生命早期空气污染物与绿地暴露对太原市学龄前儿童特应性疾病的影响

Effects of early-life exposure to air pollutants and greenness on atopic diseases in preschool children in Taiyuan,China

目的探讨生命早期空气污染与绿地暴露对学龄前儿童哮喘、鼻炎以及湿疹的影响。方法2019年11-12月,对太原市6城区15所幼儿园的学龄前儿童进行调查,发放健康问卷并邀请家长填写,收集儿童人口学特征、室内环境因素以及儿童特应性疾病患病信息。近12个月症状包括当前喘息、当前鼻炎和当前湿疹,既往医院诊断疾病包括医生诊断哮喘(J45.901)、鼻炎(J30.401)和湿疹(L23.901)。同时收集太原市空气污染物PM_(2.5)、PM_(10)、SO_(2)、NO_(2)和O_(3)浓度以及绿地水平(归一化植被指数)数据,采用混合效应回归模型分析生命早期空气污染暴露与接触绿地水平对学龄前儿童特应性疾病的影响。结果本研究共纳入4814名3~6岁学龄前儿童,混合效应回归分析结果显示:孕期O 3-8 h暴露增加了儿童医生诊断湿疹的风险,其比值比(odds ratio,OR)及95%的置信区间(confidence interval,CI)为1.007(1.001,1.015),婴儿期O 3-8 h暴露降低了儿童当前喘息、当前鼻炎以及医生诊断鼻炎的风险,OR(95%CI)值分别为0.962(0.934,0.991)、0.990(0.978,0.991)和0.962(0.934,0.999);孕期SO_(2)暴露降低了医生诊断湿疹的风险,OR(95%CI)值为0.994(0.990,0.999),婴儿期SO_(2)暴露降低了儿童当前鼻炎的风险,OR(95%CI)值为0.993(0.987,0.999)。另外,研究还发现婴儿期绿地暴露对降低学龄前儿童当前湿疹风险有显著影响,OR(95%CI)值为0.583(0.342,0.995)。结论生命早期空气污染与绿地暴露与儿童特应性疾病密切相关。

Objective To explore the influence of early-life exposure to air pollutants and greenness on asthma,rhinitis and eczema among preschool children.Methods From November to December 2019,preschool children from 15 kindergartens in six urban districts of Taiyuan,China were surveyed for information on demographic characteristics,indoor environmental factors and incidence of atopic diseases by questionnaires,which were written by their parents.Questions focused on symptoms(in the last 12 months)associated with current wheezing,current rhinitis,and current eczema,as well as previous medical diagnoses including doctor-diagnosed asthma(J45.901),doctor-diagnosed rhinitis(J30.401),and doctor-diagnosed eczema(L23.901).At the same time,data on the mass concentrations of air pollutants(PM_(2.5),PM_(10),SO_(2),NO_(2),and O_(3))and the level of greenness(normalized difference vegetation index)in Taiyuan were obtained.Mixed effects logistic regression was applied to assess the effects of early-life air pollutants and greenness exposure on preschool children′s atopic diseases.Results A total of 4814 preschool children aged 3~6 years were included.The mixed effects logistic regression analysis showed that prenatal exposure to O_(3)-8 h significantly increased the incidence risk of children′s doctor-diagnosed eczema(odds ratio,OR=1.007,95%confidence interval,CI:1.001~1.015).Infant O_(3)-8 h exposure significantly decreased the incidence risks of current wheezing(OR=0.962,95%CI:0.934,0.991),current rhinitis(OR=0.990,95%CI:0.978,0.991),and doctor-diagnosed rhinitis(OR=0.962,95%CI:0.934,0.999).Prenatal SO_(2) exposure significantly decreased the incidence risk of doctor-diagnosed eczema(OR=0.994,95%CI:0.990,0.999).Infant SO_(2) exposure significantly reduced the incidence risk of current rhinitis(OR=0.993,95%CI:0.987,0.999).Moreover,greenness exposure in infancy significantly reduced the incidence risk of current eczema in preschool children(OR=0.583,95%CI:0.342,0.995).Conclusion Early-life exposure to air pollutants and greenness was strongly associated with children′s atopic diseases.