Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Comprehensive Pneumology Center Munich, German Center for Lung Research, Munich, Germany; Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
Environ Res. 2024 Nov 1;260:119553. doi: 10.1016/j.envres.2024.119553. Epub 2024 Jul 2.
Evidence regarding the link between long-term ambient ozone (O) exposure and childhood sleep disorders is little. This study aims to examine the associations between long-term exposure to O and sleep disorders in children. We conducted a population-based cross-sectional survey, including 185,428 children aged 6-18 years in 173 schools across 14 Chinese cities during 2012 and 2018. Parents or guardians completed a checklist using Sleep Disturbance Scale for Children, and O exposure at residential and school addresses was estimated using a satellite-based spatiotemporal model. We used generalized linear mixed models to test the associations with adjustment for factors including socio-demographic variables, lifestyle, meteorology and multiple pollutants. Mean concentrations of O, particulate matter with diameters ≤2.5 mm (PM) and nitrogen dioxide (NO) were 89.0 μg/m, 42.5 μg/m and 34.4 μg/m, respectively. O and NO concentrations were similar among provinces, while PM concentration varied significantly among provinces. Overall, 19.4% of children had at least one sleep disorder. Long-term exposure to O was positively associated with odds of sleep disorders for all subtypes. For example, each interquartile increment in home-school O concentrations was associated with a higher odds ratio for global sleep disorder, at 1.22 (95% confidence interval: 1.18, 1.26). Similar associations were observed for sleep disorder subtypes. The associations remained similar after adjustment for PM and NO. Moreover, these associations were heterogeneous regionally, with more prominent associations among children residing in southeast region than in northeast and northwest regions in China. We concluded that long-term exposure to O is positively associated with risks of childhood sleep disorders. These associations varied by geographical region of China.
长期环境臭氧（O）暴露与儿童睡眠障碍之间的关联证据很少。本研究旨在研究长期 O 暴露与儿童睡眠障碍之间的关系。我们进行了一项基于人群的横断面调查，包括 2012 年至 2018 年期间在中国 14 个城市的 173 所学校的 185428 名 6-18 岁儿童。父母或监护人使用儿童睡眠障碍量表完成检查表，使用基于卫星的时空模型估算住宅和学校地址的 O 暴露。我们使用广义线性混合模型进行测试，调整了包括社会人口统计学变量、生活方式、气象和多种污染物在内的因素。O、粒径≤2.5 μm 的颗粒物（PM）和二氧化氮（NO）的平均浓度分别为 89.0 μg/m、42.5 μg/m 和 34.4 μg/m。各省的 O 和 NO 浓度相似，而 PM 浓度在各省之间差异显著。总体而言，19.4%的儿童存在至少一种睡眠障碍。长期暴露于 O 与所有亚型的睡眠障碍发生几率呈正相关。例如，家庭-学校 O 浓度的每一个四分位距增加与全球睡眠障碍的比值比相关，为 1.22（95%置信区间：1.18，1.26）。对于睡眠障碍亚型也观察到了类似的关联。调整 PM 和 NO 后，这些关联仍然相似。此外，这些关联在区域上存在异质性，在中国东南地区的儿童中，这些关联比东北地区和西北地区更为明显。我们得出结论，长期暴露于 O 与儿童睡眠障碍的风险呈正相关。这些关联在中国的地理区域上存在差异。
