南昌市PM_(2.5)对小学生健康状况的影响研究

The impact of PM_(2.5) on the health of pupils in Nanchang

目的通过对小学生健康状况和生活环境的调查,探讨细颗粒物(PM_(2.5))对小学生健康状况的影响。方法 2015年选取南昌市青云谱区为污染区,上饶市婺源县作为清洁区。采用整群随机抽样在两地各选取1所小学,各选三至五年级全部小学生作为调查对象,污染区517名,清洁区614名。调查问卷采用中国疾病预防控制中心《空气污染对人群健康影响监测项目》调查问卷,结合PM_(2.5)监控数据,对小学生健康状况和疾病发生影响因素进行调查。结果污染区呼吸系统疾病患病率17.99%,清洁区呼吸系统疾病患病率6.35%,差异有统计学意义(χ~2=36.867,P=0.000)。污染区皮肤黏膜疾病患病率15.28%,高于清洁区10.75%,差异有统计学意义(χ~2=5.156,P=0.023)。logistic回归分析显示,空气污染(OR=1.887,95%CI=1.212~2.938);被动吸烟(OR=1.974,95%CI=1.284~3.035)是小学生患呼吸系统疾病的影响因素。空气污染(OR=3.716,95%CI=2.075~6.654);被动吸烟(OR=1.792,95%CI=1.079~2.977);室内使用空气污染有关的化学物(OR=2.495,95%CI=1.549~4.019)是皮肤黏膜疾病的影响因素。空气污染(OR=2.181,95%CI=1.536~3.095);家附近有环境污染设施(OR=1.456,95%CI=1.052~2.016);被动吸烟(OR=1.922,95%CI=1.353~2.731);室内使用空气污染有关的化学物(OR=1.827,95%CI=1.318~2.533)是其他常见疾病影响因素。结论南昌市空气中PM_(2.5)与小学生呼吸系统疾病、皮肤黏膜疾病的发生有一定的影响,建议加强控制室内和公共场所吸烟量,降低空气中PM_(2.5)浓度。雾霾天气减少户外活动,戴防雾霾口罩,养成科学健康的生活方式。

Objective To evaluate the impact of PM2.5 on the health of elementary students. Methods A cluster sampling method was used to randomly select one elementary school from Qingyunpu district of Nanchang which was considered as dirty area and one school from Wuyuan county of Shangrao which was a clean area, all pupils of third, fourth and fifth grade participated in this questionnaire survey in which the guideline of ＂ the monitoring project of the impact of air pollution on health＂ by Chinese CDC was adopted. Results The prevalence of pulmonary disease, diseases of skin and mucous membrane among students from dirty area were significantly higher than that of those from clean area （17.99% vs 6.35%, 15.28% vs 10.75%, P〈 0.05）. Logistic regression analysis showed that air （ OR= 1. 887, 95 % CI： 1. 212-2. 938） and passive smoking （OR=1. 974, 95%CI： 1. 284-3. 035） were influencing factors of the prevalence of pulmonary diseases; besides these two factors, air pollution related chemical indoor use and environmental pollution sources around house were also contributed to diseases of skin and mucous membrane and other diseases as well. Conclusions PM2.5 in the air has a certain influence on the prevalence of respiratory system diseases and skin mucous membrane disease of elementary students in Nanchang.