Zhang Luyao, Dai Ruixue, Lou Wendy, Mandhane Piush, Moraes Theo J, Simons Elinor, Thorne Peter S, To Teresa, Turvey Stuart E, Subbarao Padmaja, Brook Jeffrey R
University of Toronto, Toronto, ON, Canada.
The Hospital for Sick Children, Toronto, ON, Canada.
Environ Res. 2025 Feb 15;267:120664. doi: 10.1016/j.envres.2024.120664. Epub 2024 Dec 20.
Throughout the perinatal period children are exposed to complex mixtures, including indoor chemicals such as phthalates, and biological agents. However, few studies focus on interactions between early-life co-exposures to shed light on how co-exposures modify their individual effects. Therefore, our study aims to assess whether early-life exposure to pets and related biological agents, namely pet allergens and endotoxin, modifies the association between di-(2-ethylhexyl) phthalate (DEHP) and asthma and wheeze in preschoolers to gain insight into interactions.
Using data from a Canadian birth cohort study (CHILD), we conducted two complementary analyses on respiratory outcomes. First, we combined pet ownership with DEHP measurements from house dust (N = 726). Second, we focused on a subgroup of children with exposure measurements of both DEHP and biological agents in dust (N = 261). We used multivariable logistic regression models to assess whether pets and quantified biological agent levels modify associations between DEHP and asthma at 5 years and recurrent wheeze between 2 and 5 years. Interaction terms were included in the models and stratified analyses were further conducted.
Associations between DEHP and asthma and wheeze were modified by pet ownership and related biological agents. For persistent/recurrent wheeze, the association with DEHP became larger among children with dogs at home and with higher dog allergens (p-interaction <0.1) and became smaller and insignificant when exposed to cats. Similarly, for asthma, the association with DEHP tended to be larger among children with dogs (also higher dog allergens) and among children without cats (also lower cat allergens) at home, respectively. Endotoxin levels modified the association between DEHP and persistent wheeze (p-interaction <0.1).
Early-life exposure to pets and related biological agents may modify the associations between phthalates and asthma and wheeze in children. Heterogeneity in single exposure studies could be a result of differences in co-exposures among studies.
在围产期，儿童会接触到复杂的混合物，包括邻苯二甲酸盐等室内化学物质以及生物制剂。然而，很少有研究关注早期共同暴露之间的相互作用，以阐明共同暴露如何改变它们各自的影响。因此，我们的研究旨在评估早期接触宠物及相关生物制剂，即宠物过敏原和内毒素，是否会改变学龄前儿童邻苯二甲酸二（2-乙基己基）酯（DEHP）与哮喘和喘息之间的关联，以深入了解相互作用。
利用加拿大出生队列研究（CHILD）的数据，我们对呼吸结局进行了两项补充分析。首先，我们将宠物饲养情况与房屋灰尘中的DEHP测量值相结合（N = 726）。其次，我们关注了一个亚组儿童，他们的灰尘中同时有DEHP和生物制剂的暴露测量值（N = 261）。我们使用多变量逻辑回归模型来评估宠物和定量生物制剂水平是否会改变DEHP与5岁时哮喘以及2至5岁时反复喘息之间的关联。模型中纳入了交互项，并进一步进行了分层分析。
DEHP与哮喘和喘息之间的关联因宠物饲养情况及相关生物制剂而改变。对于持续性/反复性喘息，家中养狗且狗过敏原较高的儿童中，DEHP与之的关联变得更大（交互作用p<0.1），而接触猫时则变得更小且无统计学意义。同样，对于哮喘，家中养狗（狗过敏原也较高）的儿童以及家中没有猫（猫过敏原也较低）的儿童中，DEHP与之的关联分别往往更大。内毒素水平改变了DEHP与持续性喘息之间的关联（交互作用p<0.1）。
早期接触宠物及相关生物制剂可能会改变儿童中邻苯二甲酸盐与哮喘和喘息之间的关联。单项暴露研究中的异质性可能是由于研究之间共同暴露的差异所致。
