School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Environmental Epidemiology of Lung, Brain and Skin Aging, Leibniz Research Institute for Environmental Medicine, Dusseldorf, Nordrhein-Westfalen, Germany.
BMJ Open Respir Res. 2020 Mar;7(1). doi: 10.1136/bmjresp-2019-000549.
Air pollution is a risk factor for chronic obstructive pulmonary disease (COPD). Fraction of exhaled nitric oxide (FeNO) could be a useful biomarker for health effects of air pollutants. However, there were limited data from older populations with higher prevalence of COPD and other inflammatory conditions.
We obtained data from the German Study on the influence of Air pollution on Lung function, Inflammation and Ageing. Spirometry and FeNO were measured by standard techniques. Air pollutant exposures were estimated following the European Study of Cohorts for Air Pollution Effects protocols, and ozone (O) measured at the closest ground level monitoring station. Multiple linear regression models were fitted to FeNO with each pollutant separately and adjusted for potential confounders.
In 236 women (mean age 74.6 years), geometric mean FeNO was 15.2ppb. Almost a third (n=71, 30.1%) of the women had some chronic inflammatory respiratory condition. A higher FeNO concentration was associated with exposures to fine particles (PM), PM and respirable particles (PM). There were no significant associations with PM, NO, NO, O or length of major roads within a 1 km buffer. Restricting the analysis to participants with a chronic inflammatory respiratory condition, with or without impaired lung function produced similar findings. Adjusting for diabetes did not materially alter the findings. There were no significant interactions between individual pollutants and asthma or current smoking.
This study adds to the evidence to reduce ambient PM concentrations as low as possible to protect the health of the general population.
空气污染是慢性阻塞性肺疾病（COPD）的一个风险因素。呼出气一氧化氮（FeNO）分数可能是评估空气污染物对健康影响的有用生物标志物。然而，来自老年人群的数据有限，且这些人群中 COPD 和其他炎症性疾病的患病率较高。
我们从德国空气污染对肺功能、炎症和衰老影响的研究中获取数据。采用标准技术进行肺量测定和呼出气一氧化氮检测。根据欧洲空气污染影响队列研究方案，估算空气污染物暴露情况，并在最近的地面监测站测量臭氧（O）。采用多元线性回归模型，分别用每个污染物对 FeNO 进行拟合，并调整潜在混杂因素。
在 236 名女性（平均年龄 74.6 岁）中，FeNO 的几何均数为 15.2ppb。近三分之一（n=71，30.1%）的女性患有某种慢性炎症性呼吸道疾病。较高的 FeNO 浓度与细颗粒物（PM）、PM 和可吸入颗粒物（PM）暴露有关。与 PM、NO、NO、O 或 1km 缓冲区范围内的主要道路长度均无显著相关性。将分析限制在患有慢性炎症性呼吸道疾病的参与者，无论其肺功能是否受损，均得出了类似的结果。调整糖尿病因素后，结果并未发生实质性改变。在个体污染物与哮喘或当前吸烟之间未发现显著的交互作用。
本研究进一步证明，为了保护普通人群的健康，应尽可能降低环境中 PM 的浓度。
