2000年和2010年美国邻近地区交通相关的空气污染和儿童哮喘负担
2019/04/19
摘要
背景：哮喘是美国儿童主要的慢性呼吸道疾病之一。新出现的证据表明，交通相关的空气污染(TRAP)，不是环境空气污染，可导致儿童哮喘的发病。我们估计了2000年和2010年在美国邻近地区由交通相关的空气污染引起的儿童哮喘发作病例数。
方法：采用疾病负担标准评估方法估计因交通相关的空气污染导致的儿童哮喘发病人数和百分数。我们将孩子(< 18 岁)数量和在美国人口普查区的污染物暴露与国家哮喘发病率和荟萃分析中浓度响应函数(CRF)结合起来。用NO2、PM2.5和PM10作为交通相关的空气污染暴露的代用物，其中NO2最为特异。年平均浓度由以前验证的土地利用回归(LUR)模型得到。从文献中获得哮喘发生率和每种污染物的CRF。估计数按在城市或农村生活和家庭收入中位数分层。我们还估计了在两个与现实不符的方案中超出限制的区中可预防的病例数。第一个方案使用了世界卫生组织(世卫组织)建议的空气质量年平均值作为限制。第二种方案使用每种污染物每年的最小模型浓度作为限制。
结果：2000年和2010年NO2平均浓度分别为20.6和13.2 μg / m3, PM2.5平均浓度分别为12.1和9 μg / m3，PM10平均浓度分别为21.5和17.9 μg / m3。根据污染物的不同，可归算的病例数在2000年为209 100-331 200例之间，在2010年为149 900-286 500例之间。由交通相关的空气污染引起的哮喘发生率占全部哮喘发生率在2000年为27%-42%，在2010年为18%-36%。由交通相关的空气污染引起的病例百分比（1）在城市地区高于农村地区，（2）在家庭收入中位数最低的区中更高。美国县级和498个主要城市的调查汇总结果的在线开放交互式地图和表格可以在[https://carteehdata.org/l/s/trap-burden -of-child -asthma]下载。假设污染物不超过世卫组织的空气质量建议，根据污染物和年份，可预防的事件数量在300至53,400例之间。假设污染物浓度被限制在最小模型浓度内，根据污染物和年份，可预防的儿童哮喘病例数在127,700至317,600例之间。
结论：这是第一个在美国全国范围内评估由交通相关的空气污染引起的儿童哮喘发病负担的研究。儿童哮喘的可归因负担在2000年至2010年间下降了33%。然而，相当一部分病例是可以预防的。
Traffic related air pollution and the burden of childhood asthma in the contiguous United States in 2000 and 2010.
Alotaibi R, Bechle M, Marshall JD, Ramani T, Zietsman J, Nieuwenhuijsen MJ, Khreis H.
Abstract
BACKGROUND: Asthma is one of the leading chronic airway diseases among children in the United States (US). Emerging evidence indicates that Traffic Related Air Pollution (TRAP), as opposed to ambient air pollution, leads to the onset of childhood asthma. We estimated the number of incident asthma cases among children attributable to TRAP in the contiguous US, for the years 2000 and 2010.
METHODS: The number of incident childhood asthma cases and percentage due to TRAP were estimated using standard burden of disease assessment methods. We combined children (<18 years) counts and pollutant exposures at populated US census blocks with a national asthma incidence rate and meta-analysis derived concentration response functions (CRF). NO2, PM2.5 and PM10 were used as surrogates of TRAP exposures, with NO2 being most specific. Annual average concentrations were obtained from previously validated land-use regression (LUR) models. Asthma incidence rate and a CRF for each pollutant were obtained from the literature. Estimates were stratified by urban or rural living and by median household income. We also estimated the number of preventable cases among blocks that exceeded the limit for two counterfactual scenarios. The first scenario used the recommended air quality annual averages from the World Health Organization (WHO) as a limit. The second scenario used the minimum modeled concentration for each pollutant, in either year, as a limit.
RESULTS: Average concentrations in 2000 and 2010, respectively, were 20.6 and 13.2 μg/m3 for NO2, 12.1 and 9 μg/m3 for PM2.5 and 21.5 and 17.9 μg/m3 for PM10. Attributable number of cases ranged between 209,100-331,200 for the year 2000 and 141,900-286,500 for 2010, depending on the pollutant. Asthma incident cases due to TRAP represented 27%-42% of all cases in 2000 and 18%-36% in 2010. Percentage of cases due to TRAP were higher (1) in urban areas than rural areas, and (2) in block groups with lowest median household income. Online open-access interactive maps and tables summarizing findings at the county level and 498 major US cities, are available at [https://carteehdata.org/l/s/TRAP-burden-of-childhood-asthma]. Assuming that pollutants did not exceed WHO air quality recommendations, the number of incident cases that could have been prevented ranged between 300 and 53,400, depending on the pollutant and year. Assuming that pollutant levels were limited to the minimum modeled concentration, the number of childhood asthmaincident cases that could have been prevented ranged between 127,700 and 317,600, depending on the pollutant and year.
CONCLUSION: This is the first study to estimate the burden of incident childhood asthma attributable to TRAP at a national scale in the US. The attributable burden of childhood asthma dropped by 33% between 2000 and 2010. However, a significant proportion of cases can be prevented.
