哥斯达黎加 ISA 出生队列中女性和儿童呼出气一氧化氮（FeNO）与医学状况和环境因素的横断面分析。
A cross-sectional analysis of medical conditions and environmental factors associated with fractional exhaled nitric oxide (FeNO) in women and children from the ISA birth cohort, Costa Rica.
机构信息
Department of Biological Sciences, NC State University, Raleigh, NC, USA; Center for Human Health and the Environment, NC State University, Raleigh, NC, USA.
Infants Environmental Health Program (ISA) Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica.
出版信息
Environ Res. 2023 Sep 15;233:116449. doi: 10.1016/j.envres.2023.116449. Epub 2023 Jun 23.
BACKGROUND
Fractional exhaled nitric oxide (FeNO) is a marker of airway inflammation. Elevated FeNO has been associated with environmental exposures, however, studies from tropical countries are limited. Using data from the Infants' Environmental Health Study (ISA) birth cohort, we evaluated medical conditions and environmental exposures' association with elevated FeNO.
METHODS
We performed a cross-sectional analysis of 277 women and 293 8-year old children who participated in the 8-year post-partum visit in 2019. We measured FeNO and collected information on medical conditions and environmental exposures including smoke from waste burning, work in banana plantations, and home pesticide use. We defined elevated FeNO as >25 ppb for women and >20 ppb for children. To evaluate factors associated with elevated FeNO, we used logistic regression models adjusted for obesity in women and unadjusted in children.
RESULTS
Overall elevated FeNO was common (20% of women, 13% of children). Rhinitis diagnosis was significantly associated with elevated FeNO in both women (odds ratio (OR): 3.67 95% Confidence Interval (CI): 1.81,7.35) and children (OR: 8.18 95%CI: 3.15, 21.22); wheeze was associated with elevated FeNO in women (OR: 4.50 95% CI: 2.25, 8.99). Environmental exposures were associated with elevated FeNO, but not significantly. Waste burning was associated with elevated FeNO in both women (OR: 1.58 95%CI 0.68, 4.15) and children (OR: 2.49 95%CI:0.82, 10.79). Para-occupational pesticide exposures were associated with elevated FeNO in women and children. For women, having a partner working in agriculture was associated with elevated FeNO (OR: 1.61 95%CI:0.77, 3.58) and for children, maternal work in agriculture was associated with elevated FeNO. (OR 2.08 95%CI 0.86, 4.67) CONCLUSION: Rhinitis and wheeze were associated with elevated FeNO in this rural, agricultural population. Smoke from waste burning as well as para-occupational pesticide exposure may contribute to elevated FeNO in rural communities.
背景
呼出的一氧化氮分数（FeNO）是气道炎症的标志物。FeNO 升高与环境暴露有关，但来自热带国家的研究有限。利用婴儿环境健康研究（ISA）出生队列的数据，我们评估了医疗状况和环境暴露与 FeNO 升高的关系。
方法
我们对 277 名女性和 293 名 8 岁儿童进行了横断面分析，这些儿童参加了 2019 年产后 8 年的随访。我们测量了 FeNO，并收集了医疗状况和环境暴露的信息，包括废物燃烧产生的烟雾、香蕉种植园工作和家庭使用农药。我们将 FeNO 升高定义为女性 >25 ppb 和儿童 >20 ppb。为了评估与 FeNO 升高相关的因素，我们使用了逻辑回归模型，在女性中调整了肥胖因素，在儿童中未调整。
结果
总体而言，FeNO 升高很常见（女性 20%，儿童 13%）。鼻炎诊断与女性（比值比（OR）：3.67 95%置信区间（CI）：1.81，7.35）和儿童（OR：8.18 95%CI：3.15，21.22）的 FeNO 升高均显著相关；女性的喘息与 FeNO 升高相关（OR：4.50 95%CI：2.25，8.99）。环境暴露与 FeNO 升高相关，但无统计学意义。废物燃烧与女性（OR：1.58 95%CI 0.68，4.15）和儿童（OR：2.49 95%CI：0.82，10.79）的 FeNO 升高均相关。职业相关的农药暴露与女性和儿童的 FeNO 升高相关。对于女性，其伴侣从事农业工作与 FeNO 升高相关（OR：1.61 95%CI：0.77，3.58），而对于儿童，母亲从事农业工作与 FeNO 升高相关（OR：2.08 95%CI：0.86，4.67）。
结论
在这个农村农业人群中，鼻炎和喘息与 FeNO 升高相关。废物燃烧产生的烟雾以及职业相关的农药暴露可能导致农村社区 FeNO 升高。
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