Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, 430071, PR China.
Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, 430071, PR China.
Environ Res. 2020 Dec;191:110145. doi: 10.1016/j.envres.2020.110145. Epub 2020 Aug 30.
Perfluoroalkyl substances (PFASs) are persistent organic pollutants and widespread throughout the environment. Although exposure to PFASs may contribute to the development of allergic diseases in children, evidence about this association remains inconclusive.
To conduct a systematic review and meta-analysis to assess the association between PFASs exposure and allergic diseases in children based on current evidence.
The databases including PubMed, EMBASE, and Web of Science were searched to identify all observational studies that examined the association between PFASs exposure and the risk of childhood allergic diseases. The Newcastle-Ottawa Scale was used to evaluate the quality of case-crossover studies, and a previously validated quality assessment framework was used for observational studies lacking control groups. Random-effects meta-analysis models were applied to pool odds ratio (OR) with 95% confidence intervals (CIs).
From an initial 94 articles (after duplicate removal), 13 studies through full-text assessment were included for quantitative assessment and descriptive synthesis. They are ten cohort studies, two cross-sectional studies, and one case-control study. The pooled estimates showed that perfluorononanoic acid (PFNA) was associated with eczema (OR = 0.89, 95% CI = 0.80-0.99), perfluorooctanesulfonic acid (PFOS) with atopic dermatitis (OR = 1.26, 95% CI = 1.01-1.58), and perfluorooctanoic acid (PFOA) with allergic rhinitis (OR = 1.33, 95% CI = 1.13-1.56). However, no such significant associations were found for wheeze and asthma.
The meta-analysis results suggest that PFASs exposure could potentially be associated with eczema, atopic dermatitis, and allergic rhinitis during childhood, but not with childhood asthma or wheeze. Future studies are needed to verify these findings.
全氟烷基物质（PFASs）是持久性有机污染物，广泛存在于环境中。尽管接触 PFASs 可能会导致儿童患上过敏性疾病，但这方面的证据仍不确定。
基于现有证据，对全氟烷基物质暴露与儿童过敏性疾病之间的关系进行系统评价和荟萃分析。
检索包括 PubMed、EMBASE 和 Web of Science 在内的数据库，以确定所有观察性研究，这些研究检查了 PFASs 暴露与儿童过敏性疾病风险之间的关系。使用纽卡斯尔-渥太华量表（Newcastle-Ottawa Scale）评估病例交叉研究的质量，并且对于缺乏对照组的观察性研究，使用先前验证的质量评估框架。应用随机效应荟萃分析模型来汇总比值比（OR）及其 95%置信区间（CI）。
从最初的 94 篇文章（去除重复项后）中，通过全文评估有 13 项研究被纳入进行定量评估和描述性综合分析。这些研究包括 10 项队列研究、2 项横断面研究和 1 项病例对照研究。汇总估计结果显示，全氟壬酸（PFNA）与湿疹有关（OR=0.89，95%CI=0.80-0.99），全氟辛烷磺酸（PFOS）与特应性皮炎有关（OR=1.26，95%CI=1.01-1.58），全氟辛酸（PFOA）与过敏性鼻炎有关（OR=1.33，95%CI=1.13-1.56）。然而，对于喘息和哮喘，并没有发现这种显著的相关性。
荟萃分析结果表明，PFASs 暴露可能与儿童时期的湿疹、特应性皮炎和过敏性鼻炎有关，但与儿童哮喘或喘息无关。需要进一步的研究来验证这些发现。
