空气原油化学物质与基于症状哮喘间的相关性分析
2022/08/19
摘要
背景：2010 年深水地平线 (DWH) 溢油响应和清理（OSRC）工作人员暴露于空气中的总碳氢化合物 (THC)、苯、甲苯、乙苯、邻、间和对二甲苯以及正己烷（BTEX-H）来自原油和来自燃烧/燃烧石油和天然气的 PM2.5，但我们对溢油清理工人罹患哮喘的风险知之甚少。海湾长期随访（GuLF）研究包括DWH 灾难后的 24,937 名清洁工人和 7,671 名非工人的前瞻性队列，本文旨在通过分析该研究中的数据评估哮喘与几种石油泄漏相关暴露之间的相关性，包括工作类别、THC、个别 BTEX-H 化学品、BTEX-H 混合物和 PM2.5 。
方法：本研究分析主要集中在泄漏前没有哮喘的 19,018 名工人，因其拥有完整的暴露情况、结果和协变量信息。本研究采用自我报告的喘息和自我报告的医师哮喘诊断来定义暴露后 1-3 年的哮喘发作。 THC 和 BTEX-H 根据测量数据和工作经历分配给参与者，而 PM2.5 使用模型估计值。本研究采用改进的泊松回归来估计泄漏相关暴露与哮喘之间相关性的风险比（RR）和 95% 置信区间（CI），并采用基于分位数的 g 计算方法来探索 BTEX-H 混合物对哮喘风险测综合影响。
结果：OSRC 工作人员罹患哮喘的风险高于非工作人员（RR：1.60, 95% CI：1.38, 1.85）。较高的THC 暴露水平估计值与暴露相关风险增加相关（线性趋势检验 p < 0.0001）。哮喘风险也随着接触个别 BTEX-H 化学品和化学混合物的增加而增加：BTEX-H 混合物同时增加四分位数与哮喘风险增加 1.45 相关（95% CI：1.35,1.55）。由于病例较少，单独由医生诊断的哮喘的相关性不太明显。
结论：THC 和 BTEX-H 与采用喘息症状和医生诊断定义的哮喘风险增加相关。
Associations between airborne crude oil chemicals and symptom-based asthma.
Lawrence KG, Niehoff NM, Keil AP, Braxton Jackson W 2nd, Christenbury K, Stewart PA, Stenzel MR, Huynh TB, Groth CP, Ramachandran G, Banerjee S, Pratt GC, Curry MD, Engel LS, Sandler DP.
Abstract
BACKGROUND：The 2010 Deepwater Horizon (DWH) oil spill response and cleanup (OSRC) workers were exposed to airborne total hydrocarbons (THC), benzene, toluene, ethylbenzene, o-, m-, and p-xylenes and n-hexane (BTEX-H) from crude oil and PM2.5 from burning/flaring oil and natural gas. Little is known about asthma risk among oil spill cleanup workers. We assessed the relationship between asthma and several oil spill-related exposures including job classes, THC, individual BTEX-H chemicals, the BTEX-H mixture, and PM2.5 using data from the Gulf Long-Term Follow-up (GuLF) Study, a prospective cohort of 24,937 cleanup workers and 7,671 nonworkers following the DWH disaster.
METHODS：Our analysis largely focused on the 19,018 workers without asthma before the spill who had complete exposure, outcome, and covariate information. We defined incident asthma 1-3 years following exposure using both self-reported wheeze and self-reported physician diagnosis of asthma. THC and BTEX-H were assigned to participants based on measurement data and work histories, while PM2.5 used modeled estimates. We used modified Poisson regression to estimate risk ratios (RR) and 95% confidence intervals (CIs) for associations between spill-related exposures and asthma and a quantile-based g-computation approach to explore the joint effect of the BTEX-H mixture on asthma risk.
RESULTS：OSRC workers had greater asthma risk than nonworkers (RR: 1.60, 95% CI: 1.38, 1.85). Higher estimated THC exposure levels were associated with increased risk in an exposure-dependent manner (linear trend test p < 0.0001). Asthma risk also increased with increasing exposure to individual BTEX-H chemicals and the chemical mixture: A simultaneous quartile increase in the BTEX-H mixture was associated with an increased asthma risk of 1.45 (95% CI: 1.35,1.55). With fewer cases, associations were less apparent for physician-diagnosed asthma alone.
CONCLUSIONS：THC and BTEX-H were associated with increased asthma risk defined using wheeze symptoms as well as a physician diagnosis.
