Ponsonby A L, Couper D, Dwyer T, Carmichael A, Kemp A, Cochrane J
Menzies Centre for Population Health, University of Tasmania, Hobart, Australia.
Epidemiology. 2000 Mar;11(2):128-35. doi: 10.1097/00001648-200003000-00008.
Our aim was to examine the contribution of an infant's indoor environment to childhood asthma using prospective data. We conducted a cross-sectional asthma survey in 1995 on 92% (6,378/6,911) of 7-year-olds in Tasmania, Australia. We linked these data with data collected in 1988 as part of the Tasmanian Infant Health Survey, which was designed to investigate sudden infant death. We were able to match 863 records out of the 1,111 in the 1988 survey and the 6,378 in the 1995 survey. The former group was interviewed at home at 1 month of age. In homes where at least one adult smoked in 1988, reported infant exposure to smoking in the same room in 1988 was associated with increased asthma by 1995 (relative risk = 1.52; 95% confidence interval = 1.01-2.29) after adjustment for confounders. The associations between infant exposure to environmental tobacco smoke and asthma were not consistent, however. Gas heater use in 1988 was associated with asthma (relative risk = 1.92; 95% confidence interval = 1.33-2.76). Markers of aeroallergen exposure at 1 month of age were not materially associated with asthma or wheeze. In some settings, air circulation practice with regard to bedroom door closure appeared important. Poor indoor air quality may play an important role in the development of childhood asthma.
我们的目标是利用前瞻性数据研究婴儿室内环境对儿童哮喘的影响。1995年，我们对澳大利亚塔斯马尼亚州92%（6378/6911）的7岁儿童进行了一项横断面哮喘调查。我们将这些数据与1988年作为塔斯马尼亚婴儿健康调查一部分收集的数据相联系，该调查旨在调查婴儿猝死。在1988年的1111份记录和1995年的6378份记录中，我们能够匹配863份记录。前一组在1个月大时在家中接受了访谈。在1988年至少有一名成年人吸烟的家庭中，1988年报告的婴儿在同一房间接触吸烟与到1995年哮喘发病率增加相关（相对风险 = 1.52；95%置信区间 = 1.01 - 2.29），在对混杂因素进行调整之后。然而，婴儿接触环境烟草烟雾与哮喘之间的关联并不一致。1988年使用燃气加热器与哮喘相关（相对风险 = 1.92；95%置信区间 = 1.33 - 2.76）。1个月大时的气传变应原暴露标志物与哮喘或喘息没有实质性关联。在某些情况下，卧室门关闭方面的空气流通做法似乎很重要。室内空气质量差可能在儿童哮喘的发展中起重要作用。
