論文No925
Perinatal air pollution exposure and development of asthma from birth to age 10 years
Hind Sbihi, Lillian Tamburic, Mieke Koehoorn, Michael Brauer
European Respiratory Journal, vol. 47 no. 4 1062-1071
＜背景＞
市内の大気汚染は幼少時の喘息発症に関連しているとされるが、結果は不一致である。
我々は周産期の大気汚染が「就学前」、「学童期」の喘息発症に影響するかを人口ベースの出生コホートで調べた。
＜方法＞
バンクーバー都市部で１９９９年から２００２年に生まれた６５２５４名の子供を、
１０歳になるまで行政健康データベースでフォローした。
喘息症例は、性別、年齢でマッチさせた５つのランダムに選ばれたコントロールと比較した。
異なった方法（線形補間（逆距離加重（IDW)）、地形回帰、近接）で評価された
大気汚染物質、就学前０－５歳時と学童期６－１０歳の喘息発症を
条件付きロジスティック解析で評価した。
＜結果＞
就学前に６９４８名、学童期に１７１１名が喘息を発症した。
出生体重、妊娠期間、世帯収入、母乳栄養、母親の年齢、教育レベルで補正後の解析で、
就学前の喘息リスクは交通公害で増加していた
（IDWを使用して四分位間ごとに補正オッズ比：一酸化窒素１．０６、二酸化窒素１．０９、一酸化炭素１．０５）。
低体重出生児では大気汚染の影響が強くでていた。
住居周囲の緑化は関連しなかった。
＜感想＞
大気汚染は、０－５歳の喘息発症に影響するようです。
Within-city variation in air pollution has been associated with childhood asthma development, but findings have been inconsistent. We examined whether perinatal air pollution exposure affected asthma onset during “pre-school and “school age” periods in a population-based birth cohort.
65 254 children born between 1999 and 2002 in the greater Vancouver metropolitan region were followed until age 10 years using linked administrative health databases. Asthma cases were sex- and age-matched to five randomly chosen controls. Associations between exposure to air pollutants estimated with different methods (interpolation (inverse-distance weighted (IDW)), land use regression, proximity) and incident asthma during the pre-school (0–5 years) and school age (6–10 years) periods were estimated with conditional logistic regression.
6948 and 1711 cases were identified during the pre-school and school age periods, respectively. Following adjustment for birthweight, gestational period, household income, parity, breastfeeding at discharge, maternal age and education, asthma risk during the pre-school years was increased by traffic pollution (adjusted odds ratio using IDW method per interquartile increase (95% CI): nitric oxide 1.06 (1.01–1.11), nitrogen dioxide 1.09 (1.04–1.13) and carbon monoxide 1.05 (1.01–1.1)). Enhanced impacts were observed amongst low-term-birthweight cases. Associations were independent of surrounding residential greenness.
Within-city air pollution variation was associated with new asthma onset during the pre-school years.