空气污染与神经退行性疾病

随着现代社会工业的发展,空气污染日益严重,空气污染对人体的损害也越来越大。空气污染中的有害物质,能通过各种途径引起各系统的疾病,甚至会影响儿童的身体和智力发育。研究发现,长期暴露或急性暴露在某些空气污染物中可以直接损伤中枢神经系统,或污染物引起呼吸系统和免疫系统等产生有害因子,通过外周循环到达大脑,导致大脑的神经炎症、神经毒性、氧化应激等反应,最终产生神经退行性病变,如阿尔茨海默病（Alzheimer’s disease,AD）、帕金森病（Parkinson’s disease,PD）等。     

Airborne enteric micro-organisms and ammonia levels in diaper-changing rooms in kindergartens

Aims: We evaluated risks associated with diaper changing in Finnish kindergartens where children were using either modern disposable paper or reusable cloth diapers. Methods and Results: We determined enteric micro‐organisms and ammonia in diaper‐changing rooms in four kindergartens in autumn and winter in the ambient air. No coliphages were detected in the air. The numbers of faecal coliforms and enterococci in air were typically low regardless of whether the children used either paper or cloth diapers. Ammonia concentrations increased over the background level because of diaper changing. Conclusions: The numbers of bacteria or coliphages are not expected to pose any high air hygiene risks, and increased ammonia air concentrations are unlikely to impair the health of staff or children when diapers are changed in modern kindergartens. However, increased ammonia gas concentrations indicate that some other diaper‐related gas‐phase emissions should be studied to understand better diaper‐related health risks. Significance and Impact of the Study: Modern reusable cloth baby diapers and the modern paper baby diapers used in this study are equally safe with respect to risks from airborne virus, bacteria or ammonia.     

Serious childhood injuries caused by air guns.

OBJECTIVE: To determine the severity of nonfatal injuries to children caused by air guns and pellet guns. DESIGN: Case series (hospital chart review). SETTING: Inpatient wards of the Children''s Hospital of Eastern Ontario. PATIENTS: All children under 18 years of age admitted to the hospital from Jan. 1, 1979, to Dec. 31, 1989, under ICD code E917, E922, E955, E965, E970 or E985 who had suffered air gun injuries. MAIN OUTCOME MEASURES: Personal data, circumstances of event and clinical data. RESULTS: The 43 children (37 boys) had a median age of 12 years. The circumstances of the accident were known in 20 cases: 17 children were playing and 3 were cleaning the gun when it went off. Four children thought the gun was unloaded. In five cases the bullet ricocheted into the eye. Nine injuries were self-inflicted. Injury was to the extremities in 21 (49%), the eyes in 15 (35%) and the head and neck in 7 (16%). The median length of hospital stay was 4 days. Six children had long-term disabilities, all the result of eye injuries; two had cataract surgery, and four required enucleation of the eye. CONCLUSIONS: Air guns can cause serious injury to children. Their sale needs to be banned or at least carefully regulated.     

Evaluation of conversion coefficients from measurable to risk quantities for external exposure over contaminated soil by use of physical human phantoms

Conversion coefficients from measurable quantities such as air kerma free-in-air or personal dose equivalent to effective dose were determined by phantom experiments. Heterogenic anthropomorphic phantoms representing children of one and five years age, and a Rando phantom representing an adult were exposed in the open field contaminated by different levels of radiocesium in the upper soil layer, in a forest site and inside a wooden house. LiF thermoluminescent (TL) detectors were used inside the phantoms for the estimation of organ doses and effective dose. Personal dosimeters similar to those used in radiation protection for individual dose measurements were placed onto the phantom surface (chest area). The ratios of dose values in separate organs to air kerma free-in-air varied from 0.69 to 1.15 for the children phantoms, and from 0.55 to 0.94 for the adult phantom, respectively, when irradiated in the open field. Body size (weight) was found to be the most important factor influencing the values of the conversion coefficients. The differences observed can reach approximately 40% when comparing conversion factors from air kerma free-in-air to effective dose for adults and newborns. For conversion coefficients from personal dose to effective dose, these differences can reach approximately 15%. The dependences of the various conversion coefficients on body mass were quantified by regression analysis. The results were compared with those calculated for a plane mono-energetic photon source having an energy of 700 keV and being located in the ground at a depth of 0.5 g cm⁻². Calculated and measured conversion coefficients from air kerma free-in-air to effective dose agreed within 12%.     

