Tan Teck-King, Saps Miguel, Lin Cheng-Li, Wei Chang-Ching
Division of Pediatric Gastroenterology, Department of Pediatrics, Children's Hospital, China Medical University Hospital, Taichung, Taiwan.
Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Miami Health System, FL, USA.
J Neurogastroenterol Motil. 2019 Apr 30;25(2):241-249. doi: 10.5056/jnm18135.
BACKGROUND/AIMS: Recent studies suggest that air pollution may play a role in gastrointestinal disorders. However, the effect of long-term exposure to air pollution on childhood irritable bowel syndrome (IBS) is unclear. Hence, we conducted a nationwide cohort study to investigate the association between long-term air pollution exposure and the incidence and risk of IBS in Taiwanese children during 2000-2012.
We collected data from the Taiwan National Health Insurance Research Database, linked to the Taiwan Air Quality-Monitoring Database according to the insurant living area and the air quality-monitoring station locations. Children < 18 years old, identified from January 1st, 2000, were followed-up until IBS diagnosis or December 31st, 2012. The daily average air pollutant concentrations were categorized into 4 quartile-based groups (Q1-Q4). We measured the incidence rate, hazard ratios (HRs), and 95% confidence intervals for IBS stratified by the quartiles of air pollutant concentration.
A total of 3537 children (1.39%) were diagnosed with IBS within the cohort during the follow-up period. The incidence rate for IBS increased from 0.84 to 1.76, from 0.73 to 1.68, from 0.85 to 1.98, and from 0.52 to 3.22 per 1000 person-years, with increase in the carbon monoxide, nitrogen dioxide, non-methane hydrocarbon, and methane quartile (from Q1 to Q4) exposure concentration, respectively. The adjusted HR for IBS increased with elevated carbon monoxide, nitrogen dioxide, non-methane hydrocarbon, and methane exposure in Q4 to 1.98, 2.14, 2.19, and 5.87, respectively, compared with Q1.
Long-term ambient air pollutant exposure is an environmental risk factor for childhood IBS.
背景/目的：近期研究表明，空气污染可能在胃肠道疾病中起作用。然而，长期暴露于空气污染对儿童肠易激综合征（IBS）的影响尚不清楚。因此，我们进行了一项全国性队列研究，以调查2000年至2012年期间台湾儿童长期暴露于空气污染与IBS发病率及风险之间的关联。
我们从台湾国民健康保险研究数据库收集数据，并根据被保险人居住地区和空气质量监测站位置与台湾空气质量监测数据库相链接。2000年1月1日确定的18岁以下儿童，随访至IBS诊断或2012年12月31日。每日平均空气污染物浓度分为4个基于四分位数的组（Q1-Q4）。我们测量了按空气污染物浓度四分位数分层的IBS发病率、风险比（HRs）和95%置信区间。
在随访期间，队列中共有3537名儿童（1.39%）被诊断为IBS。IBS发病率每1000人年分别从0.84增加到1.76、从0.73增加到1.68、从0.85增加到1.98、从0.52增加到3.22，分别对应一氧化碳、二氧化氮、非甲烷烃和甲烷四分位数（从Q1到Q4）暴露浓度的增加。与Q1相比，Q4中一氧化碳、二氧化氮、非甲烷烃和甲烷暴露水平升高时，IBS的校正HR分别增加到1.98、2.14、2.19和5.87。
长期暴露于环境空气污染物是儿童IBS的一个环境风险因素。
