Bonner Sebastian, Matte Thomas D, Fagan Joanne, Andreopoulos Evie, Evans David
Center for Urabn Epidemiologic Studies (CUES) of the New York Academy of Medicine, USA.
J Urban Health. 2006 Jan;83(1):129-37. doi: 10.1007/s11524-005-9012-7.
This study used results from a cross-sectional survey of parents of 3- to 5-year-old children with asthma to assess the frequency of self-reported home environmental conditions that could contribute to worsening asthma and examined the relationship between these factors and the child's asthma morbidity. Participants were 149 parents drawn from the two largest agencies that provide subsidized preschool childcare services in East and Central Harlem, inner-city communities with high prevalence of asthma. The sample represented 77% of eligibles determined by a validated case-identification instrument. Data were collected on demographics, symptoms, medication use, Emergency Department visits and hospitalization, and environmental conditions in the home. One or more of these home environmental conditions were reported by 92% of participants. Controlling for other environmental conditions and demographics, associations were found between self-reported presence of moisture or mildew on ceilings, walls, or windows and higher frequency of hospitalizations for breathing-related problems (OR = 3.31; 95% CI 1.62-6.75), frequent episodes of wheezing (OR = 3.25; 95% CI 1.8-6.0), and higher frequency of night symptoms due to asthma (OR = 2.19; 95% CI 1.4-3.41). Having a carpet or rug in the child's bedroom or the living room was also associated with hospitalizations (OR = 3.23; 95% CI 1.53-6.8), and male gender was marginally associated with the frequency of night symptoms (OR = 1.51; 95% CI .95-2.4). Asthma is prevalent in the Head Start population, and exposure to home environmental conditions that may worsen asthma is common in the socially disadvantaged populations served by Head Start programs.
本研究利用对3至5岁哮喘儿童家长进行的横断面调查结果，评估自我报告的可能导致哮喘恶化的家庭环境状况的出现频率，并研究这些因素与儿童哮喘发病率之间的关系。研究对象为149名家长，他们来自东哈莱姆和中哈莱姆提供补贴学前儿童保育服务的两家最大机构，这两个内城区社区哮喘患病率很高。该样本占经有效病例识别工具确定的符合条件者的77%。收集了有关人口统计学、症状、药物使用、急诊就诊和住院情况以及家庭环境状况的数据。92%的参与者报告了一种或多种这些家庭环境状况。在控制了其他环境状况和人口统计学因素后，发现天花板、墙壁或窗户上自我报告有潮湿或霉菌与呼吸相关问题住院频率较高（比值比=3.31；95%置信区间1.62 - 6.75）、频繁喘息发作（比值比=3.25；95%置信区间1.8 - 6.0）以及哮喘导致的夜间症状频率较高（比值比=2.19；95%置信区间1.4 - 3.41）之间存在关联。儿童卧室或客厅有地毯也与住院有关（比值比=3.23；95%置信区间1.53 - 6.8），男性性别与夜间症状频率存在微弱关联（比值比=1.51；95%置信区间0.95 - 2.4）。哮喘在“启智计划”人群中很普遍，在“启智计划”项目所服务的社会弱势群体中，接触可能使哮喘恶化的家庭环境状况很常见。
