Zhou Pei-En, Qian Zhengmin Min, McMillin Stephen Edward, Vaughn Michael G, Xie Zhong-Yue, Xu Yu-Jie, Lin Li-Zi, Hu Li-Wen, Yang Bo-Yi, Zeng Xiao-Wen, Zhang Wang-Jian, Liu Ru-Qing, Chen Gongbo, Dong Guang-Hui
Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO 63104, USA.
Toxics. 2021 Sep 14;9(9):221. doi: 10.3390/toxics9090221.
Numerous studies have demonstrated that exposure to ambient ozone (O) could have adverse effects on children's respiratory health. However, previous studies mainly focused on asthma and wheezing. Evidence for allergic rhinitis and bronchitic symptoms (e.g., persistent cough and phlegm) associated with O is limited, and results from existing studies are inconsistent. This study included a total of 59,754 children from the seven northeastern cities study (SNEC), who were aged 2 to 17 years and from 94 kindergarten, elementary and middle schools. Information on doctor-diagnosed allergic rhinitis (AR), persistent cough, and persistent phlegm was collected during 2012-2013 using a standardized questionnaire developed by the American Thoracic Society (ATS). Information for potential confounders was also collected via questionnaire. Individuals' exposure to ambient ozone (O) during the four years before the investigation was estimated using a satellite-based random forest model. A higher level of O was significantly associated with increased risk of AR and bronchitic symptoms. After controlling for potential confounders, the OR (95% CI) were 1.13 (1.07-1.18), 1.10 (1.06-1.16), and 1.12 (1.05-1.20) for AR, persistent cough, and persistent phlegm, respectively, associated with each interquartile range (IQR) rise in O concentration. Interaction analyses showed stronger adverse effects of O on AR in children aged 7-17 years than those aged 2-6 years, while the adverse association of O with cough was more prominent in females and children aged 7-12 years than in males and children aged 2-6 and 13-17 years. This study showed that long-term exposure to ambient O was significantly associated with higher risk of AR and bronchitic symptoms in children, and the association varies across age and gender. Our findings contribute additional evidence for the importance of controlling O pollution and protecting children from O exposure.
大量研究表明，暴露于环境臭氧（O）中可能会对儿童的呼吸健康产生不利影响。然而，以往的研究主要集中在哮喘和喘息方面。与臭氧相关的过敏性鼻炎和支气管炎症状（如持续咳嗽和咳痰）的证据有限，现有研究结果也不一致。本研究共纳入了来自东北七城市研究（SNEC）的59754名儿童，他们年龄在2至17岁之间，来自94所幼儿园、小学和中学。2012年至2013年期间，使用美国胸科学会（ATS）制定的标准化问卷收集了医生诊断的过敏性鼻炎（AR）、持续咳嗽和持续咳痰的信息。还通过问卷收集了潜在混杂因素的信息。使用基于卫星的随机森林模型估算了调查前四年个体暴露于环境臭氧（O）的情况。较高水平的臭氧与AR和支气管炎症状风险增加显著相关。在控制潜在混杂因素后，与臭氧浓度每升高一个四分位数间距（IQR）相关的AR、持续咳嗽和持续咳痰的OR（95%CI）分别为1.13（1.07 - 1.18）、1.10（1.06 - 1.16）和1.12（1.05 - 1.20）。交互分析显示，臭氧对7至17岁儿童的AR的不利影响比对2至6岁儿童更强，而臭氧与咳嗽的不利关联在女性和7至12岁儿童中比在男性以及2至6岁和13至17岁儿童中更为突出。本研究表明，长期暴露于环境臭氧与儿童患AR和支气管炎症状的较高风险显著相关，且这种关联因年龄和性别而异。我们的研究结果为控制臭氧污染以及保护儿童免受臭氧暴露的重要性提供了更多证据。
