Mirabelli Maria C, Golan Rachel, Greenwald Roby, Raysoni Amit U, Holguin Fernando, Kewada Priya, Winquist Andrea, Flanders W Dana, Sarnat Jeremy A
From the aAir Pollution and Respiratory Health Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA; bDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA; cDepartment of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA; and dDivision of Pulmonary, Allergy and Critical Care, Department of Medicine, University of Pittsburgh, Pittsburgh, PA.
Epidemiology. 2015 Jul;26(4):546-55. doi: 10.1097/EDE.0000000000000296.
Effects of traffic-related exposures on respiratory health are well documented, but little information is available about whether asthma control influences individual susceptibility. We analyzed data from the Atlanta Commuter Exposure study to evaluate modification of associations between rush-hour commuting, in- vehicle air pollution, and selected respiratory health outcomes by asthma control status.
Between 2009 and 2011, 39 adults participated in Atlanta Commuter Exposure, and each conducted two scripted rush-hour highway commutes. In-vehicle particulate components were measured during all commutes. Among adults with asthma, we evaluated asthma control by questionnaire and spirometry. Exhaled nitric oxide, forced expiratory volume in 1 second (FEV1), and other metrics of respiratory health were measured precommute and 0, 1, 2, and 3 hours postcommute. We used mixed effects linear regression to evaluate associations between commute-related exposures and postcommute changes in metrics of respiratory health by level of asthma control.
We observed increased exhaled nitric oxide across all levels of asthma control compared with precommute measurements, with largest postcommute increases observed among participants with below-median asthma control (2 hours postcommute: 14.6% [95% confidence interval {CI} = 5.7, 24.2]; 3 hours postcommute: 19.5% [95% CI = 7.8, 32.5]). No associations between in-vehicle pollutants and percent of predicted FEV1 were observed, although higher PM2.5 was associated with lower FEV1 % predicted among participants with below-median asthma control (3 hours postcommute: -7.2 [95% CI = -11.8, -2.7]).
Level of asthma control may influence respiratory response to in-vehicle exposures experienced during rush-hour commuting.
与交通相关的暴露对呼吸健康的影响已有充分记录，但关于哮喘控制是否会影响个体易感性的信息却很少。我们分析了亚特兰大通勤者暴露研究的数据，以评估哮喘控制状况对高峰时段通勤、车内空气污染与选定的呼吸健康结局之间关联的影响。
2009年至2011年期间，39名成年人参与了亚特兰大通勤者暴露研究，每人进行了两次按脚本进行的高峰时段高速公路通勤。在所有通勤过程中测量车内颗粒物成分。在患有哮喘的成年人中，我们通过问卷和肺功能测定来评估哮喘控制情况。在通勤前以及通勤后0、1、2和3小时测量呼出一氧化氮、一秒用力呼气量（FEV1）以及其他呼吸健康指标。我们使用混合效应线性回归，根据哮喘控制水平评估通勤相关暴露与通勤后呼吸健康指标变化之间的关联。
与通勤前测量值相比，我们观察到在所有哮喘控制水平下呼出一氧化氮均增加，在哮喘控制低于中位数的参与者中观察到通勤后增加幅度最大（通勤后2小时：14.6%[95%置信区间{CI}=5.7,24.2]；通勤后3小时：19.5%[95%CI=7.8,32.5]）。未观察到车内污染物与预测FEV1百分比之间的关联，尽管在哮喘控制低于中位数的参与者中，较高的PM2.5与较低的预测FEV1%相关（通勤后3小时：-7.2[95%CI=-11.8,-2.7]）。
哮喘控制水平可能会影响高峰时段通勤期间对车内暴露的呼吸反应。
