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首页> 外文会议>Annual conference of the International Society of Exposure Science >Incidence of Asthma and Outdoor Ambient Air Pollutants: A Population-Based Birth Cohort Study
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Incidence of Asthma and Outdoor Ambient Air Pollutants: A Population-Based Birth Cohort Study

机译：哮喘和室外环境空气污染物的发病率：基于人群的出生队列研究

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Asthma is the most common chronic disease in childhood in developed countries and there is large geographic variation in asthma incidence and prevalence. Few cohort studies have assessed associations between exposure to air pollutants and asthma onset and controversies have been noted. To our knowledge, no population based cohort study has been performed to address this issue. We constructed a population-based retrospective birth cohort in Quebec (Canada) using linked administrative health databases and precise children's residential location, to assess whether new cases of asthma in children are associated with residential exposure to ambient air pollutants. The open cohort started in 1996 and all newborns of Quebec were followed up until 12 years of age or March 2011. New asthma cases were identified through their lifetime use of medical services for asthma. The definition used for asthma case identification is based on at least two visits to a physician with a diagnosis of asthma over a two-year period, or one hospital discharge with a diagnosis of asthma. In Quebec all residents are beneficiaries of a universal health care delivery plan. Exposure at the residence of birth to summer ozone (O3) levels was estimated with a Bayesian Maximum Entropy model and to fine particulate levels (PM2.5), from MODIS satellite images. For a subgroup of children living on the island of Montreal, nitrogen dioxide (NO2) exposure was estimated with a Land Use Regression. Cox proportional hazards regressions (time 0 = birth) were used to assess risks of asthma onset with residential exposure at birth to ambient air pollutants. Models were adjusted with quintiles of the Pampalon deprivation index.There were 1119 365 children who were born in Quebec from 1996 to 2011 and 157 102 developed asthma. Mean PM2.5 and summer O3 exposure levels were 9.74+ 3.45 μg/m3 and 32.07 + 2.56 ppb. For children of Montreal, mean NO2 levels were 15.25 + 3.74 ppb. Hazard ratios for PM2.5, O3 and NO2 were respectively 1.036 (1.034-1.037), 1.033 (1.031-1.036) and 1.010 (1.007-1.013) per one unit increase in exposure levels. Preliminary results suggest that early life exposure to ambient air pollutants is associated with the development of asthma in children. By following all children of Quebec, our population-based cohort study will allow us in future work, to assess how the inter-regional geographic variation of asthma incidence in children is influenced by exposure to air pollutants.
机译：哮喘是发达国家儿童期最常见的慢性疾病，哮喘的发病率和患病率存在​​很大的地理差异。很少有队列研究评估暴露于空气污染物与哮喘发作之间的关联，并且已引起争议。据我们所知，尚未进行基于人群的队列研究来解决这个问题。我们使用相关的行政健康数据库和精确的儿童居住地，在魁北克（加拿大）建立了基于人口的回顾性出生队列，以评估儿童哮喘的新病例是否与居住在环境中的空气污染物有关。开放队列始于1996年，对魁北克所有新生儿进行了随访，直到12岁或2011年3月为止。通过终生使用哮喘医疗服务来识别新的哮喘病例。用于哮喘病例识别的定义是基于至少两次拜访两年内诊断为哮喘的医师或一次出院诊断为哮喘的。在魁北克，所有居民都是普及医疗保健计划的受益者。根据贝叶斯最大熵模型和MODIS卫星图像，估算了出生住宅中夏季臭氧（O3）的暴露水平和细颗粒物水平（PM2.5）。对于生活在蒙特利尔岛上的一小组儿童，通过土地利用回归评估了二氧化氮（NO2）的暴露量。使用Cox比例风险回归（时间0 =出生）来评估居民出生时暴露于环境空气污染物引起哮喘发作的风险。根据Pampalon剥夺指数的五分位数对模型进行了调整.1996年至2011年，魁北克有1119 365名儿童出生，其中157 102例患有哮喘。 PM2.5和夏季O3的平均暴露水平为9.74+ 3.45μg/ m3和32.07 + 2.56 ppb。蒙特利尔儿童的平均NO2水平为15.25 + 3.74 ppb。暴露水平每升高一个单位，PM2.5，O3和NO2的危险比分别为1.036（1.034-1.037），1.033（1.031-1.036）和1.010（1.007-1.013）。初步结果表明，儿童早期接触环境空气污染物与哮喘的发展有关。通过跟踪魁北克的所有儿童，我们基于人群的队列研究将使我们在未来的工作中能够评估儿童哮喘发病率的区域间地理差异如何受到暴露于空气污染物的影响。

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