背景:小儿哮喘和其他过敏性疾病的负担在美国人群中分布不均。
目的:为了确定尿生物标志物是否与哮喘发病率相关,如果协会因儿童种族而异,种族和性别。
方法:本研究纳入了n=152名医生诊断为哮喘的儿童,他们参加了学校市内哮喘干预研究(SICAS-2)。苯酚的代谢物,对羟基苯甲酸酯,多环芳烃,从基线时收集的尿液样品中分析邻苯二甲酸盐分析物。将过去2周内的哮喘症状天数分为无哮喘症状天数或任何哮喘症状天数。横截面回归模型根据年龄进行了调整,性别,感冒的数量,家庭收入,处方控制,种族和民族,体重指数(BMI)百分位数,和烟雾暴露。加权分位数和回归用于分析每个化学类别和总混合效应,控制相同的协变量。在国家环境健康科学研究所儿童健康暴露分析资源(CHEAR)的协助下进行分析。
结果:参与者主要是西班牙裔/拉丁美洲裔和低收入,平均年龄为7.83岁,过去两周平均最大哮喘症状天数为2.13(标准差:3.56)。最大浓度表示几种化学物质的极值,包括双酚-3,2,5-二氯苯酚,对羟基苯甲酸丙酯和对羟基苯甲酸甲酯,三氯生,对羟基苯甲酸甲酯和可替宁。我们发现具有过敏原敏感性的儿童与没有过敏原敏感性的儿童之间存在显着的相互作用效应和分析物的不同贡献。对于按儿童种族和种族评估效果改变的分层分析,加权分位数和相互作用模型显示,与黑人相比,其他种族和种族的儿童哮喘症状的几率降低到更大的程度,非西班牙裔儿童。
结论:对内城儿童环境化学暴露与哮喘症状之间关系的初步分析揭示了一种负相关,这可能是由于个人护理和药物使用,可以在未来的分析中进一步理解。对大多数化学品检测到有益效果。
BACKGROUND: The burden of pediatric asthma and other allergic diseases is not evenly distributed among United States populations.
OBJECTIVE: To determine whether urinary biomarkers are associated with asthma morbidity, and if associations vary by child race, ethnicity and sex.
METHODS: This study includes n = 152 children with physician-diagnosed asthma who participated in the School Inner-City Asthma Intervention Study (SICAS-2). Metabolites of phenol, paraben, polycyclic aromatic hydrocarbons, and phthalate analytes were analyzed from urine samples collected at baseline. Asthma symptom days over the past 2 weeks were dichotomized to no asthma symptom days or any asthma symptom days. Cross-sectional regression models were adjusted for age, sex, number of colds, household income, prescription control, race and ethnicity, body mass index (BMI) percentile, and smoke exposure. Weighted quantile sum regression was used to analyze each chemical class and a total mixture effect, controlling for the same covariates. Analyses were conducted with the assistance of the National Institute of Environmental Health Sciences Children\'s Health Exposure Analysis Resource (CHEAR).
RESULTS: Participants were mostly Hispanic/Latino and low income with an average age of 7.83 years and the average maximum asthma symptom days over the past two weeks of 2.13 (standard deviation: 3.56). The maximum concentrations indicate extreme values for several chemicals, including bisphenol-3, 2,5-dichlorophenol, propyl and methyl parabens, triclosan, methyl paraben and cotinine. We found a significant interaction effect and differing contributions of analytes for children with allergen sensitivity versus those that did not. For stratified analyses assessing effect modification by child race and ethnicity, weighted quantile sum interaction models showed reduced odds of asthma symptoms to a greater magnitude in children of other races and ethnicities compared to Black, Non-Hispanic children.
CONCLUSIONS: Preliminary analyses of the association between environmental chemical exposure and asthma symptoms among inner-city children revealed an inverse association, which may be due to personal care and medication use and can be understood further in future analyses. Beneficial effects were detected for most of the chemicals.