Pharmacology and Clinical Research Departments, Paris Descartes Necker Cochin, Assistance Publique - Hopitaux de Paris, Paris, France.
Pharmacology and Drug Evaluation in Children and Pregnant Women EA7323, Paris Descartes University, Sorbonne Paris Cité, Paris, France.
Arch Dis Child. 2018 Sep;103(9):828-831. doi: 10.1136/archdischild-2017-312826. Epub 2017 Dec 19.
As the results from epidemiological studies about the impact of outdoor air pollution on asthma in children are heterogeneous, our objective was to investigate the association between asthma exacerbation in children and exposure to air pollutants.
A database of 1 264 585 paediatric visits during the 2010-2015 period to the emergency rooms from 20 emergency departments (EDs) of 'Assistance Publique Hôpitaux de Paris (APHP)', the largest hospital group in Europe, was used. A total of 47 107 visits were classified as asthma exacerbations. Concentration of air pollutants (nitrogen dioxide, ozone, fine particulate matter (PM) with an aerodynamic diameter smaller than 10 µm (PM) and 2.5 µm (PM)), as well as meteorological data, evolution of respiratory syncytial virus infection and pollen exposition, were collected on an hourly or daily basis for the same period using institutional databases. To assess the association between air pollution and asthma, mixed-effects quasi-Poisson regression modelling was performed.
The only compound independently associated with ED visits for asthma was PM (P<10). The association between asthma exacerbation and PM was not linear, and a sigmoid function described the relationshipsatisfactorily. PM concentration, which gives half the maximum effect, was estimated at 13.5 µg/m.
We found an association between daily asthma exacerbation in paediatric visits to the ED and fine particulate air pollutants.
由于流行病学研究关于室外空气污染对儿童哮喘影响的结果存在异质性，我们的目的是研究儿童哮喘恶化与暴露于空气污染物之间的关联。
使用了来自 20 个急诊部（ED）的 1264585 例 2010-2015 年期间儿童就诊的数据库。共有 47107 例就诊被归类为哮喘恶化。在同一时期，使用机构数据库每小时或每天收集空气污染物（二氧化氮、臭氧、空气动力学直径小于 10μm（PM）和 2.5μm（PM）的细颗粒物）以及气象数据、呼吸道合胞病毒感染和花粉暴露的变化。为了评估空气污染与哮喘之间的关联，采用混合效应拟泊松回归模型进行分析。
唯一与 ED 就诊哮喘相关的化合物是 PM（P<10）。哮喘恶化与 PM 之间的关系不是线性的，而 sigmoid 函数则很好地描述了这种关系。估计 PM 浓度达到最大效应一半时为 13.5μg/m。
我们发现每日儿童急诊就诊哮喘恶化与细颗粒物空气污染物之间存在关联。
