Division of Pulmonary Medicine, Boston Children's Hospital.
Division of allergy and immunology, Boston Children's Hospital.
Curr Opin Allergy Clin Immunol. 2023 Apr 1;23(2):179-184. doi: 10.1097/ACI.0000000000000890. Epub 2023 Jan 12.
Higher asthma prevalence and morbidity are seen in inner-city areas, disproportionately affecting low-income families living in substandard housing. Children within these families experience more frequent asthma exacerbations, acute care and emergency department visits, and hospitalizations, thus characterizing severe asthma. In this review, we assess recent published literature focused on indoor and outdoor exposures that contribute to the development and morbidity of asthma.
Many urban environmental exposures contribute to asthma burden, including tobacco/e-cigarette smoke, pest allergens, molds, and possibly synthetic chemicals such as phthalates and bisphenol A, radon, and volatile organic compounds. Individuals living in inner-city areas also experience higher levels of air pollutants and ambient heat, further perpetuating asthma incidence and severity.
This article summarizes the latest advances and provides direction for future research on risk factors, interventions, and public policy to help alleviate the burden of asthma due to urban environment exposures.
城市中心地区哮喘发病率和患病率较高,这主要影响居住在条件较差住房中的低收入家庭。这些家庭中的儿童哮喘发作更频繁,需要更多的急性护理和急诊就诊以及住院治疗,从而使哮喘病情更为严重。在本次综述中,我们评估了最近发表的有关导致哮喘发生和发病的室内和室外暴露的文献。
许多城市环境暴露会导致哮喘负担加重,包括烟草/电子烟烟雾、害虫过敏原、霉菌以及可能的合成化学物质(如邻苯二甲酸酯和双酚 A、氡和挥发性有机化合物)。居住在城市中心地区的个体还会接触到更高水平的空气污染物和环境热,这进一步加重了哮喘的发病率和严重程度。
本文总结了最新进展,并为未来有关风险因素、干预措施和公共政策的研究提供了方向,以帮助减轻城市环境暴露导致的哮喘负担。