Moore Camille M, Thornburg Jonathan, Secor Elizabeth A, Hamlington Katharine L, Schiltz Allison M, Freeman Kristy L, Everman Jamie L, Fingerlin Tasha E, Liu Andrew H, Seibold Max A
medRxiv. 2023 Sep 23:2023.09.22.23295971. doi: 10.1101/2023.09.22.23295971.
Indoor and outdoor air pollution levels are associated with poor asthma outcomes in children. However, few studies have evaluated whether breathing zone pollutant levels associate with asthma outcomes.
Determine breathing zone exposure levels of NO , O , total PM and PM constituents among children with exacerbation-prone asthma, and examine correspondence with in-home and community measurements and associations with outcomes.
We assessed children's personal breathing zone exposures using wearable monitors. Personal exposures were compared to in-home and community measurements and tested for association with lung function, asthma control, and asthma exacerbations.
81 children completed 219 monitoring sessions. Correlations between personal and community levels of PM , NO , and O were poor, whereas personal PM and NO levels correlated with in-home measurements. However, in-home monitoring underdetected brown carbon (Personal:79%, Home:36.8%) and ETS (Personal:83.7%, Home:4.1%) personal exposures, and detected black carbon in participants without these personal exposures (Personal: 26.5%, Home: 96%). Personal exposures were not associated with lung function or asthma control. Children experiencing an asthma exacerbation within 60 days of personal exposure monitoring had 1.98, 2.21 and 2.04 times higher brown carbon (p<0.001), ETS (p=0.007), and endotoxin (p=0.012), respectively. These outcomes were not associated with community or in-home exposure levels.
Monitoring pollutant levels in the breathing zone is essential to understand how exposures influence asthma outcomes, as agreement between personal and in-home monitors is limited. Inhaled exposure to PM constituents modifies asthma exacerbation risk, suggesting efforts to limit these exposures among high-risk children may decrease their asthma burden.
In-home and community monitoring of environmental pollutants may underestimate personal exposures. Levels of inhaled exposure to PM constituents appear to strongly influence asthma exacerbation risk. Therefore, efforts should be made to mitigate these exposures.
Leveraging wearable, breathing-zone monitors, we show exposures to inhaled pollutants are poorly proxied by in-home and community monitors, among children with exacerbation-prone asthma. Inhaled exposure to multiple PM constituents is associated with asthma exacerbation risk.
室内和室外空气污染水平与儿童哮喘不良预后相关。然而，很少有研究评估呼吸带污染物水平与哮喘预后之间的关系。
确定易加重哮喘儿童呼吸带中一氧化氮（NO）、臭氧（O₃）、总细颗粒物（PM₂.₅）及其成分的暴露水平，并检验其与家庭和社区测量值的一致性以及与预后的关联。
我们使用可穿戴监测器评估儿童的个人呼吸带暴露情况。将个人暴露情况与家庭和社区测量值进行比较，并测试其与肺功能、哮喘控制和哮喘加重情况的关联。
81名儿童完成了219次监测。个人与社区的PM₂.₅、NO和O₃水平之间的相关性较差，而个人PM₂.₅和NO水平与家庭测量值相关。然而，家庭监测漏检了棕色碳（个人：79%，家庭：36.8%）和环境烟草烟雾（个人：83.7%，家庭：4.1%）的个人暴露情况，并且在没有这些个人暴露的参与者中检测到了黑碳（个人：26.5%，家庭：96%）。个人暴露与肺功能或哮喘控制无关。在个人暴露监测后60天内发生哮喘加重的儿童，其棕色碳（p<0.001）、环境烟草烟雾（p=0.007）和内毒素（p=0.012）的暴露量分别高出1.98倍、2.21倍和2.04倍。这些结果与社区或家庭暴露水平无关。
由于个人监测器与家庭监测器之间的一致性有限，因此监测呼吸带中的污染物水平对于了解暴露如何影响哮喘预后至关重要。吸入PM₂.₅成分会改变哮喘加重风险，这表明努力限制高危儿童的这些暴露可能会减轻他们的哮喘负担。
家庭和社区环境污染物监测可能低估个人暴露情况。吸入PM₂.₅成分的水平似乎强烈影响哮喘加重风险。因此，应努力减轻这些暴露。
利用可穿戴的呼吸带监测器，我们发现对于易加重哮喘的儿童，家庭和社区监测器对吸入污染物暴露的反映较差。吸入多种PM₂.₅成分与哮喘加重风险相关。