背景：2010 年深水地平线 (DWH) 溢油响应和清理（OSRC）工作人员暴露于空气中的总碳氢化合物 (THC)、苯、甲苯、乙苯、邻、间和对二甲苯以及正己烷（BTEX-H）来自原油和来自燃烧/燃烧石油和天然气的 PM2.5，但我们对溢油清理工人罹患哮喘的风险知之甚少。海湾长期随访（GuLF）研究包括DWH 灾难后的 24,937 名清洁工人和 7,671 名非工人的前瞻性队列，本文旨在通过分析该研究中的数据评估哮喘与几种石油泄漏相关暴露之间的相关性，包括工作类别、THC、个别 BTEX-H 化学品、BTEX-H 混合物和 PM2.5 。
方法：本研究分析主要集中在泄漏前没有哮喘的 19,018 名工人，因其拥有完整的暴露情况、结果和协变量信息。本研究采用自我报告的喘息和自我报告的医师哮喘诊断来定义暴露后 1-3 年的哮喘发作。 THC 和 BTEX-H 根据测量数据和工作经历分配给参与者，而 PM2.5 使用模型估计值。本研究采用改进的泊松回归来估计泄漏相关暴露与哮喘之间相关性的风险比（RR）和 95% 置信区间（CI），并采用基于分位数的 g 计算方法来探索 BTEX-H 混合物对哮喘风险测综合影响。
结果：OSRC 工作人员罹患哮喘的风险高于非工作人员（RR：1.60, 95% CI：1.38, 1.85）。较高的THC 暴露水平估计值与暴露相关风险增加相关（线性趋势检验 p < 0.0001）。哮喘风险也随着接触个别 BTEX-H 化学品和化学混合物的增加而增加：BTEX-H 混合物同时增加四分位数与哮喘风险增加 1.45 相关（95% CI：1.35,1.55）。由于病例较少，单独由医生诊断的哮喘的相关性不太明显。
结论：THC 和 BTEX-H 与采用喘息症状和医生诊断定义的哮喘风险增加相关。
(中日友好医院呼吸与危重症医学科 张婧媛 摘译 林江涛 审校)
(Environ Int. 2022 Jul 27;167:107433. doi: 10.1016/j.envint.2022.107433.)
(Environ Int. 2022 Jul 27;167:107433. doi: 10.1016/j.envint.2022.107433.)
Associations between airborne crude oil chemicals and symptom-based asthma.
Lawrence KG, Niehoff NM, Keil AP, Braxton Jackson W 2nd, Christenbury K, Stewart PA, Stenzel MR, Huynh TB, Groth CP, Ramachandran G, Banerjee S, Pratt GC, Curry MD, Engel LS, Sandler DP.
Abstract
BACKGROUND：The 2010 Deepwater Horizon (DWH) oil spill response and cleanup (OSRC) workers were exposed to airborne total hydrocarbons (THC), benzene, toluene, ethylbenzene, o-, m-, and p-xylenes and n-hexane (BTEX-H) from crude oil and PM2.5 from burning/flaring oil and natural gas. Little is known about asthma risk among oil spill cleanup workers. We assessed the relationship between asthma and several oil spill-related exposures including job classes, THC, individual BTEX-H chemicals, the BTEX-H mixture, and PM2.5 using data from the Gulf Long-Term Follow-up (GuLF) Study, a prospective cohort of 24,937 cleanup workers and 7,671 nonworkers following the DWH disaster.
METHODS：Our analysis largely focused on the 19,018 workers without asthma before the spill who had complete exposure, outcome, and covariate information. We defined incident asthma 1-3 years following exposure using both self-reported wheeze and self-reported physician diagnosis of asthma. THC and BTEX-H were assigned to participants based on measurement data and work histories, while PM2.5 used modeled estimates. We used modified Poisson regression to estimate risk ratios (RR) and 95% confidence intervals (CIs) for associations between spill-related exposures and asthma and a quantile-based g-computation approach to explore the joint effect of the BTEX-H mixture on asthma risk.
RESULTS：OSRC workers had greater asthma risk than nonworkers (RR: 1.60, 95% CI: 1.38, 1.85). Higher estimated THC exposure levels were associated with increased risk in an exposure-dependent manner (linear trend test p < 0.0001). Asthma risk also increased with increasing exposure to individual BTEX-H chemicals and the chemical mixture: A simultaneous quartile increase in the BTEX-H mixture was associated with an increased asthma risk of 1.45 (95% CI: 1.35,1.55). With fewer cases, associations were less apparent for physician-diagnosed asthma alone.
CONCLUSIONS：THC and BTEX-H were associated with increased asthma risk defined using wheeze symptoms as well as a physician diagnosis.
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非洲人特有的等位基因改变了非洲裔美国人在17q12-q21位点上的哮喘风险
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严重哮喘患者增加体力活动：一项系统综述和荟萃分析
