产前和幼儿期空气污染暴露与儿童肺功能的关系：探索对肺发育有影响的暴露窗口。
Associations between prenatal and early-life air pollution exposure and lung function in young children: Exploring influential windows of exposure on lung development.
机构信息
Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA.
Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA.
出版信息
Environ Res. 2023 Apr 1;222:115415. doi: 10.1016/j.envres.2023.115415. Epub 2023 Feb 3.
BACKGROUND
Evidence in the literature suggests that air pollution exposures experienced prenatally and early in life can be detrimental to normal lung development, however the specific timing of critical windows during development is not fully understood.
OBJECTIVES
We evaluated air pollution exposures during the prenatal and early-life period in association with lung function at ages 6-9, in an effort to identify potentially influential windows of exposure for lung development.
METHODS
Our study population consisted of 222 children aged 6-9 from the Fresno-Clovis metro area in California with spirometry data collected between May 2015 and May 2017. We used distributed-lag non-linear models to flexibly model the exposure-lag-response for monthly average exposure to fine particulate matter (PM) and ozone (O) during the prenatal months and first three years of life in association with forced vital capacity (FVC), and forced expiratory volume in the first second (FEV), adjusted for covariates.
RESULTS
PM exposure during the prenatal period and the first 3-years of life was associated with lower FVC and FEV assessed at ages 6-9. Specifically, an increase from the 5th percentile of the observed monthly average exposure (7.55 μg/m) to the median observed exposure (12.69 μg/m) for the duration of the window was associated with 0.42 L lower FVC (95% confidence interval (CI): -0.82, -0.03) and 0.38 L lower FEV (95% CI: -0.75, -0.02). The shape of the lag-response indicated that the second half of pregnancy may be a particularly influential window of exposure. Associations for ozone were not as strong and typically CIs included the null.
CONCLUSIONS
Our findings indicate that prenatal and early-life exposures to PM are associated with decreased lung function later in childhood. Exposures during the latter months of pregnancy may be especially influential.
背景
文献中的证据表明，产前和生命早期接触空气污染可能会对正常肺发育造成损害，但发育过程中关键窗口期的具体时间尚不完全清楚。
目的
我们评估了产前和生命早期阶段的空气污染暴露与 6-9 岁时肺功能的关系，以确定肺发育的潜在有影响的暴露窗口。
方法
我们的研究人群由加利福尼亚州弗雷斯诺-克洛维斯都会区的 222 名 6-9 岁儿童组成，他们在 2015 年 5 月至 2017 年 5 月期间进行了肺活量测定。我们使用分布式滞后非线性模型，灵活地建立了产前和生命前 3 年每月平均细颗粒物（PM）和臭氧（O）暴露与用力肺活量（FVC）以及第一秒用力呼气量（FEV）之间的暴露-滞后-反应关系，同时调整了协变量。
结果
产前和生命前 3 年的 PM 暴露与 6-9 岁时的 FVC 和 FEV 降低有关。具体而言，在暴露窗口期间，从观察到的每月平均暴露的第 5 百分位数（7.55μg/m）增加到中位数（12.69μg/m），与 FVC 降低 0.42L（95%置信区间（CI）：-0.82，-0.03）和 FEV 降低 0.38L（95% CI：-0.75，-0.02）有关。滞后反应的形状表明，妊娠的后半期可能是一个特别有影响的暴露窗口。臭氧的相关性不那么强，通常置信区间包含零。
结论
我们的研究结果表明，产前和生命早期接触 PM 与儿童后期肺功能下降有关。妊娠后期的暴露可能尤其具有影响力。
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