Effect of ambient air pollution on pulmonary exacerbations and lung function in cystic fibrosis
Effect of ambient air pollution on pulmonary exacerbations and lung function in cystic fibrosis
复制标题
DOI：
10.1164/rccm.200306-779oc
复制
发表时间：
2004-04-01
影响因子：
24.7
通讯作者：
Kaufman, JD
中科院分区：
文献类型：
--
作者：
Goss, CH;Newsom, SA;Kaufman, JD
关于环境因素对囊性纤维化（CF）的影响的信息是有限的。我们进行了一项队列研究，以评估CF中空气污染物的影响。这项研究包括1999年和2000年在囊性纤维化基金会国家患者登记处登记的6岁以上的患者。通过将来自空气测量信息检索系统的空气污染值与患者的家庭邮政编码相关联来评估暴露。在调整混杂因素后，颗粒物增加10 μ g/m3（均具有10 μ m（PM 10）或更小的中值空气动力学直径和具有2.5 μ m或更小的空气动力学直径（PM2.5）与8%（95%置信区间[Cl]，2 - 15%）和21%（95% CI，7 - 33%）分别增加两次或多次急性加重的几率;臭氧浓度升高10-ppb与两次或两次以上急性加重的几率增加10%（95%CI，3 - 17%）相关。PM2.5每增加10 mug/m3，在校正混杂因素后，FEV1相应下降24 ml（7 - 40）（95%CI）。PM2.5与死亡率的相关性没有达到统计学显著性（校正的RR = 1.32/10 μ g/ml 0.91 - 1.93; 95%CI）。年平均暴露于颗粒空气污染与肺疾病加重和肺功能下降的风险增加有关，表明环境暴露对CF预后的作用。
Information concerning the impact of environmental factors on cystic fibrosis (CF) is limited. We conducted a cohort study to assess the impact of air pollutants in CF. The study included patients over the age of 6 years enrolled in the Cystic Fibrosis Foundation National Patient Registry in 1999 and 2000. Exposure was assessed by linking air pollution values from the Aerometric Information Retrieval System with the patients' home zip code. After adjusting for confounders, a 10 mug/m(3) rise in particulate matter (both with a median aerodynamic diameter of 10 mum (PM10) or less and with an aerodynamic diameter of 2.5 mum or less (PM2.5) was associated with an 8% (95% confidence interval [Cl], 2-15%) and 21% (95% Cl, 7-33%) increase in the odds of two or more exacerbations, respectively; a 10-ppb rise in ozone was associated with a 10% (95% Cl, 3-17%) increase in odds of two or more exacerbations. For every increase in PM2.5 of 10 mug/m(3), there was an associated fall in FEV1 of 24 ml (7-40) (95% Cl) after adjusting for confounders. PM2.5's association with mortality did not achieve statistical significance (adjusted RR = 1.32 per 10 mug/ml 0.91-1.93; 95% Cl). Annual average exposures to particulate air pollution was associated with an increased risk of pulmonary exacerbations and a decline in lung function, suggesting a role of environmental exposures on prognosis in CF.