Modification of Traffic-related Respiratory Response by Asthma Control in a Population of Car Commuters
Modification of Traffic-related Respiratory Response by Asthma Control in a Population of Car Commuters
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DOI：
10.1097/ede.0000000000000296
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发表时间：
2015-07-01
期刊：
影响因子：
5.4
通讯作者：
Sarnat, Jeremy A.
中科院分区：
文献类型：
--
作者：
Mirabelli, Maria C.;Golan, Rachel;Sarnat, Jeremy A.
背景资料：交通相关的暴露对呼吸系统健康的影响有很好的记录，但关于哮喘控制是否影响个体易感性的信息很少。我们分析了亚特兰大通勤暴露研究的数据，以评估修改的关联高峰时间通勤，在车内的空气污染，并选择呼吸系统健康的结果哮喘control status.Methods：在2009年和2011年之间，39名成年人参加了亚特兰大通勤暴露，并进行了两个脚本高峰时间高速公路通勤。在所有通勤期间测量车内颗粒物成分。在成人哮喘患者中，我们通过问卷调查和肺量测定评估哮喘控制情况。在通勤前和通勤后0、1、2和3小时测量呼出一氧化氮、1秒用力呼气量（FEV 1）和其他呼吸健康指标。我们使用混合效应线性回归来评估通勤相关暴露与通勤后哮喘控制水平下呼吸系统健康指标变化之间的关联。结果：与通勤前测量值相比，我们观察到所有哮喘控制水平下呼出的一氧化氮均增加，其中通勤后增加最大在哮喘控制低于中位数的参与者中观察到（通勤后2小时：14.6% [95%置信区间{CI} = 5.7，24.2];通勤后3小时：19.5% [95% CI = 7.8，32.5]）。未观察到车内污染物与FEV 1预测值百分比之间的相关性，但在哮喘控制低于中位数的参与者中，较高的PM2.5与较低的FEV 1预测值百分比相关（通勤后3小时：-7.2 [95%CI =-11.8，-2.7]）。
Background: Effects of traffic-related exposures on respiratory health are well documented, but little information is available about whether asthma control influences individual susceptibility. We analyzed data from the Atlanta Commuter Exposure study to evaluate modification of associations between rush-hour commuting, in- vehicle air pollution, and selected respiratory health outcomes by asthma control status.Methods: Between 2009 and 2011, 39 adults participated in Atlanta Commuter Exposure, and each conducted two scripted rush-hour highway commutes. In-vehicle particulate components were measured during all commutes. Among adults with asthma, we evaluated asthma control by questionnaire and spirometry. Exhaled nitric oxide, forced expiratory volume in 1 second (FEV1), and other metrics of respiratory health were measured precommute and 0, 1, 2, and 3 hours postcommute. We used mixed effects linear regression to evaluate associations between commute-related exposures and postcommute changes in metrics of respiratory health by level of asthma control.Results: We observed increased exhaled nitric oxide across all levels of asthma control compared with precommute measurements, with largest postcommute increases observed among participants with below-median asthma control (2 hours postcommute: 14.6% [95% confidence interval {CI} = 5.7, 24.2]; 3 hours postcommute: 19.5% [95% CI = 7.8, 32.5]). No associations between in-vehicle pollutants and percent of predicted FEV1 were observed, although higher PM2.5 was associated with lower FEV1 % predicted among participants with below-median asthma control (3 hours postcommute: -7.2 [95% CI = -11.8, -2.7]).Conclusions: Level of asthma control may influence respiratory response to in-vehicle exposures experienced during rush-hour commuting.