Exposure to air pollution and development of asthma and rhinoconjunctivitis throughout childhood and adolescence: a population-based birth cohort study
Exposure to air pollution and development of asthma and rhinoconjunctivitis throughout childhood and adolescence: a population-based birth cohort study
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DOI：
10.1016/s2213-2600(15)00426-9
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发表时间：
2015-12-01
影响因子：
76.2
通讯作者：
Brunekreef, Bert
中科院分区：
文献类型：
--
作者：
Gehring, Ulrike;Wijga, Alet H.;Brunekreef, Bert
背景 先前发表的分析主要集中在空气污染对儿童早期和中期哮喘和鼻结膜炎的影响。然而，接触空气污染在儿童和青少年哮喘和鼻结膜炎发展中的作用仍不清楚。我们的目的是评估整个儿童期和青春期暴露于空气污染与哮喘和鼻结膜炎的发展之间的纵向关联。方法我们对来自德国、瑞典和荷兰的四项前瞻性出生队列研究的 14126 名参与者进行了一项基于人群的出生队列研究，并进行了 14-16 年的随访。我们将哮喘和鼻结膜炎的重复问卷调查报告与参与者家庭住址的年平均空气污染浓度（二氧化氮[NO2]、直径小于2.5μm[PM2.5]、小于10μm[PM10]、2.5μm至10μm[PM粗颗粒]和PM2.5吸光度[烟尘指标]）联系起来。我们分析了参与者出生地址和随访时地址的空气污染暴露与特定队列分析中哮喘和鼻结膜炎发病率和患病率的纵向关联，以及随后的荟萃分析和汇总分析。结果总体而言，14-16岁以下儿童发生哮喘的风险随着NO2暴露的增加而增加（调整后的荟萃分析比值比[OR] 1.13/10 mu g/m 3 [95% CI出生地址处的 PM2.5 吸光度（1.02-1.25]）和 PM2.5 吸光度（1.29 每 1 单位 [1.00-1.66]）。 PM2.5 和哮喘事件也显示出类似但不显着的趋势（荟萃分析 OR 1.25 每 5 mu g/m 3 [95% CI 0.94-1.66]）。这些与哮喘的关联在 4 岁之后比该年龄之前更加一致。没有迹象表明空气污染对鼻结膜炎有不利影响。 解释 生命早期接触空气污染可能会导致整个儿童期和青春期哮喘的发生，特别是在 4 岁之后，此时哮喘可以得到更可靠的诊断。减少空气污染水平可能有助于预防儿童哮喘的发生。
Background Previous published analyses have focused on the effect of air pollution on asthma and rhinoconjunctivitis throughout early and middle childhood. However, the role of exposure to air pollution in the development of childhood and adolescent asthma and rhinoconjunctivitis remains unclear. We aimed to assess the longitudinal associations between exposure to air pollution and development of asthma and rhinoconjunctivitis throughout childhood and adolescence.Methods We did a population-based birth cohort study of 14126 participants from four prospective birth cohort studies from Germany, Sweden, and the Netherlands with 14-16 years of follow-up. We linked repeated questionnaire reports of asthma and rhinoconjunctivitis with annual average air pollution concentrations (nitrogen dioxide [NO2], particulate matter [PM] with a diameter of less than 2.5 mu m [PM2.5], less than 10 mu m [PM10], and between 2.5 mu m and 10 mu m [PM coarse], and PM2.5 absorbance [indicator of soot]) at the participants' home addresses. We analysed longitudinal associations of air pollution exposure at participants' birth addresses and addresses at the time of follow-up with asthma and rhinoconjunctivitis incidence and prevalence in cohort-specific analyses, with subsequent meta-analysis and pooled analyses.Findings Overall, the risk of incident asthma up to age 14-16 years increased with increasing exposure to NO2 (adjusted meta-analysis odds ratio [OR] 1.13 per 10 mu g/m 3 [95% CI 1.02-1.25]) and PM2.5 absorbance (1.29 per 1 unit [1.00-1.66]) at the birth address. A similar, albeit non-significant, trend was shown for PM2.5 and incident asthma (meta-analysis OR 1.25 per 5 mu g/m 3 [95% CI 0.94-1.66]). These associations with asthma were more consistent after age 4 years than before that age. There was no indication of an adverse effect of air pollution on rhinoconjunctivitis.Interpretation Exposure to air pollution early in life might contribute to the development of asthma throughout childhood and adolescence, particularly after age 4 years, when asthma can be more reliably diagnosed. Reductions in levels of air pollution could help to prevent the development of asthma in children.