Modig L, Torén K, Janson C, Jarvholm B, Forsberg B
Dept of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden.
Eur Respir J. 2009 Jun;33(6):1261-7. doi: 10.1183/09031936.00101108. Epub 2009 Feb 27.
Few studies have investigated the relationship between vehicle exhaust and the new onset of asthma among adults. The aim of the present prospective cohort study was to investigate the relationship between the cumulative incidence of asthma and onset of asthma among adults and vehicle exhaust concentrations at home. Participants from three Swedish cities included in the Respiratory Health in Northern Europe cohort constituted the study population. Exposure at each participant's home was calculated using dispersion models. We also used <50 m distance to nearest major road as a more simple indicator of exposure. The adjusted model included 3,609 participants, of which 107 were classified as onset cases and 55 as true incident cases of asthma. There was a positive association between asthma onset (odds ratio (OR) per 10 microg x m(-3) 1.46, 95% confidence interval (CI) 1.07-1.99) and incident asthma (OR per 10 microg x m(-3) 1.54, 95% CI 1.00-2.36) and the levels of nitrogen dioxide (NO(2)), which remained statistically significant after adjusting for potential confounders. The relationship between asthma and NO(2) was not significantly modified by sex, hay fever or wheeze. The risk of developing asthma was also significantly related to living close to a major road. The current study suggests that elevated levels of vehicle exhaust outside the home increase the risk of onset and incident asthma among adults.
很少有研究调查过汽车尾气与成年人哮喘新发病例之间的关系。本前瞻性队列研究的目的是调查成年人哮喘累积发病率及哮喘发病情况与家庭环境中汽车尾气浓度之间的关系。来自北欧队列研究中瑞典三个城市的参与者构成了研究人群。使用扩散模型计算每位参与者家中的暴露情况。我们还将距离最近主要道路<50米作为更简单的暴露指标。调整后的模型纳入了3609名参与者,其中107例被归类为发病病例,55例为哮喘确诊新发病例。哮喘发病(每10微克·米-3的比值比(OR)为1.46,95%置信区间(CI)为1.07 - 1.99)和哮喘新发病例(每10微克·米-3的OR为1.54,95%CI为1.00 - 2.36)与二氧化氮(NO₂)水平呈正相关,在对潜在混杂因素进行调整后,这种相关性仍具有统计学意义。哮喘与NO₂之间的关系在性别、花粉热或喘息方面未出现显著变化。患哮喘的风险也与居住在靠近主要道路的地方显著相关。当前研究表明,家庭外部汽车尾气水平升高会增加成年人哮喘发病及新发病例的风险。