School of Energy Science and Engineering, Central South University, Changsha 410083, China.
XiangYa School of Public Health, Central South University, Changsha 410078, China.
Environ Res. 2023 Jan 1;216(Pt 3):114713. doi: 10.1016/j.envres.2022.114713. Epub 2022 Nov 5.
The rapid increase of food allergy (FA) has become the "second wave" of allergy epidemic and is now a major global public health concern. Mounting evidence indicates that early life exposure to air pollution is associated with the "first wave" of allergy epidemic (including asthma, allergic rhinitis and eczema) in children, but little is known about its association with FA.
We hypothesize FA has triple exposure pathways, gut-skin-airway, and investigate the effects of airway exposure to outdoor and indoor air pollution on childhood FA.
A cohort study of 2598 preschool children aged 3-6 years old was conducted in Changsha, China. The prevalence of FA was surveyed using a standard questionnaire by International Study of Asthma and Allergies in Childhood (ISAAC). Exposure to indoor air pollution was assessed by four indicators: new furniture, redecoration, mold or dampness, and window condensation. Exposure to outdoor air pollution was evaluated by the concentrations of PM10, SO2 and NO2, which were obtained from the monitored stations. Both prenatal and postnatal exposure windows were considered. The association between exposure to outdoor/indoor air pollution and childhood FA was estimated by multiple logistic regression models using odds ratio (OR) and a 95% confidence interval (CI).
A total of 14.9% children reported FA. The prevalence was significantly associated with exposure to indoor air pollution, OR (95% CI) = 1.93 (1.35-2.75) for prenatal exposure to mold/dampness and 1.49 (1.07-2.10) and 1.41 (1.04-1.89) respectively for postnatal exposure to new furniture and window condensation. The prevalence of FA was also associated with prenatal and postnatal exposure to outdoor air pollution, particularly the traffic-related air pollutant NO2, with adjusted ORs (95% Cls) respectively 1.24 (1.00-1.54) and 1.38 (1.03-1.85) per interquartile range (IQR) increase. Sensitivity analysis showed that the association between outdoor/indoor air pollution and childhood FA was significant only in young children aged 3-4 years.
Early-life exposure to high levels of outdoor and indoor air pollution in China due to the rapid economic growth and fast urbanization in the past decades may contribute to the rapid increase of food allergy (FA) in children. Our study indicates that, in addition to gut and skin, airway may be a new route of food sensitization. Air pollution leads to the first and second waves of allergy epidemics, suggesting a concept of 'one allergy' disease.
食物过敏（FA）的迅速增加已成为过敏流行的“第二波”，目前是一个主要的全球公共卫生关注问题。越来越多的证据表明，儿童早期暴露于空气污染与过敏流行的“第一波”（包括哮喘、过敏性鼻炎和湿疹）有关，但人们对其与 FA 的关系知之甚少。
我们假设 FA 有三条暴露途径，即肠道-皮肤-气道，并研究气道暴露于室外和室内空气污染对儿童 FA 的影响。
在中国长沙，对 2598 名 3-6 岁的学龄前儿童进行了一项队列研究。使用国际儿童哮喘和过敏研究（ISAAC）的标准问卷调查 FA 的患病率。通过四个指标评估室内空气污染：新家具、重新装修、霉菌或潮湿以及窗户冷凝。通过监测站获得 PM10、SO2 和 NO2 的浓度来评估室外空气污染的暴露情况。考虑了产前和产后的暴露窗口。使用优势比（OR）和 95%置信区间（CI）通过多因素逻辑回归模型估计暴露于室外/室内空气污染与儿童 FA 之间的关系。
共有 14.9%的儿童报告了 FA。患病率与室内空气污染暴露显著相关，产前暴露于霉菌/潮湿的 OR（95%CI）为 1.93（1.35-2.75），而产后新家具和窗户冷凝的 OR 分别为 1.49（1.07-2.10）和 1.41（1.04-1.89）。FA 的患病率也与产前和产后暴露于室外空气污染有关，特别是与交通有关的空气污染物 NO2，调整后的 OR（95%Cl）分别为每增加一个四分位距（IQR）1.24（1.00-1.54）和 1.38（1.03-1.85）。敏感性分析表明，仅在 3-4 岁的幼儿中，室外/室内空气污染与儿童 FA 之间的关联才具有统计学意义。
由于过去几十年中国经济的快速增长和快速城市化，导致儿童早期暴露于高水平的室外和室内空气污染，可能导致儿童食物过敏（FA）的迅速增加。我们的研究表明，除了肠道和皮肤之外，气道可能是食物致敏的新途径。空气污染导致过敏流行的第一波和第二波，提示了“一种过敏”疾病的概念。
