交通相关的空气污染与生命最初 8 年哮喘和过敏的发展。
Traffic-related air pollution and the development of asthma and allergies during the first 8 years of life.
机构信息
Institute for Risk Assessment Sciences, Utrecht University, The Netherlands.
出版信息
Am J Respir Crit Care Med. 2010 Mar 15;181(6):596-603. doi: 10.1164/rccm.200906-0858OC. Epub 2009 Dec 3.
RATIONALE
The role of air pollution exposure in the development of asthma, allergies, and related symptoms remains unclear, due in part to the limited number of prospective cohort studies with sufficiently long follow-ups addressing this problem.
OBJECTIVES
We studied the association between traffic-related air pollution and the development of asthma, allergy, and related symptoms in a prospective birth cohort study with a unique 8-year follow-up.
METHODS
Annual questionnaire reports of asthma, hay fever, and related symptoms during the first 8 years of life were analyzed for 3,863 children. At age 8, measurements of allergic sensitization and bronchial hyperresponsiveness were performed for subpopulations (n = 1,700 and 936, respectively). Individual exposures to nitrogen dioxide (NO(2)), particulate matter (PM(2.5)), and soot at the birth address were estimated by land-use regression models. Associations between exposure to traffic-related air pollution and repeated measures of health outcomes were assessed by repeated-measures logistic regression analysis. Effects are presented for an interquartile range increase in exposure after adjusting for covariates.
MEASUREMENTS AND MAIN RESULTS
Annual prevalence was 3 to 6% for asthma and 12 to 23% for asthma symptoms. Annual incidence of asthma was 6% at age 1, and 1 to 2% at later ages. PM(2.5) levels were associated with a significant increase in incidence of asthma (odds ratio [OR], 1.28; 95% confidence interval [CI], 1.10-1.49), prevalence of asthma (OR, 1.26; 95% CI, 1.04-1.51), and prevalence of asthma symptoms (OR, 1.15; 95% CI, 1.02-1.28). Findings were similar for NO(2) and soot. Associations were stronger for children who had not moved since birth. Positive associations with hay fever were found in nonmovers only. No associations were found with atopic eczema, allergic sensitization, and bronchial hyperresponsiveness.
CONCLUSIONS
Exposure to traffic-related air pollution may cause asthma in children.
背景
空气污染暴露在哮喘、过敏和相关症状的发展中的作用尚不清楚，部分原因是前瞻性队列研究数量有限，且这些研究对该问题的随访时间不够长。
目的
我们在一项具有独特 8 年随访的前瞻性出生队列研究中，研究了交通相关空气污染与哮喘、过敏和相关症状发展之间的关系。
方法
对 3863 名儿童在生命的头 8 年中每年的哮喘、干草热和相关症状的问卷调查报告进行了分析。在 8 岁时，对亚人群（分别为 1700 人和 936 人）进行了过敏敏化和支气管高反应性的测量。利用土地利用回归模型估计了出生地址处二氧化氮（NO2）、细颗粒物（PM2.5）和煤烟的个体暴露量。采用重复测量逻辑回归分析评估了交通相关空气污染暴露与健康结果的重复测量之间的关系。在调整了协变量后，结果表示为暴露于四分位距增加后的情况。
测量和主要结果
哮喘的年患病率为 3%至 6%，哮喘症状的年患病率为 12%至 23%。1 岁时哮喘的年发病率为 6%，之后的发病率为 1%至 2%。PM2.5 水平与哮喘发病率（比值比[OR]，1.28；95%置信区间[CI]，1.10-1.49）、哮喘患病率（OR，1.26；95% CI，1.04-1.51）和哮喘症状患病率（OR，1.15；95% CI，1.02-1.28）的显著增加相关。NO2 和煤烟也有类似的发现。对于自出生以来未搬家的儿童，相关性更强。仅在未搬家的儿童中发现与花粉热的阳性关联。与特应性湿疹、过敏敏化和支气管高反应性无关联。
结论
交通相关空气污染的暴露可能会导致儿童哮喘。
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