早期暴露于 PM 成分与儿童哮喘和喘息：来自中国儿童家庭健康研究的发现。
Early-life exposure to PM constituents and childhood asthma and wheezing: Findings from China, Children, Homes, Health study.
机构信息
School of Public Health, Wuhan University of Science and Technology, Wuhan, China.
School of Public Health, Fudan University, Shanghai, China.
出版信息
Environ Int. 2022 Jul;165:107297. doi: 10.1016/j.envint.2022.107297. Epub 2022 May 15.
BACKGROUND
Emerging evidence suggests that early-life (in-utero and first-year since birth) exposure to ambient PM is a risk factor for asthma onset and exacerbation among children, while the hazards caused by PM compositions remain largely unknown.
OBJECTIVE
To examine potential associations of early-life exposures to PM mass and its major chemical constituents with childhood asthma and wheezing.
METHODS
By conducting the Phase II of the China, Children, Homes, Health study, we investigated 30,325 preschool children aged 3-6 years during 2019-2020 in mainland China. Early-life exposure to PM mass and its constituents (i.e., black carbon [BC], organic matter [OM], nitrate, ammonium, sulfate) were calculated based on monthly estimates at a 1 km × 1 km resolution from satellite-based models. We adopted a novel quantile-based g-computation approach to assess the effect of a mixture of PM constituents on childhood asthma/wheezing.
RESULTS
The average PM concentrations during in-utero and the first year since birth were 64.7 ± 10.6 and 61.8 ± 10.5 µg/m, respectively. Early-life exposures to a mixture of major PM constituents were significantly associated with increased risks of asthma and wheezing, while no evident compositions-wheezing associations were found in the first year. Each quintile increases in all five PM components exposures in utero was accordingly associated with an odds ratio of 1.18 [95% confidence interval: 1.07-1.29] for asthma and 1.08 [1.01-1.16] for wheezing. BC, OM and SO contributed more to risks of asthma and wheezing than the other PM constituents during early life, wherein the effects of BC were only observed during pregnancy. Sex subgroup analyses suggested stronger associations among girls of first-year exposures to PM components with childhood asthma.
CONCLUSION
Early-life exposures to ambient PM, particularly compositions of BC, OM and SO, are associated with an increased risk of childhood asthma.
背景
新出现的证据表明，儿童生命早期（宫内和出生后第一年）暴露于环境 PM 是哮喘发病和加重的危险因素，而 PM 成分造成的危害在很大程度上尚不清楚。
目的
研究生命早期暴露于 PM 质量及其主要化学成分与儿童哮喘和喘息的潜在关联。
方法
通过开展中国儿童家庭健康研究（China, Children, Homes, Health study）第二阶段研究，我们于 2019-2020 年期间调查了中国大陆 30325 名 3-6 岁学龄前儿童。基于卫星模型估算的 1km×1km 分辨率的月度数据，计算生命早期 PM 质量及其成分（即黑碳 [BC]、有机物 [OM]、硝酸盐、铵、硫酸盐）的暴露量。我们采用一种新的基于分位数的 g 计算方法来评估 PM 成分混合物对儿童哮喘/喘息的影响。
结果
宫内和出生后第一年的平均 PM 浓度分别为 64.7±10.6 和 61.8±10.5µg/m。生命早期暴露于主要 PM 成分混合物与哮喘和喘息的风险增加显著相关，而在出生后的第一年并未发现明显的成分-喘息关联。与宫内五成分暴露量最低 quintile 相比，各 quintile 增加与哮喘的比值比（OR）分别为 1.18（95%置信区间 [CI]：1.07-1.29）和 1.08（95%CI：1.01-1.16）。BC、OM 和 SO 在生命早期对哮喘和喘息的风险贡献大于其他 PM 成分，而 BC 的影响仅在妊娠期观察到。性别亚组分析表明，女孩在出生后第一年对 PM 成分的暴露与儿童哮喘的关联更强。
结论
生命早期暴露于环境 PM，尤其是 BC、OM 和 SO 的成分，与儿童哮喘的风险增加有关。
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