INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, Villejuif, France; University of Versailles St-Quentin-en-Yvelines, UMR 1168, Montigny le Bretonneux, France; ISGLobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain.
Inserm, UMR 1152, Pathophysiology and Epidemiology of Respiratory Diseases, Paris, France.
J Allergy Clin Immunol. 2020 Mar;145(3):834-842.e6. doi: 10.1016/j.jaci.2019.11.040. Epub 2020 Jan 23.
Very few studies have examined the association between long-term outdoor air pollution and rhinitis severity in adults.
We sought to assess the cross-sectional association between individual long-term exposure to air pollution and severity of rhinitis.
Participants with rhinitis from 2 multicenter European cohorts (Epidemiological Study on the Genetics and Environment on Asthma and the European Community Respiratory Health Survey) were included. Annual exposure to NO, PM, PM, and PM (calculated by subtracting PM from PM) was estimated using land-use regression models derived from the European Study of Cohorts for Air Pollution Effects project, at the participants' residential address. The score of rhinitis severity (range, 0-12), based on intensity of disturbance due to symptoms reported by questionnaire, was categorized into low (reference), mild, moderate, and high severity. Polytomous logistic regression models with a random intercept for city were used.
A total of 1408 adults with rhinitis (mean age, 52 years; 46% men, 81% from the European Community Respiratory Health Survey) were included. The median (1st quartile-3rd quartile) score of rhinitis severity was 4 (2-6). Higher exposure to PM was associated with higher rhinitis severity (adjusted odds ratio [95% CI] for a 10 μg/m increase in PM: for mild: 1.20 [0.88-1.64], moderate: 1.53 [1.07-2.19], and high severity: 1.72 [1.23-2.41]). Similar results were found for PM. Higher exposure to NO was associated with an increased severity of rhinitis, with similar adjusted odds ratios whatever the level of severity. Adjusted odds ratios were higher among participants without allergic sensitization than among those with, but interaction was found only for NO CONCLUSIONS: People with rhinitis who live in areas with higher levels of pollution are more likely to report more severe nasal symptoms. Further work is required to elucidate the mechanisms of this association.
很少有研究探讨长期户外空气污染与成年人鼻炎严重程度之间的关系。
我们旨在评估个体长期暴露于空气污染与鼻炎严重程度之间的横断面关系。
纳入来自 2 个多中心欧洲队列（哮喘遗传学和环境研究以及欧洲社区呼吸健康调查）的鼻炎患者。使用来源于欧洲空气污染效应研究队列项目的土地利用回归模型，估算参与者居住地址处的每年氮氧化物（NO）、颗粒物（PM）、细颗粒物（PM）和粗颗粒物（PM）暴露量（通过从 PM 中减去 PM 来计算）。根据问卷报告的症状干扰程度，将鼻炎严重程度评分（范围 0-12）分为低（参考）、轻度、中度和高度严重程度。采用带有城市随机截距的多分类逻辑回归模型。
共纳入 1408 例鼻炎患者（平均年龄 52 岁；46%为男性，81%来自欧洲社区呼吸健康调查）。鼻炎严重程度评分中位数（1 四分位数-3 四分位数）为 4（2-6）。PM 暴露量较高与鼻炎严重程度较高相关（PM 每增加 10μg/m 的调整比值比[95%置信区间]：轻度：1.20[0.88-1.64]，中度：1.53[1.07-2.19]，高度：1.72[1.23-2.41]）。对于 PM，也发现了类似的结果。NO 暴露量较高与鼻炎严重程度增加相关，无论严重程度如何，调整后的比值比相似。在无过敏敏感的参与者中，调整后的比值比高于有过敏敏感的参与者，但仅发现了与 NO 的交互作用。
生活在污染水平较高地区的鼻炎患者更有可能报告更严重的鼻部症状。需要进一步研究阐明这种关联的机制。
