ACID AEROSOL--RESPIRATORY EFFECTS IN INFANTS AND MOTHERS

动物和人类对照研究表明，接触酸性物质 气溶胶影响气道反应性、粘膜纤毛清除和肺 气流 初步数据表明，长期暴露于低水平 环境酸性气溶胶可能与慢性肺病有关， 尤其是支气管炎。 美国环保署正在积极考虑一项环境 酸性气溶胶空气质量标准。 这样的标准将启动一个 主要的国家监管控制工作基于几个，方法上 弱，学习。 酸性气溶胶与健康关系的流行病学研究 影响受到明显的空间和时间限制， 环境酸性气溶胶的可变性，室外浓度低， 存在混杂的空气污染物和评估困难 暴露。 据推测，住宅室内暴露不会 目前还没有关于室内暴露的研究。 我们已经确定，无排气管的煤油空间加热器是 室内酸性气溶胶。 这些结果在现场测量中得到证实。 考虑到受影响的人数（1800万） 加热器已经在美国销售，它们是家庭热量的主要来源 在一些国家）和接触水平，煤油加热器使用者 将构成一个独特的人口，在其中确定一个 酸性气溶胶暴露与呼吸系统健康影响之间的关系。 这项研究验证了一个假设，即暴露于高浓度 煤油造成的酸性和硫酸盐气溶胶空气污染物 使用加热器与急性或慢性上呼吸道疾病的风险增加有关。 和下呼吸道症状的婴儿年龄6-24个月（敏感 （包括咳嗽、痰、喘鸣、流鼻水/鼻塞等）。 假设婴儿的非吸烟暴露母亲也处于 呼吸道症状的风险增加， 还测试呼气流量。 这些协会将被评估为 调整其他已知风险因素时的剂量反应关系 （环境烟草烟雾、NO2、母亲吸烟、健康状况等）。 研究人群将从8，700例活产婴儿中选择， 在18个月的时间里，在YHN医院。 暴露婴儿（N=300）和 他们的非吸烟母亲（N=228）将住在使用煤油加热器的家中。 他们将与婴儿对照组（N=600）进行比较， 非吸烟母亲（N=456）在非加热期间不使用煤油 季节，包括婴儿和 母亲和同时使用加热器。 昼夜高峰流量差异 在供暖和非供暖期间， 赛季将被记录。 嵌套式暴露评估方案将 将控制使用的和潜在的混杂因素。 如果季节性 发现症状率和肺功能测量结果存在差异 这种设计将允许曝光效果之间的区别， 季节变化的影响。 这项研究将有重要的意义，在确定是否有一个 环境空气质量标准需要酸性气溶胶，以保护 公共卫生 它还将确定任何增加的健康风险， 大量的煤油取暖器用户。

Animal and controlled human studies indicate that exposure to acidic aerosol affect airway reactivity, mucociliary clearance and pulmonary airflow. Preliminary data suggests that long term exposure to low level ambient acidic aerosol may be associated with chronic lung disease, particularly bronchitis. The U.S. EPA is actively considering an Ambient Air Quality Standard for acidic aerosol. Such a standard would initiate a major national regulatory control effort based on a few, methodologically weak, studies. Epidemiologic studies of an association between acidic aerosol and health effects have been handicapped by the pronounced spatial and temporal variability of ambient acidic aerosol, the low outdoor concentrations, presence of confounding air contaminants and difficulties assessing exposures. It has been assumed that residential indoor exposures do not exist and not studies of indoor exposures have been done. We have identified unvented kerosene space heaters as a major source of indoor acidic aerosol. These results are confirmed in field measurements. Given the potential for the number of individuals exposed (18 million heaters have been sold in the U.S. and they are a major source of home heat in a number of countries) and the levels of exposure, kerosene heater users would constitute a unique population in which to determine the nature of an association between acidic aerosol exposure and respiratory health effects. This study tests the hypothesis that exposures to elevated concentrations of acidic and sulfate aerosol air contaminants, resulting from kerosene heater use are associated with an increased risk of acute or chronic upper and lower respiratory symptoms in infants age 6-24 months (a sensitive population), including cough, phlegm, wheeze, runny/stuffy nose, etc. The hypothesis that the nonsmoking exposed mothers of the infants are also at an increased risk of respiratory symptoms and reversible decrements in peak expiratory flow is also tested. these associations will be evaluated for a dose response relation while adjusting for other known risk factors (environmental tobacco smoke, NO2, maternal smoking, health status, etc.). The study population will be selected from 8,700 live deliveries occurring at YHN Hospital during a 18 month period. The exposed infants (N=300) and their nonsmoking mothers (N=228) will live in homes using kerosene heaters. They will be compared to a control group of infants (N=600) and their nonsmoking mothers (N=456) not using kerosene during the nono-heating season including reports of respiratory symptoms in both the infants and mothers and concurrent use of the heater. Diurnal peak flow differences for the mothers for a two week period during the heating and non-heating season will be recorded. A nested-exposure assessment protocol will be employed and potential confounding factors will be controlled. If seasonal differences are found for symptom rates and pulmonary function measurements this design will allow for a distinction between exposure effects and seasonal variation effects. This study will have important implications in determining whether an Ambient Air Quality Standard is needed for acidic aerosol to protect the public health. It will also identify any increased health risk for the large population of kerosene heater users.