产前和早期接触空气污染与幼儿肺功能的关系：探索暴露对肺发育的影响窗口
2023/02/20
摘要
研究背景：文献中的证据表明，出生前和生命早期经历的空气污染暴露可能对正常的肺部发育有害，但发育过程中关键窗口的具体时间尚不完全清楚。
研究目的：我们评估了出生前和生命早期的空气污染暴露与6-9岁肺功能的关系，以确定对肺发育有潜在影响的暴露窗口。
实验方法：我们的研究人群包括222名来自加利福尼亚州弗雷斯诺-克洛维斯都市区的6-9岁儿童，他们在2015年5月至2017年5月期间收集了肺活量测量数据。我们使用分布滞后非线性模型，灵活地模拟了产前月和生命前三年期间月平均暴露于细颗粒物（PM2.5）和臭氧（O3）的暴露滞后反应，并与强迫肺活量（FVC）和第一秒强迫呼气量（FEV1）相关，并对协变量进行了调整。
结果：在产前和出生后头3年的PM2.5暴露与6-9岁时评估的FVC和FEV1的降低有关。具体来说，从观察到的月平均暴露量的第5百分位数（7.55μg/m3）增加到窗口期观察到的暴露量的中位数（12.69μg/m3），与FVC降低0.42L（95%置信区间（CI）：-0.82，-0.03）和FEV1降低0.38L（95%CI：-0.75，-0.02）有关。滞后反应的形状表明，怀孕的后半段可能是一个特别有影响的接触窗口。臭氧的关联性没有那么强，典型的CIs包括无效。
结论：我们的发现表明，产前和早期接触PM2.5与儿童后期肺功能下降有关。怀孕后几个月的暴露可能特别有影响。
Associations between prenatal and early-life air pollution exposure and lung function in young children: Exploring influential windows of exposure on lung development
Neophytou, A. M., Lutzker, L., Good, K. M., Mann, J. K., Noth, E. M., Holm, S. M., Costello, S., Tyner, T., Nadeau, K. C., Eisen, E. A., Lurmann, F., Hammond, S. K., & Balmes, J. R. (2023).
Abstract
BACKGROUND:Evidence in the literature suggests that air pollution exposures experienced prenatally and early in life can be detrimental to normal lung development, however the specific timing of critical windows during development is not fully understood.
OBJECTIVES:We evaluated air pollution exposures during the prenatal and early-life period in association with lung function at ages 6-9, in an effort to identify potentially influential windows of exposure for lung development.
METHODS:Our study population consisted of 222 children aged 6-9 from the Fresno-Clovis metro area in California with spirometry data collected between May 2015 and May 2017. We used distributed-lag non-linear models to flexibly model the exposure-lag-response for monthly average exposure to fine particulate matter (PM2.5) and ozone (O3) during the prenatal months and first three years of life in association with forced vital capacity (FVC), and forced expiratory volume in the first second (FEV1), adjusted for covariates.
RESULTS:PM2.5 exposure during the prenatal period and the first 3-years of life was associated with lower FVC and FEV1 assessed at ages 6-9. Specifically, an increase from the 5th percentile of the observed monthly average exposure (7.55 μg/m3) to the median observed exposure (12.69 μg/m3) for the duration of the window was associated with 0.42 L lower FVC (95% confidence interval (CI): -0.82, -0.03) and 0.38 L lower FEV1 (95% CI: -0.75, -0.02). The shape of the lag-response indicated that the second half of pregnancy may be a particularly influential window of exposure. Associations for ozone were not as strong and typically CIs included the null.
CONCLUSION:Our findings indicate that prenatal and early-life exposures to PM2.5 are associated with decreased lung function later in childhood. Exposures during the latter months of pregnancy may be especially influential.
研究背景：文献中的证据表明，出生前和生命早期经历的空气污染暴露可能对正常的肺部发育有害，但发育过程中关键窗口的具体时间尚不完全清楚。
研究目的：我们评估了出生前和生命早期的空气污染暴露与6-9岁肺功能的关系，以确定对肺发育有潜在影响的暴露窗口。
实验方法：我们的研究人群包括222名来自加利福尼亚州弗雷斯诺-克洛维斯都市区的6-9岁儿童，他们在2015年5月至2017年5月期间收集了肺活量测量数据。我们使用分布滞后非线性模型，灵活地模拟了产前月和生命前三年期间月平均暴露于细颗粒物（PM2.5）和臭氧（O3）的暴露滞后反应，并与强迫肺活量（FVC）和第一秒强迫呼气量（FEV1）相关，并对协变量进行了调整。
结果：在产前和出生后头3年的PM2.5暴露与6-9岁时评估的FVC和FEV1的降低有关。具体来说，从观察到的月平均暴露量的第5百分位数（7.55μg/m3）增加到窗口期观察到的暴露量的中位数（12.69μg/m3），与FVC降低0.42L（95%置信区间（CI）：-0.82，-0.03）和FEV1降低0.38L（95%CI：-0.75，-0.02）有关。滞后反应的形状表明，怀孕的后半段可能是一个特别有影响的接触窗口。臭氧的关联性没有那么强，典型的CIs包括无效。
结论：我们的发现表明，产前和早期接触PM2.5与儿童后期肺功能下降有关。怀孕后几个月的暴露可能特别有影响。
(中日友好医院呼吸与危重症医学科 沈焜路 摘译 林江涛 审校)
(Environ Res. 2023 Feb 3. DOI: 10.1016/j.envres.2023.115415)
(Environ Res. 2023 Feb 3. DOI: 10.1016/j.envres.2023.115415)
Associations between prenatal and early-life air pollution exposure and lung function in young children: Exploring influential windows of exposure on lung development
Neophytou, A. M., Lutzker, L., Good, K. M., Mann, J. K., Noth, E. M., Holm, S. M., Costello, S., Tyner, T., Nadeau, K. C., Eisen, E. A., Lurmann, F., Hammond, S. K., & Balmes, J. R. (2023).
Abstract
BACKGROUND:Evidence in the literature suggests that air pollution exposures experienced prenatally and early in life can be detrimental to normal lung development, however the specific timing of critical windows during development is not fully understood.
OBJECTIVES:We evaluated air pollution exposures during the prenatal and early-life period in association with lung function at ages 6-9, in an effort to identify potentially influential windows of exposure for lung development.
METHODS:Our study population consisted of 222 children aged 6-9 from the Fresno-Clovis metro area in California with spirometry data collected between May 2015 and May 2017. We used distributed-lag non-linear models to flexibly model the exposure-lag-response for monthly average exposure to fine particulate matter (PM2.5) and ozone (O3) during the prenatal months and first three years of life in association with forced vital capacity (FVC), and forced expiratory volume in the first second (FEV1), adjusted for covariates.
RESULTS:PM2.5 exposure during the prenatal period and the first 3-years of life was associated with lower FVC and FEV1 assessed at ages 6-9. Specifically, an increase from the 5th percentile of the observed monthly average exposure (7.55 μg/m3) to the median observed exposure (12.69 μg/m3) for the duration of the window was associated with 0.42 L lower FVC (95% confidence interval (CI): -0.82, -0.03) and 0.38 L lower FEV1 (95% CI: -0.75, -0.02). The shape of the lag-response indicated that the second half of pregnancy may be a particularly influential window of exposure. Associations for ozone were not as strong and typically CIs included the null.
CONCLUSION:Our findings indicate that prenatal and early-life exposures to PM2.5 are associated with decreased lung function later in childhood. Exposures during the latter months of pregnancy may be especially influential.
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