Lavery Amy M, Waubant Emmanuelle, Casper T Charles, Roalstad Shelly, Candee Meghan, Rose John, Belman Anita, Weinstock-Guttman Bianca, Aaen Greg, Tillema Jan-Mendelt, Rodriguez Moses, Ness Jayne, Harris Yolanda, Graves Jennifer, Krupp Lauren, Charvet Leigh, Benson Leslie, Gorman Mark, Moodley Manikum, Rensel Mary, Goyal Manu, Mar Soe, Chitnis Tanuja, Schreiner Teri, Lotze Tim, Greenberg Benjamin, Kahn Ilana, Rubin Jennifer, Waldman Amy T
Division of Child Neurology Children's Hospital of Philadelphia Philadelphia Pennsylvania.
University of California San Francisco San Francisco California.
Ann Clin Transl Neurol. 2018 Sep 27;5(10):1146-1153. doi: 10.1002/acn3.616. eCollection 2018 Oct.
We previously identified air quality as a risk factor of interest for pediatric multiple sclerosis. The purpose of this study is to more closely examine the association between the six criteria air pollutants and pediatric MS as well as identify specific areas of toxic release using data from the Toxic Release Inventory.
Pediatric MS cases ( = 290) and healthy controls ( = 442) were included as part of an ongoing case-control study. We used the National Emissions Inventory system to estimate particulate exposure by county of residence for each participant. Proximity to Toxic Release Inventory (TRI) sites was also assessed using ArcGIS mapping tools. Risk-Screening Environmental Indicators (RSEI) classified counties at risk to exposure of environmental toxic releases.
Fine particulate matter (PM ), carbon monoxide (CO), sulfur dioxide (SO ), and lead air emissions were associated with increased odds for pediatric MS ( < 0.01) for those residing within 20 miles of an MS center. Most study participants (75%) resided within 5 miles of at least one TRI site; however, the mean total pounds of stack air releases was higher for sites near MS cases (81,000 tons) compared to those near healthy controls (35,000 tons, = 0.002). Average RSEI scores did not differ significantly between cases and controls.
Out of several air pollutants examined, we show that fine particulate matter and three other criteria pollutants (SO , CO, and lead) were statistically associated with higher odds for pediatric MS.
我们之前已确定空气质量是儿童多发性硬化症的一个相关风险因素。本研究的目的是更深入地研究六种标准空气污染物与儿童多发性硬化症之间的关联,并利用有毒物质排放清单数据确定有毒物质释放的具体区域。
作为一项正在进行的病例对照研究的一部分,纳入了儿童多发性硬化症病例(n = 290)和健康对照(n = 442)。我们使用国家排放清单系统来估计每位参与者居住县的颗粒物暴露情况。还使用ArcGIS绘图工具评估了与有毒物质排放清单(TRI)站点的距离。风险筛选环境指标(RSEI)对有环境有毒物质释放暴露风险的县进行了分类。
对于居住在距离多发性硬化症中心20英里范围内的人群,细颗粒物(PM)、一氧化碳(CO)、二氧化硫(SO)和铅排放与儿童多发性硬化症患病几率增加相关(P < 0.)。大多数研究参与者(75%)居住在至少一个TRI站点5英里范围内;然而,与健康对照附近的站点(35000吨,P = 0.002)相比,多发性硬化症病例附近站点的平均总烟囱空气排放量更高(81000吨)。病例组和对照组的平均RSEI分数没有显著差异。
在所研究的几种空气污染物中,我们发现细颗粒物和其他三种标准污染物(SO、CO和铅)与儿童多发性硬化症的较高患病几率在统计学上相关。