Division of Pulmonary, Allergy, Critical Care Medicine, Department of Medicine, Columbia University College of Physicians and Surgeons, NY 10032, USA.
Respir Med. 2011 Jun;105(6):869-76. doi: 10.1016/j.rmed.2010.11.022. Epub 2010 Dec 15.
Previously, we reported that prenatal exposures to polycyclic aromatic hydrocarbons (PAH) and postnatal environmental tobacco smoke (ETS) in combination were associated with respiratory symptoms at ages 1 and 2 years. Here, we hypothesized that children exposed to both prenatal PAH and ETS may be at greater risk of asthma and seroatopy at ages 5-6 years, after controlling for current pollution exposure.
Prenatal PAH exposure was measured by personal air monitoring over 48 h. ETS exposure, respiratory symptoms and asthma at ages 5-6 years were assessed through questionnaire. Immunoglobulin (Ig) E was measured by Immunocap.
A significant interaction between prenatal PAH and prenatal (but not postnatal) ETS exposure on asthma (p < 0.05), but not IgE, was detected. Among children exposed to prenatal ETS, a positive nonsignificant association was found between prenatal PAH exposure and asthma (OR 1.96, 95% CI [0.95-4.05]). Among children without exposure to prenatal ETS, a negative nonsignificant association was found between prenatal PAH exposure and asthma (OR 0.65, 95% CI [0.41-1.01]). Prenatal PAH exposure was not associated with asthma or IgE at age 5-6 years.
Combined prenatal exposure to PAH and ETS appears to be associated with asthma but not seroatopy at age 5-6. Exposure to PAH alone does not appear associated with either asthma or seroatopy at age 5-6 years. Discerning the differential effects between ETS exposed and ETS nonexposed children requires further study.
此前,我们报道多环芳烃(PAH)和产后环境烟草烟雾(ETS)联合暴露与 1 岁和 2 岁时的呼吸道症状有关。在这里,我们假设在控制当前污染暴露的情况下,暴露于产前 PAH 和 ETS 的儿童在 5-6 岁时可能有更高的哮喘和血清病风险。
通过 48 小时的个人空气监测来测量产前 PAH 暴露。通过问卷调查评估 5-6 岁时的 ETS 暴露、呼吸道症状和哮喘。通过免疫捕获法测量免疫球蛋白(Ig)E。
在哮喘(p<0.05)方面,产前 PAH 和产前(而非产后)ETS 暴露之间存在显著的相互作用,但在 IgE 方面没有。在暴露于产前 ETS 的儿童中,发现产前 PAH 暴露与哮喘之间存在正相关(比值比 1.96,95%置信区间 [0.95-4.05]),但无统计学意义。在未暴露于产前 ETS 的儿童中,发现产前 PAH 暴露与哮喘之间存在负相关(比值比 0.65,95%置信区间 [0.41-1.01]),但无统计学意义。产前 PAH 暴露与 5-6 岁时的哮喘或 IgE 无关。
产前同时暴露于 PAH 和 ETS 似乎与 5-6 岁时的哮喘有关,但与血清病无关。单独暴露于 PAH 似乎与 5-6 岁时的哮喘或血清病无关。进一步研究需要区分 ETS 暴露和非 ETS 暴露儿童之间的差异效应。