儿童环境酞酸酯类暴露与注意缺陷多动障碍的相关性研究  

Correlation between Environmental Phthalate Exposure and Attention Deficit Hyperactivity Disorder in Children

作　　者：陶文凤 蒋雪燕 王乐 杜玉开[1] 沈敏[1] TAO Wenfeng;JIANG Xueyan;SHEN Min(Department of Maternal and Child Health,School of Public Health,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,430030,China)

机构地区：[1]华中科技大学同济医学院公共卫生学院儿少卫生与妇幼保健系,湖北武汉430030

出　　处：《中国社会医学杂志》2020年第5期510-514,共5页Chinese Journal of Social Medicine

基　　金：国家自然科学基金项目(81673180)。

摘　　要：目的了解儿童环境酞酸酯暴露途径、类型和频率,探讨酞酸酯暴露与注意缺陷多动障碍(attention-deficit hyperactivity disorder,ADHD)的关联,为预防儿童ADHD提供科学的依据。方法采用整群抽样的方法,选取武汉市某小学1~6年级学生为调查对象。采用自行设计的儿童健康与行为状况调查表及NICHQ Vanderbilt ADHD评估量表进行问卷调查。结果共调查1316例儿童,ADHD患病率为3.88%(51/1316)。男女童性别比为1.68∶1(32/19),其中8~9岁、6~7岁和12~13岁儿童ADHD的患病率分别为5.05%,4.93%和4.19%。单因素分析显示,儿童ADHD与使用个人护理产品的种类数(种)、一次性饭盒的使用有关;多因素Logistic回归分析结果显示,儿童使用一次性饭盒(OR=1.95,95%CI0.95~4.02)、写作业的桌面为PVC材质(OR=1.64,95%CI0.92~2.92,P>0.05)ADHD患病风险增加有关,但差异无统计学意义。结论日常环境暴露酞酸酯可能与儿童ADHD与患病风险增加有关,应提高公众关于酞酸酯类物质暴露对儿童身心危害的意识,并监管相关产品酞酸酯类的安全含量,以降低儿童暴露水平,预防身心相关疾病。Objective To know the routes,types and frequency of phthalate exposure to children,to explore the association with attention-deficit hyperactivity disorder(ADHD),and to provide a scientific evidence for ADHD prevention in school-aged children.Methods A cluster sampling method was used to recruit students with grade 1st^6th(including 710 boys and 606 girls)in a primary school affiliated to a university in Wuhan.Children's Health and Behavior Questionnaire and the NICHQ Vanderbilt ADHD Assessment Scale were used to evaluate the exposure resource of phthalates and symptoms of ADHD.Results A total of 1316 children were enrolled in the survey,51 children had ADHD symptom,and the prevalence was 3.88%(51/1316).The sex ratio of male to female students was 1.68:1(32/19).Children aged 8~9 years,6~7 years and 12~13 years old had the higher prevalence of ADHD(5.05%,4.93%and 4.19%respectively)than children aged 10~11 years old(2.72%).The number of types of personal care products,and using disposable lunch boxes were related with ADHD in children.The results of multiple logistic regression analysis showed that children using plastic fast-food boxes(OR=1.95,95%CI:0.95~4.02)and PVC desks(OR=1.64,95%CI:0.92~2.92,P>0.05)were associated with higher risk of ADHD,but no significant differences were found.Conclusion This finding provided the primary evidence that environmental exposure to phthalates might related with ADHD.The education program should be conducted to improve people's awareness of the risks of phthalate exposure to children,and the level of phthalate related productions should be tested to guarantee the safety among children.

关 键 词：学龄儿童 酞酸酯暴露 注意缺陷多动障碍 相关性研究 

分 类 号：R179[医药卫生—妇幼卫生保健]