Department of Environmental Health, School of Public Health, Fudan University, Shanghai, 200032, China.
Shanghai Municipal Center for Disease Control & Prevention, Shanghai, China.
Environ Pollut. 2021 Feb 15;271:116329. doi: 10.1016/j.envpol.2020.116329. Epub 2020 Dec 17.
Limited data were on the acute respiratory responses in the elderly in response to personal exposure of particulate matter (PM). In order to evaluate the changes of airway inflammation and pulmonary functions in the elderly in response to individual exposure of particles (PM, PM and PM), we analyzed 43 elderly subjects with either asthma, chronic obstructive pulmonary disease (COPD) or Asthma COPD Overlap (ACO) and 40 age-matched subjects without asthma nor COPD in an urban community in Shanghai, China. Data were collected at the baseline and in 6 follow-ups from August 2016 to December 2018, once every 3 months except for the last twice with a 6-month interval. In each follow-up, pulmonary functions, fractional exhaled nitric oxide (FeNO), 7-day continuous personal exposure to airborne particles were measured. Multivariate linear mixed effect regression models were applied to investigate the quantitative changes of pulmonary functions and FeNO in two respective groups. The results showed that on average 4.7 follow-up visits were completed in each participant. In subjects with CRDs, an inter-quartile range (IQR) increase of personal exposure to PM, PM and PM was significantly associated with an average increase of FeNO(Lag1) of 6.7 ppb (95%CI 1.2, 9.9 ppb), 6.2 ppb (95%CI 1.5, 12.0 ppb) and 5.6 ppb (95%CI 1.5, 11.0 ppb), respectively, and an average decrease of FEV1(Lag2) of -3.6 L (95%CI -6.0, -1.1 L), -3.6 L (95%CI -6.4, -0.8 L) and -3.2 L (95%CI -5.8, -0.6 L), respectively, in the single-pollutant model. These associations remained consistent in the two-pollutant models adjusting for gaseous air pollutants. Stratified analysis showed that subjects with lower BMI, females and non-allergies were more sensitive to particle exposure. No robust significant effects were observed in the subjects without CRDs. Our study provided data on the susceptibility of the elderly with CRDs to particle exposure of PM and PM, and the modification effects by BMI, gender and history of allergies.
针对老年人因个人暴露于颗粒物（PM）而导致的急性呼吸道反应，相关数据十分有限。为了评估老年人因个体暴露于颗粒物质（PM、PM 和 PM）而导致的气道炎症和肺功能的变化，我们在中国上海的一个城市社区中，分析了 43 名患有哮喘、慢性阻塞性肺疾病（COPD）或哮喘-COPD 重叠综合征（ACO）的老年患者和 40 名年龄匹配、无哮喘和 COPD 的对照者的数据。这些数据收集自 2016 年 8 月至 2018 年 12 月的 6 次随访，每 3 个月一次，除最后两次随访间隔为 6 个月。在每次随访中，均测量了肺功能、呼出气一氧化氮分数（FeNO）和 7 天连续个人暴露于空气中的颗粒物。采用多变量线性混合效应回归模型来研究两组患者肺功能和 FeNO 的定量变化。结果表明，每位参与者平均完成了 4.7 次随访。在患有 CRD 的患者中，个人暴露于 PM、PM 和 PM 的四分位间距（IQR）增加与 FeNO（Lag1）的平均增加分别为 6.7 ppb（95%CI 1.2，9.9 ppb）、6.2 ppb（95%CI 1.5，12.0 ppb）和 5.6 ppb（95%CI 1.5，11.0 ppb）有关，与 FEV1（Lag2）的平均降低分别为-3.6 L（95%CI -6.0，-1.1 L）、-3.6 L（95%CI -6.4，-0.8 L）和-3.2 L（95%CI -5.8，-0.6 L）有关，这些关联在单污染物模型中保持一致，并在调整了气态空气污染物的双污染物模型中仍然一致。分层分析表明，BMI 较低、女性和非过敏患者对颗粒物质暴露更为敏感。在无 CRD 的患者中，未观察到稳健的显著影响。本研究提供了有关 CRD 老年人对 PM 和 PM 颗粒物质暴露的易感性数据，以及 BMI、性别和过敏史的修饰作用。
