哮喘联盟

   摘要
   背景：近期综述总结发现交通相关污染与儿童哮喘发生率之间有关联，但并非所有研究都赞同这一观点。研究几乎只依赖于父母报告症状或父母报告的哮喘和喘息诊断。我们旨在采用以登记为基础的结局数据，探索交通暴露是否与早期哮喘高发率有关。
   方法：我们研究了瑞典南部的一个出生队列，包括N=26128名有结局和暴露数据的儿童（出生时间：2005.7-2010）。在这些儿童中，N=7898有额外的协变量信息。随访此队列至2011年末。居住地址的交通强度和分散模型NOX含量(100x100 m grid)与登记的哮喘治疗（瑞典处方药登记）和住院数据及细支气管炎、阻塞性支气管炎和哮喘的初级医疗诊断数据（Scania医疗登记）有关。，通过对儿童出生8个月后去儿童卫生保健中心的父母发放调查问卷来获得协变量信息。采用Cox比例风险回归来进行统计分析。
   结果：居住在靠近≥8640辆车/天的道路（相比1-8640辆车/天的道路）与首次购买吸入性β2-兴奋剂（校正危险比adj.HR = 0.9，95%可信区间：0.8-1.0）、第三年购买吸入性β2-兴奋剂（adj.HR = 0.7，95%可信区间：0.6-0.9）以及细支气管炎（adj.HR = 0.7，95%可信区间：0.6-0.9）、阻塞性支气管炎（adj.HR =1.0, 95%可信区间：0.9-1.2）或哮喘（adj.HR = 0.7，95%可信区间：0.6- 0.9）发生率增高均无关。对吸入性皮质激素和有关NOX的分析得到相似的结果。
   结论：交通相关暴露与瑞典南部0～6岁儿童哮喘治疗或诊断、细支气管炎或阻塞性支气管炎发生率增高无关。本结果可能依赖于此地区交通污染程度低，大体低于WHO推荐的NO2水平。
 

（刘国梁 审校）
Environ Health. 2013 Oct 26;12(1):91. [Epub ahead of print]

 

Asthma incidence in children growing up close to traffic: a registry-based birth
cohort.
 

Lindgren A, Stroh E, Björk J, Jakobsson K.
 

Abstract
BACKGROUND: Recent reviews conclude an association between traffic-related pollution and incidence of asthma in children, but not all studies agree. Studies have almost exclusively relied on parental-reported symptoms or parental-reported diagnoses of asthma and wheeze. Our aim was to investigate if traffic exposure is associated with higher incidence of early onset asthma, using registry-based outcome data.
METHODS: We investigated a birth cohort in southern Sweden, consisting of N = 26 128 children with outcome and exposure data (born July 2005--2010). Of these children, N = 7898 had additional covariate information. The cohort was followed to the end of 2011.Traffic intensity, and dispersion-modeled concentrations of NOX (100x100 m grid), at residential addresses, were linked with registry data on dispensed asthma medication (the Swedish Prescribed Drug Register), and hospital and primary health care diagnoses of bronchiolitis, obstructive bronchitis and asthma (The Scania Health Care Register).Covariate information was obtained from questionnaires distributed to parents at Child Health Care-centre visits, eight months after birth. Cox proportional hazards regression was used for the statistical analyses.
RESULTS: Living in close proximity to a road with >=8640 cars/day (compared to 0--8640 cars/day), was not associated with higher incidence of first purchase of inhaled beta2-agonist (adjusted hazard ratio (adj.HR) = 0.9, 95% CI: 0.8-1.0); third year purchase of inhaled beta2-agonist (adj.HR = 0.7, 95% CI: 0.6-0.9); bronchiolitis (adj.HR = 0.7, 95% CI: 0.6-0.9), obstructive bronchitis (adj.HR = 1.0, 95% CI: 0.9-1.2), or asthma (adj.HR = 0.7, 95% CI: 0.6- 0.9). Similar results were found for inhaled corticosteroids, and in relation to NOX.
CONCLUSIONS: Traffic-related exposure was not associated with higher incidence of asthma medication, or diagnoses of asthma, bronchiolitis, or obstructive bronchitis, in children 0--6 years in southern Sweden. This may depend on the low levels of traffic pollution in the area, mainly well below the WHO-guideline for NO2.
 

Environ Health. 2013 Oct 26;12(1):91. [Epub ahead of print]