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环境因素、父母特应性与小学生特应性皮炎:台湾的一项横断面研究。

Environmental factors, parental atopy and atopic eczema in primary-school children: a cross-sectional study in Taiwan.

作者信息

Lee Y-L, Li C-W, Sung F-C, Yu H-S, Sheu H-M, Guo Y L

机构信息

Department of Occupational and Environmental Medicine, National Cheng Kung University, Tainan, Taiwan.

出版信息

Br J Dermatol. 2007 Dec;157(6):1217-24. doi: 10.1111/j.1365-2133.2007.08215.x. Epub 2007 Oct 4.

Abstract

BACKGROUND

Parental atopy and environmental exposure are recognized risk factors for atopic eczema (AE) in childhood. However, the relative contributions of specific risk factors and the overall contributions of hereditary and environmental exposure remain unexplored.

OBJECTIVES

To identify risk factors, estimate the population attributable risk (PAR) of environmental exposure, and compare the AE data for boys vs. girls in primary-school children.

METHODS

During a February to June 2001 cross-sectional, Taiwan-based questionnaire survey, we investigated 23 980 children from 22 primary schools, all located within 1 km of an air-monitoring station.

RESULTS

The 12-month prevalence of AE was reported as 6.1% in boys and 4.9% in girls. In both sexes, the risk of AE was strongly associated with parental atopy and perceived ambient air pollution. The presence of cockroaches [odds ratio (OR) 1.18, 95% confidence interval (CI) 1.00-1.40] and visible mould on walls at home (OR 1.46, 95% CI 1.22-1.70) were also significantly related to AE for girls; however, only visible mould on walls (and not the presence of cockroaches) at home was related to AE for boys (OR 1.40, 95% CI 1.18-1.66). While mutually adjusted models were applied, we found adjusted ORs and PARs were similar in boys and girls in hereditary and outdoor environmental factors. The PAR of indoor environmental factors was higher in girls (8.4%) than in boys (5.5%). There was no interaction between parental atopy and environmental factors.

CONCLUSIONS

Parental atopy contributed more to AE than indoor or outdoor environmental factors. Girls may be more susceptible to indoor environmental factors than boys.

摘要

背景

父母患特应性疾病和环境暴露是儿童期特应性皮炎(AE)公认的风险因素。然而,特定风险因素的相对贡献以及遗传和环境暴露的总体贡献仍未得到探索。

目的

识别风险因素,估计环境暴露的人群归因风险(PAR),并比较小学儿童中男孩与女孩的AE数据。

方法

在2001年2月至6月基于台湾的横断面问卷调查中,我们调查了来自22所小学的23980名儿童,所有学校均位于距离空气监测站1公里范围内。

结果

报告的AE 12个月患病率在男孩中为6.1%,在女孩中为4.9%。在两性中,AE风险均与父母患特应性疾病以及感知到的环境空气污染密切相关。家中有蟑螂[比值比(OR)1.18,95%置信区间(CI)1.00 - 1.40]和墙壁上可见霉菌(OR 1.46,95% CI 1.22 - 1.70)也与女孩的AE显著相关;然而,家中墙壁上可见霉菌(而非有蟑螂)与男孩的AE相关(OR 1.40,95% CI 1.18 - 1.66)。当应用相互调整模型时,我们发现在遗传和室外环境因素方面,男孩和女孩的调整后OR和PAR相似。室内环境因素的PAR在女孩中(8.4%)高于男孩(5.5%)。父母患特应性疾病与环境因素之间不存在交互作用。

结论

父母患特应性疾病对AE的影响大于室内或室外环境因素。女孩可能比男孩更容易受到室内环境因素的影响。

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