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Allergo Journal

, Volume 28, Issue 1, pp 20–30 | Cite as

Luftschadstoffe und primäre Prävention von Allergien

  • Joachim HeinrichEmail author
Übersicht
  • 43 Downloads

Zusammenfassung

Hintergrund

Luftschadstoffe wie Feinstaub (PM2,5) und Stickstoffdioxid (NO2) in der Außenluft stehen seit Langem in Verdacht, die Entwicklung von Asthma und allergischer Rhinitis zu verursachen. Diverse systematische Reviews der letzten 15 Jahre kommen aber zu unterschiedlichen Ergebnissen, ob diese Luftschadstoffe tatsächlich eine kausale Rolle für die Entstehung von Asthma, allergischer Rhinitis und Ekzem spielen.

Methoden

Basierend auf publizierten systematischen Reviews und den neuesten Publikationen wird der aktuelle Kenntnisstand der epidemiologischen Evidenz dargestellt und das Potenzial einer primären Prävention dieser allergischen Erkrankungen durch Verringerung oder Vermeidung der Exposition mit diesen Luftschadstoffen bewertet.

Ergebnisse

Trotz umfangreicher Literaturrecherche, Darstellung neuester Ergebnisse und Fokussierung auf die für unsere Belange qualitativ hochwertigen Geburtskohortenstudien unterstützen epidemiologische Ergebnisse nicht ausreichend die Vorstellung von einer kausalen Beziehung zwischen den beiden ausgewählten Luftschadstoffen PM2,5 und NO2 und Asthma. Epidemiologische Studien zeigen überwiegend keine Effekte dieser Luftschadstoffe auf die allergische Sensibilisierung und das Auftreten von Heuschnupfen. Die wenigen Studien, die den Zusammenhang zwischen Luftschadstoffen und Ekzem untersucht haben, zeigen überwiegend keine Assoziation.

Schlussfolgerung

Wenn die Evidenz einer kausalen Rolle dieser Luftschadstoffe für das Auftreten von Allergien nicht eindeutig belegt ist, muss man folgerichtig schließen, dass eine primäre Prävention von Allergien durch die Verbesserung der Luftqualität wahrscheinlich nicht möglich ist. Allerdings liegt eine ausreichende Evidenz dafür vor, dass Exazerbationen von allergischen Erkrankungen durch Luftschadstoffe ausgelöst werden können. Allein daraus ergibt sich das Erfordernis, für die Einhaltung der bestehenden Grenzwerte von Luftschadstoffen zu sorgen, um speziell Allergiker vor gesundheitlichen Beeinträchtigungen zu schützen.

Schlüsselwörter

Feinstaub Stickstoffdioxid Asthma Allergische Rhinitis Sensibilisierung 

Abkürzungen

COPD

Chronisch-obstruktive Lungenerkrankung

GIS

Geographische Informationssysteme

IgE

Immunglobulin E

LUR

„Land-use regression“-Modell (um die Verteilung von Luftschafstoffen nachzuvollziehen)

NO

Stickstoffmonoxid

NO2

Stickstoffdioxid

PM

Feinstaub

SO2

Schwefeldioxid

TRAP

Verkehrsabhängige Luftschadstoffe

Th2

T-Helferzellen vom Typ 2

UFP

Ultrafeiner Staub

VOC

Füchtige organische Substanzen

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  1. 1.Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin WHO Collaborating Centre for Occupational HealthKlinikum der Innenstadt MünchenMünchenDeutschland

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