室内空气质量对学龄儿童急性上呼吸道感染发病影响的前瞻性队列研究
|
摘要
目的探索室内空气质量危险因素对儿童急性上呼吸道感染的影响。方法采用了前瞻性开放式队列研究方法,在2013年开始共募集6 035名学龄儿童(8～12岁)作为基线人群,2014—2017年逐年开展随访,观察队列人群急性上呼吸道感染发病情况,分析室内空气质量相关危险因素对儿童急性上呼吸道感染发病的影响。结果队列在2014—2017年逐年开展随访,4年分别随访1 824、3 064、3 177、3 151人,经协变量校正后统计分析结果显示,房屋面积不足50m~2(RR=1.304,95%CI=1.036～1.642)、购置大家具距今不足半年(RR=1.287,95%CI=1.008～1.643)、每周3d以上二手烟暴露(RR=1.314,95%CI=1.049～1.646)、饲养宠物(RR=1.198,95%CI=1.014～1.417)、使用家用化学品(RR=1.321,95%CI=1.164～1.498)是影响儿童急性上呼吸道感染的室内空气质量危险因素。结论队列研究证实室内空气质量危险因素能够影响学龄儿童急性上呼吸道感染发病。
Objectives To evaluate the effect of indoor air pollution on the incidence of acute upper respiratory infections in schoolchildren. Methods A prospective and dynamic cohort investigation was designed in this study. A total of 6 035 schoolchildren(8-12 years old) were recruited as baseline population beginning in 2013. The follow-up was conducted year by year from 2014 to 2017 to observe the incidence of acute upper respiratory infections in the cohort. The RR(Relative risk) and 95% CI(95% confidence interval) were calculated with the multiple logistic regression model to evaluate the effect of indoor air pollution risk factors on the incidence of acute upper respiratory infections in schoolchildren. Results The cohort was followed up from 2014 to 2017. 1 824, 3 064, 3 177 and 3 151 schoolchildren were followed up in the four years, respectively. After covariate correction, the statistical analysis results revealed that, residential housing area less than 50 m~2(RR=1.304, 95% CI=1.036～1.642), purchase of large furniture less than half a year ago(RR=1.287, 95% CI=1.008～1.643), passive smoking more than 3 days per week(RR=1.314, 95% CI=1.049～1.646), keeping pets(RR=1.198, 95% CI=1.014～1.417), and use of household chemicals(RR=1.321, 95% CI=1.164～1.498) were risk factors for acute upper respiratory infections in children. Conclusion Cohort study reveals that indoor air pollution risk factors can affect the incidence of acute upper respiratory infections in schoolchildren.
Objectives To evaluate the effect of indoor air pollution on the incidence of acute upper respiratory infections in schoolchildren. Methods A prospective and dynamic cohort investigation was designed in this study. A total of 6 035 schoolchildren(8-12 years old) were recruited as baseline population beginning in 2013. The follow-up was conducted year by year from 2014 to 2017 to observe the incidence of acute upper respiratory infections in the cohort. The RR(Relative risk) and 95% CI(95% confidence interval) were calculated with the multiple logistic regression model to evaluate the effect of indoor air pollution risk factors on the incidence of acute upper respiratory infections in schoolchildren. Results The cohort was followed up from 2014 to 2017. 1 824, 3 064, 3 177 and 3 151 schoolchildren were followed up in the four years, respectively. After covariate correction, the statistical analysis results revealed that, residential housing area less than 50 m~2(RR=1.304, 95% CI=1.036～1.642), purchase of large furniture less than half a year ago(RR=1.287, 95% CI=1.008～1.643), passive smoking more than 3 days per week(RR=1.314, 95% CI=1.049～1.646), keeping pets(RR=1.198, 95% CI=1.014～1.417), and use of household chemicals(RR=1.321, 95% CI=1.164～1.498) were risk factors for acute upper respiratory infections in children. Conclusion Cohort study reveals that indoor air pollution risk factors can affect the incidence of acute upper respiratory infections in schoolchildren.
引文
[ 1 ] GBD 2017 Risk Factor Collaborators.Global,regional,and national comparative risk assessment of 84 behavioural,environmental and occupational,and metabolic risks or clusters of risks for 195 countries and territories,1990-2017:a systematic analysis for the Global Burden of Disease Study 2017[J].Lancet,2018,392 (10159):1923-1994.
[ 2 ] SB Gordon,NG Bruce,J Grigg,et al.Respiratory risks from household air pollution in low and middle income countries[J].Lancet Respir Med,2014,2 (10):823-860.
[ 3 ] 殷鹏,蔡玥,刘江美,等.1990与2013年中国归因于室内空气污染的疾病负担分析[J].中华预防医学杂志,2017,57(1):53-57.
[ 4 ] CHEN F,LIN Z,CHEN R,et al.The effects of PM2.5 on asthmatic and allergic diseases or symptoms in preschool children of six Chinese cities,based on China,Children,Homes and Health (CCHH) project[J].EnvironPollut,2018(232):329-337.
[ 5 ] A Molter,RM Agius,Fde Vocht,et al.Long-term exposure to PM10 and NO2 in association with lung volume and airway resistance in the MAAS birth cohort[J].Environ Health Perspect,2013,121 (10):1232-1238.
[ 6 ] 符霞林,龚晓辉,谭菊香,等.儿童喘息性疾病影响因素分析[J].公共卫生与预防医学,2018,29(5):77-80.
[ 7 ] Brunekreef,Von Mutius,WONG G,et al.Exposure to cats and dogs,and symptoms of asthma,rhinoconjunctivitis,and eczema[J].Epidemiology,2012,23(5):742-750.
[ 2 ] SB Gordon,NG Bruce,J Grigg,et al.Respiratory risks from household air pollution in low and middle income countries[J].Lancet Respir Med,2014,2 (10):823-860.
[ 3 ] 殷鹏,蔡玥,刘江美,等.1990与2013年中国归因于室内空气污染的疾病负担分析[J].中华预防医学杂志,2017,57(1):53-57.
[ 4 ] CHEN F,LIN Z,CHEN R,et al.The effects of PM2.5 on asthmatic and allergic diseases or symptoms in preschool children of six Chinese cities,based on China,Children,Homes and Health (CCHH) project[J].EnvironPollut,2018(232):329-337.
[ 5 ] A Molter,RM Agius,Fde Vocht,et al.Long-term exposure to PM10 and NO2 in association with lung volume and airway resistance in the MAAS birth cohort[J].Environ Health Perspect,2013,121 (10):1232-1238.
[ 6 ] 符霞林,龚晓辉,谭菊香,等.儿童喘息性疾病影响因素分析[J].公共卫生与预防医学,2018,29(5):77-80.
[ 7 ] Brunekreef,Von Mutius,WONG G,et al.Exposure to cats and dogs,and symptoms of asthma,rhinoconjunctivitis,and eczema[J].Epidemiology,2012,23(5):742-750.