Department of Respiratory Medicine, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China.
School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China.
Ecotoxicol Environ Saf. 2024 Nov 1;286:117231. doi: 10.1016/j.ecoenv.2024.117231. Epub 2024 Oct 28.
Limited evidence was available on ambient air pollution and pediatric atopic dermatitis (AD). The study aimed to evaluate the associations between short-term exposure to air pollutants and outpatient visits for pediatric AD. From 2016-2018, we collected data on six criteria air pollutants (PM, PM, NO, SO, CO and O) and daily outpatient visits for pediatric AD in 66 hospitals, covering all districts in Shanghai, China. The over-dispersed Poisson generalized additive model (GAM) was applied to fit the associations of criteria air pollutants with hospital visits. Two-pollutant models were fitted and stratified analyses by sex, age and season were conducted. We identified 477,833 outpatient visits for pediatric AD. Each interquartile range (IQR) increase in PM (IQR: 30.9 μg/m), PM (8.9 μg/m), NO (25.5 μg/m), SO (5.8 μg/m) and CO (0.283 mg/m) on the concurrent day was significantly associated with increments of 2.08 % (95 % CI: 0.53 %, 3.65 %), 2.53 % (95 % CI: 0.87 %, 4.22 %), 8.14 % (95 % CI: 6.24 %, 10.08 %), 5.67 % (95 % CI: 3.58 %, 7.80 %), and 2.27 % (95 % CI: 0.70 %, 3.87 %) in pediatric AD outpatient visits, respectively. The effects of NO remained robust after adjustment for other air pollutants. The exposure-response curves for PM and PM were steeper for moderate-lower concentrations, with a flatten curves at high concentration; nearly linear relationships were found for NO. Higher associations of NO exposure on AD were detected in children under 6 years old (p=0.01); and we observed larger effect of air pollutants in cool seasons (p<0.001 for PM, PM, NO and CO; p=0.043 for SO). This study indicated that short-term exposure to air pollution could increase risk of outpatient visits for pediatric AD.
有关环境空气污染与儿科特应性皮炎（AD）的证据有限。本研究旨在评估短期暴露于空气污染物与儿科 AD 门诊就诊之间的关联。 2016-2018 年，我们在中国上海的所有区收集了六项标准空气污染物（PM 、 PM 、 NO 、 SO 、 CO 和 O ）和每日儿科 AD 门诊就诊的数据。应用过度分散的泊松广义加性模型（GAM）拟合了标准空气污染物与医院就诊之间的关联。拟合了双污染物模型，并按性别、年龄和季节进行了分层分析。我们确定了 477833 例儿科 AD 门诊就诊。与当日 PM （IQR：30.9μg/m ）、 PM （8.9μg/m ）、 NO （25.5μg/m ）、 SO （5.8μg/m ）和 CO （0.283mg/m ）的每一个四分位距（IQR）增加分别显著相关的是儿科 AD 门诊就诊的 2.08%（95%CI：0.53%，3.65%）、2.53%（95%CI：0.87%，4.22%）、8.14%（95%CI：6.24%，10.08%）、5.67%（95%CI：3.58%，7.80%）和 2.27%（95%CI：0.70%，3.87%）。在调整其他空气污染物后，NO 的影响仍然稳健。 PM 和 PM 的暴露反应曲线在中低浓度下更为陡峭，在高浓度下曲线变平；在 NO 中发现了近乎线性的关系。在 6 岁以下儿童中，NO 暴露与 AD 的相关性更高（p=0.01）；我们观察到在凉爽季节，空气污染物的影响更大（p<0.001 对于 PM 、 PM 、 NO 和 CO ； p=0.043 对于 SO ）。本研究表明，短期暴露于空气污染可能会增加儿科 AD 门诊就诊的风险。
