Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY, USA.
J Expo Sci Environ Epidemiol. 2012 May-Jun;22(3):258-66. doi: 10.1038/jes.2012.3. Epub 2012 Feb 29.
Differential exposure to combustion by-products and allergens may partially explain the marked disparity in asthma prevalence (3-18%) among New York City neighborhoods. Subclinical changes in airway inflammation can be measured by fractional exhaled nitric oxide (FeNO). FeNO could be used to test independent effects of these environmental exposures on airway inflammation. Seven- and eight-year-old children from neighborhoods with lower (range 3-9%, n=119) and higher (range 11-18%, n=121) asthma prevalence participated in an asthma case-control study. During home visits, FeNO was measured, and samples of bed dust (allergens) and air (black carbon; BC) were collected. Neighborhood built-environment characteristics were assessed for the 500 m surrounding participants' homes. Airborne BC concentrations in homes correlated with neighborhood asthma prevalence (P<0.001) and neighborhood densities of truck routes (P<0.001) and buildings burning residual oil (P<0.001). FeNO concentrations were higher among asthmatics with than in those without frequent wheeze (≥4 times/year) (P=0.002). FeNO concentrations correlated with domestic BC among children without seroatopy (P=0.012) and with dust mite allergen among children with seroatopy (P=0.020). The association between airborne BC in homes and both neighborhood asthma prevalence and FeNO suggest that further public health interventions on truck emissions standards and residual oil use are warranted.
不同地区燃烧副产品和过敏原的暴露程度不同,这可能部分解释了纽约市不同社区哮喘患病率(3-18%)的显著差异。气道炎症的亚临床变化可以通过呼出气一氧化氮分数(FeNO)来测量。FeNO 可用于测试这些环境暴露对气道炎症的独立影响。来自哮喘患病率较低(范围 3-9%,n=119)和较高(范围 11-18%,n=121)社区的 7 至 8 岁儿童参加了一项哮喘病例对照研究。在家庭访问期间,测量了 FeNO,并采集了床尘(过敏原)和空气(黑碳;BC)样本。评估了参与者家庭周围 500 米范围内的社区建筑环境特征。家庭空气中的 BC 浓度与社区哮喘患病率(P<0.001)以及卡车路线(P<0.001)和燃烧残余油的建筑物(P<0.001)的社区密度相关。经常喘息(≥4 次/年)的哮喘患者的 FeNO 浓度高于无喘息患者(P=0.002)。在无血清过敏的儿童中,FeNO 浓度与家庭内 BC 相关(P=0.012),在血清过敏的儿童中,FeNO 浓度与尘螨过敏原相关(P=0.020)。家庭空气中的 BC 与社区哮喘患病率和 FeNO 之间的关联表明,有必要进一步对卡车排放标准和残余油使用采取公共卫生干预措施。