甘肃省农村居民吸烟、固体燃料使用与肺功能异常相关性研究

Relationship of Smoking and Solid Fuel Usage with Pulmonary Dysfunction of Rural Residents in Gansu Province, China

目的了解甘肃省农村地区居民呼吸系统健康情况,探究吸烟和固体燃料使用与肺功能异常的关系。方法于2015年8—11月采用多阶段分层随机抽样的方法选取甘肃省3个监测点18个村共1522名(40~80)岁居民为研究对象,对其进行问卷调查和肺功能检查,采用二水平Logistic回归模型分析主动吸烟和固体燃料使用对肺功能的影响,应用相加模型、相乘模型对危险因素间的交互作用进行分析。结果肺功能异常的检出率为22.0%,居民吸烟率为41.7%,固体燃料使用率为69.3%。吸烟和使用固体燃料取暖及做饭均与肺功能异常具有关系(P<0.05)。调整混杂因素后,二水平Logistic回归分析结果显示,每日吸烟量≥20支、固体燃料使用≥10年者患肺功能异常的风险最高(P<0.05)。吸烟且使用固体燃料可使肺功能异常的发生风险增加,但二者仅存在相乘交互作用并无相加交互作用。结论使用固体燃料和主动吸烟与甘肃省农村居民肺功能异常有关,吸烟量和燃料使用年数越多,肺功能异常的患病风险越大。

Objective To investigate the respiratory health of residents in the rural areas of Gansu province, China, and to explore the relationship of smoking and solid fuel usage with pulmonary dysfunction. MethodsFrom August to November, 2015, 1 522 residents aged between 40 and 80 years from 18 villages at three surveillance sites in Gansu province were enrolled in the study using multi-stage stratified random sampling. A questionnaire survey and pulmonary function examination were performed on the subjects. A two-level logistic regression model was used to analyze the effects of active smoking and solid fuel usage on the pulmonary function;an additive model and a multiplicative model were used to analyze the interactions between risk factors. Results The detection rate of abnormal pulmonary function was 22.0%, while the resident smoking rate was 41.7%, and the solid fuel usage rate was 69.3%. Abnormal pulmonary function was related to smoking and solid fuel usage for heating or cooking(P <0.05). After adjusting for confounding factors, the two-level logistic regression analysis indicated that smoking ≥20 cigarettes per day and solid fuel usage for ≥10 years posed the highest risk of abnormal pulmonary function(P <0.05). Smoking and solid fuel usage may increase the risk of abnormal pulmonary function, but there was only multiplicative interaction(without additive interaction) between the two factors. Conclusion Active smoking and solid fuel usage are related to abnormal pulmonary function in the rural residents in Gansu province. The risk of abnormal pulmonary function increases with increased cigarette consumption and years of solid fuel usage.