哮喘联盟

   摘要
   背景：生命早期被认为是决定哮喘进展的关键时期，但是，早期环境空气污染暴露对儿童哮喘的影响尚不清楚。
   目的：本研究旨在评价胎儿期和一岁内环境空气污染暴露对学龄前儿童哮喘发病的影响。
   方法：2011年9月至2012年1月期间，共有2490名3～6岁的经医生诊断的中国哮喘儿童参与有关哮喘的问卷调查。儿童接触到的主要空气污染物有代表工业废气污染的二氧化氯(SO2)、代表交通废气污染的二氧化氮(NO2)以及直径≤10µm的混合颗粒物(PM10)，环境质量监测站通过反距离加权法估算出污染物浓度。运用Logistic回归分析，根据比值比(OR)和95%可信区间(CI)评价早期污染物暴露与儿童哮喘的关系。
   结果：早期空气污染物暴露与儿童哮喘有关。SO2 和NO2暴露与儿童哮喘显著相关：SO2每增加50µg/m3、NO2每增加15µg/m3，胎儿期校正OR值(95% CI)分别为1.45(1.02-2.07)和1.74 (1.15-2.62)，一岁内校正OR值分别为1.62 (1.01-2.60) 和1.90 (1.20-3.00)。与低浓度暴露相比，中国SO2 和NO2的联合高浓度暴露显著增加了哮喘发病风险，校正OR值(95% CI)胎儿期为1.76 (1.18-2.64)、一岁内为1.85 (1.22-2.79)。相对于女童来说，男童的这种相关性更高；相对于年龄更大的5～6岁儿童来说，年龄更小的3～4岁儿童的这种相关性更高。
   结论：早期空气污染物暴露与儿童哮喘有关，其中，空气污染的水平与来源发挥着重要作用。中国高浓度空气污染和工业、交通废气联合污染，可导致近期儿童哮喘发病的快速增加。
 

（杨冬 审校）
Environ Res. 2015 Oct 7;143(Pt A):83-92. doi: 10.1016/j.envres.2015.09.032. [Epub ahead of print]
 

Early life exposure to ambient air pollution and childhood asthma in China.
 

Deng Q1, Lu C2, Norbäck D3, Bornehag CG4, Zhang Y5, Liu W6, Yuan H7, Sundell J8.
 

Abstract
BACKGROUND:Early life is suggested to be a critical time in determining subsequent asthma development, but the extent to which the effect of early-life exposure to ambient air pollution on childhood asthma is unclear.
OBJECTIVES:We investigated doctor-diagnosed asthma in preschool children due to exposure to ambient air pollution in utero and during the first year of life.
METHODS:In total 2490 children aged 3-6 years participated in a questionnaire study regarding doctor-diagnosed asthma between September 2011 and January 2012 in China. Children's exposure to critical air pollutants, sulfur dioxide (SO2) as proxy of industrial air pollution, nitrogen dioxide (NO2) as proxy of traffic pollution, and particulate matter≤10µm in diameter (PM10) as a mixture, was estimated from the concentrations measured at the ambient air quality monitoring stations by using an inverse distance weighted (IDW) method. Logistic regression analysis was employed to determine the relationship between early-life exposure and childhood asthma in terms of odds ratio (OR) and 95% confidence interval (CI).
RESULTS:Association between early-life exposure to air pollutants and childhood asthma was observed. SO2 and NO2 had significant associations with adjusted OR (95% CI) of 1.45 (1.02-2.07) and 1.74 (1.15-2.62) in utero and 1.62 (1.01-2.60) and 1.90 (1.20-3.00) during the first year for per 50µg/m3 and 15µg/m3 increase respectively. Exposure to the combined high level of SO2 and NO2 in China significantly elevated the asthmatic risk with adjusted OR (95% CI) of 1.76 (1.18-2.64) in utero and 1.85 (1.22-2.79) during the first year compared to the low level exposure. The associations were higher for males and the younger children aged 3-4 than females and the older children aged 5-6.
CONCLUSIONS:Early-life exposure to ambient air pollution is associated with childhood asthma during which the level and source of air pollution play important roles. The high level and nature of combined industrial and traffic air pollution in China may contribute to the recent rapid increase of childhood asthma.
 

Environ Res. 2015 Oct 7;143(Pt A):83-92. doi: 10.1016/j.envres.2015.09.032. [Epub ahead of print]