利福尼亚州洛杉矶县和圣地亚哥县82%的哮喘儿童，成功完成了对其居住街道交叉路口的交通密度和空气污染暴露情况的赋值。生活在高臭氧区域以及空气动力学直径小于10微米的颗粒物浓度高的区域的哮喘儿童，症状出现得更频繁，而居住在交通繁忙区域附近的儿童报告的急诊室就诊/住院情况更多。CHIS在哮喘EPHT方面的优势包括样本量大且具有代表性、每两年收集一次数据以及确定重要的社会人口统计学和居住地址信息。缺点是其横断面设计、依赖家长对诊断和症状的报告以及缺乏一些潜在混杂因素的信息。
尽管存在局限性，但CHIS为研究空气污染与儿童哮喘发病率以支持EPHT提供了一个有用的框架，特别是因为后续调查弥补了一些明显的不足。我们计划采用2003年和2005年CHIS的数据以及新的暴露评估方法，重新审视此处提出的问题。
