Hansell Anna L, Rose Nectarios, Cowie Christine T, Belousova Elena G, Bakolis Ioannis, Ng Kitty, Toelle Brett G, Marks Guy B
MRC-PHE Centre for Environment and Health, Imperial College London, London, United Kingdom; Public Health and Primary Care Directorate, Imperial College Healthcare NHS Trust, London, United Kingdom.
Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia; New South Wales Health Ministry, Sydney, New South Wales, Australia.
PLoS One. 2014 Jun 20;9(6):e98978. doi: 10.1371/journal.pone.0098978. eCollection 2014.
Evidence for an association between traffic-related air pollution and allergic disease is inconsistent, possibly because the adverse effects may be limited to susceptible subgroups and these have not been identified. This study examined children in the Childhood Asthma Prevention Study (CAPS), potentially susceptible to air pollution effects because of a family history of asthma.
We examined cross-sectional associations at age eight years between road density within 75 m and 50 m of home address weighted by road type (traffic density), as a proxy for traffic-related air pollution, on the following allergic and respiratory outcomes: skin prick tests (SPTs), total and specific serum IgE, pre- and post-bronchodilator lung function, airway hyperresponsiveness, exhaled NO, and reported asthma and rhinitis.
Weighted road density was positively associated with allergic sensitisation and allergic rhinitis. Adjusted relative risk (RR) for house dust mite (HDM) positive SPT was 1.25 (95% CI: 1.06-1.48), for detectable house dust mite-specific IgE was 1.19 (95% CI: 1.01-1.41) and for allergic rhinitis was 1.30 (95% CI: 1.03-1.63) per 100 m local road or 33.3 m motorway within 50 m of home. Associations were also seen with small decrements of peak and mid-expiratory flows and increased risk of asthma, current wheeze and rhinitis in atopic children.
Associations between road density and allergic disease were found in a potentially susceptible subgroup of children at high risk of developing atopy and asthma.
交通相关空气污染与过敏性疾病之间关联的证据并不一致，这可能是因为其不良影响可能仅限于易感亚组，而这些亚组尚未被识别。本研究对儿童哮喘预防研究（CAPS）中的儿童进行了调查，这些儿童因有哮喘家族史而可能易受空气污染影响。
我们研究了在儿童8岁时，以道路类型加权的家庭住址75米和50米范围内的道路密度（交通密度）作为交通相关空气污染的替代指标，与以下过敏性和呼吸道结局之间的横断面关联：皮肤点刺试验（SPT）、总血清IgE和特异性血清IgE、支气管扩张剂使用前后的肺功能、气道高反应性、呼出一氧化氮（NO），以及报告的哮喘和鼻炎。
加权道路密度与过敏性致敏和过敏性鼻炎呈正相关。在家居50米范围内，每100米当地道路或33.3米高速公路，屋尘螨（HDM）阳性SPT的校正相对风险（RR）为1.25（95%置信区间：1.06 - 1.48），可检测到的屋尘螨特异性IgE的校正相对风险为1.19（95%置信区间：1.01 - 1.41），过敏性鼻炎的校正相对风险为1.30（95%置信区间：1.03 - 1.63）。在特应性儿童中，还发现道路密度与呼气峰值流量和呼气中期流量的小幅下降以及哮喘、当前喘息和鼻炎风险增加之间存在关联。
在有发生特应性和哮喘高风险的潜在易感儿童亚组中，发现了道路密度与过敏性疾病之间的关联。
