Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, 610 N. Walnut Street, Madison, WI 53726, USA.
Department of Psychiatry, School of Medicine, University of Michigan, Ann Arbor, MI 48109, USA.
Int J Environ Res Public Health. 2018 Jan 6;15(1):84. doi: 10.3390/ijerph15010084.
Adverse perceptions of neighborhood safety, aesthetics and quality including access to resources can induce stress and may make individuals more sensitive to cardiopulmonary effects of air pollution exposure. Few studies have examined neighborhood perceptions as important and modifiable non-chemical stressors of the built environment that may exacerbate effects of air pollution on cardiopulmonary health outcomes, particularly among general population based cohorts. This study examined associations between low-level chronic exposure to fine particulate matter (PM) and cardiopulmonary health, and the potential mediating or modifying effects of adverse neighborhood perceptions. Using data from the Survey of the Health of Wisconsin (SHOW), 2230 non-asthmatic adults age 21-74 were included in the analyses. The overall goals of this study were to assess if individuals who experience stress from neighborhood environments in which they live were more sensitive to low levels of fine particular matter (PM μg/m³). Demographic predictors of air pollution exposure included younger age, non-White race, lower education and middle class income. After adjustments, objective lung function measures (FEV1 and FEV1 to FVC ratio) were the only cardiopulmonary health indicators significantly associated with chronic three-year annual averages of PM. Among all non-asthmatics, a ten unit increase in estimated three year annual average PM exposure was significantly associated with lower forced expiratory volume (L) in one second FEV1 (β = -0.40 μg/L; 95% CI -0.45, -0.06). Among all individuals, adverse perceptions of the neighborhood built environment did not appear to statistically moderate or mediate associations. However, stratified analysis did reveal significant associations between PM and lung function (FEV1) only among individuals with negative perceptions and increased reports of neighborhood stressors. These findings included individuals who felt their neighborhoods were poorly maintained (β = -0.82; 95% CI -1.35, -0.28), experienced stress from crime (β = -0.45; 95% CI -0.94, 0.04) or reported neighborhood is not well maintained (β = -1.13, CI -2.04, -0.24). These significant associations were similar for FEV1 to FVC ratio. Multi-pronged approaches addressing both neighborhood built environment aesthetics and air pollution regulation may be necessary to protect vulnerable and susceptible individuals and reduce persistent inequalities.
不良的邻里安全、美观和质量感知，包括获取资源的机会，会引发压力，并可能使个人对空气污染暴露的心肺影响更加敏感。很少有研究探讨邻里感知作为重要的、可改变的建筑环境非化学应激源，这些应激源可能会加剧空气污染对心肺健康结果的影响，尤其是在基于一般人群的队列中。本研究调查了低水平慢性细颗粒物 (PM) 暴露与心肺健康之间的关系，以及不良邻里感知的潜在中介或调节作用。本研究使用来自威斯康星州健康调查 (SHOW) 的数据，纳入了 2230 名年龄在 21-74 岁之间、非哮喘的成年人进行分析。本研究的总体目标是评估生活在感到压力的邻里环境中的个体对低水平细颗粒物 (PM μg/m³) 是否更敏感。空气污染暴露的人口统计学预测因素包括年龄较小、非白种人、教育程度较低和中产阶级收入。调整后，客观的肺功能指标（FEV1 和 FEV1/FVC 比值）是与 PM 慢性三年年平均水平显著相关的唯一心肺健康指标。在所有非哮喘患者中，估计三年年平均 PM 暴露量每增加十个单位，与用力呼气量 (FEV1) 降低显著相关 (β = -0.40 μg/L; 95%CI -0.45,-0.06)。在所有个体中，邻里建筑环境的不良感知似乎没有在统计学上调节或中介这些关联。然而，分层分析确实显示，在对邻里环境持负面看法且报告邻里压力源增加的个体中，PM 与肺功能（FEV1）之间存在显著关联。这些发现包括感到邻里环境维护不善的个体（β = -0.82; 95%CI -1.35,-0.28）、受到犯罪压力的个体（β = -0.45; 95%CI -0.94,0.04）或报告邻里环境维护不善的个体（β = -1.13,CI -2.04,-0.24）。FEV1/FVC 比值也存在类似的显著关联。解决邻里建筑环境美观和空气污染监管问题的多管齐下的方法可能是保护脆弱和易感个体、减少持续不平等现象的必要手段。
