Barry Rebecca J, Pickett William, Rennie Donna C, Dosman James A, Pahwa Punam, Hagel Louise, Karunanayake Chandima, Lawson Joshua A
Department of Community Health and Epidemiology, Queen's University, Kingston, Ontario, Canada.
Pediatr Pulmonol. 2014 Sep;49(9):842-51. doi: 10.1002/ppul.22903. Epub 2013 Oct 25.
Researchers have historically reported that farm children have a lower prevalence of asthma compared to more urban children. Potential explanations include theories surrounding differences in personal factors, access to health care, engagement in health risk behaviors, and differences in the environment.
The aims of this study were to: (1) confirm whether the prevalence of asthma varies between farm and small town status among children living in Saskatchewan; (2) identify risk and protective factors for asthma, and use this information to infer which of the above theories is most explanatory for any observed geographic variations in pediatric asthma.
Rural students (N = 2383, 42% participation rate) from the province of Saskatchewan participated in a 2011 cross-sectional study. Parents completed a survey that included questions about location of residence, respiratory symptoms, potential risk factors for respiratory disease, and exposures to farm activities. Multiple logistic regression was used to examine relations between respiratory outcomes (asthma, wheeze) with farm type and farm activities, while accounting for factors that may underlie such relations.
Asthma and wheeze prevalence did not differ by residential status. Living on a grain farm (OR = 0.64, 95% CI = 0.43-0.96), cleaning or playing in pens (OR = 0.69, 95% CI = 0.46-1.02), filling grain bins (OR = 0.56, 95% CI = 0.32-0.96), and riding horses (OR = 0.65, 95% CI = 0.40-1.05) were protective factors for ever diagnosis with asthma.
We identified a number of risk and protective factors for asthma and associated wheeze. This suggests the need to focus on specific environmental explanations to better understand previously observed associations between farm residential status and asthma.
研究人员历来报告称，与城市儿童相比，农村儿童哮喘患病率较低。可能的解释包括围绕个人因素、获得医疗保健的机会、参与健康风险行为以及环境差异的理论。
本研究的目的是：（1）确认居住在萨斯喀彻温省的儿童中，农村和小镇儿童的哮喘患病率是否存在差异；（2）确定哮喘的风险和保护因素，并利用这些信息推断上述哪种理论最能解释观察到的小儿哮喘地理差异。
萨斯喀彻温省的农村学生（N = 2383，参与率42%）参加了2011年的横断面研究。家长完成了一项调查，其中包括关于居住地点、呼吸道症状、呼吸道疾病潜在风险因素以及接触农场活动的问题。在考虑可能构成此类关系基础的因素的同时，使用多元逻辑回归来检验呼吸道结局（哮喘、喘息）与农场类型和农场活动之间的关系。
哮喘和喘息患病率不因居住状况而异。生活在谷物农场（比值比[OR]=0.64，95%置信区间[CI]=0.43 - 0.96）、在畜栏中清洁或玩耍（OR = 0.69，95% CI = 0.46 - 1.02）、装满谷物仓（OR = 0.56，95% CI = 0.32 - 0.96）以及骑马（OR = 0.65，95% CI = 0.40 - 1.05）是曾被诊断为哮喘的保护因素。
我们确定了一些哮喘和相关喘息的风险和保护因素。这表明需要关注特定的环境解释，以更好地理解先前观察到的农场居住状况与哮喘之间的关联。
