哮喘联盟

   摘要
   城市内大气污染的变化与童年时期哮喘的进展是有密切关系的，但是目前的研究结果并不一致。我们旨在探索围产期大气污染暴露是否会对基于人群的出生队列在学龄前至学龄阶段哮喘的发作产生影响。研究使用联网的健康管理数据库对65254例在1999年至2002年间出生于温哥华大都市区域的儿童进行随访直至10岁。将哮喘病例与五个随机挑选的对照进行性别和年龄的匹配。暴露与大气污染之间的联系将使用不同的方法（插值法（反距离权重（IDW）），土地利用回归，接近度）进行估计，而学龄前（0-5岁）和学龄（6-10岁）阶段发作的哮喘将使用条件逻辑回归进行估计。分别有6948例和1711例儿童被判定为在学龄前和学龄时期。接下来要对产重、妊娠期、家庭收入、奇偶性、出院后的母乳喂养、孕母的年龄和学历进行校正，学龄前阶段的哮喘风险由于交通污染而增加（每四分位的增长使用IDW法校正优势比(95% CI)：一氧化氮1.06 (1.01-1.11)，二氧化氮1.09 (1.04-1.13)和一氧化碳1.05 (1.01-1.1))。可以观察到在低出生体重的病例中这种影响会增强。这种关联性与住宅周围的绿化情况无关。城市内大气污染的变化与学龄前时期的新发哮喘密切相关。
 

（杨冬 审校）
Eur Respir J. 2016 Feb 8. pii: ERJ-00746-2015. doi: 10.1183/13993003.00746-2015. [Epub ahead of print]


 

Perinatal air pollution exposure and development of asthma from birth to age 10 years.
 

Sbihi H1, Tamburic L2, Koehoorn M2, Brauer M2.
 

Abstract
Within-city variation in air pollution has been associated with childhood asthma development, but findings have been inconsistent. We examined whether perinatal air pollution exposure affected asthma onset during "pre-school and "school age" periods in a population-based birth cohort.65 254 children born between 1999 and 2002 in the greater Vancouver metropolitan region were followed until age 10 years using linked administrative health databases. Asthma cases were sex- and age-matched to five randomly chosen controls. Associations between exposure to air pollutants estimated with different methods (interpolation (inverse-distance weighted (IDW)), land use regression, proximity) and incident asthma during the pre-school (0-5 years) and school age (6-10 years) periods were estimated with conditional logistic regression.6948 and 1711 cases were identified during the pre-school and school age periods, respectively. Following adjustment for birthweight, gestational period, household income, parity, breastfeeding at discharge, maternal age and education, asthma risk during the pre-school years was increased by traffic pollution (adjusted odds ratio using IDW method per interquartile increase (95% CI): nitric oxide 1.06 (1.01-1.11), nitrogen dioxide 1.09 (1.04-1.13) and carbon monoxide 1.05 (1.01-1.1)). Enhanced impacts were observed amongst low-term-birthweight cases. Associations were independent of surrounding residential greenness.Within-city air pollution variation was associated with new asthma onset during the pre-school years.
 

Eur Respir J. 2016 Feb 8. pii: ERJ-00746-2015. doi: 10.1183/13993003.00746-2015. [Epub ahead of print]