Juvenile idiopathic arthritis and exposure to fine particulate air pollution.
Juvenile idiopathic arthritis and exposure to fine particulate air pollution.
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发表时间：
2009-09
影响因子：
3.7
通讯作者：
Andrew S. Zeft;S. Prahalad;S. Lefèvre;B. Clifford;Bernadette McNally;J. Bohnsack;C. Pope
中科院分区：
文献类型：
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作者：
Andrew S. Zeft;S. Prahalad;S. Lefèvre;B. Clifford;Bernadette McNally;J. Bohnsack;C. Pope
目的吸入细颗粒物，包括空气动力学直径小于或等于2.5微米切点(PM2.5)的颗粒物，与全身炎症和各种心肺健康事件的临床表现有关。犹他州瓦萨奇山脉沿线的市区在空气条件停滞期间PM2.5浓度很高。在幼年特发性关节炎(JIA)的新患者中，短期吸入暴露可能会引发炎症事件，表现为症状发作。这项研究评估了JIA症状出现与区域空气污染的时间变化之间的潜在联系，这些变化是通过停滞的空气条件和PM2.5浓度来衡量的。方法采用病例-交叉设计，分析居住在犹他州瓦萨奇前线的338例JIA病例的区域环境PM2.5浓度与发病日期的关系。患者来自山间各州儿童风湿病数据库(1993-2006)。通过匹配控制时间趋势、季节性、月份和工作日。选择PM2.5暴露窗口和空气滞留天数，确定短期累积暴露对JIA症状发生的影响。结果前14天PM2.5浓度升高和空气停滞与学龄前儿童JIA发病风险显著相关(RR=1.60，95%CI 1.00~2.54)，但与年龄较大儿童无关。男性和全身性起病的JIA的风险升高更大。结论接触滞留污染空气可能是婴幼儿JIA的环境危险因素，可能是由污染所致的肺部炎症所致。
OBJECTIVES Inhalation of fine particulate matter, including particles with an aerodynamic diameter less than or equal to a 2.5-microm cut point (PM2.5), has been associated with systemic inflammation and the clinical presentation of various cardiopulmonary heath events. The urban area along Utah's Wasatch Mountains has high PM2.5 concentrations during periods of stagnant air conditions. Short-term inhalation exposures may trigger inflammatory events presenting as symptom onset in new patients with juvenile idiopathic arthritis (JIA). This study evaluated potential associations between JIA symptom onset and temporal changes in regional air pollution measured by stagnant air conditions and PM2.5 concentrations. METHODS A case-crossover design was used to analyze associations of regional ambient PM2.5 concentrations with onset date of 338 JIA cases living on Utah's Wasatch Front. Patients were drawn from the Intermountain States Database of Childhood Rheumatic Diseases (1993-2006). Time trends, seasonality, month, and weekday were controlled for by matching. Selected exposure windows of PM2.5 and stagnant air days were used in the model to determine the effect of short term cumulative exposure on JIA symptom onset. RESULTS Increased concentrations of PM2.5 and stagnant air conditions in the preceding 14 days were associated with significantly elevated risk of JIA onset in preschool aged children (RR=1.60, 95% CI 1.00-2.54) but not older children. Elevated risk was larger in males and in systemic onset JIA. CONCLUSION Exposure to stagnant polluted air may be an environmental risk factor for JIA in young children, potentially triggered by pollution-induced pulmonary mediated inflammation.