Nafstad P, Jaakkola J J K, Skrondal A, Magnus P
Department of General Practice and Community Medicine, The Medical Faculty, University of Oslo, Oslo, Norway.
Indoor Air. 2005 Apr;15(2):69-75. doi: 10.1111/j.1600-0668.2004.00310.x.
Day care centers provide an important exposure arena with potential harmful health effects for children. This study has linked health effect data from a survey among 942 3-5-year-old Oslo children with information on day care center characteristics collected during inspection of the 175 day care centers these children attended. The aim of the study was to estimate associations between dampness problems and other building characteristics and several respiratory health outcomes. Dampness problems (sign of molds, water leakage, damage to floor/wall) were observed in 51% of the day care centers. In multiple logistic regression analyses none of the studied symptoms and diseases (nightly cough, blocked or runny nose without common cold, wheeze, heavy breathing or chest tightness, the common cold, tonsillitis/pharyngitis, otitis media, bronchitis, pneumonia, asthma, and allergic rhinitis) were systematically associated with dampness problems or type of ventilation in day care centers. None of the studied indicators of day care center exposures were found to have a clear effect on day care children's respiratory health. Even so this study does not rule out negative health effects of day care center exposures. The study demonstrates that population-based studies of these relations are demanding with regard to assessment of exposure and health outcomes.
Simple and easy-to-register indicators of exposures like dampness problems and type of ventilation assessed in 175 day care centers were not related to respiratory health among 3-5-year-old Norwegian children attending the day care centers. The study does not rule out negative health effects of day care center exposures, but demonstrates methodological challenges needed to be addressed in studies of health effects of the day care environment.
日托中心为儿童提供了一个重要的接触环境,可能对儿童健康产生有害影响。本研究将942名3至5岁奥斯陆儿童的健康影响数据与在检查他们所就读的175所日托中心时收集的日托中心特征信息联系起来。该研究的目的是估计潮湿问题和其他建筑特征与几种呼吸系统健康结果之间的关联。在51%的日托中心观察到潮湿问题(霉菌迹象、漏水、地板/墙壁损坏)。在多因素逻辑回归分析中,所研究的症状和疾病(夜间咳嗽、无感冒时鼻塞或流涕、喘息、呼吸急促或胸闷、普通感冒、扁桃体炎/咽炎、中耳炎、支气管炎、肺炎、哮喘和过敏性鼻炎)均未与日托中心的潮湿问题或通风类型存在系统性关联。未发现所研究的日托中心接触指标对日托儿童的呼吸系统健康有明显影响。即便如此,本研究并未排除日托中心接触对健康产生的负面影响。该研究表明,基于人群的这些关系研究在暴露评估和健康结果评估方面要求较高。
在175所日托中心评估的诸如潮湿问题和通风类型等简单易记录的暴露指标与在这些日托中心就读的3至5岁挪威儿童的呼吸系统健康无关。该研究并未排除日托中心接触对健康产生的负面影响,但表明在日托环境健康影响研究中需要解决方法学挑战。