Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA 94720-7360, USA.
Neurotoxicology. 2012 Mar;33(2):246-54. doi: 10.1016/j.neuro.2011.09.004. Epub 2011 Sep 24.
We investigated whether early life chronic exposure to woodsmoke, using personal passive 48-h carbon monoxide (CO) as an indicator, is associated with children's neurodevelopmental and behavioral performance. CO measures were collected every 3 months from 2002 to 2005 among mother-child dyads during the Randomized Exposure Study of Pollution Indoors and Respiratory Effects (RESPIRE) stove intervention trial in San Marcos, Guatemala. From March to June, 2010, study children of age 6-7 years, performed a follow-up non-verbal, culturally adapted neurodevelopmental assessment. We found inverse associations between CO exposure of pregnant mothers during their 3rd trimesters (m=3.8ppm ± 3.0ppm; range: 0.6-12.5 ppm) and child neuropsychological performance. Scores on 4 out of 11 neuropsychological tests were significantly associated with mothers' 3rd trimester CO exposures, including visuo-spatial integration (p<0.05), short-term memory recall (p<0.05), long-term memory recall (p<0.05), and fine motor performance (p<0.01) measured using the Bender Gestalt-II's Copy, Immediate Recall, and an adapted version of a Delayed Recall Figures drawing, and the Reitan-Indiana's Finger Tapping Tests, respectively. These 4 significant finding persisted with adjustment for child sex, age, visual acuity, and household assets (socio-economic status). Summary performance scores were also significantly associated with maternal 3rd trimester CO when adjusted for these covariates. Other variables accounting for variance but were excluded in our final multiple regression models included the following: HOME environment stimulation score, child examiner, WHO height-for-age percentile, and age that the infant stopped breastfeeding. This seems to be the first study on woodsmoke exposure and neurodevelopment, and the first longitudinal birth cohort study on chronic early life CO exposures, determined by high quality measures of mothers' and infants' personal CO exposures, and using well-established, reliable child neuropsychological tests. Further research is needed to replicate our results and inform future interventions and air quality standards for woodsmoke and CO.
我们研究了儿童在生命早期长期暴露于柴烟（通过个人被动采集的 48 小时一氧化碳（CO）作为指示物）是否与他们的神经发育和行为表现有关。在危地马拉圣马科斯的随机室内污染和呼吸道影响（RESPIRE）炉干预试验中，于 2002 年至 2005 年期间，每 3 个月对母婴对子进行 CO 测量。2010 年 3 月至 6 月，年龄在 6-7 岁的研究儿童进行了后续的非语言、文化适应的神经发育评估。我们发现，母亲在妊娠晚期（均值=3.8ppm±3.0ppm；范围：0.6-12.5ppm）的 CO 暴露与儿童神经心理表现呈负相关。在 11 项神经心理测试中的 4 项测试中，母亲妊娠晚期 CO 暴露与儿童神经心理表现显著相关，包括视空间整合（p<0.05）、短期记忆回忆（p<0.05）、长期记忆回忆（p<0.05）和精细运动表现（p<0.01），分别通过 Bender Gestalt-II 的复制、即时回忆和改编后的延迟回忆图形绘制以及 Reitan-Indiana 的手指敲击测试来评估。在调整了儿童性别、年龄、视力和家庭资产（社会经济地位）后，这 4 项显著发现仍然存在。在调整了这些协变量后，综合表现得分也与母亲妊娠晚期 CO 显著相关。在我们最终的多元回归模型中，纳入了以下可能导致差异但被排除的其他变量：家庭环境刺激评分、儿童检查者、世界卫生组织身高年龄百分位数和婴儿停止母乳喂养的年龄。这似乎是第一项关于柴烟暴露和神经发育的研究，也是第一项关于通过母亲和婴儿个人 CO 暴露的高质量测量以及使用成熟可靠的儿童神经心理测试来确定的慢性早期生命 CO 暴露的纵向出生队列研究。需要进一步的研究来复制我们的结果，并为未来的柴烟和 CO 干预和空气质量标准提供信息。