The effect of coal stoves and environmental tobacco smoke on the level of urinary 1-hydroxypyrene

The objective of this study was to investigate a relationship between indoor air pollution from heating and cooking with coal-burning stoves and from environmental tobacco smoke (ETS), and the level of urinary 1-hydroxypyrene (1-OH-PY). 1-OH-PY was analysed in children living in three areas of Silesia, a province in Poland. Urine samples were collected in winter, (1) from children exposed to ETS and smoke resulting from indoor coal-burning and (2) from control children. Airborne particulates had been sampled by use of stationary samplers by the Regional Sanitary-Epidemiological Station, Katowice throughout 12 months prior to the urine sampling. The urinary level of 1-OH-PY tended to increase in children exposed to ETS, but the increase was not significant. The concentrations of 1-OH-PY in urine of passive smokers were significantly elevated only in Bytom where an index of smoking parents of the studied children was highest as compared to other areas. Exposure to polycyclic aromatic hydrocarbons (PAH) due to domestic heating and cooking with coal-burning stoves resulted in significantly increased levels of 1-OH-PY. The results of this study indicate that the uptake of PAH due to indoor air pollution strongly affected the level of 1-OH-PY and that the main source of PAH in indoor air was the household use of coal for heating and/or cooking. When the results associated with this kind of exposure were excluded, median 1-OH-PY levels from the three examined areas assumed a pattern more similar to that of the benzo(a)pyrene (BaP) concentrations in ambient air.     

Human biomonitoring of cadmium and lead exposure of child-mother pairs from Germany living in the vicinity of industrial sources (hot spot study NRW).

Cadmium (Cd) and lead (Pb) exposure of children and their mothers living in the vicinity of industrial sources (metal refining) was assessed by a cross-sectional study performed in 2000. Study areas were the highly industrialized city of Duisburg and a rural area of North Rhine Westphalia, Germany. Exposure to ambient air concentrations of Cd and Pb was calculated from a Lagrange dispersion model using data sets from ambient air quality measurements. Cd in blood and urine and Pb in blood were measured by AAS. Mean age (years) was 6.4 (range 5.5-7.7) for children (n = 238) and 36 (range 23-48) for mothers (n = 213). A total of 49% of the children were males. Factors suspected to influence metal levels in blood or urine were obtained by questionnaire. Individual ambient Cd and Pb levels according to the home address ranged from 0.5 ng/m3 (Cd) and 0.03 microg/m3 (Pb) (rural area) up to 31.2 ng/m3 (Cd) and 0.73 microg/m3 (Pb) (industrialized area). Cd levels (geometric mean) in blood (0.13 and 0.10 microg/L) and urine (both areas 0.09 microg/L) of children did not differ between the two areas. Cd levels in blood and urine of mothers from the industrialized area were higher (blood 0.39 microg/L, urine 0.28 microg/L) than in those from the rural area (blood 0.25 microg/L, urine 0.25 microg/L). Pb levels in the blood of children from the industrialized area were higher (31 microg/L) than in those from the rural area (21 microg/L). Pb levels in the blood of mothers did not differ between the two areas (both 24 microg/L). Pb levels in blood showed a significant association between child and mother (n = 192; r = 0.26, p < 0.001). This did not apply for Cd in blood or urine. Regression analysis clearly revealed that Pb levels in ambient air were associated with Pb in the blood of children. Minor associations were also found between Cd in air and Cd in the blood of mothers and between Cd in air and urine of mothers.     

The relationship between obesity and seasonal variation in body weight among elementary school children in Tokyo

Typical patterns of seasonal variation in body weight among Japanese children involve increases during the fall and/or winter and decreases during the summer. However, atypical variations, namely, increases in weight during the summer, have been reported for obese children. The present study examines whether weight gain during the summer (i.e., July through September) is a possible cause of obesity. We examined seasonal changes in weight for 446 elementary school children in Tokyo in six waves between 1972 and 2004. Weight was measured monthly for 6 years in each child and was evaluated by means of time-series analysis. Overall, significant seasonal variations in weight were found in 86% of the children, most of which were typical (i.e., decreases during the summer and increases during the fall, winter, and/or early spring). On the other hand, weight gain in the summer was observed exclusively among obese children. Children whose weight increased during the summer holiday spent most of their time comfortably indoors because of air conditioners, which became popular in 1970s. A possible explanation of the observed weight gain during the summer seems to be changes in life style associated with the use of air conditioning, concomitant with insufficient physical exercise and excessive consumption of food and drink, which could disturb the rhythms of seasonal weight changes and lead to obesity.     

