Benka-Coker Wande O, Loftus Christine, Karr Catherine, Magzamen Sheryl
Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado.
Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Washington.
Environ Epidemiol. 2019 Jun 19;3(3):e046. doi: 10.1097/EE9.0000000000000046. eCollection 2019 Jun.
Environmental contributions to pediatric asthma morbidity have been studied extensively in urban settings; exposures characteristic of agricultural and rural communities have received less attention despite a comparable burden of morbidity.
We obtained repeated urine samples (n = 139) from 16 school-age children with asthma in the Yakima Valley of Washington State between July and October 2012. Biomarkers of organophosphate (OP) pesticide exposure (dialkyl phosphates [DAPs]) and asthma exacerbation (leukotriene E4 [LTE4]) were analyzed in samples. Corresponding 24-hour average particulate matter <2.5 μg (PM) and maximum 8-hour ozone concentration data for the study period were available from local monitoring stations. We evaluated the independent and multi-pollutant associations between LTE4 and exposure to ambient air pollutants and DAPs using generalized estimating equations. For multi-domain and multi-pollutant models, we created categorized pollution combination levels and estimated the relative health impact of exposure to pollutant mixtures.
In single-pollutant models, an interquartile range increase in exposures to DAPs was associated with increase in LTE4 levels (β: 4.1 [0.6-7.6] pg/mg). PM and ozone were also associated with increase in LTE4, though confidence intervals contained the null value. Increase in LTE4 levels was consistently associated with increase in median-dichotomized multi-pollutant combination exposures; the highest effect estimates were observed with joint highest (vs. the lowest) category of the three-pollutant exposure (PM, ozone, and OP; β: 53.5, 95% confidence interval = 24.2, 82.8 pg/mg).
Concurrent short-term exposure to criteria air pollutants and OPs in an agricultural community was associated with an increase in a marker of asthma morbidity.
环境因素对小儿哮喘发病率的影响在城市环境中已得到广泛研究；尽管农业和农村社区的发病率负担相当，但这些社区特有的暴露情况却较少受到关注。
2012年7月至10月期间，我们从华盛顿州亚基马山谷的16名患有哮喘的学龄儿童中获取了重复的尿液样本（n = 139）。分析样本中有机磷（OP）农药暴露（二烷基磷酸酯[DAPs]）和哮喘加重（白三烯E4[LTE4]）的生物标志物。研究期间相应的24小时平均小于2.5微克颗粒物（PM）和8小时最大臭氧浓度数据可从当地监测站获得。我们使用广义估计方程评估了LTE4与环境空气污染物和DAPs暴露之间的独立和多污染物关联。对于多领域和多污染物模型，我们创建了分类的污染组合水平，并估计了接触污染物混合物的相对健康影响。
在单污染物模型中，DAPs暴露增加一个四分位数间距与LTE4水平升高相关（β：4.1[0.6 - 7.6]pg/mg）。PM和臭氧也与LTE4升高相关，尽管置信区间包含零值。LTE4水平升高始终与中位数二分法多污染物组合暴露增加相关；在三种污染物暴露（PM、臭氧和OP）的联合最高（与最低）类别中观察到最高的效应估计值（β：53.5，95%置信区间 = 24.2，82.8 pg/mg）。
农业社区中同时短期接触标准空气污染物和有机磷与哮喘发病率标志物的增加有关。
