交通相关的空气污染与哮喘的发生、持续及低水平的肺功能
2018/04/04
摘要
背景及目的：已知交通相关的空气污染（TRAP）会加剧现有的呼吸系统疾病。我们研究了TRAP暴露对有或没有哮喘患者以及有或没有肺功能低下人群的长期影响
方法：在前瞻性塔斯马尼亚纵向健康研究（TAHS）中研究了TRAP暴露与哮喘（研究对象： 689名）和肺功能（研究对象：599名）之间的关联。年龄45岁的TRAP暴露量采用两种基于居住地址的方法测量：年平均NO2暴露量;居住地与主干道的距离。使用调整后的多项式逻辑回归来模拟45年的TRAP暴露与哮喘和肺功能的变化之间的关联，使用TAHS的三次随访数据（45,50和53年）。
结果：对于那些截至45岁从未患过哮喘的人来说，居住地距离主干道<200米与50岁到53岁之间哮喘发病率增加相关（校正比值比[aOR] 5.20; 95％CI 1.07,25.4）。居住地距离主干道<200m的哮喘患者与> 200m的哮喘患者相比，症状持续的风险会增加（aOR = 5.21; 95％CI为1.54,17.6 ）。
结论：对于中年人，居住地与主干道距离200米以下（TRAP暴露标志）会影响哮喘的发展和持续。这些发现对于初中级哮喘预防策略具有公共卫生意义。
Traffic related air pollution and development and persistence of asthma and low lung function
Bowatte G, Lodge CJ, Knibbs LD
Abstract
BACKGROUND AND OBJECTIVE:Traffic Related Air Pollution (TRAP) exposure is known to exacerbate existing respiratory diseases. We investigated longer term effects of TRAP exposure for individuals with or without existing asthma, and with or without lower lung function.
METHODS:Associations between TRAP exposure and asthma (n = 689) and lung function (n = 599) were investigated in the prospective Tasmanian Longitudinal Health Study (TAHS). TRAP exposure at age 45 years was measured using two methods based on residential address: mean annual NO2 exposure; and distance to nearest major road. Adjusted multinomial logistic regression was used to model the association between exposure to TRAP at 45 years and changes in asthma and lung function, using three follow ups of TAHS (45, 50 and 53 years).
RESULTS:For those who never had asthma by 45, living <200 m from a major road was associated with increased odds of new asthma that persisted from 50 to 53 years (adjusted Odds Ratio [aOR] 5.20; 95% CI 1.07, 25.4). Asthmatic participants at 45 had an increased risk of persistent asthma up to 53 years if they were living <200 m from a major road, compared with asthmatic participants living >200 m from a major road (aOR = 5.21; 95% CI 1.54, 17.6).
CONCLUSIONS:For middle aged adults, living <200 m for a major road (a marker of TRAP exposure) influences both the development and persistence of asthma. These findings have public health implications for asthma prevention strategies in primary and secondary settings.
背景及目的：已知交通相关的空气污染（TRAP）会加剧现有的呼吸系统疾病。我们研究了TRAP暴露对有或没有哮喘患者以及有或没有肺功能低下人群的长期影响
方法：在前瞻性塔斯马尼亚纵向健康研究（TAHS）中研究了TRAP暴露与哮喘（研究对象： 689名）和肺功能（研究对象：599名）之间的关联。年龄45岁的TRAP暴露量采用两种基于居住地址的方法测量：年平均NO2暴露量;居住地与主干道的距离。使用调整后的多项式逻辑回归来模拟45年的TRAP暴露与哮喘和肺功能的变化之间的关联，使用TAHS的三次随访数据（45,50和53年）。
结果：对于那些截至45岁从未患过哮喘的人来说，居住地距离主干道<200米与50岁到53岁之间哮喘发病率增加相关（校正比值比[aOR] 5.20; 95％CI 1.07,25.4）。居住地距离主干道<200m的哮喘患者与> 200m的哮喘患者相比，症状持续的风险会增加（aOR = 5.21; 95％CI为1.54,17.6 ）。
结论：对于中年人，居住地与主干道距离200米以下（TRAP暴露标志）会影响哮喘的发展和持续。这些发现对于初中级哮喘预防策略具有公共卫生意义。
(中日友好医院呼吸与危重症医学科 张科文 摘译 林江涛 审校)
(Environ Int. 2018 Apr;113:170-176. doi: 10.1016/j.envint)
Traffic related air pollution and development and persistence of asthma and low lung function
Bowatte G, Lodge CJ, Knibbs LD
Abstract
BACKGROUND AND OBJECTIVE:Traffic Related Air Pollution (TRAP) exposure is known to exacerbate existing respiratory diseases. We investigated longer term effects of TRAP exposure for individuals with or without existing asthma, and with or without lower lung function.
METHODS:Associations between TRAP exposure and asthma (n = 689) and lung function (n = 599) were investigated in the prospective Tasmanian Longitudinal Health Study (TAHS). TRAP exposure at age 45 years was measured using two methods based on residential address: mean annual NO2 exposure; and distance to nearest major road. Adjusted multinomial logistic regression was used to model the association between exposure to TRAP at 45 years and changes in asthma and lung function, using three follow ups of TAHS (45, 50 and 53 years).
RESULTS:For those who never had asthma by 45, living <200 m from a major road was associated with increased odds of new asthma that persisted from 50 to 53 years (adjusted Odds Ratio [aOR] 5.20; 95% CI 1.07, 25.4). Asthmatic participants at 45 had an increased risk of persistent asthma up to 53 years if they were living <200 m from a major road, compared with asthmatic participants living >200 m from a major road (aOR = 5.21; 95% CI 1.54, 17.6).
CONCLUSIONS:For middle aged adults, living <200 m for a major road (a marker of TRAP exposure) influences both the development and persistence of asthma. These findings have public health implications for asthma prevention strategies in primary and secondary settings.
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妊娠期间母亲哮喘的严重程度和控制以及后代哮喘的风险
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成人哮喘死亡率高：一项随访15年、基于人群的队列研究