Stress and physiological,behavioral and performance patterns of children under varied air ion levels

The possibility that individual differences in reactivity to stressors are a major factor underlying discordant results reported for air ion studies prompted an investigation of response patterns in school children under both normal indoor air ion levels and moderately increased negative air ion levels (4000±500/cm³). It was hypothesized that the impact of stressors is reduced with high negative air ionization, and that resultant changes in stress effects would be differentially exhibited according to the children's normal degree of stimulus reactivity. A counter-balanced, replicative, withinssubject design was selected, and the subjects were 12 environmentally sensitive, 1st–4th grade school children. In addition to monitoring stress effects on activity level, attention span, concentration to task and conceptual performance, measures were also made of urinary 5-hydroxyindole acetic acid levels and skin resistance response (SRR) to determine if changes extended to the physiological state. The cold water test was used to add physical stress and enable calculations of Lacey's autonomic lability scores (ALS) as indicators of individual reactivity. The results show main effects for air ions on both physiological parameters, with 48% less change in %SRR (P<0.01) and 46% less change in urinary 5-HIAA levels (P<0.055) during negative air ions, indicating increased stress tolerance. Strong interactive effects for ALS x air ion condition appeared, with high and low ALS children reacting oppositely to negative air ions in measures of skin resistance level (P<0.01), wrist activity (P<0.01) and digit span backwards (P<0.004). Thus individual differences in autonomic reactivity and the presence or absence of stressors appear as critical elements for internal validity, and in preventing consequent skewed results from obscuring progress in air ion research.     

Royal College of Physicians and Surgeons of Canada: annual meeting draws over 2000 physicians

In a review of 19 years'' experience with inhalation of foreign bodies by children the 33 patients (mean age 28 months) were found to have presented most frequently with wheezing or coughing, or both, of recent onset, and to have decreased air entry, rhonchi or respiratory stridor, or a combination of these signs. Eighteen children had inhaled a nut, a pea or a bean. The other 15 had inhaled various organic and inorganic objects. All the children underwent bronchoscopy, and the foreign body was completely removed in 19 during the first procedure; the remainder required repeated bronchoscopy or direct surgical removal of the foreign body, or both. Permanent disability or death was not encountered. The findingsof the study indicate that early bronchoscopic removal is the preferred treatment when a child inhales a foreign body.     

Indoor Air Pollution Aggravates Symptoms of Atopic Dermatitis in Children

Most of researches on the impact of indoor air pollutants on atopic dermatitis (AD) have been based upon animal models, in vitro experiments and case-control studies. However, human data to elucidate the role of indoor air pollution on worsening symptoms of pre-existing AD from a longitudinal study are scarce. The objective of this prospective study was to evaluate the effect of indoor air pollution on AD symptoms in children. We surveyed 30 children with AD in a day-care centre, which moved to a new building during the study. These children stayed there for 8 hours a day Monday through Friday, and their daily symptom scores were recorded. Indoor and outdoor air pollutant levels were continuously measured 24 hours a day for 12 months (Period 1 to 4). Data were analyzed using a generalized linear mixed model. Compared to the period before moving (Period 1), concentrations of indoor air pollutants mostly increased after moving (Period 2) and decreased by natural ventilation and bake-out (Periods 3 and 4). The rate of positive AD symptom increased from 32.8% (Period 1) up to 43.8% (Period 2) and 50.5% (Period 3), then decreased to 35.4% in Period 4 (P < 0.0001). When the delayed effects of indoor air pollutants on AD symptoms 2 days later were evaluated, AD symptoms significantly increased by 12.7% (95% CI: -0.01 to 27.1) as toluene levels increased by 1 ppb (P = 0.05). In conclusion, indoor air pollutants increase the risk of AD aggravation in children and toluene in the indoor environment might act as an aggravating factor.     

