Ellison-Loschmann L, Sunyer J, Plana E, Pearce N, Zock J-P, Jarvis D, Janson C, Antó J M, Kogevinas M
Centre for Research in Environmental Epidemiology (CREAL), Municipal Institute of Medical Research (IMIM), Pompeu Fabra University, 80 Dr Aiguader Rd, Barcelona 08003, Spain.
Eur Respir J. 2007 May;29(5):897-905. doi: 10.1183/09031936.00101606. Epub 2007 Jan 10.
The present study investigated the relationship between socioeconomic status, using measures of occupational class and education level, and the prevalence and incidence of asthma (with and without atopy) and chronic bronchitis using data from the European Community Respiratory Health Survey (ECRHS). Asthma and chronic bronchitis were studied prospectively within the ECRHS (n = 9,023). Incidence analyses comprised subjects with no history of asthma or bronchitis at baseline. Asthma symptoms were also assessed as a continuous score. Bronchitis risk was associated with low educational level (prevalence odds ratio (POR) 1.9; 95% confidence interval (CI) 1.4-2.8) and occupational class (1.8; 1.2-2.7). Incident bronchitis also increased with low educational level (risk ratio (RR) 2.8; 95%CI 1.5-5.4). Prevalent and incident asthma with no atopy were associated with low educational level. Subjects in the low occupational class (incident risk ratio (IRR) 1.4; 95%CI 1.2-1.7) and education group (IRR 1.3; 95% CI 1.1-1.6) had higher mean asthma scores than those in higher socioeconomic groups. Lower educational level was associated with increased risk of prevalent and incident chronic bronchitis and asthma with no atopy. Lower socioeconomic groups tended to have a higher prevalence and incidence of asthma, particularly higher mean asthma scores. Adjustment for variables associated with asthma and bronchitis explained little of the observed health differences by socioeconomic status.
本研究利用职业阶层和教育水平指标来衡量社会经济地位，并使用欧洲共同体呼吸健康调查（ECRHS）的数据，调查了社会经济地位与哮喘（有或无特应性）及慢性支气管炎的患病率和发病率之间的关系。在ECRHS（n = 9,023）中对哮喘和慢性支气管炎进行了前瞻性研究。发病率分析包括基线时无哮喘或支气管炎病史的受试者。哮喘症状也作为一个连续评分进行评估。支气管炎风险与低教育水平（患病率比值比（POR）1.9；95%置信区间（CI）1.4 - 2.8）和职业阶层（1.8；1.2 - 2.7）相关。新发支气管炎也随着低教育水平而增加（风险比（RR）2.8；95%CI 1.5 - 5.4）。无特应性的哮喘患病率和发病率与低教育水平相关。低职业阶层（发病风险比（IRR）1.4；95%CI 1.2 - 1.7）和教育组（IRR 1.3；95%CI 1.1 - 1.6）的受试者比社会经济地位较高组的受试者有更高的平均哮喘评分。较低的教育水平与慢性支气管炎和无特应性哮喘的患病率和发病率增加相关。社会经济地位较低的群体往往有更高的哮喘患病率和发病率，特别是更高的平均哮喘评分。对与哮喘和支气管炎相关的变量进行调整后，社会经济地位所观察到的健康差异几乎没有得到解释。
