暴露于环境污染物与36个月大儿童呼吸道疾病风险：韩国儿童环境健康研究（Ko-CHENS）。

文献信息

中文摘要

目的： 本研究旨在利用韩国儿童环境健康研究的数据，探讨暴露于环境污染物及周围居住环境与36个月大儿童呼吸道疾病发生之间的关联。
方法： 从新生儿中获取人口统计学信息和人体测量数据。在36个月大时，通过家访测量室内环境污染物水平（颗粒物[PM₁₀和PM2.5]、挥发性有机化合物和屋尘螨过敏原）。分析血液中重金属（铅、汞和镉）浓度以及尿液中环境激素代谢物。使用结构化问卷评估6种常见呼吸道疾病（婴儿哮喘、当前哮喘、反复喘息、过敏性鼻炎、毛细支气管炎和肺炎）的存在情况及居住环境特征。采用基于分位数的g计算来估计暴露于物理和化学环境因素混合物与呼吸道疾病风险的联合关联。
结果： 在总共4059名儿童中，当前过敏性鼻炎是36个月大时最常见的呼吸道疾病。与无呼吸道疾病的儿童相比，患有呼吸道疾病的儿童暴露于环境烟草烟雾和养宠物的频率显著更高。反复喘息和肺炎儿童的尘螨浓度更高。混合物暴露分析显示，总体混合物暴露与当前过敏性鼻炎呈正相关，主要由铅和邻苯二甲酸酯代谢物驱动，并与肺炎呈正相关，主要归因于邻苯二甲酸酯代谢物。暴露于多种化学物质的混合物与婴儿哮喘和当前哮喘呈正相关。
结论： 直接和间接暴露于环境污染物与幼儿呼吸道疾病的发生密切相关，早期周围的居住环境在决定呼吸道疾病风险中也起着关键作用。这些发现支持需要在个人和社区层面进行系统且可持续的环境管理，以保护特别易受环境危害影响的儿童。

英文摘要

PURPOSE: This study aimed to investigate the association of exposure to environmental pollutants and surrounding residential environments with the development of respiratory illnesses in 36-month-old children using data from the Korean CHildren's ENvironmental health Study.
METHODS: Demographic information and anthropometric measurements were obtained from the newborns. At 36 months of age, indoor environmental pollutant levels (particulate matter [PM₁₀ and PM2.5], volatile organic compounds, and house dust mite allergens) were measured during home visits. Concentrations of both heavy metals (lead, mercury, and cadmium) in blood and metabolites of environmental hormones in urine were analyzed. A structured questionnaire was used to assess the presence of 6 common respiratory illnesses (infantile asthma, current asthma, recurrent wheezing, allergic rhinitis, bronchiolitis, and pneumonia) and residential environmental characteristics. Quantile-based g-computation was employed to estimate the joint association of exposure to mixtures of physical and chemical environmental factors with the risk of respiratory illnesses.
RESULTS: Among the total of 4,059 children, current allergic rhinitis was the most prevalent respiratory illness at 36 months. Compared with children without respiratory illnesses, those with respiratory illnesses showed significantly higher frequencies of exposure to environmental tobacco smoking and pet ownership. Dust mite concentrations were higher among children with recurrent wheezing and pneumonia. Mixture exposure analysis revealed that overall mixture exposure was positively associated with current allergic rhinitis, largely driven by lead and phthalate metabolites, and with pneumonia, mainly attributable to phthalate metabolites. Exposure to a mixture of multiple chemicals was positively associated with infantile asthma and current asthma.
CONCLUSIONS: Direct and indirect exposures to environmental pollutants are closely associated with the development of respiratory illnesses in young children, and the surrounding residential environment during early childhood also plays a critical role in determining respiratory disease risk. These findings support the need for systematic and sustainable environmental management at both individual and community levels to protect children who are particularly vulnerable to environmental hazards.