Timing and Duration of Traffic-related Air Pollution Exposure and the Risk for Childhood Wheeze and Asthma
Timing and Duration of Traffic-related Air Pollution Exposure and the Risk for Childhood Wheeze and Asthma
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DOI：
10.1164/rccm.201407-1314oc
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发表时间：
2015-08-15
影响因子：
24.7
通讯作者：
LeMasters, Grace
中科院分区：
文献类型：
--
作者：
Brunst, Kelly J.;Ryan, Patrick H.;LeMasters, Grace
基本原理：交通相关的空气污染（TRAP）暴露的时间和持续时间可能是重要的儿童喘息和哮喘development.Objectives：我们研究了TRAP暴露和纵向喘息表型和哮喘之间的关系，在7岁。方法：儿童完成临床检查，每年从1岁到4岁和7岁。在每个年龄评估父母报告的喘鸣，并在7岁时定义纵向喘鸣表型（早发型、迟发型、持续性）和哮喘。参与者的时间加权暴露于TRAP，从出生到7岁，估计使用土地使用回归模型。研究TRAP暴露与喘息表型和哮喘之间的关系。测量和主要结果：出生时高TRAP暴露与短暂性和持续性喘息表型显著相关（校正比值比[aOR] = 1.64; 95%置信区间[CI]，1.04-2.57和aOR = 2.31; 95% CI，1.28-4.15）;出生至1岁和1至2岁的暴露也与持续性喘息相关。只有从出生到7岁的TRAP平均暴露水平高的儿童发生哮喘的风险显著增加（aOR = 1.71; 95%CI，1.01-2.88）。结论：早期生活中暴露于TRAP与持续性喘息的风险增加有关，但只有在整个儿童期长期暴露于高水平的TRAP与哮喘的发生有关。
Rationale: The timing and duration of traffic-related air pollution (TRAP) exposure may be important for childhood wheezing and asthma development.Objectives: We examined the relationship between TRAP exposure and longitudinal wheezing phenotypes and asthma at age 7 years.Methods: Children completed clinical examinations annually from age 1 year through age 4 years and age 7 years. Parental-reported wheezing was assessed at each age, and longitudinal wheezing phenotypes (early-transient, late-onset, persistent) and asthma were defined at age 7 years. Participants' time-weighted exposure to TRAP, from birth through age 7 years, was estimated using a land-use regression model. The relationship between TRAP exposure and wheezing phenotypes and asthma was examined. Measurements and MainResults: High TRAP exposure at birth was significantly associated with both transient and persistent wheezing phenotypes (adjusted odds ratio [aOR] = 1.64; 95% confidence interval [CI], 1.04-2.57 and aOR = 2.31; 95% CI, 1.28-4.15, respectively); exposure from birth to age 1 year and age 1 to 2 years was also associated with persistent wheeze. Only children with high average TRAP exposure from birth through age 7 years were at significantly increased risk for asthma (aOR = 1.71; 95% CI, 1.01-2.88).Conclusions: Early-life exposure to TRAP is associated with increased risk for persistent wheezing, but only long-term exposure to high levels of TRAP throughout childhood was associated with asthma development.