空气污染与广州市儿童呼吸系统健康关联的横断面研究

Cross-sectional study on the relationship of outdoor air pollution with children's respiratory health in Guangzhou City

目的研究空气污染与学龄儿童呼吸系统健康的关联。方法于2006年选择广州市海珠区、白云区和花都区分别代表空气污染程度为高、中、低的污染区,抽取这3个区8所小学3年级和4年级小学生。通过标准化问卷调查这些儿童的家庭、社会经济状况和呼吸道症状及疾病史等。采用卡方检验、方差分析和logistic回归等方法分析不同空气污染程度对儿童呼吸系统症状和疾病之间的关系。结果高、中、低污染区的PM10、NO2、SO2的平均浓度差异均有统计学意义(均P<0.01)。3个地区分别调查了772、713、694名小学生。各区年龄均数和标准差分别为(9.8±0.8)、(10.2±0.9)、(10.1±0.9)岁,差异有统计学意义(P<0.01)。3个区的儿童被动吸烟率分别为17.4%(134/772)、11.9%(85/713)、8.7%(60/694)(P<0.01)。在校正父母哮喘和过敏史、室内因素(毛毯、发霉、新家具)、儿童过敏史、户外活动等混杂因素后,高污染区男孩喘息、既往哮喘、现患过敏性鼻炎和现患支气管炎的患病风险高于低污染区男孩(OR=3.96、16.74、2.29、3.79),而高污染区女孩感冒时咳嗽、喷嚏、既往哮喘、既往过敏性鼻炎、现患过敏性鼻炎和既往肺炎的患病风险高于低污染区女孩(OR=1.66、2.08、5.95、2.78、3.59、2.43)。与低污染区男孩相比,中污染区男孩既往哮喘、既往过敏性鼻炎、现患过敏性鼻炎的患病风险升高(OR=9.94、1.70、2.10)。结论广州市空气污染水平与儿童呼吸系统健康有显著关联。空气污染高浓度区的儿童呼吸道症状和疾病患病风险显著高于低浓度区。

Objective To investigate the relationship of air pollution with children＇ s respiratory health. Methods Study subjects were schoolchildren in grades 3 and 4 of primary schools in three districts （Haizhu, Baiyun, and Huadu） with different air pollution levels （heavy, moderate, and low pollution） in Guangzhou City. Standard questionnaires were used to collect the information of children＇ s home environment, socioeconomic characteristics, and history of respiratory symptoms/diseases. X2.test, analysis of variance and logistic regression analysis were used to analyze the relationship of different air pollution levels with children＇ s respiratory symptoms and diseases. Results The difference of average air concen- tration of PMI0, NO2 and SOs in these districts had statistical significance （P 〈 0. 01 ）. 772 children in heavy pollution district （HPD）, 713 children in moderate pollution district （MPD） and 694 children in low pollution district （LPD） were investigated. Average and standard deviation of children age in three districts were 9. 8 ± 0. 8, 10. 2 ± 0. 9, and 10. 1 ＋ 0. 9 years, respectively. The difference had statistical significance （P 〈 0. 01 ）. Passive smoking rates of children in these districts were 17.4% （134/772）, 11.9% （ 85/713 ）, and 8. 7 % （60/694）. The difference had statistical significance also （ P 〈 0. 01 ）. After adjustment for several potential confounders （parental asthma and allergy, indoor risk factors including carpets, mould, and new furniture, history of allergy, and outdoor activities, etc. ）, boys in the HPD had higher risks for wheezing, ever asthma, current allergic rhinitis, and current bronchitis than those in the LPD（ OR =3.96, 16. 74, 2. 29, 3.79）. Girls in the HPD had higher risks for cough with cold, sneeze, ever asthma, ever allergic rhinitis, current allergic rhinitis, and ever pneumonia than those in the LPD （OR = 1.66, 2. 08, 5.95, 2.78, 3.59, 2.43）. In comparison with boys in the LPD, those in the MPD showed increased risks for ever asthma, ever allergic rhinitis, and current allergic rhinitis （ OR = 9. 94, 1.70, 2. 10）. Conclusion Air pollution level in Guangzhou City was significantly associated with children＇ s respiratory health. Children living in the HPD had significantly increased risks for the prevalence of respiratory symptoms and diseases.