Wilson Donald, Takahashi Ken, Pan Guowei, Chan Chang-Chuan, Zhang Shujuan, Feng Yiping, Hoshuyama Tsutomu, Chuang Kai-Jen, Lin Ro-Ting, Hwang Jing-Shiang
Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences (IIES), University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu-shi, Fukuoka 807-8555, Japan.
Respir Med. 2008 Nov;102(11):1536-44. doi: 10.1016/j.rmed.2008.06.010. Epub 2008 Aug 6.
In China, significant levels of environmental pollution, substandard worksite quality and high rates of smoking predispose the population to potentially high risks of respiratory illnesses and other diseases. We assessed the prevalence of respiratory symptoms and their risks in relation to personal, occupational and environmental risk factors in a heavy-industry province of northeastern China.
Lifestyle, health, residential and occupational data were obtained in 2002 from 31,704 adults of six cities in Liaoning, China, using self-assessment questionnaires. General linear and multi-level models were used to evaluate prevalence rates and risks of respiratory symptoms, related to both individual and combined exposures to environmental and occupational risk factors.
The crude prevalence rates (PRs) for persistent cough, persistent phlegm, wheeze and asthma were 2.3, 3.8, 2.1 and 1.0%, respectively. The odds ratios (ORs) of all four respiratory symptoms examined were increased by: smoking (ORs from 2.06 to 5.02), occupational dust (ORs from 1.35 to 1.72), occupational gas (ORs from 1.48 to 1.72) and presence of irritating smoke during cooking (ORs from 1.54 to 2.22). An index combining proximity of residence to road, factory or chimney, indoor coal use and presence of irritating smoke during cooking was associated with up to 3.9-fold increased risks of all symptoms. Increasing values of each risk factor were generally associated with dose-response trends in prevalence rates and risks (all p for trend <0.01).
The crude PRs of symptoms were lower than those reported by European and American studies but closer to those of previous Chinese studies. The risks of respiratory symptoms in this population were increased by smoking, occupational exposures to dust and gas, and combined residence-related exposures such as living close to a main road, factory or chimney, indoor coal use and the presence of irritating smoke during cooking, among other risk factors.
在中国，严重的环境污染、不达标的工作场所质量以及高吸烟率使民众面临呼吸系统疾病和其他疾病的潜在高风险。我们评估了中国东北一个重工业省份中呼吸道症状的患病率及其与个人、职业和环境风险因素相关的风险。
2002年，通过自我评估问卷从中国辽宁省六个城市的31704名成年人中获取生活方式、健康状况、居住和职业数据。使用一般线性模型和多层次模型评估与环境和职业风险因素的个体及综合暴露相关的呼吸道症状患病率和风险。
持续性咳嗽、持续性咳痰、喘息和哮喘的粗患病率分别为2.3%、3.8%、2.1%和1.0%。所检查的所有四种呼吸道症状的比值比（OR）因以下因素而升高：吸烟（OR为2.06至5.02）、职业粉尘（OR为1.35至1.72）、职业气体（OR为1.48至1.72）以及烹饪时有刺激性烟雾（OR为1.54至2.22）。一个综合了居住地与道路、工厂或烟囱的距离、室内燃煤以及烹饪时有刺激性烟雾的指标与所有症状的风险增加高达3.9倍相关。每个风险因素值的增加通常与患病率和风险的剂量反应趋势相关（所有趋势p<0.01）。
症状的粗患病率低于欧美研究报告的水平，但更接近中国以往的研究结果。该人群呼吸道症状的风险因吸烟、职业暴露于粉尘和气体以及与居住相关的综合暴露（如居住在主干道、工厂或烟囱附近、室内燃煤以及烹饪时有刺激性烟雾）等其他风险因素而增加。
