Associations of mobile source air pollution during the first year of life with childhood pneumonia, bronchiolitis, and otitis media.
Associations of mobile source air pollution during the first year of life with childhood pneumonia, bronchiolitis, and otitis media.
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DOI：
10.1097/ee9.0000000000000007
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发表时间：
2018-03
期刊：
影响因子：
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通讯作者：
Strickland MJ
中科院分区：
文献类型：
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作者：
Kennedy CM;Pennington AF;Darrow LA;Klein M;Zhai X;Bates JT;Russell AG;Hansen C;Tolbert PE;Strickland MJ
文本中提供了补充数字内容。在生命早期暴露于机动车辆的空气污染可能会增加对常见儿科感染的易感性。我们估计了来自Kaiser空气污染和儿科哮喘研究的22，441名儿童在生命第一年期间居住暴露于交通中的主要细颗粒物，氮氧化物和一氧化碳与2岁时发生的肺炎，细支气管炎和中耳炎事件之间的关联，2000-2010年间出生并由Kaiser Permanente格鲁吉亚保险的儿童的回顾性出生队列。使用病历定义每个结局的首次临床诊断时间。暴露于交通污染物的基础上观察校准的估计，从一个研究线源扩散模型近地表释放和儿童居住的历史。使用考克斯比例风险模型对相关性进行建模，暴露作为连续线性变量，自然对数转换连续变量，并按五分位数分类。在随访期间，2,181名儿童被诊断为肺炎，5,533名儿童被诊断为细支气管炎，14,374名儿童被诊断为中耳炎。我们观察到早期交通暴露与所有三种结果之间存在正相关;肺炎的置信区间最宽，因为它是最不常见的结果。例如，在自然对数标度上，氮氧化物增加1个单位（增加2.7倍）的校正风险比为细支气管炎1.19（95% CI = 1.12，1.27），中耳炎1.17（1.12，1.22），肺炎1.08（0.97，1.20）。我们的研究结果为暴露于交通排放和儿童早期常见儿科感染之间的适度，积极的关联提供了证据。
Supplemental Digital Content is available in the text. Exposure to air pollution from motor vehicles in early life may increase susceptibility to common pediatric infections. We estimated associations between residential exposure to primary fine particulate matter, nitrogen oxides, and carbon monoxide from traffic during the first year of life and incident pneumonia, bronchiolitis, and otitis media events by age 2 years in 22,441 children from the Kaiser Air Pollution and Pediatric Asthma Study, a retrospective birth cohort of children born during 2000–2010 and insured by Kaiser Permanente Georgia. Time to first clinical diagnosis of each outcome was defined using medical records. Exposure to traffic pollutants was based on observation-calibrated estimates from A Research LINE-source dispersion model for near surface releases and child residential histories. Associations were modeled using Cox proportional hazards models, with exposure as a continuous linear variable, a natural-log transformed continuous variable, and categorized by quintiles. During follow-up, 2,181 children were diagnosed with pneumonia, 5,533 with bronchiolitis, and 14,374 with otitis media. We observed positive associations between early-life traffic exposures and all three outcomes; confidence intervals were widest for pneumonia as it was the least common outcome. For example, adjusted hazard ratios for a 1-unit increase in nitrogen oxides on the natural log scale (a 2.7-fold increase) were 1.19 (95% CI = 1.12, 1.27) for bronchiolitis, 1.17 (1.12, 1.22) for otitis media, and 1.08 (0.97, 1.20) for pneumonia. Our results provide evidence for modest, positive associations between exposure to traffic emissions and common pediatric infections during early childhood.