Son Ji-Young, Kim Ho, Lee Jong-Tae, Kim Sun-Young
Department of Epidemiology & Biostatistics, School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Korea.
J Prev Med Public Health. 2006 Jan;39(1):81-6.
A number of studies have reported associations between the ambient air pollution concentrations and various health outcomes. Especially, ozone is well known for primary risk factor of asthma attacks. The results of a recent study indicate that the size of the effect on health outcomes due to air pollution varied according to several conditions, including age, gender, race and the socioeconomic status. Therefore, this study was conducted to examine the associations of ozone with the childhood asthma hospitalizations as stratified by the socioeconomic status (SES) at the community level in Seoul, Korea, 2002.
SES at aggregated levels was measured on the basis of average regional health-insurance rate per citizen in the area. We applied the generalized additive model to analyze the effect of ozone on asthma after controlling for the potential confounding variables that were capable of influencing the results.
Our analysis showed that the number of children who were hospitalized for asthma increased as the SES of the residence area decreased. The estimated relative risks of hospitalization for asthma, as stratified by the SES of the community level, were 1.12 (95% confidence interval 1.00-1.25) in districts with the highest SES levels, 1.24 (95% CI=1.08-1.43) within the moderate SES levels, and 1.32 (95% CI=1.11-1.58) in the districts with the lowest SES levels.
Our analysis showed that exposure to air pollution did not equally affect the health status of individuals. This suggests that not only the biological-sensitivity markers, but also the SES of the subjects should be considered as potentially confounding factors.
多项研究报告了环境空气污染浓度与各种健康结果之间的关联。特别是,臭氧是哮喘发作的主要危险因素,这是广为人知的。最近一项研究的结果表明,空气污染对健康结果的影响大小因年龄、性别、种族和社会经济地位等多种因素而异。因此,本研究旨在考察2002年韩国首尔社区层面按社会经济地位(SES)分层的臭氧与儿童哮喘住院之间的关联。
基于该地区每位居民的平均区域健康保险费率来衡量总体层面的社会经济地位。我们应用广义相加模型来分析在控制了可能影响结果的潜在混杂变量后臭氧对哮喘的影响。
我们的分析表明,因哮喘住院的儿童数量随着居住地区社会经济地位的降低而增加。按社区层面社会经济地位分层,哮喘住院的估计相对风险在社会经济地位最高的地区为1.12(95%置信区间1.00 - 1.25),中等社会经济地位地区为1.24(95%置信区间 = 1.08 - 1.43),社会经济地位最低的地区为1.32(95%置信区间 = 1.11 - 1.58)。
我们的分析表明,接触空气污染对个体健康状况的影响并不相同。这表明不仅生物敏感性标志物,而且受试者的社会经济地位都应被视为潜在的混杂因素。