Lee Ji-Young, Leem Jong-Han, Kim Hwan-Cheol, Lamichhane Dirga Kumar, Hwang Seung-Sik, Kim Jeong-Hee, Park Myung-Sook, Jung Dal-Young, Ko Jung-Keun, Kwon Ho-Jang, Hong Soo-Jong
a Department of Social and Preventive Medicine, College of Medicine , Inha University , Incheon , Korea.
b Department of Occupational and Environmental Medicine , Ewha Womans University College of Medicine , Seoul , Korea.
J Asthma. 2018 Mar;55(3):223-230. doi: 10.1080/02770903.2017.1313270. Epub 2017 Dec 19.
This study examined the role of exposure to traffic-related air pollution (TRAP) on susceptibility to asthma in children with past episodes of bronchiolitis.
The baseline data included 2,627 school children aged 6-14 years who had participated in the longitudinal follow-up survey of the Children's Health and Environmental Research of Korea. Lifetime wheezing, past episodes of bronchiolitis, and doctor-diagnosed asthma were evaluated using an International Study of Asthma and Allergies in Childhood questionnaire. We used generalized linear regression with binomial distribution to calculate the relative risk (RR) between TRAP, assessed by proximity to a main road and the total length of roads, and asthma.
Compared with the subjects who had less than 100 m of road length within 200-m radius from their home, those with more than 500 m of road length had significantly increased odds for infantile bronchiolitis (adjusted OR [aOR]: 1.57, 95% confidence interval [CI]: 1.01-2.42). Positive exposure-response relationships were found between residential proximity to the main road and asthma (aOR: 1.79, 95% CI: 1.05-3.06; <75 m vs. >700 m from a main road, P for the trend = 0.02). Closer residential proximity to the main road (<75 m) and bronchiolitis combined increased the risks of newly diagnosed asthma (adjusted RR: 3.62, 95% CI: 1.07-12.26) compared with those without bronchiolitis and living ≥ 75 m away from the main road.
TRAP appeared to be associated with an increased asthma among children with bronchiolitis, indicating the importance of modifying effects of bronchiolitis in asthma pathogenesis.
本研究探讨暴露于交通相关空气污染（TRAP）对既往有细支气管炎发作史的儿童患哮喘易感性的影响。
基线数据包括2627名6 - 14岁的在校儿童，他们参与了韩国儿童健康与环境研究的纵向随访调查。使用儿童哮喘和过敏国际研究问卷评估终身喘息、既往细支气管炎发作史以及医生诊断的哮喘。我们采用二项分布的广义线性回归来计算TRAP（通过与主干道的距离和道路总长度评估）与哮喘之间的相对风险（RR）。
与家周围200米半径内道路长度小于100米的受试者相比，道路长度超过500米的受试者患婴儿细支气管炎的几率显著增加（调整后的比值比[aOR]：1.57，95%置信区间[CI]：1.01 - 2.42）。在居住距离主干道与哮喘之间发现了正暴露 - 反应关系（aOR：1.79，95% CI：1.05 - 3.06；距离主干道<75米与>700米相比，趋势P值 = 0.02）。与没有细支气管炎且居住在距离主干道≥75米的人相比，居住距离主干道更近（<75米）且患有细支气管炎的人患新诊断哮喘的风险增加（调整后的RR：3.62，95% CI：1.07 - 12.26）。
TRAP似乎与细支气管炎患儿哮喘发病率增加有关，表明细支气管炎在哮喘发病机制中的调节作用具有重要意义。
