Department of Otolaryngology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, 1678 Dongfang Rd, Pudong, Shanghai, 200127, China.
Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, 1678 Dongfang Rd, Pudong, Shanghai, 200127, China.
Respir Res. 2022 Mar 5;23(1):48. doi: 10.1186/s12931-022-01967-1.
The prevalence of allergic respiratory disease (ARD) is increasing worldwide during the last few decades, causing a great disease burden especially for children. Air pollution has been increasingly considered as a potential contributor to this trend, but its role in ARD induced by house dust mite (HDM-ARD) remains unclear, especially in time-series study.
A positive reporting of respiratory allergy to named allergens was included by serum specific IgE testing. A time series Quasi-Poisson regression with distributed lag non-linear model, combined with generalized linear model was used to examine the effects of air pollutants on ARD, HDM-ARD and ARD induced by non-house dust mite (NHDM-ARD).
A total of 16,249 cases of ARD, including 8,719 HDM-ARD and 8,070 NHDM-ARD from 1 Jan 2013 to 31 Dec 2017 were involved in this study. Air pollutants were significantly associated with clinical visits for childhood ARD and HDM-ARD. Exposure to higher O and interquartile range (IQR) increment in O (40.6 µg/m) increased the risks of clinical visits for childhood HDM-ARD (RR for the 95th percentile of O: 1.26, 95% confidence interval (CI): 1.03, 1.55; RR for IQR increment (40.6 µg/m): 1.09, 95% CI: 1.01, 1.17) and ARD (RR for the 95th percentile of O: 1.19, 95% CI: 1.03, 1.38; RR for IQR increment (40.6 µg/m): 1.06, 95% CI: 1.01, 1.12). In addition, higher O was associated with increased RR of boys with ARD (RR for the 95th percentile: 1.26, 95% CI: 1.05, 1.51; RR for IQR increment (40.6 µg/m): 1.09, 95% CI: 1.02, 1.16) and HDM-ARD (RR for the 95th percentile: 1.36, 95% CI: 1.06, 1.75; RR for IQR increment (40.6 µg/m): 1.11, 95% CI: 1.02, 1.22), but not in girls.
Exposure to O appeared to be a trigger of clinical visits for childhood ARD, especially for HDM-ARD and boys. These findings provide novel evidence on the impact of air pollution on HDM-ARD, which may have significant implications for designing effective intervention programs to control and prevent childhood ARD, especially HDM-ARD, in China and other similar developing countries.
在过去几十年中，全球范围内过敏呼吸道疾病（ARD）的患病率不断增加，给儿童带来了巨大的疾病负担。空气污染已被越来越多地认为是导致这种趋势的一个潜在因素，但它在屋尘螨（HDM-ARD）引起的 ARD 中的作用仍不清楚，特别是在时间序列研究中。
通过血清特异性 IgE 检测，包括对已知过敏原的呼吸道过敏的阳性报告。采用具有分布滞后非线性模型的准泊松回归与广义线性模型相结合的方法，研究了空气污染物对 ARD、HDM-ARD 和非屋尘螨（NHDM-ARD）引起的 ARD 的影响。
本研究共纳入了 2013 年 1 月 1 日至 2017 年 12 月 31 日期间的 16249 例 ARD 病例，其中包括 8719 例 HDM-ARD 和 8070 例 NHDM-ARD。空气污染物与儿童 ARD 和 HDM-ARD 的就诊次数显著相关。暴露于较高的 O3 和 O3 浓度的四分位距（IQR）增量（40.6μg/m3）增加了儿童患 HDM-ARD（O3 第 95 百分位数的 RR：1.26，95%置信区间（CI）：1.03，1.55；O3 浓度增量（40.6μg/m3）的 RR：1.09，95%CI：1.01，1.17）和 ARD（O3 第 95 百分位数的 RR：1.19，95%CI：1.03，1.38；O3 浓度增量（40.6μg/m3）的 RR：1.06，95%CI：1.01，1.12）的风险。此外，较高的 O3 与男孩患 ARD（O3 第 95 百分位数的 RR：1.26，95%CI：1.05，1.51；O3 浓度增量（40.6μg/m3）的 RR：1.09，95%CI：1.02，1.16）和 HDM-ARD（O3 第 95 百分位数的 RR：1.36，95%CI：1.06，1.75；O3 浓度增量（40.6μg/m3）的 RR：1.11，95%CI：1.02，1.22）的 RR 增加有关，但在女孩中没有。
暴露于 O3 似乎是儿童 ARD 就诊的一个触发因素，尤其是对 HDM-ARD 和男孩。这些发现为空气污染对 HDM-ARD 的影响提供了新的证据，这可能对制定有效的干预计划以控制和预防中国和其他类似发展中国家的儿童 ARD，特别是 HDM-ARD，具有重要意义。
