Blood lead level and risk of asthma.
Blood lead level and risk of asthma.
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DOI：
10.1289/ehp.7453
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发表时间：
2005-07
影响因子：
10.4
通讯作者：
Johnson CC
中科院分区：
文献类型：
--
作者：
Joseph CL;Havstad S;Ownby DR;Peterson EL;Maliarik M;McCabe MJ Jr;Barone C;Johnson CC
哮喘和铅中毒在美国城市儿童中很普遍。铅暴露可能与免疫球蛋白E的过度产生有关，可能会增加哮喘风险，并导致种族差异。这项研究的目的是检验血铅水平(BLL)与哮喘发病风险之间的种族差异。我们建立并跟踪了一个队列，通过患者接触和从医院数据库中获得的药物声明，前瞻性地确定哮喘的发病。参与者是管理护理参与者，在1-3岁时测量和记录BLL。我们使用多变量分析技术来确定BLL与哮喘流行时期和发病时间的关系。从1995年到1998年，在4634名接受铅筛查的儿童中，69.5%是非裔美国人，50.5%是男性，平均年龄为1.2岁。在非裔美国人中，bll≥5和bll≥10μg/dL与哮喘无关。在高加索人群中，血淋巴细胞≥5μg/dL与哮喘的相关性略有升高，但并不显著[调整危险比(AdjHR)=1.4；95%可信区间(CI)0.7~2.9；p=0.40]。尽管少数高加索人具有高BLL，但当使用更严格的哮喘标准时，adjHR增加到2.7(95%CI，0.9-8.1；p=0.09)。与具有5μg/dL血液病的高加索人相比，无论血液病如何，非裔美国人患哮喘的风险都显著增加(adjHR=1.43.0)。我们的结论是，未观察到BLL对非裔美国人哮喘风险的影响。这些结果表明，需要进一步探索种族、哮喘表型、遗传易感性和包括铅在内的社会环境暴露之间的复杂相互关系。
Asthma and lead poisoning are prevalent among urban children in the United States. Lead exposure may be associated with excessive production of immunoglobulin E, possibly increasing asthma risk and contributing to racial disparities. The objective of this study was to examine racial differences in the association of blood lead level (BLL) to risk of developing asthma. We established and followed a cohort prospectively to determine asthma onset, using patient encounters and drug claims obtained from hospital databases. Participants were managed care enrollees with BLL measured and documented at 1–3 years of age. We used multiple variable analysis techniques to determine the relationship of BLL to period prevalent and incident asthma. Of the 4,634 children screened for lead from 1995 through 1998, 69.5% were African American, 50.5% were male, and mean age was 1.2 years. Among African Americans, BLL ≥5 and BLL ≥10 μg/dL were not associated with asthma. The association of BLL ≥5 μg/dL with asthma among Caucasians was slightly elevated, but not significant [adjusted hazard ratio (adjHR) = 1.4; 95% confidence interval (CI), 0.7–2.9; p = 0.40]. Despite the small number of Caucasians with high BLL, the adjHR increased to 2.7 (95% CI, 0.9–8.1; p = 0.09) when more stringent criteria for asthma were used. When compared with Caucasians with BLL < 5 μg/dL, African Americans were at a significantly increased risk of asthma regardless of BLL (adjHR = 1.4–3.0). We conclude that an effect of BLL on risk of asthma for African Americans was not observed. These results demonstrate the need for further exploration of the complex interrelationships between race, asthma phenotype, genetic susceptibilities, and socioenvironmental exposures, including lead.
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影响因子：
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Celedón, JC;Sredl, D;Cloutier, M
通讯作者：
Cloutier, M
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