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[背景]将交通源空气污染作为幼儿期呼吸道感染的危险因素的研究很少。[目的]在10个欧洲出生队列——BAMSE(瑞典)、GASPII(意大利)、GINIplus和LISAplus(德国)、MAAS(英国)、PIAMA(荷兰)和4个INMA队列(西班牙)——中研究空气污染与肺炎、哮喘及中耳炎之间的相关性,并使用meta分析得出综合效应估值。[方法]评价家长报告的医师诊断的儿童早期肺炎、中耳炎以及哮喘与全年平均污染物水平[二氧化氮(NO2)、氮氧化物(NOx)、≤2.5μm的颗粒物(PM2.5)、PM2.5吸光度、PM10、PM2.5-10(粗PM)]间的关联,污染物浓度的估计采用土地利用回归模型并根据孩子的出生住址分配。作为ESCAPE项目的一部分,每个研究区域都采用相同的方案建立回归模型。用logistic回归来计算每个研究校正后的效应估值,用随机效应meta分析来计算合并的估计值。[结果]除了PM2.5外的所有污染物,肺炎的合并校正优势比(OR)均升高(例如,NO2每增加10μg/m3,OR=1.30,95%CI:1.02~1.65;PM10每增加10μg/m3的OR=1.76,95%CI:1.00~3.09)。对于中耳炎和哮喘,除了NO2与中耳炎间的关联(每10μg/m3对应的OR=1.09,95%CI:1.02~1.16),所有分析的结果均无显著性。[结论]对ESCAPE项目中10个欧洲出生队列进行的meta分析为空气污染和儿童早期肺炎之间的相关性找到一致性的证据,也为与中耳炎间的相关性找到了一些证据。
[Background] Few studies have used air pollution from traffic sources as a risk factor for early childhood respiratory infections. [Purpose] To study air in 10 European birth cohorts - BAMSE (Sweden), GASPII (Italy), GINIplus and LISAplus (Germany), MAAS (United Kingdom), PIAMA (Netherlands) and 4 INMA cohorts (Spain) Pollution was associated with pneumonia, asthma and otitis media and a meta-analysis was used to arrive at a composite effect estimate. [Methods] The physician-evaluated diagnosis of early childhood pneumonia, otitis media and asthma was compared with the annual mean level of pollutants [NO2, NOx, PM2.5, PM2.5 absorbance, PM10, PM2.5-10 (coarse PM)]. The estimation of pollutant concentration was based on land use regression model and distribution according to children’s birth place. As part of the ESCAPE project, the same scenario was used for each study area to establish a regression model. Logistic regression was used to calculate the adjusted effect estimates for each study, and the randomized meta-analysis was used to calculate the combined estimates. [Results] The combined odds ratio (OR) of pneumonia was increased for all pollutants except PM2.5 (for example, OR = 1.30,95% CI: 1.02-1.6 for every 10μg / m3 increase of NO2; OR = 1.76 at 95 [mu] g / m3, 95% CI: 1.00-3.09). For otitis media and asthma, all analyzes were insignificant except for the association between NO2 and otitis media (OR = 1.09, 95% CI: 10 <2> / m3 for each 10 [mu] g / m3). [Conclusions] A meta-analysis of 10 European birth cohorts in the ESCAPE project found evidence of agreement in the correlation between air pollution and early childhood pneumonia and some evidence for the association with otitis media.