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暴露于交通环境与早期生活中的呼吸道感染:一项队列研究。

Exposure to traffic and early life respiratory infection: A cohort study.

作者信息

Rice Mary B, Rifas-Shiman Sheryl L, Oken Emily, Gillman Matthew W, Ljungman Petter L, Litonjua Augusto A, Schwartz Joel, Coull Brent A, Zanobetti Antonella, Koutrakis Petros, Melly Steven J, Mittleman Murray A, Gold Diane R

机构信息

Pulmonary and Critical Care Unit, Massachusetts General Hospital, Boston, Massachusetts.

Cardiovascular Epidemiology Research Unit, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

出版信息

Pediatr Pulmonol. 2015 Mar;50(3):252-259. doi: 10.1002/ppul.23029. Epub 2014 Mar 27.

Abstract

We examined whether proximity to a major roadway and traffic density around the home during pregnancy are associated with risk of early life respiratory infection in a pre-birth cohort in the Boston area. We geocoded addresses for 1,263 mother-child pairs enrolled during the first trimester of pregnancy in Project Viva during 1999-2002. We calculated distance from home to nearest major roadway and traffic density in a 100 m buffer around the home. We defined respiratory infection as maternal report of ≥1 doctor-diagnosed pneumonia, bronchiolitis, croup, or other respiratory infection from birth until the early childhood visit (median age 3.3). We used relative risk regression models adjusting for potential confounders to estimate associations between traffic exposures and risk of respiratory infection. Distance to roadway during pregnancy was associated with risk of respiratory infection. In fully adjusted models, relative risks (95% CI) for respiratory infection were: 1.30 (1.08, 1.55) for <100 m, 1.15 (0.93, 1.41) for 100 to <200 m, and 0.95 (0.84, 1.07) for 200 to <1,000 m compared with living ≥1,000 m away from a major roadway. Each interquartile range increase in distance to roadway was associated with an 8% (95% CI 0.87, 0.98) lower risk, and each interquartile range increase in traffic density was associated with a 5% (95% CI 0.98, 1.13) higher risk of respiratory infection. Our findings suggest that living close to a major roadway during pregnancy may predispose the developing lung to infection in early life. Pediatr Pulmonol. 2015; 50:252-259. © 2014 Wiley Periodicals, Inc.

摘要

我们研究了孕期居住地点与主要道路的距离以及家庭周围的交通密度是否与波士顿地区一个产前队列中儿童早期呼吸道感染的风险相关。我们对1999年至2002年期间参与“活力计划”的1263对母婴进行了地址地理编码,这些母婴在孕期的头三个月登记入组。我们计算了从家到最近主要道路的距离以及家周围100米缓冲区内的交通密度。我们将呼吸道感染定义为母亲报告孩子从出生到幼儿期就诊(中位年龄3.3岁)期间,有≥1次医生诊断的肺炎、细支气管炎、哮吼或其他呼吸道感染。我们使用相对风险回归模型,并对潜在混杂因素进行调整,以估计交通暴露与呼吸道感染风险之间的关联。孕期与道路的距离与呼吸道感染风险相关。在完全调整模型中,呼吸道感染的相对风险(95%置信区间)为:距离道路<100米时为1.30(1.08,1.55),100至<200米时为1.15(0.93,1.41),200至<1000米时为0.95(0.84,1.07),而居住在距离主要道路≥1000米处的相对风险为1。道路距离每增加一个四分位间距,呼吸道感染风险降低8%(95%置信区间0.87,0.98),交通密度每增加一个四分位间距,呼吸道感染风险增加5%(95%置信区间0.98,1.13)。我们的研究结果表明,孕期居住在靠近主要道路的地方可能会使发育中的肺部在生命早期易受感染。《儿科肺病学》。2015年;50:252 - 259。©2014威利期刊公司

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