| Autor: |
Achakulwisut P; Milken Institute School of Public Health, George Washington University, Washington, DC, USA., Brauer M; School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada; Institute for Health Metrics and Evaluation, Seattle, WA, USA., Hystad P; College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA., Anenberg SC; Milken Institute School of Public Health, George Washington University, Washington, DC, USA. Electronic address: sanenberg@gwu.edu. |
| Jazyk: |
angličtina |
| Zdroj: |
The Lancet. Planetary health [Lancet Planet Health] 2019 Apr; Vol. 3 (4), pp. e166-e178. Date of Electronic Publication: 2019 Apr 11. |
| DOI: |
10.1016/S2542-5196(19)30046-4 |
| Abstrakt: |
Background: Paediatric asthma incidence is associated with exposure to traffic-related air pollution (TRAP), but the TRAP-attributable burden remains poorly quantified. Nitrogen dioxide (NO 2 ) is a major component and common proxy of TRAP. In this study, we estimated the annual global number of new paediatric asthma cases attributable to NO 2 exposure at a resolution sufficient to resolve intra-urban exposure gradients.
Methods: We obtained 2015 country-specific and age-group-specific asthma incidence rates from the Institute for Health Metrics and Evaluation for 194 countries and 2015 population counts at a spatial resolution of 250 × 250 m from the Global Human Settlement population grid. We used 2010-12 annual average surface NO 2 concentrations derived from land-use regression at a resolution of 100 × 100 m, and we derived concentration-response functions from relative risk estimates reported in a multinational meta-analysis. We then estimated the NO 2 -attributable burden of asthma incidence in children aged 1-18 years in 194 countries and 125 major cities at a resolution of 250 × 250 m.
Findings: Globally, we estimated that 4·0 million (95% uncertainty interval [UI] 1·8-5·2) new paediatric asthma cases could be attributable to NO 2 pollution annually; 64% of these occur in urban centres. This burden accounts for 13% (6-16) of global incidence. Regionally, the greatest burdens of new asthma cases associated with NO 2 exposure per 100 000 children were estimated for Andean Latin America (340 cases per year, 95% UI 150-440), high-income North America (310, 140-400), and high-income Asia Pacific (300, 140-370). Within cities, the greatest burdens of new asthma cases associated with NO 2 exposure per 100 000 children were estimated for Lima, Peru (690 cases per year, 95% UI 330-870); Shanghai, China (650, 340-770); and Bogota, Colombia (580, 270-730). Among 125 major cities, the percentage of new asthma cases attributable to NO 2 pollution ranged from 5·6% (95% UI 2·4-7·4) in Orlu, Nigeria, to 48% (25-57) in Shanghai, China. This contribution exceeded 20% of new asthma cases in 92 cities. We estimated that about 92% of paediatric asthma incidence attributable to NO 2 exposure occurred in areas with annual average NO 2 concentrations lower than the WHO guideline of 21 parts per billion.
Interpretation: Efforts to reduce NO 2 exposure could help prevent a substantial portion of new paediatric asthma cases in both developed and developing countries, and especially in urban areas. Traffic emissions should be a target for exposure-mitigation strategies. The adequacy of the WHO guideline for ambient NO 2 concentrations might need to be revisited.
Funding: George Washington University.
(Copyright © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY NC ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.) |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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