Cytogenetic effects in children and mothers exposed to air pollution assessed by the frequency of micronuclei and fluorescence in situ hybridization (FISH): a family pilot study in the Czech Republic

A family pilot study was conducted in the Czech Republic to test the hypothesis that exposure to air pollution with particulate matter (PM) in children results in detectable effects indicated by a number of biomarkers of exposure and early effects. The frequency of micronuclei (MN) in peripheral blood lymphocytes (PBLs) was analysed to assess the cytogenetic effects in children and mothers living in two different areas. From each area two groups of children from a total of 24 families (mean age: 6.0+/-0.6 and 9.0+/-1.2 years) in a total of 47 children and 19 mothers (mean age: 33.6+/-3.9 years) participated. Chromosome aberrations determined with fluorescence in situ hybridization (FISH) painting for chromosomes #1 and #4 were analysed in 39 children and 20 parents. Teplice, a mining district, in Northern Bohemia was selected for the analyses of the effects in a population exposed to high levels of air pollution, especially during winter, and compared with a population from the rural area of Prachatice in Southern Bohemia. Significant higher frequencies of MN were found in the younger children living in the Teplice area as compared with those living in the Prachatice area (7.0+/-2.3 per thousand versus 4.9+/-2.0 per thousand, p=0.04). Higher levels of MN were also measured in the older children and the mothers from the Teplice area (9.2+/-3.7 per thousand versus 6.6+/-4.4 per thousand) and (12.6+/-3.4 per thousand versus 10.1+/-4.0 per thousand). The increased MN frequency may be associated with elevated carcinogenic polycyclic aromatic hydrocarbons (c-PAHs) concentration of the PM(2.5) measured in the ambient Teplice air, but other factors like genotoxic compounds from the diet or protective effect of micronutrients, which was not addressed in this pilot study, may also differ between the two areas. MN frequencies were found to increase with age in children. Lower MN frequency was found in boys as compared to girls. The result of the FISH analyses showed a low number of individuals with detectable levels of aberrations and no significant increases in genomic frequency of stable chromosome exchanges (F(G)/100) were found in children or parents from the Teplice area in comparison with those from the Prachatice area. The family pilot study indicates that MN is a valuable and sensitive biomarker for early biological effect in children and adults living in two different areas characterised with significant exposure differences in c-PAHs concentrations during winter.     

Infecciones hospitalarias aspergilosas bronco-pulmonares en lactantes y niños menores

Routine histological investigations of the lungs of 38 children led to the discovery during the second half of 1970 of 4 cases of pulmonary aspergillosis in hospitalized children between 3 1/2 weeks and 2 years of age. Those cases represented 10.5% of all children, autopsiated during this period with an hospitalization period of more than 7 days. In two cases Aspergillus filaments did not invade pulmonary tissue, but in the two other cases Aspergillus mycelium had invaded the walls of adjacent pulmonary arteries with resultant arteritis, thrombosis and hemorrhagic infarction. The author believes, that the mycoses were acquired by inhalation of contaminated air. But he can not base this supposition of factual evidence.     

Association between Traffic-Related Air Pollution in Schools and Cognitive Development in Primary School Children: A Prospective Cohort Study

Background

Air pollution is a suspected developmental neurotoxicant. Many schools are located in close proximity to busy roads, and traffic air pollution peaks when children are at school. We aimed to assess whether exposure of children in primary school to traffic-related air pollutants is associated with impaired cognitive development.

