BACKGROUND Pediatric allergic diseases are a major public health concern, and previous studies have suggested that exposure to traffic-related air pollution (TRAP) exposure is a risk factor. These studies have typically assessed TRAP exposure using traffic measures, such as distance to major roads, or by modeling air pollutant concentrations; however inconsistent associations with pediatric allergic diseases have often been found. Using road proximity and density, we previously found an association between TRAP and atopic eczema among approximately 15,000 children living in Seoul, Korea, heavily populated and highly polluted city in which traffic is a major emission source. We aimed to conduct a parallel analysis using modeled air pollution concentrations and thus examine the consistency of the association. Specifically, we examined the associations of individual-level annual-average concentrations of NO2, PM10, and PM2.5 with symptoms and diagnoses of three pediatric allergic diseases including asthma, allergic rhinitis, and atopic eczema. METHODS The study population included 14,614 children from the Seoul Atopy Friendly School Project Survey in Seoul, Korea, in 2010. To assess individual exposures to TRAP among these children, we predicted annual-average concentrations of NO2, PM10, and PM2.5 at the children's home addresses in 2010 using universal kriging and land use regression models along with regulatory air quality monitoring data and geographic characteristics. Then, we estimated odds ratios (ORs) of the three allergic diseases for interquartile increases in air pollution concentrations after adjusting for individual risk factors in mixed effects logistic regression. RESULTS Symptoms and diagnoses of atopic eczema symptoms showed an association with NO2 (OR = 1.07, 95% confidence interval = 1.02-1.13; 1.08, 1.03-1.14) and PM10 (1.06, 1.01-1.12; 1.07, 1.01-1.13). ORs of PM2.5 were positive but not statistically significant (1.01, 0.95-1.07; 1.04, 0.98-1.10). No association was found between asthma and allergic rhinitis, although PM2.5 showed a marginal association with allergic rhinitis. CONCLUSIONS Our consistent findings regarding the association between TRAP and the prevalence of atopic eczema using traffic measures and surrogate air pollutants suggested the effect of TRAP on children's health. Follow-up studies should elucidate the causal link, to support subsequent policy considerations and minimize adverse health effects in children.

中文翻译：

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基于模拟的空气污染浓度和交通措施，在韩国首尔，交通相关的空气污染与小儿过敏性疾病的暴露之间的关联：比较分析。

背景技术小儿过敏性疾病是主要的公共卫生问题，并且先前的研究表明暴露于交通相关的空气污染（TRAP）是危险因素。这些研究通常使用交通措施（例如到主要道路的距离）或通过模拟空气污染物浓度来评估TRAP暴露。但是，经常发现与小儿过敏性疾病的关联不一致。利用道路的接近度和密度，我们先前发现生活在人口众多，污染严重的韩国首尔的约15,000名儿童中，TRAP与过敏性湿疹之间存在关联，韩国是交通主要排放源。我们旨在使用建模的空气污染浓度进行平行分析，从而检查关联的一致性。特别，我们检查了个体水平的年平均NO2，PM10和PM2.5浓度与三种儿科过敏性疾病（包括哮喘，过敏性鼻炎和特应性湿疹）的症状和诊断的关联。方法该研究人群包括2010年在韩国首尔进行的首尔抗过敏友好学校项目调查中的14,614名儿童。为了评估这些儿童中TRAP的暴露量，我们预测了儿童中NO2，PM10和PM2.5的年平均浓度。 2010年使用通用克里金法和土地利用回归模型以及监管空气质量监测数据和地理特征的儿童住所。然后，我们在混合效应逻辑回归分析中调整了个体风险因素后，估计了三种过敏性疾病的空气污染浓度四分位数增加的比值比（OR）。结果特应性湿疹症状的症状和诊断显示与NO2（OR = 1.07，95％置信区间= 1.02-1.13; 1.08，1.03-1.14）和PM10（1.06，1.01-1.12; 1.07，1.01-1.13）相关。PM2.5的OR呈阳性，但无统计学意义（1.01、0.95-1.07； 1.04、0.98-1.10）。尽管PM2.5与过敏性鼻炎之间的关系很小，但哮喘与过敏性鼻炎之间没有关联。结论我们通过交通措施和替代性空气污染物对TRAP与特应性湿疹患病率之间的关联的一致发现表明TRAP对儿童健康的影响。