Department of Public Health, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan; Center for Environmental Information Science, 3-2-7 Kudan-minami, Chiyoda-ku, Tokyo, 102-0074, Japan.
Department of Preventive Medicine and Public Health, School of Medicine, Keio University, 35 Shinanomachi, Sinjyuku-ku, Tokyo 160-8582, Japan.
Sci Total Environ. 2021 Jan 20;753:141585. doi: 10.1016/j.scitotenv.2020.141585. Epub 2020 Aug 18.
There has been little study on the effect of Asian dust exposure on respiratory symptoms among children who are vulnerable to environmental factors. In this panel study, we investigated the effect of Asian dust on respiratory symptoms among children with and without asthma, and their sensitivity. Children attending two elementary schools (137 total), and 23 children with asthma from cooperating medical institutions in Fukuoka prefecture were recruited. Subjects measured peak expiratory flow rate (PEF), and recorded asthma-like symptoms, cough, nasal symptoms and use of medication in a diary from April 1, 2013 to June 30, 2013. To assess exposure to Asian dust, we used Light Detection and Ranging (LIDAR) data. For the analysis of the association between Asian dust and respiratory symptoms, the case-crossover design and generalized estimating equation (GEE) models were used. Taking individual sensitivity to respiratory aggravation into consideration, the subjects were classified into three groups: children without asthma, children with asthma who do not use long-term preventive medication (CA) and children with asthma who use long-term preventive medication (CA-LTM). For CA, Asian dust exposure was significantly associated with asthma-like symptoms, with a hazard ratio of 5.17 (95%CI: 1.02=26.12) at Lag0, and the change in %maxPEF, -1.65% (95%CI:-2.82, -0.48) at Lag0. For children without asthma, a statistically significant association was found between Asian dust exposure and the change in %maxPEF, -0.56% (95%CI: -1.31, -0.08) at Lag1. However, no adverse effects were observed in CA-LTM. Temperature had significant effects on %maxPEF for three groups. Asian dust, photochemical oxidant and pollen caused simultaneously additive adverse effects on nasal symptoms for children without asthma. This study suggests the possibility that long-term preventive medication to manage asthma may suppress aggravation of respiratory symptoms due to Asian dust and may be an effective prevention.
针对易受环境因素影响的儿童，有关暴露于亚洲沙尘对其呼吸道症状影响的研究较少。在这项面板研究中，我们调查了亚洲沙尘对患有和未患有哮喘的儿童的呼吸道症状的影响及其敏感性。我们招募了两所小学的 137 名儿童（共 137 名）和来自福冈县合作医疗机构的 23 名哮喘患儿。从 2013 年 4 月 1 日至 2013 年 6 月 30 日，研究对象使用皮托管（PEF）和日记记录哮喘样症状、咳嗽、鼻部症状和药物使用情况。为了评估亚洲沙尘的暴露情况，我们使用了激光雷达（LIDAR）数据。为了分析亚洲沙尘与呼吸道症状之间的关系，我们使用了病例交叉设计和广义估计方程（GEE）模型。考虑到个体对呼吸道恶化的敏感性，将研究对象分为三组：无哮喘的儿童、不使用长期预防药物的哮喘儿童（CA）和使用长期预防药物的哮喘儿童（CA-LTM）。对于 CA，亚洲沙尘暴露与哮喘样症状显著相关，滞后 0 时的危险比为 5.17（95%CI：1.02=26.12），最大呼气峰流速（%maxPEF）的变化为-1.65%（95%CI：-2.82，-0.48）。对于无哮喘的儿童，在滞后 1 时，亚洲沙尘暴露与 %maxPEF 的变化之间存在统计学显著关联，为-0.56%（95%CI：-1.31，-0.08）。然而，在 CA-LTM 中没有观察到不良反应。温度对三组的 %maxPEF 均有显著影响。对于无哮喘的儿童，亚洲沙尘、光化学氧化剂和花粉同时对鼻部症状产生相加的不利影响。本研究表明，长期预防药物治疗哮喘可能抑制亚洲沙尘引起的呼吸道症状恶化，是一种有效的预防措施。
