Parental Stress Increases the Detrimental Effect of Traffic Exposure on Children's Lung Function
Parental Stress Increases the Detrimental Effect of Traffic Exposure on Children's Lung Function
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DOI：
10.1164/rccm.201104-0720oc
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发表时间：
2011-10-01
影响因子：
24.7
通讯作者：
McConnell, Rob
中科院分区：
文献类型：
--
作者：
Islam, Talat;Urman, Robert;McConnell, Rob
理论基础：新的证据表明，心理社会应激增强了交通暴露对哮喘发展的影响。目的：我们假设心理社会应激也会改变交通暴露对肺功能缺陷的影响。方法：我们研究了1,399名参加南加州儿童健康研究的参与者(平均年龄11.2岁)。我们使用分层混合模型来评估与交通相关的空气污染和压力对肺功能的联合影响。测量和主要结果：根据父母在研究开始时对感知压力量表(范围0-16)的反应来评估每个孩子家庭的心理社会压力。根据土地利用回归模型，估计了学校和居民对一氧化氮、二氧化氮和氮氧化物总量(NOx)的暴露，这些都是与交通相关的污染混合物的替代品。在来自高压力家庭(父母感知压力量表)的儿童中，家庭和学校的NOx每增加21.8ppb，FEV1缺陷分别为4.5(95%可信区间，-6.5至-2.4)和2.8%(-5.7至0.3)。这些污染物效应在高压力家庭中显著大于低压力家庭(住宅和学校NOx的交互作用P值分别为0.007和0.05)。来自低压力家庭的儿童没有观察到显著的NOx影响。在FVC中也观察到了类似的关联模式。在调整了社会人口学因素并将分析限制在非哮喘儿童之后，FEV1和FVC的观察到的相关性仍然存在。结论：高压力的家庭环境与家庭和学校空气污染对肺功能影响的易感性增加有关。
Rationale: Emerging evidence indicates that psychosocial stress enhances the effect of traffic exposure on the development of asthma.Objectives: We hypothesized that psychosocial stress would also modify the effect of traffic exposure on lung function deficits.Methods: We studied 1,399 participants in the Southern California Children's Health Study undergoing lung function testing (mean age, 11.2 yr). We used hierarchical mixed models to assess the joint effect of traffic-related air pollution and stress on lung function.Measurements and Main Results: Psychosocial stress in each child's household was assessed based on parental response to the perceived stress scale (range, 0-16) at study entry. Exposures to nitric oxide, nitrogen dioxide, and total oxides of nitrogen (NOx), surrogates of the traffic-related pollution mixture, were estimated at schools and residences based on a land-use regression model. Among children from high-stress households (parental perceived stress scale >4) deficits in FEV1 of 4.5 (95% confidence interval, -6.5 to -2.4) and of 2.8% (-5.7 to 0.3) were associated with each 21.8 ppb increase in NOx at homes and schools, respectively. These pollutant effects were significantly larger in the high-stress compared with lower-stress households (interaction P value 0.007 and 0.05 for residential and school NOx, respectively). No significant NOx effects were observed in children from low-stress households. A similar pattern of association was observed for FVC. The observed associations for FEV1 and FVC remained after adjusting for sociodemographic factors and after restricting the analysis to children who do not have asthma.Conclusions: A high-stress home environment is associated with increased susceptibility to lung function effects of air pollution both at home and at school.