Methods and Findings

We conducted a prospective study of children (n = 2,715, aged 7 to 10 y) from 39 schools in Barcelona (Catalonia, Spain) exposed to high and low traffic-related air pollution, paired by school socioeconomic index; children were tested four times (i.e., to assess the 12-mo developmental trajectories) via computerized tests (n = 10,112). Chronic traffic air pollution (elemental carbon [EC], nitrogen dioxide [NO2], and ultrafine particle number [UFP; 10–700 nm]) was measured twice during 1-wk campaigns both in the courtyard (outdoor) and inside the classroom (indoor) simultaneously in each school pair. Cognitive development was assessed with the n-back and the attentional network tests, in particular, working memory (two-back detectability), superior working memory (three-back detectability), and inattentiveness (hit reaction time standard error). Linear mixed effects models were adjusted for age, sex, maternal education, socioeconomic status, and air pollution exposure at home.Children from highly polluted schools had a smaller growth in cognitive development than children from the paired lowly polluted schools, both in crude and adjusted models (e.g., 7.4% [95% CI 5.6%–8.8%] versus 11.5% [95% CI 8.9%–12.5%] improvement in working memory, p = 0.0024). Cogently, children attending schools with higher levels of EC, NO2, and UFP both indoors and outdoors experienced substantially smaller growth in all the cognitive measurements; for example, a change from the first to the fourth quartile in indoor EC reduced the gain in working memory by 13.0% (95% CI 4.2%–23.1%). Residual confounding for social class could not be discarded completely; however, the associations remained in stratified analyses (e.g., for type of school or high-/low-polluted area) and after additional adjustments (e.g., for commuting, educational quality, or smoking at home), contradicting a potential residual confounding explanation.

Conclusions

Children attending schools with higher traffic-related air pollution had a smaller improvement in cognitive development.     

Myxovirus Dissemination by Air

Myxoviruses including 150 strains of parainfluenza 1, 15 of parainfluenza 3 and five of influenza B virus were isolated from nasopharyngeal secretions obtained from 300 children less than 3 years of age who developed acute laryngotracheobronchitis during the preceding 48 hours. The patients were examined between October 1966 and January 1967, the peak monthly rate of virus isolation (67%) occurring during January. Parainfluenza 1 virus was isolated from air obtained in the vicinity of one of 30 children whose nasopharyngeal secretions yielded this agent. Samples comprising 150 litres of air were collected for virus assay by placing an Andersen sampler about 60 cm. from the child''s face inside an oxygen tent which surrounded the patient. These findings confirm previous observations that parainfluenza 1 virus is the dominant agent associated with acute laryngotracheobronchitis in children in Toronto, and they show that this virus is disseminated in the air.     

Acute effects of air pollution changes in schoolchildren: the Gardanne coal basin study

In the literature, studies devoted to shortterm effects of air pollution episodes in children have provided controversial results. To evaluate if acute air pollution changes in the Gardanne coal basin (France) could have deleterious effects on children's pulmonary function, we studied 160 children on two different days. Each in-school examination consisted of a short questionnaire and a spirometric assessment. The area included districts of high and low pollution levels. In the former, the two examinations took place at different air pollution levels whereas, in the latter, the air pollution levels were comparable. We obtained higher spirometric values during the second examination, regardless of air pollution changes and suggesting a learning effect, which vanished when we used FEV₁/FVC ratio. The difference in FEV₁/FVC between days of low and high pollution was significant but merely equal to 2%. There was no change of clinical symptom score.     

Evaluation of urinary trans-3'-hydroxycotinine as a biomarker of children's environmental tobacco smoke exposure.

The utility of urinary trans-3'-hydroxy cotinine (3HC) as a biomarker of environmental tobacco smoke (ETS) exposure was investigated in comparison with urinary cotinine (COT), the sum (3HC + COT), and ratio of the two nicotine metabolites (3HC/COT). Participants were 150 ETS exposed children (aged 1-44 months) and their parents. Child urine samples were collected during 3weekly baseline assessments and at interviews administered 3, 6, 12, and 18 months after baseline. Findings indicate that 3HC and COT can be measured reliably (rho = 0.96, 0.88) and show equivalent levels of repeated measures stability (rho = 0.71, 0.75). COT, 3HC, and 3HC + COT showed equally strong associations with air nicotine levels, reported ETS contamination, and reported ETS exposure (r=0.60-0.70). The intraclass correlations of 3HC/COT were lower than those for COT or 3HC. Older children had a higher 3HC/COT ratio than younger children (3.5 versus 2.2), and non-Hispanic White children had a higher ratio than African-American children (3.2 versus 1.9). These findings suggest that COT, 3HC, and 3HC + COT are approximately equivalent and equally strong biomarkers of ETS exposure in children. Moreover, 3HC/COT may provide a useful indicator to investigate age- and race-related differences in the metabolism of COT and 3HC.     

