Ambient Air Pollution Exposure and Incident Adult Asthma in a Nationwide Cohort of U.S. Women
Ambient Air Pollution Exposure and Incident Adult Asthma in a Nationwide Cohort of U.S. Women
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DOI：
10.1164/rccm.201403-0525oc
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发表时间：
2014-10-15
影响因子：
24.7
通讯作者：
London, Stephanie J.
中科院分区：
文献类型：
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作者：
Young, Michael T.;Sandler, Dale P.;London, Stephanie J.
理由：有限的先前数据表明，与交通相关的空气污染与成人哮喘事件之间存在关联。目的：评估环境空气污染暴露(PM2.5和二氧化氮、NO2)与哮喘和呼吸道症状的关系。方法：Sister研究是美国一项关于乳腺癌患者姐妹中乳腺癌危险因素和其他健康结局(n=50,884)的队列研究。利用纳入道路信息的国家土地利用/克里格法模型，估计了参与者住址的(2006年)环境PM2.5和NO2的年平均浓度。随访结果(2008-2012年)包括无基线症状的女性中发生的自我报告的喘息、慢性咳嗽和医生诊断的哮喘。测量和主要结果：调整后的分析包括254例哮喘、1,023例喘息和1,559例慢性咳嗽。对于估计的PM2.5四分位数差(3.6ug/m(3))，发生哮喘的调整优势比为1.2(95%可信区间=0.99-1.46，P=0.063)，发生喘息的调整优势比为1.14(95%可信区间=1.04-1.26，P=0.008)。对于NO2，有证据表明与喘息有关(AOR=1.08，95%CI=1.00-1.17，P=0.048每5.8ppb智商)。两种污染物与咳嗽发生率均无显著相关性(P=0.194)。结论：暴露于PM2.5可增加成年女性发生哮喘的风险，PM2.5和NO2可增加哮喘的发病风险。
Rationale: Limited prior data suggest an association between traffic-related air pollution and incident asthma in adults. No published studies assess the effect of long-term exposures to particulate matter less than 2.5 mu m in diameter (PM2.5) on adult incident asthma.Objectives: To estimate the association between ambient air pollution exposures (PM2.5 and nitrogen dioxide, NO2) and development of asthma and incident respiratory symptoms.Methods: The Sister Study is a U.S. cohort study of risk factors for breast cancer and other health outcomes (n = 50,884) in sisters of women with breast cancer (enrollment, 2003-2009). Annual average (2006) ambient PM2.5 and NO2 concentrations were estimated at participants' addresses, using a national land-use/kriging model incorporating roadway information. Outcomes at follow-up (2008-2012) included incident self-reported wheeze, chronic cough, and doctor-diagnosed asthma in women without baseline symptoms.Measurements and Main Results: Adjusted analyses included 254 incident cases of asthma, 1,023 of wheeze, and 1,559 of chronic cough. For an interquartile range (IQR) difference (3.6 mu g/m(3)) in estimated PM2.5 exposure, the adjusted odds ratio (aOR) was 1.20 (95% confidence interval [CI] = 0.99-1.46, P = 0.063) for incident asthma and 1.14(95% CI = 1.04-1.26, P = 0.008) for incident wheeze. For NO2, there was evidence for an association with incident wheeze (aOR = 1.08, 95% CI = 1.00-1.17, P = 0.048 per IQR of 5.8 ppb). Neither pollutant was significantly associated with incident cough (PM2.5: aOR = 0.95, 95% CI = 0.88-1.03, P = 0.194; NO2: aOR = 1.00, 95% CI = 0.93-1.07, P = 0.939).Conclusions: Results suggest that PM2.5 exposure increases the risk of developing asthma and that PM2.5 and NO2 increase the risk of developing wheeze, the cardinal symptom of asthma, in adult women.