Infant Infections and Respiratory Symptoms in Relation to in Utero Arsenic Exposure in a U.S. Cohort.
Infant Infections and Respiratory Symptoms in Relation to in Utero Arsenic Exposure in a U.S. Cohort.
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DOI：
10.1289/ehp.1409282
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发表时间：
2016-06
影响因子：
10.4
通讯作者：
Karagas MR
中科院分区：
文献类型：
--
作者：
Farzan SF;Li Z;Korrick SA;Spiegelman D;Enelow R;Nadeau K;Baker E;Karagas MR
砷与免疫功能紊乱和高度暴露人群的感染易感性有关。在我们的美国研究地区，砷含量超过美国环保署的限制，这对孕妇和婴儿来说尤其令人担忧。我们调查了子宫内砷暴露是否会影响出生后第一年感染和呼吸道症状的风险。我们前瞻性地获得了关于婴儿感染和症状的信息，包括在4个月、8个月和12个月时的持续时间和治疗（n = 412）。使用广义估计方程模型调整潜在的混杂因素，我们评估孕妇怀孕尿砷和婴儿感染和症状之间的关联在第一年。母亲尿砷每增加一倍与第一年需要处方药的感染总数增加有关[相对危险度（RR）= 1.1; 95%CI：1.0，1.2]。尿砷与呼吸道症状密切相关（呼吸困难、喘息和咳嗽）持续≥ 2天或需要处方药（RR = 1.1; 95% CI：1.0，1.2; RR = 1.2; 95% CI：1.0，1.5）和喘息持续≥ 2天，导致就诊或处方药治疗（RR = 1.3; 95% CI：1.0，1.7; RR = 1.3; 95% CI：1.0，1.8; RR = 1.5; 95% CI：1.0，2.2）。还观察到与腹泻（RR = 1.4; 95% CI：1.1，1.9）和发热导致就诊（RR = 1.2; 95% CI：1.0，1.5）相关。在我们的研究人群中，子宫内砷暴露与出生后第一年感染的风险较高相关，特别是需要药物治疗的感染，以及腹泻和呼吸道症状。Farzan SF，Li Z，Korrick SA，Spiegelman D，Enelow R，Nadeau K，Baker E，Karagas MR. 2016.美国队列中与宫内砷暴露相关的婴儿感染和呼吸道症状环境健康展望124：840-847; http：dx.doi.org/10.1289/ehp.1409282
Arsenic has been linked to disrupted immune function and greater infection susceptibility in highly exposed populations. Well arsenic levels above the U.S. EPA limit occur in our U.S. study area and are of particular concern for pregnant women and infants. We investigated whether in utero arsenic exposure affects the risk of infections and respiratory symptoms over the first year of life. We prospectively obtained information on infant infections and symptoms, including their duration and treatment (n = 412) at 4, 8, and 12 months using a parental telephone survey. Using generalized estimating equation models adjusted for potential confounders, we evaluated the association between maternal pregnancy urinary arsenic and infant infections and symptoms over the first year. Each doubling of maternal urinary arsenic was related to increases in the total number of infections requiring prescription medication in the first year [relative risk (RR) = 1.1; 95% CI: 1.0, 1.2]. Urinary arsenic was related specifically to respiratory symptoms (difficulty breathing, wheezing, and cough) lasting ≥ 2 days or requiring prescription medication (RR = 1.1; 95% CI: 1.0, 1.2; and RR = 1.2; 95% CI: 1.0, 1.5, respectively), and wheezing lasting ≥ 2 days, resulting in a doctor visit or prescription medication treatment (RR = 1.3; 95% CI: 1.0, 1.7; RR = 1.3; 95% CI: 1.0, 1.8, and RR = 1.5; 95% CI: 1.0, 2.2, respectively). Associations also were observed with diarrhea (RR = 1.4; 95% CI: 1.1, 1.9) and fever resulting in a doctor visit (RR = 1.2; 95% CI: 1.0, 1.5). In utero arsenic exposure was associated with a higher risk of infection during the first year of life in our study population, particularly infections requiring medical treatment, and with diarrhea and respiratory symptoms. Farzan SF, Li Z, Korrick SA, Spiegelman D, Enelow R, Nadeau K, Baker E, Karagas MR. 2016. Infant infections and respiratory symptoms in relation to in utero arsenic exposure in a U.S. cohort. Environ Health Perspect 124:840–847; http://dx.doi.org/10.1289/ehp.1409282