Effects of ambient air pollution on upper and lower respiratory symptoms and peak expiratory flow in children
Effects of ambient air pollution on upper and lower respiratory symptoms and peak expiratory flow in children
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DOI：
10.1016/s0140-6736(98)06311-9
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发表时间：
1999-03-13
期刊：
影响因子：
168.9
通讯作者：
Schouten, JP
中科院分区：
文献类型：
--
作者：
Boezen, HM;van der Zee, SC;Schouten, JP
背景以前的流行病学研究表明，环境空气污染量增加对呼吸系统疾病儿童呼吸道症状的患病率有急性影响。我们调查了支气管高反应性（BHR）和相对较高的血清总IgE浓度（bbb60 kU/L，中位数）的儿童是否易受空气污染的影响。方法我们收集了荷兰农村和城市地区三个冬季（1992-95）儿童的数据。每天记录下呼吸道症状（喘息、喘息发作、呼吸短促）、上呼吸道症状（喉咙痛、流鼻涕或鼻塞）和呼气流量峰值，持续3个月。采用logistic回归估计了直径小于10 μ m的空气悬浮颗粒物、黑烟、二氧化硫和二氧化氮的急性效应。结果632例患儿中有459例（73%）资料完整。其中，26%有BHR且血清总IgE相对较高（高于中位数），36%无BHR且总IgE为60 kU/L或以下，15%有BHR且总IgE为60 kU/L或以下，23%总IgE大于60 kU/L但无BHR。在BHR和血清总IgE相对较高的儿童中，颗粒物质每增加100 μ m/m(3)，下呼吸道症状的患病率显著增加32%至139%，黑烟、SO2或NO2每增加40 μ m/m(3)，下呼吸道症状的患病率显著增加16%至131%。在这一组中，呼气流量峰值下降超过10%的情况更常见的是空气中的颗粒物和黑烟增加。在其他三组儿童中，空气污染的增加与呼吸道症状的流行或呼气峰流量的减少之间没有一致的正相关或负相关。结论BHR和血清总IgE浓度较高的儿童易受空气污染的影响。虽然我们的比值比相当低（范围为1.16-2.39），但空气污染对公众健康的总体影响可能很大，因为这些比值比指的是大量人群。
Background Previous epidemiological studies have shown acute effects of increased amounts of ambient air pollution on the prevalence of respiratory symptoms in children with respiratory disorders. We investigated whether children with bronchial hyperresponsiveness (BHR) and relatively high serum concentrations of total IgE (>60 kU/L, the median value) are susceptible to air pollution.Methods We collected data from children during three winters (1992-95) in rural and urban areas of the Netherlands. Lower respiratory symptoms (wheeze, attacks of wheezing, shortness of breath), upper respiratory symptoms (sore throat, runny or blocked nose), and peak expiratory flow were recorded daily for 3 months. The acute effects of airborne particulate matter with a diameter of less than 10 mu m, black smoke, sulphur dioxide, and nitrogen dioxide were estimated by logistic regression.Findings 459 (73%) of 632 children had complete data. Of these, 26% had BHR and relatively high (above median) serum total IgE, 36% had no BHR and total IgE of 60 kU/L or less, 15% had BHR and total IgE of 60 kU/L or less, and 23% had a total IgE of more than 60 kU/L but no BHR. In children with BHR and relatively high serum total IgE the prevalence of lower respiratory symptoms increased significantly by between 32% and 139% for each 100 mu m/m(3) increase in particulate matter, and between 16% acid 131% for each 40 mu m/m(3) increase in black smoke, SO2, or NO2. Decrease in peak expiratory flow of more than 10% in that group was more common with increased airborne particulate matter and black smoke. There were no consistent positive or negative associations between increased air pollution and prevalence of respiratory symptoms or decrease in peak expiratory flow in the other three groups of children.Interpretation Children with BHR and relatively high concentrations of serum total IgE are susceptible to air pollution. Although our odds ratios were rather low (range 1.16-2.39) the overall effect of air pollution on public health is likely to be substantial since these odds ratios refer to large numbers of people.