氡衰变产物的粒子放射性与慢性阻塞性肺疾病患者肺功能下降。
Particle radioactivity from radon decay products and reduced pulmonary function among chronic obstructive pulmonary disease patients.
机构信息
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
出版信息
Environ Res. 2023 Jan 1;216(Pt 1):114492. doi: 10.1016/j.envres.2022.114492. Epub 2022 Oct 6.
BACKGROUND
Radon (Rn) decay products can attach to particles in the air, be inhaled, and potentially cause airway damage.
RESEARCH QUESTION
Is short-term exposure to particle radioactivity (PR) attributable to radon decay products emitted from particulate matter ≤2.5 μm in diameter (PM) associated with pulmonary function in chronic obstructive pulmonary disease (COPD) patients?
STUDY DESIGN AND METHODS
In this cohort study, 142 elderly, predominantly male patients with COPD from Eastern Massachusetts each had up to 4 one-week long seasonal assessments of indoor (home) and ambient (central site) PR and PM over the course of a year (467 assessments). Ambient and indoor PR were measured as α-activity on archived PM filter samples. Ratios of indoor/ambient PR were calculated, with higher ratios representing PR from an indoor source of radon decay. We also considered a measure of outside air infiltration that could dilute the concentrations of indoor radon decay products, the indoor/ambient ratio of sulfur concentrations in PM filter samples. Spirometry pre- and post-bronchodilator (BD) forced expiratory volume in 1 s (FEV) and forced vital capacity (FVC) were conducted following sampling. Generalized additive mixed models were adjusted for meteorologic variables, seasonality, and individual-level determinants of pulmonary function. We additionally adjusted for indoor PM and black carbon (BC).
RESULTS
PR exposure metrics indicating radon decay product exposure from an indoor source were associated with a reduction in FEV and FVC. Patients in homes with high indoor PR (≥median) and low air infiltration (<median) compared to others had a -26.9 (95% CI: -61.4, 7.7) mL and -75.4 (95% CI: -128.6, -22.2) mL reduction in post-BD FEV and FVC, respectively. These associations remained similar after PM and BC adjustment.
INTERPRETATION
Our findings raise concern about the harmful effects of PR exposures attributable to residential radon on pulmonary function in patients with COPD.
背景
氡（Rn）衰变产物可附着在空气中的颗粒上，被吸入体内，并可能导致气道损伤。
研究问题
直径≤2.5μm 的颗粒物（PM）中释放的氡衰变产物产生的短期颗粒放射性（PR）暴露是否与慢性阻塞性肺疾病（COPD）患者的肺功能有关？
研究设计和方法
在这项队列研究中，来自马萨诸塞州东部的 142 名老年、以男性为主的 COPD 患者，在一年的时间里，每个患者接受了最多 4 次为期一周的室内（家庭）和环境（中心地点）PR 和 PM 的季节性评估（共 467 次评估）。环境和室内 PR 是通过对存档的 PM 滤膜样本进行α-活性测量来测量的。计算了室内/环境 PR 的比值，比值较高代表来自室内氡衰变的 PR。我们还考虑了一种可能稀释室内氡衰变产物浓度的室外空气渗透测量值，即 PM 滤膜样本中硫浓度的室内/环境比值。采样后进行支气管扩张剂（BD）前后的肺活量计（FEV）和用力肺活量（FVC）预-和后-测定。广义加性混合模型调整了气象变量、季节性和肺功能个体决定因素。我们还调整了室内 PM 和黑碳（BC）。
结果
表明来自室内源的氡衰变产物暴露的 PR 暴露指标与 FEV 和 FVC 降低有关。与其他患者相比，家中 PR 水平较高（≥中位数）且空气渗透水平较低（<中位数）的患者，BD 后 FEV 和 FVC 分别减少了-26.9（95%CI：-61.4，7.7）mL 和-75.4（95%CI：-128.6，-22.2）mL。在调整 PM 和 BC 后，这些关联仍然相似。
结论
我们的研究结果令人担忧，因为住宅氡导致的 PR 暴露对 COPD 患者的肺功能可能产生有害影响。
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