Respiratory symptoms and peak expiratory flow in children with asthma in relation to volatile organic compounds in exhaled breath and ambient air
Respiratory symptoms and peak expiratory flow in children with asthma in relation to volatile organic compounds in exhaled breath and ambient air
复制标题
DOI：
10.1038/sj.jea.7500287
复制
发表时间：
2003-09-01
期刊：
影响因子：
--
通讯作者：
Pellizzari, ED
中科院分区：
文献类型：
--
作者：
Delfino, RJ;Gong, H;Pellizzari, ED
室内挥发性有机化合物(VOCs)与哮喘有关，但关于环境暴露的流行病学研究很少，也没有关于呼吸健康和呼出VOCs之间关系的数据，呼气VOCs是VOC暴露的生物标志物。我们在洛杉矶的一个社区招募了26名患有轻度哮喘的西班牙裔儿童，这些社区靠近主要高速公路和卡车运输路线，VOC水平很高。两人退出，三人呼气峰流速(PEF)或呼吸VOC数据无效，留下21人。儿童每天填写症状日记并进行PEF操作，1999年11月，2000年1月。我们的目标是在哮喘发作和基线无症状日收集呼气VOC样本，但6名受试者仅在无症状日提供样本。用气相色谱-质谱法分析了106份呼气样品。有8种挥发性有机化合物是定量的。可检测75%的呼气样品(苯、二氯甲烷、苯乙烯、四氯乙烯、甲苯、间、对二甲苯、邻二甲苯和对二氯苯)。控制温度和呼吸道感染的VOC暴露-反应关系的广义估计方程和混合线性回归模型。我们发现烦人或更严重的哮喘症状与当天呼气中苯的浓度[优势比(OR)2.03，95%可信区间(CI)0.80，5.11]呈轻微正相关，但与其他呼气VOCs无关。在与呼气VOCs相同的人日内测量的环境石油相关VOCs显示，甲苯、间二甲苯、对二甲苯、邻二甲苯和苯等症状的相关性明显更强(OR 5.93，95%CI 1.64，21.4)。在呼吸样本日，症状也与1小时环境中的NO2，OR 8.13(1.52，43.4)和SO2，OR 2.36(1.16，4.81)有关。夜间PEF与相同的环境VOCs、NO2和SO2之间存在一致的反相关关系。与O-3无关。鉴于该地区的交通密度很高，与环境VOCs的相关性比与呼气VOCs的相关性更强，这表明环境VOC测量是日常接触燃烧相关化合物的更好标志，这些化合物被认为与急性哮喘有关。或者，症状反应的低样本量(每108个呼吸样本中有5-21个反应)可能导致了呼吸VOCs的不显著结果。
Indoor volatile organic compounds (VOCs) have been associated with asthma, but there is little epidemiologic work on ambient exposures, and no data on relationships between respiratory health and exhaled breath VOCs, which is a biomarker of VOC exposure. We recruited 26 Hispanic children with mild asthma in a Los Angeles community with high VOC levels near major freeways and trucking routes. Two dropped out, three had invalid peak expiratory flow (PEF) or breath VOC data, leaving 21. Children filled out symptom diaries and performed PEF maneuvers daily, November 1999 January 2000. We aimed to collect breath VOC samples on asthma episode and baseline symptom-free days, but six subjects only gave samples on symptom-free days. We analyzed 106 breath samples by GC-MS. Eight VOCs were quanti. able in >75% of breath samples (benzene, methylene chloride, styrene, tetrachloroethylene, toluene, m,p-xylene, o-xylene, and p-dichlorobenzene). Generalized estimating equation and mixed linear regression models for VOC exposure-response relationships controlled for temperature and respiratory infections. We found marginally positive associations between bothersome or more severe asthma symptoms and same day breath concentrations of benzene [odds ratio ( OR) 2.03, 95% confidence interval (CI) 0.80, 5.11] but not other breath VOCs. Ambient petroleum-related VOCs measured on the same person-days as breath VOCs showed notably stronger associations with symptoms, including toluene, m,p-xylene, o-xylene, and benzene (OR 5.93, 95% CI 1.64, 21.4). On breath sample days, symptoms were also associated with 1-h ambient NO2, OR 8.13 (1.52, 43.4), and SO2, OR 2.36 (1.16, 4.81). Consistent inverse relationships were found between evening PEF and the same ambient VOCs, NO2, and SO2. There were no associations with O-3. Given the high traffic density of the region, stronger associations for ambient than for breath VOCs suggest that ambient VOC measurements were better markers for daily exposure to combustion-related compounds thought to be causally related to acute asthma. Alternatively, the low sample size of symptom responses (5-21 responses per 108 breath samples) may have led to the nonsignificant results for breath VOCs.