Callesen M, Bekö G, Weschler C J, Sigsgaard T, Jensen T K, Clausen G, Toftum J, Norberg L A, Høst A
Department of Pediatrics, Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.
Indoor Air. 2014 Apr;24(2):136-47. doi: 10.1111/ina.12060. Epub 2013 Aug 19.
Previous studies, often using data from questionnaires, have reported associations between various characteristics of indoor environments and allergic disease. The aim of this study has been to investigate possible associations between objectively assessed indoor environmental factors and clinically confirmed asthma, rhinoconjunctivitis, and atopic dermatitis. The study is a cross-sectional case-control study of 500 children aged 3-5 years from Odense, Denmark. The 200 cases had at least two parentally reported allergic diseases, while the 300 controls were randomly selected from 2835 participating families. A single physician conducted clinical examinations of all 500 children. Children from the initially random control group with clinically confirmed allergic disease were subsequently excluded from the control group and admitted in the case group, leaving 242 in the healthy control group. For most children, specific IgE's against various allergens were determined. In parallel, dust samples were collected and air change rates were measured in the children's bedrooms. The dust samples were analyzed for phthalate esters, polycyclic aromatic hydrocarbons (PAH), nicotine, and various allergens. Among children diagnosed with asthma, concentrations of nicotine were higher (P < 0.05) and cat allergens were lower (P < 0.05) compared with the healthy controls; air change rates were lower for those sensitized (specific IgE+) compared with those not sensitized (specific IgE-, P < 0.05); and dust mite allergens were higher for specific IgE+ cases compared with healthy controls (P < 0.05). When disease status was based solely on questionnaire responses (as opposed to physician diagnosis), significant associations were found between di(2-ethylhexyl) phthalate (DEHP) and dog allergens in dust and current wheeze.
以往的研究，通常使用问卷调查数据，报告了室内环境的各种特征与过敏性疾病之间的关联。本研究的目的是调查客观评估的室内环境因素与临床确诊的哮喘、鼻结膜炎和特应性皮炎之间可能存在的关联。该研究是一项横断面病例对照研究，研究对象为来自丹麦欧登塞的500名3至5岁儿童。200例病例至少有两种经家长报告的过敏性疾病，而300名对照则从2835个参与家庭中随机选取。由一名医生对所有500名儿童进行临床检查。最初随机选取的对照组中临床确诊患有过敏性疾病的儿童随后被排除在对照组之外，并纳入病例组，健康对照组剩下242名儿童。对大多数儿童测定了针对各种过敏原的特异性IgE。同时，收集了灰尘样本并测量了儿童卧室的换气率。对灰尘样本进行了邻苯二甲酸酯、多环芳烃（PAH）、尼古丁和各种过敏原的分析。在诊断为哮喘的儿童中，与健康对照组相比，尼古丁浓度较高（P<0.05），猫过敏原较低（P<0.05）；与未致敏（特异性IgE-）的儿童相比，致敏（特异性IgE+）儿童的换气率较低（P<0.05）；与健康对照组相比，特异性IgE+病例的尘螨过敏原较高（P<0.05）。当疾病状态仅基于问卷调查回答（而非医生诊断）时，发现灰尘中的邻苯二甲酸二（2-乙基己基）酯（DEHP）和狗过敏原与当前喘息之间存在显著关联。
