한국 청소년에서 납 노출과 기관지천식의 관계
Association between lead exposure and increased risk of bronchial asthma in Korean adolescents
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose: Several studies have reported an association between lead exposure and increased risk of allergic sensitization and asthma. According to the Centers for Disease Control and Prevention guidelines, An elevated blood lead level (BLL) is defined as a BLL of ≥5 μg/dL. However, no safe BLL has been identified, and it is controversial whether a BLL of <5 μg/dL affects the risk of asthma. Methods: We examined asthma prevalences and BLLs using data from the 2010–2013 Korea National Health and Nutrition Examination Survey (KNHANES), which was a cross-sectional survey of 1,478 adolescence (aged 10–19 years) throughout the country. The adjusted odds ratios (ORs) (with 95% confidence intervals [CIs]) for the prevalence of asthma in adolescence with elevated BLLs were calculated by complex samples multivariate logistic regression analysis. The presence of asthma was based on self-reported, physician-diagnosed asthma in the Health Interview Surveys. Results: The mean of total BLLs was 1.33 μg/dL. Overall, 5.1% (n=71) of the subjects were physician diagnosed asthma. In the model controlling for population characteristics, the adjusted odds ratio for asthma per 1 μg/dL increase in blood lead was 1.94, 95% CI (1.06, 3.57), and stronger associations were observed among boys (adjusted OR, 2.31; 95% CI, [1.18, 4.51]). The group of BLL≥2 μg/dL was associated with an OR of 2.84 (95% CI, 1.06, 7.63) for asthma, after adjusting for potential confounding factors in boys. Conclusion: Our results suggest an association between total BLLs and asthma in Korean adolescent boys, although confirmation is warranted in further prospective studies.
Abstract
Purpose: Several studies have reported an association between lead exposure and increased risk of allergic sensitization and asthma. According to the Centers for Disease Control and Prevention guidelines, An elevated blood lead level (BLL) is defined as a BLL of ≥5 μg/dL. However, no safe BLL has been identified, and it is controversial whether a BLL of <5 μg/dL affects the risk of asthma. Methods: We examined asthma prevalences and BLLs using data from the 2010–2013 Korea National Health and Nutrition Examination Survey (KNHANES), which was a cross-sectional survey of 1,478 adolescence (aged 10–19 years) throughout the country. The adjusted odds ratios (ORs) (with 95% confidence intervals [CIs]) for the prevalence of asthma in adolescence with elevated BLLs were calculated by complex samples multivariate logistic regression analysis. The presence of asthma was based on self-reported, physician-diagnosed asthma in the Health Interview Surveys. Results: The mean of total BLLs was 1.33 μg/dL. Overall, 5.1% (n=71) of the subjects were physician diagnosed asthma. In the model controlling for population characteristics, the adjusted odds ratio for asthma per 1 μg/dL increase in blood lead was 1.94, 95% CI (1.06, 3.57), and stronger associations were observed among boys (adjusted OR, 2.31; 95% CI, [1.18, 4.51]). The group of BLL≥2 μg/dL was associated with an OR of 2.84 (95% CI, 1.06, 7.63) for asthma, after adjusting for potential confounding factors in boys. Conclusion: Our results suggest an association between total BLLs and asthma in Korean adolescent boys, although confirmation is warranted in further prospective studies.
