Effects of ambient pollen concentrations on frequency and severity of asthma symptoms among asthmatic children.
Effects of ambient pollen concentrations on frequency and severity of asthma symptoms among asthmatic children.
复制标题
DOI：
10.1097/ede.0b013e31823b66b8
复制
发表时间：
2012-01
期刊：
影响因子：
--
通讯作者：
Bell ML
中科院分区：
文献类型：
--
作者：
DellaValle CT;Triche EW;Leaderer BP;Bell ML
先前关于环境花粉暴露与日常呼吸道症状之间关系的研究产生了不一致的结果。我们在哮喘儿童队列中调查了这些关系，使用花粉暴露模型来估计个体环境暴露。在康涅狄格、马萨诸塞州和纽约的430名4-12岁哮喘儿童中，记录了他们的每日喘息症状、夜间症状、呼吸短促、胸闷、持续咳嗽和抢救药物使用情况。使用混合效应模型估计树木、草、杂草和所有类型花粉的每日环境暴露量。我们根据哮喘维持药物和对草或杂草花粉的致敏性进行分层分析。使用广义估计方程对每个症状结局和花粉类型进行单独的logistic回归分析。我们调整了最高日温度、最高8小时平均臭氧、细颗粒物（PM2.5）、季节和抗生素使用的分析。在对特定花粉敏感的儿童中观察到关联；这些关联因哮喘维持药物的使用而异。即使暴露于相对较低水平的杂草花粉（6-9粒/立方米），与服用维持药物的致敏儿童相比，也会增加呼吸短促、胸闷、抢救药物使用、喘息和持续咳嗽。草花粉暴露≥2粒/m3与未服用维持药物的致敏儿童相比，与暴露量较低的儿童相比，与喘息、夜间症状、呼吸短促和持续咳嗽相关。即使是低水平的花粉暴露也与日常哮喘症状有关。
Previous studies on the associations between ambient pollen exposures and daily respiratory symptoms have produced inconsistent results. We investigated these relationships in a cohort of asthmatic children, using pollen exposure models to estimate individual ambient exposures. Daily symptoms of wheeze, night symptoms, shortness of breath, chest tightness, persistent cough and rescue medication use were recorded in a cohort of 430 children age 4-12 years with asthma in Connecticut, Massachusetts and New York. Daily ambient exposures to tree, grass, weed and all-type pollen were estimated using mixed effects models. We stratified analyses by asthma maintenance medication and sensitization to grass or weed pollens. Separate logistic regression analysis using generalized estimating equations were performed for each symptom outcome and pollen type. We adjusted analyses for maximum daily temperature, maximum 8-hr average ozone, fine particles (PM2.5), season and antibiotic use. Associations were observed among children sensitized to specific pollens; these associations varied by use of asthma maintenance medication. Exposures to even relatively low levels of weed pollen (6-9 grains/m3) were associated with increased shortness of breath, chest tightness, rescue medication use, wheeze, and persistent cough, compared with lower exposure among sensitized children taking maintenance medication. Grass pollen exposures ≥2 grains/m3 were associated with wheeze, night symptoms, shortness of breath and persistent cough compared with lower exposure among sensitized children who did not take maintenance medication. Even low-level pollen exposure was associated with daily asthmatic symptoms.