National Heart and Lung Institute, Imperial College London, London, United Kingdom; ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
Environ Int. 2020 Mar;136:105474. doi: 10.1016/j.envint.2020.105474. Epub 2020 Jan 18.
Uncertainly continues to exist regarding the role of air pollution on pediatric asthma and allergic conditions, especially as air pollution levels have started to decrease in recent decades.
We examined associations of long-term air pollution levels at the home address with pediatric eczema, rhinoconjunctivitis and asthma prevalences in five birth cohorts (BIB, EDEN, GASPII, RHEA and INMA) from seven areas in five European countries.
Current eczema, rhinoconjunctivitis and asthma were assessed in children aged four (N = 6527) and eight years (N = 2489). A multi-morbidity outcome (≥2 conditions versus none) was also defined. Individual outdoor levels of nitrogen dioxide (NO), nitrogen oxides, mass of particulate matter with an aerodynamic diameter <10 μm (PM), 10-2.5 μm (PM) and <2.5 μm (PM), and PM absorbance were assigned to the birth, four- and eight-year home addresses using highly defined spatial air pollution exposure models. Cohort-specific cross-sectional associations were assessed using logistic regression models adjusted for demographic and environmental covariates and combined in a random effects meta-analysis.
The overall prevalence of pediatric eczema, rhinoconjunctivitis and asthma at four years was 15.4%, 5.9% and 12.4%. We found no increase in the prevalence of these outcomes at four or eight years with increasing air pollution exposure. For example, the meta-analysis adjusted odds ratios (95% confidence intervals) for eczema, rhinoconjunctivitis and asthma at four years were 0.94 (0.81, 1.09), 0.90 (0.75, 1.09), and 0.91 (0.74, 1.11), respectively, per 10 μg/m increase in NO at the birth address, and 1.00 (0.81, 1.23), 0.70 (0.49, 1.00) and 0.88 (0.54, 1.45), respectively, per 5 μg/m increase in PM at the birth address.
In this large meta-analysis of five birth cohorts, we found no indication of adverse effects of long-term air pollution exposure on the prevalence of current pediatric eczema, rhinoconjunctivitis or asthma.
空气污染对儿科哮喘和过敏的影响仍存在不确定性，尤其是在近几十年来空气污染水平开始下降的情况下。
我们研究了五个欧洲国家七个地区的五个出生队列（BIB、EDEN、GASPII、RHEA 和 INMA）中家庭住址长期空气污染水平与儿童特应性皮炎、鼻结膜炎和哮喘患病率之间的关系。
在 4 岁（N=6527）和 8 岁（N=2489）的儿童中评估当前特应性皮炎、鼻结膜炎和哮喘的患病率。还定义了一种多疾病结局（≥2 种疾病与无疾病）。使用高度定义的空间空气污染暴露模型，将氮氧化物（NO）、氮氧化物、质量小于 10μm（PM）、10-2.5μm（PM）和小于 2.5μm（PM）以及 PM 吸光度的个体室外水平分配给出生、4 岁和 8 岁的家庭住址。使用逻辑回归模型评估队列特异性横断面关联，并在随机效应荟萃分析中进行合并。
4 岁时儿科特应性皮炎、鼻结膜炎和哮喘的总体患病率为 15.4%、5.9%和 12.4%。我们没有发现随着空气污染暴露的增加，这些结果的患病率在 4 岁或 8 岁时增加。例如，调整出生地址 NO 每增加 10μg/m 时，4 岁时特应性皮炎、鼻结膜炎和哮喘的荟萃分析调整比值比（95%置信区间）分别为 0.94（0.81，1.09）、0.90（0.75，1.09）和 0.91（0.74，1.11），以及出生地址 PM 每增加 5μg/m 时，4 岁时特应性皮炎、鼻结膜炎和哮喘的荟萃分析调整比值比（95%置信区间）分别为 1.00（0.81，1.23）、0.70（0.49，1.00）和 0.88（0.54，1.45）。
在这项对五个出生队列的大型荟萃分析中，我们没有发现长期空气污染暴露对当前儿科特应性皮炎、鼻结膜炎或哮喘患病率有不良影响的迹象。
