Spencer-Hwang Rhonda, Soret Sam, Knutsen Synnove, Shavlik David, Ghamsary Mark, Beeson W Lawrence, Kim Wonha, Montgomery Susanne
School of Public Health, Loma Linda University, Nichol Hall Room 1201, Loma Linda, CA, 92354, USA,
J Community Health. 2015 Oct;40(5):1015-23. doi: 10.1007/s10900-015-0026-0. Epub 2015 Apr 19.
Inland southern California is a region of public health concern, especially for children, given the area's perennially poor air quality and increasing sources of local pollution. One elementary school specifically is located only a few hundred yards from the San Bernardino Railyard, one of the busiest goods movement facilities in California, potentially increasing respiratory problems. Through ENRRICH (Environmental Railyard Research Impacting Community Health) Project, we assessed association of proximity to a major freight railyard on adverse respiratory health in schoolchildren. Respiratory screening was provided for children at two elementary schools: one near the railyard and a socio-demographically matched comparison school 7 miles away. Screening included testing for airway inflammation (FE NO), lung function (peak expiratory flow, PEF) and parent reported respiratory symptoms. Parental questionnaires collected additional information. Log-binomial and linear regression assessed associations. Children attending school near the railyard were more likely to exhibit airway obstruction with higher prevalence of abnormal PEF (<80%): prevalence ratio (PR) = 1.59 (95% CI 1.19-2.12). The association with inflammation was less clear. Children at the exposure school, who had lived 6 months or longer at their current address (vs. all children at that school) were more likely to have values suggesting inflammation (FE NO > 20 ppb) (PR = 1.44, 95% CI 1.02-2.02) and present with a trend for increased adverse respiratory symptoms. Children attending school near the railyard were significantly more likely to display respiratory health challenges. Ideally these low-income, low resource communities should be supported to implement sustainable intervention strategies to promote an environment where children can live healthier and thrive.
南加州内陆地区是一个受到公共卫生关注的区域,尤其是对于儿童而言,考虑到该地区常年糟糕的空气质量以及当地污染来源的不断增加。具体来说,有一所小学距离圣贝纳迪诺铁路货场仅几百码,而圣贝纳迪诺铁路货场是加利福尼亚最繁忙的货物运输设施之一,这可能会增加呼吸道问题。通过“丰富”(环境铁路货场研究影响社区健康)项目,我们评估了靠近主要货运铁路货场与学童不良呼吸健康之间的关联。为两所小学的儿童提供了呼吸筛查:一所靠近铁路货场,另一所是在7英里外社会人口统计学特征匹配的对照学校。筛查包括气道炎症检测(呼出一氧化氮,FeNO)、肺功能检测(呼气峰值流速,PEF)以及家长报告的呼吸道症状。家长问卷收集了更多信息。对数二项式和线性回归评估了关联。在靠近铁路货场上学的儿童更有可能出现气道阻塞,异常PEF(<80%)的患病率更高:患病率比(PR)=1.59(95%置信区间1.19 - 2.12)。与炎症的关联不太明确。在暴露学校中,在其当前住址居住6个月或更长时间的儿童(相对于该校所有儿童)更有可能有提示炎症的值(FeNO>20 ppb)(PR = 1.44,95%置信区间1.02 - 2.02),并且呈现出不良呼吸道症状增加的趋势。在靠近铁路货场上学的儿童明显更有可能面临呼吸健康挑战。理想情况下,应该支持这些低收入、资源匮乏的社区实施可持续的干预策略,以促进一个能让儿童更健康地生活和茁壮成长的环境。