Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts.
Ann Am Thorac Soc. 2023 May;20(5):698-704. doi: 10.1513/AnnalsATS.202209-805OC.
With more frequent and intense precipitation events across the globe due to a changing climate, there is a need to understand the relationship between precipitation and respiratory health. Precipitation may trigger asthma exacerbations, but little is known about how precipitation affects lung function and airway inflammation in early adolescents. To determine if short-term precipitation exposure is associated with lung function and airway inflammation in early adolescents and if ever having a diagnosis of asthma modifies associations of precipitation with lung function and airway inflammation. In a prospective prebirth cohort, Project Viva, that included 1,019 early adolescents born in the northeastern United States, we evaluated associations of 1-, 2-, 3-, and 7-day moving averages of precipitation in the preceding week and forced expiratory volume in 1 second, forced vital capacity, and fractional exhaled nitric oxide (Fe) using linear regression. We used log-transformed Fe with effect estimates presented as percentage change. We adjusted for maternal education and household income at enrollment; any smoking in the home in early adolescence; child sex, race/ethnicity, and ever asthma diagnosis; and age, height, weight, date, and season (as sine and cosine functions of visit date) at the early adolescent visit and moving averages for mean daily temperature (same time window as exposure). In fully adjusted linear models, 3- and 7-day moving averages for precipitation were positively associated with Fe but not lung function. Every 2-mm increase in the 7-day moving average for precipitation was associated with a 4.0% (95% confidence interval, 1.1, 6.9) higher Fe. There was evidence of effect modification by asthma status: Precipitation was associated with lower forced vital capacity and higher Fe among adolescents with asthma. We also found that outdoor aeroallergen sensitization (immunoglobulin E against common ragweed, oak, ryegrass, or silver birch) modified associations of precipitation with Fe, with higher Fe in sensitized adolescents compared with nonsensitized adolescents. The associations of precipitation with Fe were not explained by relative humidity or air pollution exposure. We found that greater short-term precipitation may trigger airway inflammation in adolescents, particularly among those with asthma.
由于气候变化导致全球降水更加频繁和剧烈，因此需要了解降水与呼吸健康之间的关系。降水可能会引发哮喘发作，但对于降水如何影响早期青少年的肺功能和气道炎症知之甚少。为了确定短期降水暴露是否与早期青少年的肺功能和气道炎症有关，以及是否曾经被诊断患有哮喘会改变降水与肺功能和气道炎症之间的关联。在一个包括美国东北部 1019 名早期青少年的前瞻性产前队列研究中，我们使用线性回归评估了前一周 1 天、2 天、3 天和 7 天的降水移动平均值与 1 秒用力呼气量（FEV1）、用力肺活量（FVC）和呼出的一氧化氮分数（Fe）之间的关系。我们使用对数转换后的 Fe 进行了分析，其效应估计值表示为百分比变化。我们调整了入组时母亲的教育程度和家庭收入；青少年期家中任何吸烟情况；儿童性别、种族/族裔和曾被诊断患有哮喘；以及青少年就诊时的年龄、身高、体重、日期和季节（作为就诊日期的正弦和余弦函数）以及同期的平均日温度（与暴露相同的时间窗口）。在完全调整后的线性模型中，降水的 3 天和 7 天移动平均值与 Fe 呈正相关，但与肺功能无关。降水 7 天移动平均值每增加 2 毫米，Fe 就会升高 4.0%（95%置信区间为 1.1%，6.9%）。有证据表明哮喘状态存在效应修饰：在患有哮喘的青少年中，降水与较低的 FVC 和较高的 Fe 相关。我们还发现，户外过敏原致敏（对普通豚草、橡树、黑麦草或银桦的免疫球蛋白 E）改变了降水与 Fe 的关系，与未致敏的青少年相比，致敏的青少年的 Fe 更高。降水与 Fe 的关系不能用相对湿度或空气污染暴露来解释。我们发现，短期内降水增加可能会引发青少年的气道炎症，特别是在患有哮喘的青少年中。
