Air pollution and family related determinants of asthma onset and persistent wheezing in children: nationwide case-control study [儿童哮喘发作和持续喘息的空气污染与家庭相关决定因素：全国病例对照研究]

• 分享：

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2791 (Published 19 August 2020)
Cite this as: BMJ 2020;370:m2791

Authors
Gitte J Holst, Carsten B Pedersen, Malene Thygesen, Jørgen Brandt, Camilla Geels, Jakob H Bønløkke, Torben Sigsgaard

Abstract
Objective To identify risk factors (air pollution and family related) for the onset of asthma and persistent wheezing in children.

Design Nationwide case-control study.

Setting Denmark.

Participants All Danish children born from 1997 to 2014 and followed for asthma onset and persistent wheezing from age 1 year to 15 years.

Main outcome measure Onset of asthma and persistent wheezing.

Results A higher incidence of asthma was found in children of parents with asthma (adjusted hazard ratio 2.29 (95% confidence interval 2.22 to 2.35) and mothers who smoked during pregnancy (1.20, 1.18 to 1.22), whereas a lower incidence was found in children of parents with high educational attainment (0.72, 0.69 to 0.75) and high incomes (0.85, 0.81 to 0.89). Exposure to particulate matter ≤2.5 µm (PM2.5) and ≤10 µm (PM10) and nitrate was associated with an increased risk of asthma and persistent wheezing, with hazard ratios per 5 µg/m3 increase in pollutant concentrations 1.05 (1.03 to 1.07) for PM2.5, 1.04 (1.02 to 1.06) for PM10, and 1.04 (1.03 to 1.04) for nitrogen dioxide. Only the positive association of PM2.5 with asthma and persistent wheezing remained robust across the different models and in sensitivity analyses.

Conclusions The findings of this study suggest that children exposed to higher levels of PM2.5 are more likely to develop asthma and persistent wheezing than children who are not exposed. Other risk factors associated with these outcomes were parental asthma, parental education, and maternal smoking during pregnancy.