被动吸烟与家养宠物对儿童哮喘及哮喘样症状影响

Environmental tobacco smoke exposure enhances effects of pets ownership on asthma and asthma-related symptoms in children

目的探讨被动吸烟与家养宠物对儿童哮喘及哮喘样症状的交互效应。方法采用整群随机抽样方法在广西百色市随机抽取6所小学,采用国际统一的标准问卷美国胸腔协会(ATS)调查表对所选学校的所有儿童进行有关被动吸烟、饲养宠物以及哮喘及哮喘样症状等情况调查。结果广西百色市3 473名儿童中,持续咳嗽、持续咳痰、哮喘、哮喘现患、喘鸣现患的发生率分别为11.52%(400/3 473)、6.68%(232/3 473)、7.63%(265/3 473)、2.04%(71/3 473)、4.15%(144/3 473),17.71%(615/3 473)的儿童目前家中饲养宠物,目前暴露环境烟雾的比率高达39.48%(1 371/3 473);在调整了儿童的年龄、性别、父母文化程度等混杂因素后,多因素非条件logistic回归分析表明,与既不被动吸烟又不家养宠物的儿童比较,单纯暴露被动吸烟或家养宠物可使儿童患有持续咳嗽的风险分别增高28%(OR=1.28,95%CI=0.98～1.66)和8%(OR=1.08,95%CI=0.73～1.61),而同时暴露于这2个因素使儿童患有持续咳嗽的危险性增加155%(OR=2.55,95%CI=1.85～3.51);暴露于被动吸烟和家养宠物对儿童持续咳嗽影响的交互效应有统计学意义(χ2=5.50,P=0.019),但对哮喘及其他哮喘样症状影响的交互效应均无统计学意义(P>0.05)。结论被动吸烟与家养宠物均可增加儿童患有哮喘及哮喘样症状的风险,且两者对儿童持续咳嗽的影响存在明显交互效应。

Objective To investigate the interactive effects of pet ownership and environmental tobacco smoke （ETS） on children＇s asthma and asthma-related symptoms. Methods Using cluster random sampling method,6 primary schools in Baise city were randomly selected, and all children in the selected schools were recruited for a survey. The information about the children＇s respiratory diseases ,conditions of pet ownership and ETS exposure were collected with an international standard questionnaire compiled by American Thoracic Society. Results A total of 3 473 subjects com- pleted the questionnaire with a response rate of 88.67%. The results showed that the prevalence of persistent cough ,persistent phlegm, doctor-diagnosed asthma, current asthma, and current wheeze were 11.52% ,6.68 %, 7.63 %, 2.04%, and 4.15%, respectively. The percentages of children exposed to pet and ETS were 17.71% and 39.48%, respectively. After adjustments for age, gender and other confounding factors, the results from multivariate unconditional logistic regression analyses showed that either pet ownership or the ETS exposure significantly increased the risk of respiratory diseases and symptoms in the children. There was a significant interaction between pet ownership and ETS exposure on persistent cough in the children（X^2 = 5.50, P = 0.019）, whereas, the combined effects of these two factors on doctor-diagnosed asthma, current asthma, and wheeze were not statistically significant （P〉 0.05）. Conclusion The results of the study demonstrates that pet ownership and ETS exposure increases the risk of respiratory diseases and symptoms in children and there are significant interactive effects between the two factors on some respiratory diseases and symptoms.