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急性温度和空气污染暴露对成人肺功能的影响:哮喘患者的队列研究。

Impact of acute temperature and air pollution exposures on adult lung function: A panel study of asthmatics.

机构信息

College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, United States of America.

Superfund Research Program, Oregon State University, Corvallis, Oregon, United States of America.

出版信息

PLoS One. 2022 Jun 28;17(6):e0270412. doi: 10.1371/journal.pone.0270412. eCollection 2022.

Abstract

BACKGROUND

Individuals with respiratory conditions, such as asthma, are particularly susceptible to adverse health effects associated with higher levels of ambient air pollution and temperature. This study evaluates whether hourly levels of fine particulate matter (PM2.5) and dry bulb globe temperature (DBGT) are associated with the lung function of adult participants with asthma.

METHODS AND FINDINGS

Global positioning system (GPS) location, respiratory function (measured as forced expiratory volume at 1 second (FEV1)), and self-reports of asthma medication usage and symptoms were collected as part of the Exposure, Location, and Lung Function (ELF) study. Hourly ambient PM2.5 and DBGT exposures were estimated by integrating air quality and temperature public records with time-activity patterns using GPS coordinates for each participant (n = 35). The relationships between acute PM2.5, DBGT, rescue bronchodilator use, and lung function collected in one week periods and over two seasons (summer/winter) were analyzed by multivariate regression, using different exposure time frames. In separate models, increasing levels in PM2.5, but not DBGT, were associated with rescue bronchodilator use. Conversely DBGT, but not PM2.5, had a significant association with FEV1. When DBGT and PM2.5 exposures were placed in the same model, the strongest association between cumulative PM2.5 exposures and the use of rescue bronchodilator was identified at the 0-24 hours (OR = 1.030; 95% CI = 1.012-1.049; p-value = 0.001) and 0-48 hours (OR = 1.030; 95% CI = 1.013-1.057; p-value = 0.001) prior to lung function measure. Conversely, DBGT exposure at 0 hours (β = 3.257; SE = 0.879; p-value>0.001) and 0-6 hours (β = 2.885; SE = 0.903; p-value = 0.001) hours before a reading were associated with FEV1. No significant interactions between DBGT and PM2.5 were observed for rescue bronchodilator use or FEV1.

CONCLUSIONS

Short-term increases in PM2.5 were associated with increased rescue bronchodilator use, while DBGT was associated with higher lung function (i.e. FEV1). Further studies are needed to continue to elucidate the mechanisms of acute exposure to PM2.5 and DBGT on lung function in asthmatics.

摘要

背景

患有哮喘等呼吸道疾病的个体特别容易受到较高水平的环境空气污染和温度的不利健康影响。本研究评估了细颗粒物(PM2.5)和干球温度(DBGT)的每小时水平是否与成年哮喘患者的肺功能有关。

方法和发现

全球定位系统(GPS)位置、呼吸功能(以 1 秒用力呼气量(FEV1)衡量)以及哮喘药物使用和症状的自我报告作为暴露、位置和肺功能(ELF)研究的一部分进行了收集。通过将空气质量和温度公共记录与使用 GPS 坐标的每个参与者的时间活动模式相结合,估算了每小时的环境 PM2.5 和 DBGT 暴露(n=35)。通过多元回归分析了在一周内和两个季节(夏季/冬季)收集的急性 PM2.5、DBGT、急救支气管扩张剂使用与肺功能之间的关系,使用了不同的暴露时间框架。在单独的模型中,PM2.5 水平的升高与急救支气管扩张剂的使用有关,但 DBGT 水平的升高与 FEV1 无关。当将 DBGT 和 PM2.5 暴露置于同一模型中时,发现 PM2.5 累积暴露与急救支气管扩张剂使用之间的最强关联发生在 0-24 小时(OR=1.030;95%CI=1.012-1.049;p 值=0.001)和 0-48 小时(OR=1.030;95%CI=1.013-1.057;p 值=0.001)。相反,在测量肺功能之前,DBGT 在 0 小时(β=3.257;SE=0.879;p 值>0.001)和 0-6 小时(β=2.885;SE=0.903;p 值=0.001)时的暴露与 FEV1 有关。在急救支气管扩张剂使用或 FEV1 方面,未观察到 DBGT 和 PM2.5 之间的显著相互作用。

结论

PM2.5 的短期增加与急救支气管扩张剂的使用增加有关,而 DBGT 与更高的肺功能(即 FEV1)有关。需要进一步的研究来继续阐明急性暴露于 PM2.5 和 DBGT 对哮喘患者肺功能的影响机制。

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