空气污染暴露与儿童肺功能：ESCAPE 项目。
Air pollution exposure and lung function in children: the ESCAPE project.
机构信息
Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
出版信息
Environ Health Perspect. 2013 Nov-Dec;121(11-12):1357-64. doi: 10.1289/ehp.1306770. Epub 2013 Sep 27.
BACKGROUND
There is evidence for adverse effects of outdoor air pollution on lung function of children. Quantitative summaries of the effects of air pollution on lung function, however, are lacking due to large differences among studies.
OBJECTIVES
We aimed to study the association between residential exposure to air pollution and lung function in five European birth cohorts with a standardized exposure assessment following a common protocol.
METHODS
As part of the European Study of Cohorts for Air Pollution Effects (ESCAPE) we analyzed data from birth cohort studies situated in Germany, Sweden, the Netherlands, and the United Kingdom that measured lung function at 6-8 years of age (n = 5,921). Annual average exposure to air pollution [nitrogen oxides (NO2, NOx), mass concentrations of particulate matter with diameters < 2.5, < 10, and 2.5-10 μm (PM2.5, PM10, and PMcoarse), and PM2.5 absorbance] at the birth address and current address was estimated by land-use regression models. Associations of lung function with estimated air pollution levels and traffic indicators were estimated for each cohort using linear regression analysis, and then combined by random effects meta-analysis.
RESULTS
Estimated levels of NO2, NOx, PM2.5 absorbance, and PM2.5 at the current address, but not at the birth address, were associated with small decreases in lung function. For example, changes in forced expiratory volume in 1 sec (FEV1) ranged from -0.86% (95% CI: -1.48, -0.24%) for a 20-μg/m3 increase in NOx to -1.77% (95% CI: -3.34, -0.18%) for a 5-μg/m3 increase in PM2.5.
CONCLUSIONS
Exposure to air pollution may result in reduced lung function in schoolchildren.
背景
有证据表明室外空气污染对儿童肺功能有不良影响。然而，由于研究之间存在很大差异，因此缺乏关于空气污染对肺功能影响的定量综合分析。
目的
我们旨在研究欧洲五个出生队列中居住环境空气污染暴露与肺功能之间的关联，这些队列采用标准化的暴露评估方法，遵循共同的方案。
方法
作为欧洲空气污染效应研究队列（ESCAPE）的一部分，我们分析了来自德国、瑞典、荷兰和英国的出生队列研究的数据，这些研究在儿童 6-8 岁时测量了肺功能（n=5921）。使用基于土地利用的回归模型，估计了出生地址和当前地址的年度平均空气污染[氮氧化物（NO2、NOx）、直径<2.5、<10 和 2.5-10μm（PM2.5、PM10 和 PMcoarse）及 PM2.5 吸光度]暴露水平。使用线性回归分析对每个队列的肺功能与估计的空气污染水平和交通指标之间的关系进行了估计，然后通过随机效应荟萃分析进行了综合。
结果
当前地址而非出生地址的估计 NO2、NOx、PM2.5 吸光度和 PM2.5 水平与肺功能的小幅度下降相关。例如，FEV1 的变化范围从 NOx 增加 20μg/m3 时的-0.86%（95%CI：-1.48，-0.24%）到 PM2.5 增加 5μg/m3 时的-1.77%（95%CI：-3.34，-0.18%）。
结论
暴露于空气污染可能导致学龄儿童肺功能下降。
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