Influence of Ambient Air Pollutant Sources on Clinical Encounters for Infant Bronchiolitis
Influence of Ambient Air Pollutant Sources on Clinical Encounters for Infant Bronchiolitis
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DOI：
10.1164/rccm.200901-0117oc
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发表时间：
2009-11-15
影响因子：
24.7
通讯作者：
Brauer, Michael
中科院分区：
文献类型：
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作者：
Karr, Catherine J.;Demers, Paul A.;Brauer, Michael
理由：关于环境空气污染对婴儿毛细支气管炎影响的数据很少。目的：我们评估几种空气污染物及其来源对婴儿毛细支气管炎的影响。方法：将不列颠哥伦比亚省乔治亚空气盆地因毛细支气管炎住院或门诊就诊的婴儿（n = 11,675）在出生当天与多达10名对照受试者进行匹配。在区域监测网络的基础上，评估了直径小于等于2.5 μ m的颗粒物（PM2.5）、PM10、NO2/NO、SO2、CO和O-3的暴露情况。使用区域开发的土地利用回归（LUR）模型对NO2、NO、PM2.5和黑碳以及高速公路附近的交通暴露进行了评估。还评估了接触木材烟雾和工业排放物的情况。使用条件逻辑回归得出风险估计，并根据婴儿性别、第一民族（加拿大政府对公认土著群体的称呼）地位、母亲教育程度、年龄、收入水平、胎次、怀孕期间吸烟和开始母乳喂养进行调整。测量结果和主要结果：一生中暴露于NO2、NO、SO2、CO、木烟暴露天数和点源排放评分的四分位数增加与毛细支气管炎风险增加相关（例如，调整比值比[ORadj] NO2, 95%置信区间[CI]， 1.12,1.09-1.16； ORadj木烟，95% CI, 1.08,1.04-1.11）。居住在主要高速公路50米范围内的婴儿的风险高出6%（1.06,0.97-1.17）。没有观察到增加暴露于PM10、PM2.5或黑碳的不利影响。臭氧暴露与其他污染物呈负相关，与毛细支气管炎风险呈负相关。结论：来自多种来源的空气污染物可能增加婴儿毛细支气管炎，需要临床护理。交通、当地点源排放和木材烟雾都可能导致该病。
Rationale: Data regarding the influence of ambient air pollution on infant bronchiolitis are few.Objectives: We evaluated the impact of several air pollutants and their sources on infant bronchiolitis.Methods: Infants in the Georgia Air Basin of British Columbia with an inpatient or outpatient clinical encounter for bronchiolitis (n = 11,675) were matched on day of birth to as many as 10 control subjects. Exposure to particulate matter with a diameter of 2.5 mu m or less (PM2.5), PM10, NO2/NO, SO2, CO, and O-3 were assessed on the basis of a regional monitoring network. Traffic exposure was assessed using regionally developed land use regression (LUR) models of NO2, NO, PM2.5, and black carbon as well as proximity to highways. Exposure to wood smoke and industrial emissions was also evaluated. Risk estimates were derived using conditional logistic regression and adjusted for infant sex and First Nations (Canadian government term for recognized aboriginal groups) status and for maternal education, age, income-level, parity, smoking during pregnancy, and initiation of breastfeeding.Measurements and Main Results: An interquartile increase in lifetime exposure to NO2, NO, SO2, CO, wood-smoke exposure days, and point source emissions score was associated with increased risk of bronchiolitis (e.g., adjusted odds ratio [ORadj] NO2, 95% confidence interval [CI], 1.12,1.09-1.16; ORadj wood smoke, 95% CI, 1.08,1.04-1.11). Infants who lived within 50 meters of a major highway had a 6% higher risk (1.06, 0.97-1.17). No adverse effect of increased exposure to PM10, PM2.5, or black carbon, was observed. Ozone exposure was negatively correlated with the other pollutants and negatively associated with the risk of bronchiolitis.Conclusions: Air pollutants from several sources may increase infant bronchiolitis requiring clinical care. Traffic, local point source emissions, and wood smoke may contribute to this disease.