Abstract：
The joint effect of air pollutants at relatively low levels requires further investigation. Here, a database study was performed to evaluate the effects of exposure to mixtures of air pollutants during pregnancy, infancy, and childhood on childhood persistent asthma. We used the Japan Medical Data Center database, which provides access to family linkages and healthcare provider addresses, and included child-mother dyads in which the child was born between January 2010 and January 2017. The exposure of interest was ground-level air pollutants, and the primary outcome was childhood persistent asthma at 45 years of age, as defined based on outpatient and inpatient asthma disease codes and/or asthma medication dispensing claims. The weighted quantile sum (WQS) regression was used to evaluate the effects of air pollutant mixtures on 52,526 child-mother dyads from 1149 of 1907 municipalities (60.3 %) in Japan. The WQS regression models showed that with every 10th percentile increase in the WQS index, ground-level air pollutants during pregnancy, infancy, and childhood increased the risk of childhood persistent asthma by an odds ratio of 1.04 (95 % CI: 1.02-1.05; p<0.001), 1.02 (95 % CI: 1.01-1.03; p<0.001), and 1.03 (95 % CI: 1.01-1.04; p<0.001), respectively. Moreover, particulate matter with an aerodynamic diameter ≤ 2.5 µm was assigned the highest weight across all three exposure periods. Relatively high weights were assigned to suspended particulate matter and photochemical oxidants during pregnancy, carbon monoxide during infancy, and photochemical oxidants during childhood. Our study showed that a mixture of low-level air pollutants has a detrimental association with childhood persistent asthma.
摘要：
相对低水平的空气污染物的联合影响需要进一步调查。这里,进行了一项数据库研究，以评估怀孕期间暴露于空气污染物混合物的影响，婴儿期,和儿童对儿童持续性哮喘的影响。我们使用了日本医疗数据中心的数据库,它提供了对家庭联系和医疗保健提供者地址的访问，并且包括孩子在2010年1月至2017年1月期间出生的孩子-母亲双联体。感兴趣的暴露是地面空气污染物，主要结果是45岁的儿童持续性哮喘，根据门诊和住院哮喘疾病代码和/或哮喘药物分配索赔定义。加权分位数和（WQS）回归用于评估空气污染物混合物对日本1907年1149个城市（60.3％）的52,526个儿童母亲的影响。WQS回归模型显示，WQS指数每增加10个百分位数，怀孕期间的地面空气污染物，婴儿期,和儿童期增加了儿童持续性哮喘的风险1.04（95％CI：1.02-1.05；p<0.001），1.02（95%CI：1.01-1.03；p<0.001），和1.03（95%CI：1.01-1.04；p<0.001），分别。此外，空气动力学直径≤2.5µm的颗粒物在所有三个暴露期内都被指定为最高重量.在怀孕期间，相对较高的重量被分配给悬浮的颗粒物和光化学氧化剂，婴儿期的一氧化碳，和童年时期的光化学氧化剂。我们的研究表明，低水平空气污染物的混合物与儿童持续性哮喘有不利的联系。
