社区儿童哮喘及过敏性疾病的环境影响因素分析  

Environment-related factors associated with asthma and allergies among schoolchildren in two communities, Shanghai

作　　者：张莉君 郭常义[1] 许慧慧[1] 许东[2] 沈先标[3] 张江华[1] 潘梅竹[1] 吴凡[1] 

机构地区：[1]上海市疾病预防控制中心环境卫生科,上海200336 [2]上海市徐汇区疾病预防控制中心 [3]上海市宝山区疾病预防控制中心

出　　处：《环境与健康杂志》2014年第8期702-706,共5页Journal of Environment and Health

基　　金：中美公共卫生人才培训项目Fogarty基金(TW005741-07);上海市国际科技合作基金(13430710200);上海市卫生和计划生育委员会面上项目(20134289;20124377);上海市公共卫生重点学科-环境卫生学(12GWZX0401)

摘　　要：目的了解上海市两社区儿童哮喘及过敏性疾病患病的环境影响因素。方法收集2013年1—12月上海市中心城区A社区和北部郊县B社区附近的空气监测国控点数据,指标包括PM2.5、PM10、O3、CO、SO2和NO2。在两社区各选择1所小学,调查校内3~5年级学生的家庭环境及呼吸系统健康状况等,比较疾病患病及症状发生率的差异,并分析其影响因素。结果 A社区大气PM2.5、O3、CO和SO2平均浓度高于B社区,差异有统计学意义（P〈0.01）。A社区儿童哮喘、哮喘现患、过敏性鼻炎、湿疹患病率及喘鸣样症状、持续咳嗽发生率均高于B社区（P〈0.05或P〈0.01）。多因素分析显示,居住在A社区、父母有哮喘和过敏史、家庭附近车辆较多可增加儿童哮喘的患病风险;父母有哮喘、过敏史和家庭附近车辆较多可增加哮喘现患的风险;居住在A社区、父母过敏史、家庭附近车辆较多可增加过敏性鼻炎患病风险,经常参加户外活动与过敏性鼻炎患病呈正相关;父母有过敏史和使用装修材料可增加湿疹的患病风险,母亲文化程度高的儿童湿疹患病率较高,差异均有统计学意义（P〈0.05或P〈0.01）。居住在A社区、父母过敏及哮喘史、房龄〉10年可增加喘鸣样症状的患病风险;父母过敏可增加持续咳嗽的患病风险;扫地拖地频率与喘鸣样症状发生呈负相关,差异均有统计学意义（P〈0.05或P〈0.01）。结论 A社区空气污染程度高于B社区,儿童哮喘及过敏性疾病的患病率亦较高。遗传、室内外环境、生活习惯等均与该疾病的发生有关。Objective To explore the environment-relatd factors associated with asthma and allergies among schoolchildren in two communities of Shanghai. Methods Daily air quality real-time monitoring data of PM2.5, PM10, O3, CO, SO2 and NOxin2013 from two environmental monitoring spots（one spot was located in urban district, within community A and another in suburban district, 5 km away from community B） of Shanghai were collected. A cross-sectional survey of respiratory diseases was conducted among 1 310 school age children（8-11 years old） in the two communities. The collected variables included living environment, family habits, parents’ susceptibility to asthma and related allergies, respiratory symptoms and so on.Results Levels of PM2.5,O3,CO,and SO2 in air of community A were higher than in community B（P〈0.01）. Prevalences of asthma,current asthma, allergic rhinitis, eczema, wheezing and chronic cough in community A were all higher than those in community B（P 〈0.05 or P 〈0.01）. After adjustment of potential confounders for gender and age,asthma was associated with residents in community A, parents with asthma and allergic history, traffic congestion near house. Also,current asthma was associated with parents with asthma and allergic history, traffic congestion near house. Allergic rhinitis were associated with living in community A, parents with allergic history, traffic congestion near house, and was positively correlated with regular outdoor activity. Eczema were associated with parents with allergic history and the use of decoration materials, as well as higher level of maternal education（P〈0.05 or P〈0.01）. Living in community A, parents with asthma and allergic history and completion more than 10 years for residential building were risk factors for wheezing. Parental allergic history was a risk factor for persistent cough. Frequency of mopping floor was negatively correlated with the prevalance of wheezing. Conclusion Air pollution in community A is more serious than community B in S

关 键 词：空气污染 哮喘 过敏性疾病 儿童 

分 类 号：R181.3[医药卫生—流行病学]