Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR_S 1085, F-35000, Rennes, France.
Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR_S 1085, F-35000, Rennes, France.
Environ Pollut. 2024 Dec 15;363(Pt 2):125206. doi: 10.1016/j.envpol.2024.125206. Epub 2024 Oct 30.
Uncertainty remains regarding the effects of outdoor air pollution in rural areas on childhood asthma, rhinitis, and eczema. Although these diseases often coexist, few studies have examined the effects of air pollution on their multimorbidity. The objective of this study was to investigate the associations of pregnancy exposure to outdoor fine particulate matter (PM) and nitrogen dioxide (NO) with childhood asthma, rhinitis, eczema, and their multimorbidity. We included children from the 6-year (n = 1322) and 12-year (n = 1118) follow-up of the Pélagie mother-child cohort in Brittany, France where 64% of the participants lived in rural areas. Asthma, rhinitis, eczema, and a multimorbidity phenotype (concomitant presence of ≥2 diseases) were defined by validated questionnaires. PM and NO concentrations during pregnancy were modeled at residential address using land use regression. We assessed associations using logistic regressions per interquartile range (PM: 3 μg/m; NO: 10 μg/m). We also performed stratification by type of area (urban and rural). Asthma, rhinitis, eczema, and the multimorbidity phenotype prevalence were 12%, 20%, 22% and 12% at 6-years, and 10%, 23%, 19% and 11% at 12-years of follow-up. At 6-years, for eczema, a tendency of an association was observed with NO (OR = 1.15, 95% CI = 0.97-1.36, p-value = 0.10), and stratification by type of area showed statistically significant associations for PM (1.49 (1.03-2.13), p = 0.03) and NO (1.40 (1.08-1.82), p = 0.01) in the urban stratum. At 12-years, main analyses showed a tendency of associations of PM (1.38 (0.98-1.93), p = 0.07) and NO (1.25 (0.98-1.59), p = 0.07) with asthma, and of NO with the multimorbidity phenotype (1.23 (0.97-1.56), p = 0.09). While overall results were not statistically significant, associations in urban settings were stronger than in rural ones at 6-years suggesting that possible differences between the effects in urban and rural areas should be further explored.
农村地区室外空气污染对儿童哮喘、鼻炎和湿疹的影响仍存在不确定性。尽管这些疾病通常同时存在，但很少有研究探讨空气污染对其多种疾病的影响。本研究旨在调查孕妇在怀孕期间暴露于室外细颗粒物（PM）和二氧化氮（NO）与儿童哮喘、鼻炎、湿疹及其多种疾病的关联。我们纳入了法国布列塔尼佩拉吉母婴队列的 6 岁（n=1322）和 12 岁（n=1118）随访的儿童，其中 64%的参与者居住在农村地区。哮喘、鼻炎、湿疹和多种疾病表型（同时存在≥2种疾病）通过验证后的问卷进行定义。在妊娠期间，使用土地利用回归模型在居住地址处对 PM 和 NO 浓度进行建模。我们使用逻辑回归评估每四分位距（PM：3μg/m；NO：10μg/m）的关联。我们还按区域类型（城市和农村）进行分层。在 6 岁时，哮喘、鼻炎、湿疹和多种疾病表型的患病率分别为 12%、20%、22%和 12%，在 12 岁时分别为 10%、23%、19%和 11%。在 6 岁时，对于湿疹，NO 呈正相关趋势（OR=1.15，95%CI=0.97-1.36，p 值=0.10），并且按区域类型分层显示 PM（1.49（1.03-2.13），p=0.03）和 NO（1.40（1.08-1.82），p=0.01）在城市地区存在统计学显著关联。在 12 岁时，主要分析显示 PM（1.38（0.98-1.93），p=0.07）和 NO（1.25（0.98-1.59），p=0.07）与哮喘呈正相关趋势，NO 与多种疾病表型呈正相关（1.23（0.97-1.56），p=0.09）。尽管总体结果无统计学意义，但在 6 岁时城市地区的关联强于农村地区，这表明应该进一步探讨城市和农村地区之间可能存在的影响差异。
