Impact of road proximity on infants and children with bronchopulmonary dysplasia
Impact of road proximity on infants and children with bronchopulmonary dysplasia
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DOI：
10.1002/ppul.24594
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发表时间：
2019-12-05
影响因子：
3.1
通讯作者：
McGrath-Morrow, Sharon A.
中科院分区：
文献类型：
--
作者：
Collaco, Joseph M.;Morrow, Michael;McGrath-Morrow, Sharon A.
早产儿的发病风险很高，包括肺部疾病（支气管肺发育不良[BPD]）。很少有人知道环境因素，可以影响结果的BPD。我们试图评估交通相关空气污染（TRAP）对BPD呼吸结果的作用。方法从约翰霍普金斯BPD诊所共纳入784例受试者。护理人员完成了关于环境暴露和呼吸结果（急性护理使用和慢性症状）的问卷调查。到最近的主要道路的距离来自受试者的地理编码的住宅地址。结果大约一半的受试者（53.8%）居住在500米的主要道路。居住在主要道路500米以内的受试者更可能是非白人（P = 0.006），估计家庭收入较低（P <0.001），居住在人口更密集的邮政编码（P <0.001）比那些居住在500米以外的人。住宅和道路之间的距离每增加1公里，活动限制的可能性降低35%（P = 0.005）。在靠近主要道路的情况下，急性护理使用没有差异。结论靠近主要道路与慢性呼吸道症状有关，例如活动限制（例如呼吸困难），并且往往也与夜间症状有关。自我报告的少数民族和估计家庭收入较低的家庭可能更有可能受到TRAP的影响。有必要进一步研究，以确定TRAP与其他室内和室外空气污染源的影响，以及确定对抗污染相关呼吸道疾病的最佳方法。
Introduction Infants born prematurely are at high risk for morbidities, including lung disease (bronchopulmonary dysplasia [BPD]). Little is known regarding environmental factors that can impact outcomes in BPD. We sought to assess the role of traffic-related air pollution (TRAP) on respiratory outcomes in BPD. Methods A total of 784 subjects were included from the Johns Hopkins BPD clinic. Caregivers completed questionnaires on environmental exposures and respiratory outcomes (acute care use and chronic symptoms). Distance to the nearest major roadway was derived from subjects' geocoded residential addresses. Results Approximately half of the subjects (53.8%) lived within 500 m of a major roadway. Subjects who lived within 500 m of a major roadway were more likely to be non-white (P = .006), have a lower estimated household income (P < .001) and live in more densely populated zip codes (P < .001) than those who lived further than 500 m away. For every 1 km increase in distance between residence and roadway, the likelihood of activity limitations decreased by 35% (P = .005). No differences in acute care use were seen with proximity to major roadways. Conclusions Proximity to a major roadway was associated with chronic respiratory symptoms, such as activity limitations (eg, dyspnea), and tended to be associated with nighttime symptoms as well. Self-reported minorities and families with lower estimated household incomes may be more likely to be exposed to TRAP. Further research is necessary to define the effects of TRAP versus other sources of indoor and outdoor air pollution as well as to determine the best ways of combatting pollution-related respiratory morbidities.