The effect of air pollution on lung development from 10 to 18 years of age
The effect of air pollution on lung development from 10 to 18 years of age
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DOI：
10.1056/nejmoa040610
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发表时间：
2004-09-09
影响因子：
158.5
通讯作者：
Peters, J
中科院分区：
文献类型：
--
作者：
Gauderman, WJ;Avol, E;Peters, J
背景资料：暴露于空气污染是否会对肺功能的增长产生不利影响，在此期间发生的快速肺发育的10和18 years.Methods：在这项前瞻性研究中，我们招募了1759名儿童（平均年龄，10岁）从学校在12个南加州社区和肺功能每年测量8年。流失率约为每年10%。这些社区代表了广泛的臭氧、酸蒸气、二氧化氮和颗粒物的环境暴露。采用线性回归分析空气污染与第一秒用力呼气量（FEV1）和其他肺功能测定指标的关系。在8年的时间里，FEV1增长的缺陷与二氧化氮暴露有关（P=0.005），酸蒸汽（P=0.004），空气动力学直径小于2.5微米的颗粒物（PM2.5）（P=0.04）和元素碳（P=0.007），即使在调整了几个潜在的混杂因素和效果修饰符。还观察到与其他肺量测定指标相关。暴露于污染物与18岁时达到的FEV1的临床和统计学显著缺陷相关。例如，18岁受试者中FEV 1较低的估计比例（定义为观察到的FEV1与预期的FEV1之比小于80%）在最高PM2.5暴露水平下是最低暴露水平下的4.9倍（7.9%对1.6%，P=0.002）。结论：这项研究的结果表明，目前的空气污染水平具有慢性，对10至18岁儿童的肺发育产生不良影响，导致儿童成年后达到的FEV1出现临床显著缺陷。
Background: Whether exposure to air pollution adversely affects the growth of lung function during the period of rapid lung development that occurs between the ages of 10 and 18 years is unknown.Methods: In this prospective study, we recruited 1759 children (average age, 10 years) from schools in 12 southern California communities and measured lung function annually for eight years. The rate of attrition was approximately 10 percent per year. The communities represented a wide range of ambient exposures to ozone, acid vapor, nitrogen dioxide, and particulate matter. Linear regression was used to examine the relationship of air pollution to the forced expiratory volume in one second (FEV1) and other spirometric measures.Results: Over the eight-year period, deficits in the growth of FEV1 were associated with exposure to nitrogen dioxide (P=0.005), acid vapor (P=0.004), particulate matter with an aerodynamic diameter of less than 2.5 microm (PM2.5) (P=0.04), and elemental carbon (P=0.007), even after adjustment for several potential confounders and effect modifiers. Associations were also observed for other spirometric measures. Exposure to pollutants was associated with clinically and statistically significant deficits in the FEV1 attained at the age of 18 years. For example, the estimated proportion of 18-year-old subjects with a low FEV1 (defined as a ratio of observed to expected FEV1 of less than 80 percent) was 4.9 times as great at the highest level of exposure to PM2.5 as at the lowest level of exposure (7.9 percent vs. 1.6 percent, P=0.002).Conclusions: The results of this study indicate that current levels of air pollution have chronic, adverse effects on lung development in children from the age of 10 to 18 years, leading to clinically significant deficits in attained FEV1 as children reach adulthood.