참고문헌 (31)
- "Korean guideline for asthma Korean Academy of Asthma" (2015)[URL]
- Lemanske RF Jr, "Asthma: clinical expression and molecular mechanisms", J Allergy Clin Immunol, 125(2 Suppl 2), pp.S95~S102 (2010)
- Lee JH, "Multi-media and multi-pathway aggregate risk assessment(IV) -Lead (Pb) -" (2014), Institute of Environmental Protection and Safety; Neo Environmental Business Co.; Institute for Environmental Research; Yonsei University
- Dietert RR, "Developmental immunotoxicology of lead", Toxicol Appl Pharmacol, 198, pp.86~94 (2004)
- Bellanger AP, "Reactions of airway epithelial cells to birch pollen grains previously exposed to in situ atmospheric Pb concentrations: a preliminary assay of allergenicity", Biol Trace Elem Res, 150, pp.391~395 (2012)
- Boskabaddy MH, "Inhaled lead exposure affects tracheal responsiveness and lung inflammation in guinea pigs during sensitization", Biol Trace Elem Res, 154, pp.363~371 (2013)
- Farkhondeh T, "The effect of lead exposure on tracheal responsiveness to methacholine and ovalbumin, total and differential white blood cells count, and serum levels of immunoglobulin E, histamine, and cytokines in guinea pigs", Hum Exp Toxicol, 33, pp.325~333 (2014)
- Gao D, "Lead effects on development and function of bone marrow-derived dendritic cells promote Th2 immune responses", Toxicol Appl Pharmacol, 222, pp.69~79 (2007)
- Heo Y, "Lead differentially modifies cytokine production in vitro and in vivo", Toxicol Appl Pharmacol, 138, pp.149~157 (1996)
- Hsiao CL, "Effects of environmental lead exposure on T-helper cell-specific cytokines in children", J Immunotoxicol, 8, pp.284~287 (2011)
- Joseph CL, "Blood lead level and risk of asthma", Environ Health Perspect, 113, pp.900~904 (2005)
- Motosue AM, "Lead exposure risk is associated with asthma in a low-income urban hispanic population: results of the Communities Organized against Asthma and Lead (COAL) project", J Allergy Clin Immunol, 123(2 Suppl), pp.S20~ (2009)
- Pugh Smith P, "Lead poisoning and asthma among low-income and African American children in Saginaw, Michigan", Environ Res, 111, pp.81~86 (2011)
- Wang IJ, "Lead exposure, IgE, and the risk of asthma in children", J Expo Sci Environ Epidemiol, 27, pp.478~483 (2017)
- Zeng X, "Heavy metals in PM2.5 and in blood, and children's respiratory symptoms and asthma from an e-waste recycling area", Environ Pollut, 210, pp.346~353 (2016)
- "What do parents need to know to protect their children?" (2017)[URL]
- "Adult Blood Lead Epidemiology and Surveillance (ABLES)"[URL]
- Gidlow D, "Lead toxicity", Occup Med (Lond), 65, pp.770~ (2015)
- Ahn HS, "Hong Chang Yee textbook of pediatrics" (2016), MiraeN
- "The Aisa-Pacific perspective: redefining obesity and its treatment" (2000), Health Communications Australia
- Janson S, "National Asthma Education and Prevention Program, Expert Panel Report. II: overview and application to primary care", Lippincotts Prim Care Pract, 2, pp.578~588 (1998)
- Kim JW, "Association between asthma and physical activity in Korean adolescents: the 3rd Korea Youth Risk Behavior Web-based Survey (KYRBWS-III)", Eur J Public Health, 22, pp.864~868 (2012)
- Mohammed AA, "Blood lead levels and childhood asthma", Indian Pediatr, 52, pp.303~306 (2015)
- Wells EM, "The relationship of blood lead with immunoglobulin E, eosinophils, and asthma among children: NHANES 2005-2006", Int J Hyg Environ Health, 217, pp.196~204 (2006)
- Kim JH, "The association between serum lead and total immunoglobulin E levels according to allergic sensitization", Am J Rhinol Allergy, 30, pp.e48~e52 (2016)
- Min JY, "Blood lead levels and increased bronchial responsiveness", Biol Trace Elem Res, 123, pp.41~46 (2008)
- Dong J, "Physical activity, a critical exposure factor of environmental pollution in children and adolescents health risk assessment", Int J Environ Res Public Health, 15 (2018)
- Zahran S, "Linking source and effect: resuspended soil lead, air lead, and children's blood lead levels in Detroit, Michigan", Environ Sci Technol, 47, pp.2839~2845 (2013)
- Lin S, "Environmental lead pollution and elevated blood lead levels among children in a rural area of China", Am J Public Health, 101, pp.834~841 (2011)
- Richmond-Bryant J, "A multi-level model of blood lead as a function of air lead", Sci Total Environ, 461-462, pp.207~213 (2013)
- Chen K, "Effect of lead pollution control on environmental and childhood blood lead level in Nantong, China: an interventional study", Environ Sci Technol, 48, pp.12930~12936 (2014)