背景：哮喘是美国儿童主要的慢性呼吸道疾病之一。新出现的证据表明，交通相关的空气污染(TRAP)，不是环境空气污染，可导致儿童哮喘的发病。我们估计了2000年和2010年在美国邻近地区由交通相关的空气污染引起的儿童哮喘发作病例数。
方法：采用疾病负担标准评估方法估计因交通相关的空气污染导致的儿童哮喘发病人数和百分数。我们将孩子(< 18 岁)数量和在美国人口普查区的污染物暴露与国家哮喘发病率和荟萃分析中浓度响应函数(CRF)结合起来。用NO2、PM2.5和PM10作为交通相关的空气污染暴露的代用物，其中NO2最为特异。年平均浓度由以前验证的土地利用回归(LUR)模型得到。从文献中获得哮喘发生率和每种污染物的CRF。估计数按在城市或农村生活和家庭收入中位数分层。我们还估计了在两个与现实不符的方案中超出限制的区中可预防的病例数。第一个方案使用了世界卫生组织(世卫组织)建议的空气质量年平均值作为限制。第二种方案使用每种污染物每年的最小模型浓度作为限制。
结果：2000年和2010年NO2平均浓度分别为20.6和13.2 μg / m3, PM2.5平均浓度分别为12.1和9 μg / m3，PM10平均浓度分别为21.5和17.9 μg / m3。根据污染物的不同，可归算的病例数在2000年为209 100-331 200例之间，在2010年为149 900-286 500例之间。由交通相关的空气污染引起的哮喘发生率占全部哮喘发生率在2000年为27%-42%，在2010年为18%-36%。由交通相关的空气污染引起的病例百分比（1）在城市地区高于农村地区，（2）在家庭收入中位数最低的区中更高。美国县级和498个主要城市的调查汇总结果的在线开放交互式地图和表格可以在[https://carteehdata.org/l/s/trap-burden -of-child -asthma]下载。假设污染物不超过世卫组织的空气质量建议，根据污染物和年份，可预防的事件数量在300至53,400例之间。假设污染物浓度被限制在最小模型浓度内，根据污染物和年份，可预防的儿童哮喘病例数在127,700至317,600例之间。
结论：这是第一个在美国全国范围内评估由交通相关的空气污染引起的儿童哮喘发病负担的研究。儿童哮喘的可归因负担在2000年至2010年间下降了33%。然而，相当一部分病例是可以预防的。
(中日友好医院呼吸与危重症医学科 禹汶伯 摘译 林江涛 审校)
(Environ Int. 2019 Mar 28. pii: S0160-4120(18)32538-8. doi: 10.1016/j.envint.2019.03.041.)
(Environ Int. 2019 Mar 28. pii: S0160-4120(18)32538-8. doi: 10.1016/j.envint.2019.03.041.)
Traffic related air pollution and the burden of childhood asthma in the contiguous United States in 2000 and 2010.
Alotaibi R, Bechle M, Marshall JD, Ramani T, Zietsman J, Nieuwenhuijsen MJ, Khreis H.
Abstract
BACKGROUND: Asthma is one of the leading chronic airway diseases among children in the United States (US). Emerging evidence indicates that Traffic Related Air Pollution (TRAP), as opposed to ambient air pollution, leads to the onset of childhood asthma. We estimated the number of incident asthma cases among children attributable to TRAP in the contiguous US, for the years 2000 and 2010.
METHODS: The number of incident childhood asthma cases and percentage due to TRAP were estimated using standard burden of disease assessment methods. We combined children (<18 years) counts and pollutant exposures at populated US census blocks with a national asthma incidence rate and meta-analysis derived concentration response functions (CRF). NO2, PM2.5 and PM10 were used as surrogates of TRAP exposures, with NO2 being most specific. Annual average concentrations were obtained from previously validated land-use regression (LUR) models. Asthma incidence rate and a CRF for each pollutant were obtained from the literature. Estimates were stratified by urban or rural living and by median household income. We also estimated the number of preventable cases among blocks that exceeded the limit for two counterfactual scenarios. The first scenario used the recommended air quality annual averages from the World Health Organization (WHO) as a limit. The second scenario used the minimum modeled concentration for each pollutant, in either year, as a limit.
RESULTS: Average concentrations in 2000 and 2010, respectively, were 20.6 and 13.2 μg/m3 for NO2, 12.1 and 9 μg/m3 for PM2.5 and 21.5 and 17.9 μg/m3 for PM10. Attributable number of cases ranged between 209,100-331,200 for the year 2000 and 141,900-286,500 for 2010, depending on the pollutant. Asthma incident cases due to TRAP represented 27%-42% of all cases in 2000 and 18%-36% in 2010. Percentage of cases due to TRAP were higher (1) in urban areas than rural areas, and (2) in block groups with lowest median household income. Online open-access interactive maps and tables summarizing findings at the county level and 498 major US cities, are available at [https://carteehdata.org/l/s/TRAP-burden-of-childhood-asthma]. Assuming that pollutants did not exceed WHO air quality recommendations, the number of incident cases that could have been prevented ranged between 300 and 53,400, depending on the pollutant and year. Assuming that pollutant levels were limited to the minimum modeled concentration, the number of childhood asthmaincident cases that could have been prevented ranged between 127,700 and 317,600, depending on the pollutant and year.
CONCLUSION: This is the first study to estimate the burden of incident childhood asthma attributable to TRAP at a national scale in the US. The attributable burden of childhood asthma dropped by 33% between 2000 and 2010. However, a significant proportion of cases can be prevented.
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阐明哮喘与肥胖之间的因果关系：双向孟德尔随机研究
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按居住地分列的美国儿童哮喘控制，治疗，医疗保健利用和支出趋势：2003-2014
