Montnémery P, Bengtsson P, Elliot A, Lindholm L H, Nyberg P, Löfdahl C G
Department of Clinical Neuroscience, Lund University, Sweden.
Respir Med. 2001 Sep;95(9):744-52. doi: 10.1053/rmed.2001.1129.
We wanted to test whether living environment, occupation and social position are risk factors for asthma and chronic bronchitis/emphysema (CBE). The prevalence of bronchial asthma, CBE, respiratory symptoms and smoking habits in a random sample of 12,071 adults aged 20-59 years was assessed in a postal survey with a slightly modified questionnaire previously used in central and northern Sweden (The OLIN studies). Occupation was coded according to a socio-economic classification system. Six different living environment areas were defined; city-countryside, seaside-not seaside and living close to heavy traffic-not living close to heavy traffic. Multiple logistic regression analysis (forward conditional) was applied to estimate the association between the proposed set of risk factors and self-reported obstructive lung diseases and lower respiratory symptoms controlling for age, gender and smoking. After two reminders, the response rate was 70.1% (n=8469); 33.8% of the responders were smokers. In all, 469 subjects (5.5%) stated that they had asthma and 4.6% reported CBE. Besides smoking, which was a risk for both asthma and CBE, there were different risk patterns for self-reported asthma and CBE. In the economically active population there was a tendency that CBE was more common among 'unskilled and semi-skilled workers'. This fact was further emphasized when the population was merged into the two groups 'low social position' and 'middle/high social position', with 'low social position' as a risk for CBE (OR=1.35, 95% CI=1.06-1.72). No social risk factors were identified for asthma. Living close to heavy traffic was a risk factor for asthma (OR=1.29, 95% CI=1.02-1.62) but not for CBE. Apart from this no living environmental risk factors for obstructive pulmonary diseases were identified. Asthma symptoms and long-standing cough were more common among those subjects living close to heavy traffic compared to those not living close to heavy traffic. To conclude, low social position was a risk factor for CBE and living close to heavy traffic was a risk factor for asthma.
我们想要测试生活环境、职业和社会地位是否为哮喘以及慢性支气管炎/肺气肿（CBE）的风险因素。通过一项邮寄调查，使用先前在瑞典中部和北部使用过的经过略微修改的问卷，对12071名年龄在20至59岁的成年人随机样本中的支气管哮喘、CBE、呼吸道症状及吸烟习惯的患病率进行了评估（OLIN研究）。职业根据社会经济分类系统进行编码。定义了六个不同的生活环境区域；城市 - 乡村、海边 - 非海边以及居住在交通繁忙地区附近 - 不住在交通繁忙地区附近。应用多元逻辑回归分析（向前条件法）来估计所提出的一组风险因素与自我报告的阻塞性肺病及下呼吸道症状之间的关联，并对年龄、性别和吸烟进行控制。经过两次提醒后，回复率为70.1%（n = 8469）；33.8%的回复者为吸烟者。总共有四百六十九名受试者（5.5%）表示他们患有哮喘，4.6%报告患有CBE。除了吸烟是哮喘和CBE的风险因素外，自我报告的哮喘和CBE存在不同的风险模式。在经济活跃人群中，有一种趋势是CBE在“非熟练和半熟练工人”中更为常见。当人群合并为“低社会地位”和“中/高社会地位”两组时，这一事实得到进一步强调，其中“低社会地位”是CBE的一个风险因素（比值比=1.35，95%置信区间=1.06 - 1.72）。未发现哮喘的社会风险因素。居住在交通繁忙地区附近是哮喘的一个风险因素（比值比=1.29，95%置信区间=1.02 - 1.62），但不是CBE的风险因素。除此之外，未发现阻塞性肺病的生活环境风险因素。与不住在交通繁忙地区附近的受试者相比，居住在交通繁忙地区附近的受试者中哮喘症状和长期咳嗽更为常见。总之，低社会地位是CBE的一个风险因素，居住在交通繁忙地区附近是哮喘的一个风险因素。