European Directives for Air Quality: Analysis of the New Limits in Comparison with Asthmatic Symptoms in Children Living in the Oporto Metropolitan Area,Portugal

This study analyzes the air pollutant concentrations in the Oporto Metropolitan Area, Portugal, comparing them with the limits fixed by the previous legislation currently in force, as well as by European Union (EU) Directives. The impacts were estimated using the prevalence of asthmatic symptoms and asthma in children as indicators. The objectives were: (i) to evaluate the impact on air quality associated with the reduction of sulphur content in fuels, (ii) to compare health impacts associated with SO₂ and particles with the limits fixed by both legislations, and (iii) to assess whether the delayed application of the EU Directives can be associated with health risks. It was concluded that: (i) after the reduction of sulphur content in fuels, a reduction of 60% of the annual averages of SO₂ concentration was observed, as well as a decrease in the rates of asthmatic symptoms and asthma in children, (ii) the limits fixed by the previous legislation do not protect against health impacts of SO₂ and particles, but the new EU Directives are protective; the EU limits for PM₁₀ are very difficult to attain, being probably unnecessarily low concerning the impact on asthmatic symptoms and asthma in children, and (iii) the delayed application of the EU Directives can be associated with unnecessary health risks.     

Odors and Sensations of Humidity and Dryness in Relation to Sick Building Syndrome and Home Environment in Chongqing,China

The prevalence of perceptions of odors and sensations of air humidity and sick building syndrome symptoms in domestic environments were studied using responses to a questionnaire on the home environment. Parents of 4530 1–8 year old children from randomly selected kindergartens in Chongqing, China participated. Stuffy odor, unpleasant odor, pungent odor, mold odor, tobacco smoke odor, humid air and dry air in the last three month (weekly or sometimes) was reported by 31.4%, 26.5%, 16.1%, 10.6%, 33.0%, 32.1% and 37.2% of the parents, respectively. The prevalence of parents’ SBS symptoms (weekly or sometimes) were: 78.7% for general symptoms, 74.3% for mucosal symptoms and 47.5% for skin symptoms. Multi-nominal regression analyses for associations between odors/sensations of air humidity and SBS symptoms showed that the odds ratio for “weekly” SBS symptoms were consistently higher than for “sometimes” SBS symptoms. Living near a main road or highway, redecoration, and new furniture were risk factors for perceptions of odors and sensations of humid air and dry air. Dampness related problems (mold spots, damp stains, water damage and condensation) were all risk factors for perceptions of odors and sensations of humid air and dry air, as was the presence of cockroaches, rats, and mosquitoes/flies, use of mosquito-repellent incense and incense. Protective factors included cleaning the child’s bedroom every day and frequently exposing bedding to sunshine. In conclusion, adults’ perceptions of odors and sensations of humid air and dry air are related to factors of the home environment and SBS symptoms are related to odor perceptions.     

Air trapping on chest CT is associated with worse ventilation distribution in infants with cystic fibrosis diagnosed following newborn screening

Background

In school-aged children with cystic fibrosis (CF) structural lung damage assessed using chest CT is associated with abnormal ventilation distribution. The primary objective of this analysis was to determine the relationships between ventilation distribution outcomes and the presence and extent of structural damage as assessed by chest CT in infants and young children with CF.

Methods

Data of infants and young children with CF diagnosed following newborn screening consecutively reviewed between August 2005 and December 2009 were analysed. Ventilation distribution (lung clearance index and the first and second moment ratios [LCI, M₁/M₀ and M₂/M₀, respectively]), chest CT and airway pathology from bronchoalveolar lavage were determined at diagnosis and then annually. The chest CT scans were evaluated for the presence or absence of bronchiectasis and air trapping.

Results

Matched lung function, chest CT and pathology outcomes were available in 49 infants (31 male) with bronchiectasis and air trapping present in 13 (27%) and 24 (49%) infants, respectively. The presence of bronchiectasis or air trapping was associated with increased M₂/M₀ but not LCI or M₁/M₀. There was a weak, but statistically significant association between the extent of air trapping and all ventilation distribution outcomes.

Conclusion

These findings suggest that in early CF lung disease there are weak associations between ventilation distribution and lung damage from chest CT. These finding are in contrast to those reported in older children. These findings suggest that assessments of LCI could not be used to replace a chest CT scan for the assessment of structural lung disease in the first two years of life. Further research in which both MBW and chest CT outcomes are obtained is required to assess the role of ventilation distribution in tracking the progression of lung damage in infants with CF.