Environmental issues in managing asthma.
Environmental issues in managing asthma.
复制标题
DOI：
--
复制
发表时间：
2008-05
期刊：
影响因子：
2.5
通讯作者：
G. Diette;M. McCormack;N. Hansel;P. Breysse;E. Matsui
中科院分区：
文献类型：
--
作者：
G. Diette;M. McCormack;N. Hansel;P. Breysse;E. Matsui
哮喘的管理需要注意室内和室外的环境暴露。美国人大部分时间都呆在室内，在那里他们有更大的能力来改变他们的环境。室内环境既含有污染物(如颗粒物、二氧化氮、二手烟和臭氧)，也含有毛茸茸的宠物、尘螨、蟑螂、啮齿动物和霉菌产生的过敏原。室内颗粒物由室内来源(如烹饪和清洁活动)产生的颗粒和从室外渗入的颗粒组成。二氧化氮的来源包括燃气炉、炉子和壁炉。室内颗粒物和二氧化氮与哮喘发病率有关。室内臭氧浓度主要受室外臭氧浓度的影响。室内臭氧暴露对健康的影响还没有得到很好的研究。相比之下，有大量证据表明二手烟对健康有害。指南建议并不是针对优化室内空气质量的具体建议。2007年国家哮喘教育和预防项目哮喘指南建议消除室内吸烟并改善通风。尽管指南指出，没有足够的证据推荐空气净化器，但空气净化器和减少产生室内污染物的活动可能是改善哮喘患者健康的可靠而实用的方法。这些指南对避免过敏原更为具体；它们建议确定个人对免疫球蛋白E敏感的过敏原，并采用多方面的综合策略来减少接触。影响哮喘的室外空气污染物包括颗粒物、臭氧、二氧化氮和二氧化硫，指南建议哮喘患者在这些污染物升高时避免在户外运动。户外过敏原包括树木、草和杂草花粉，它们的浓度因季节而异。减少接触的建议包括呆在室内，关闭窗户和门，使用空调，也许还有高效的微粒抑制器(HEPA)空气过滤器，以及每天彻底清洗以消除身体的过敏原。
Management of asthma requires attention to environmental exposures both indoors and outdoors. Americans spend most of their time indoors, where they have a greater ability to modify their environment. The indoor environment contains both pollutants (eg, particulate matter, nitrogen dioxide, secondhand smoke, and ozone) and allergens from furred pets, dust mites, cockroaches, rodents, and molds. Indoor particulate matter consists of particles generated from indoor sources such as cooking and cleaning activities, and particles that penetrate from the outdoors. Nitrogen dioxide sources include gas stoves, furnaces, and fireplaces. Indoor particulate matter and nitrogen dioxide are linked to asthma morbidity. The indoor ozone concentration is mainly influenced by the outdoor ozone concentration. The health effects of indoor ozone exposure have not been well studied. In contrast, there is substantial evidence of detrimental health effects from secondhand smoke. Guideline recommendations are not specific for optimizing indoor air quality. The 2007 National Asthma Education and Prevention Program asthma guidelines recommend eliminating indoor smoking and improving the ventilation. Though the guidelines state that there is insufficient evidence to recommend air cleaners, air cleaners and reducing activities that generate indoor pollutants may be sound practical approaches for improving the health of individuals with asthma. The guidelines are more specific about allergen avoidance; they recommend identifying allergens to which the individual is immunoglobin E sensitized and employing a multifaceted, comprehensive strategy to reduce exposure. Outdoor air pollutants that impact asthma include particulate matter, ozone, nitrogen dioxide, and sulfur dioxide, and guidelines recommend that individuals with asthma avoid exertion outdoors when these pollutants are elevated. Outdoor allergens include tree, grass, and weed pollens, which vary in concentration by season. Recommendations to reduce exposure include staying indoors, keeping windows and doors closed, using air conditioning and perhaps high-efficiency particulate arrestor (HEPA) air filters, and thorough daily washing to remove allergens from one's person.