Associations of personal exposure to air pollutants with airway mechanics in children with asthma,Environment International

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Associations of personal exposure to air pollutants with airway mechanics in children with asthma
Environment International ( IF 10.3 ) Pub Date : 2020-03-13 , DOI: 10.1016/j.envint.2020.105647
Linchen He , Zhen Li , Yanbo Teng , Xiaoxing Cui , Karoline K. Barkjohn , Christina Norris , Lin Fang , Lili Lin , Qian Wang , Xiaojian Zhou , Jianguo Hong , Feng Li , Yinping Zhang , James J. Schauer , Marilyn Black , Michael H. Bergin , Junfeng (Jim) Zhang

Background

The importance of airway mechanics has been increasingly recognized in pediatric asthma. However, no studies have examined responses of airway mechanics to air pollution exposure in asthmatic children.

Methods

In this panel study involving indoor air filtration manipulation that created a large gradient of personal exposure to PM_2.5, the airway mechanics and lung function of 43 asthmatic children 5–13 years old in a suburb of Shanghai were measured four times within 3 consecutive months. Concentrations of indoor and outdoor PM_2.5 and ozone were coupled with individual time-activity data to calculate personal exposures. Linear mixed effects models were used to examine the relationships of personal exposure with indicators of airway mechanics and lung function, respectively.

Results

An interquartile range (IQR) increase in 24-hour average PM_2.5 personal exposure (30.3 µg/m³) in the prior day was associated with significant increases in small airway resistance (R₅-R₂₀) of 15.8%, total airway resistance (R₅) of 6.3%, and airway inflammation (FeNO) of 9.6%. These associations were stronger in children with lower blood eosinophil counts (<450/µL). No significant associations were found between personal PM_2.5 exposure and lung function. Low-level ozone exposure (daily maximum 8-hour exposure range 1.1–56.4 ppb) was not significantly associated with any of the outcomes.

Conclusion

Changes in personal PM_2.5 exposure, partly enhanced by air filtration, were associated with significant changes in airway resistance and inflammation in children with asthma. These findings suggest the importance of reducing PM_2.5 exposure, via personal air quality management, in improving airflow limitation in the airways, especially the small airways.

中文翻译：

哮喘儿童个人暴露于空气污染物与气道力学的关系

背景

气道力学的重要性已在小儿哮喘中得到越来越多的认识。然而，尚无研究检查哮喘儿童气道力学对空气污染暴露的反应。

方法

在这项涉及室内空气过滤操作的面板研究中，个人暴露于PM _2.5的梯度很大，在连续三个月内对上海郊区43名5-13岁哮喘儿童的气道力学和肺功能进行了四次测量。室内和室外PM _2.5和臭氧的浓度与单独的时间活动数据相结合，以计算个人暴露量。线性混合效应模型用于检验个人暴露与气道力学指标和肺功能指标之间的关系。

结果

前一天24小时PM _2.5个人平均暴露量（30.3 µg / m ³）的四分位数范围（IQR）增加与小气道阻力（R ₅ -R ₂₀）显着增加15.8％，总气道阻力有关（R ₅）为6.3％，气道炎症（FeNO）为9.6％。在血液中嗜酸性粒细胞计数较低（<450 / µL）的儿童中，这些关联更强。在个人PM _2.5暴露与肺功能之间未发现明显关联。低水平的臭氧暴露（每天最大8小时暴露范围1.1-56.4 ppb）与任何结果均无显着相关。