Department of Psychology, University of California, 1285 Psychology Building, Box 951563, Los Angeles, CA, 90095-1563, USA.
Department of Human Development and Family Studies, The Pennsylvania State University, 216 Health and Human Development Building, University Park, PA, 16802, USA.
Int J Behav Med. 2023 Jun;30(3):398-408. doi: 10.1007/s12529-022-10103-8. Epub 2022 Jun 2.
Outdoor air pollution, including ozone (O) pollution, and childhood family environments may interact and impact asthma exacerbations in children. Previous epidemiology studies have primarily focused on stress in the home, rather than support, and whether psychosocial factors modify the association between pollution and health outcomes, rather than whether pollution exposure modifies associations between psychosocial factors and health outcomes.
Data from the cross-sectional 2003 representative, population-based California Health Interview Survey were linked with air quality monitoring data on O pollution from the California Air Resources Board. Adolescents (N = 209) ages 12-17 who reported an asthma diagnosis and lived within 5 mi of the nearest air monitoring station had linked O data for a 12-month period preceding the survey interview date. Adolescents reported perceived available support from an adult at home and frequency of asthma symptoms.
In unadjusted models, for adolescents living in high O pollution regions, greater perceived support was related to lower asthma symptom frequency. Follow-up analyses suggested that the most plausible interpretation of the interaction was that O exposure modified the association between perceived support and symptom frequency. O × perceived support interactions were not statistically significant after adjusting for covariates.
These data provide preliminary evidence that the association between the lack of support in the home environment and worse asthma symptoms may be stronger in areas with higher O exposure. Future work may benefit from incorporating personal pollution exposure assessments, comprehensive family environment assessments, and longitudinal follow-up of asthma exacerbations over time.
室外空气污染，包括臭氧（O）污染，以及儿童家庭环境可能相互作用并影响儿童哮喘发作。以前的流行病学研究主要集中在家庭中的压力，而不是支持，以及心理社会因素是否改变了污染与健康结果之间的关系，而不是污染暴露是否改变了心理社会因素与健康结果之间的关系。
2003 年具有代表性的、基于人群的加利福尼亚健康访谈调查的横断面数据与加利福尼亚空气资源委员会的臭氧污染空气质量监测数据相联系。报告有哮喘诊断且居住在最近空气监测站 5 英里范围内的 12-17 岁青少年（N=209），在调查访谈日期之前的 12 个月内有与 O 相关的链接数据。青少年报告了在家里感受到的成人的支持程度和哮喘症状的发生频率。
在未调整的模型中，对于生活在高 O 污染地区的青少年来说，感知到的支持越多，哮喘症状的发生频率越低。后续分析表明，交互作用最合理的解释是 O 暴露改变了感知支持与症状频率之间的关联。调整协变量后，O×感知支持的交互作用不再具有统计学意义。
这些数据初步表明，家庭环境中缺乏支持与更严重的哮喘症状之间的关联可能在 O 暴露较高的地区更强。未来的研究可能受益于纳入个人污染暴露评估、全面的家庭环境评估以及随着时间的推移对哮喘发作的纵向随访。
