Association of asthma symptoms with peak particulate air pollution and effect modification by anti-inflammatory medication use.
Association of asthma symptoms with peak particulate air pollution and effect modification by anti-inflammatory medication use.
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DOI：
10.1289/ehp.021100607
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发表时间：
2002-10
影响因子：
10.4
通讯作者：
McLaren CE
中科院分区：
文献类型：
--
作者：
Delfino RJ;Zeiger RS;Seltzer JM;Street DH;McLaren CE
室外监测仪每小时数据的最大值可能比24小时PM平均值更好地捕捉室外颗粒物（PM）暴露对哮喘儿童的不利影响，后者构成了美国现行法规的基础。此外，哮喘儿童服用抗炎药物可能会防止空气污染物和空气过敏原的促炎作用。我们检查了哮喘儿童亚组中使用和不使用常规抗炎药物的污染物与哮喘症状的关联强度，并测试了不同颗粒平均时间的关联。这是一项对22名哮喘儿童（9-19岁）的每日小组研究，从1996年3月到4月（1,248人日）。他们住在南加州半农村地区的非吸烟家庭中，该地区处于空气逆温混合区（范围，1200 - 2100英尺），空气污染从南加州城市地区转移过来。从日记序数得分得出的因变量是干扰日常活动的哮喘症状发作。室外监测点最小至90百分位暴露水平为12-63微克/米(3)，1小时PM < 10微米的空气动力学直径（PM(10)）；8-46微克/米(3)8小时PM(10)；7-32微克/米(3)24小时PM(10)；45-88 ppb 1小时O(3)；8小时NO(2) 6-26 ppb；12小时白天真菌70-4,714粒/m(3)；24小时花粉为12-744粒/m(3)。用控制自相关的广义估计方程对数据进行分析。不受天气、星期几或线性时间趋势的影响。在12名未服用抗炎药物的哮喘儿童中，与10名服用抗炎药物的儿童相比，这种关联明显更强。哮喘发作与滞后0至90百分位污染物变化相关的比值比（95%置信区间）分别为1小时最大PM（10）、1.92（1.22-3.02）和0.96 (0.25-3.69)；8小时最大PM（10）分别为1.68（0.91-3.09）和0.75 (0.18-3.04)；24小时平均PM（10）分别为1.35（0.82-2.22）和0.80 (0.24-2.69)；1小时最大O(3), 1.28（0.75-2.17）比0.76 (0.24-2.44)；8小时最大NO(2)分别为1.91（1.07-3.39）和1.08 (0.30-3.93)；12小时真菌，1.89 (1.24-2.89)vs 0.90 (0.35-2.30)；24小时花粉率为1.90（0.99 ~ 3.67）比0.85（0.18 ~ 3.91）。在未服用抗炎药物的受试者中，呼吸道感染与污染物的关联更强。虽然滞后0- 1小时最大PM（10）显示出最强的关联，但在阈值的敏感性分析测试中，滞后0和滞后3天移动平均（滞后0-2）8小时最大PM和24小时平均PM（10）的相关性最强。大多数污染物的影响在很大程度上是由上层五分之一的浓度驱动的。抗炎药物使用对暴露-反应关系的差异与空气污染物和过敏原炎症机制的实验数据一致。
Maxima of hourly data from outdoor monitors may capture adverse effects of outdoor particulate matter (PM) exposures in asthmatic children better than do 24-hr PM averages, which form the basis of current regulations in the United States. Also, asthmatic children on anti-inflammatory medications may be protected against the proinflammatory effects of air pollutants and aeroallergens. We examined strengths of pollutant associations with asthma symptoms between subgroups of asthmatic children who were on versus not on regularly scheduled anti-inflammatory medications, and tested associations for different particle averaging times. This is a daily panel study of 22 asthmatic children (9-19 years of age) followed March through April 1996 (1,248 person-days). They lived in nonsmoking households in a semirural area of Southern California within the air inversion mixing zone (range, 1,200-2,100 feet) with transported air pollution from urban areas of Southern California. The dependent variable derived from diary ordinal scores is episodes of asthma symptoms that interfered with daily activities. Minimum to 90th-percentile levels of exposures at the outdoor monitoring site were 12-63 microg/m(3) for 1-hr PM < 10 microm in aerodynamic diameter (PM(10)); 8-46 microg/m(3) for 8-hr PM(10); 7-32 microg/m(3) for 24-hr PM(10); 45-88 ppb for 1-hr O(3); 6-26 ppb for 8-hr NO(2); 70-4,714 particles/m(3) for 12-hr daytime fungi; and 12-744 particles/m(3) for 24-hr pollen. Data were analyzed with generalized estimating equations controlling for autocorrelation. There was no confounding by weather, day of week, or linear time trend. Associations were notably stronger in 12 asthmatic children who were not taking anti-inflammatory medications versus 10 subjects who were. Odds ratios (95% confidence intervals) for asthma episodes in relation to lag 0 minimum to 90th-percentile pollutant changes were, respectively, 1-hr maximum PM(10), 1.92 (1.22-3.02) versus 0.96 (0.25-3.69); 8-hr maximum PM(10), 1.68 (0.91-3.09) versus 0.75 (0.18-3.04); 24-hr average PM(10), 1.35 (0.82-2.22) versus 0.80 (0.24-2.69); 1-hr maximum O(3), 1.28 (0.75-2.17) versus 0.76 (0.24-2.44); 8-hr maximum NO(2), 1.91 (1.07-3.39) versus 1.08 (0.30-3.93); 12-hr fungi, 1.89 (1.24-2.89) versus 0.90 (0.35-2.30); 24-hr pollen, 1.90 (0.99-3.67) versus 0.85 (0.18-3.91). Pollutant associations were stronger during respiratory infections in subjects not on anti-inflammatory medications. Although lag 0 1-hr maximum PM(10) showed the strongest association, the most robust associations were for lag 0 and 3-day moving averages (lags 0-2) of 8-hr maximum and 24-hr mean PM(10) in sensitivity analyses testing for thresholds. Most pollutant effects were largely driven by concentrations in the upper quintile. The divergence of exposure-response relationships by anti-inflammatory medication use is consistent with experimental data on inflammatory mechanisms of airborne pollutants and allergens.
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DOI：
10.1164/ajrccm.162.5.9908113
发表时间：
2000-11-01
影响因子：
24.7
作者：
Mortimer, KM;Tager, IB;Redline, S
通讯作者：
Redline, S
影响因子：
10.4
作者：
Delfino, RJ;Zeiger, RS;Street, DH
通讯作者：
Street, DH
影响因子：
10.4
作者：
McConnell, R;Berhane, K;Peters, JM
通讯作者：
Peters, JM
影响因子：
10
作者：
Anderson, HR;de Leon, AP;Strachan, DP
通讯作者：
Strachan, DP
影响因子：
3.3
作者：
Nel, A E;Diaz-Sanchez, D;Li, N
通讯作者：
Li, N