Ramratnam Sima K, Han Yueh-Ying, Rosas-Salazar Christian, Forno Erick, Brehm John M, Rosser Franziska, Marsland Anna L, Colón-Semidey Angel, Alvarez María, Miller Gregory E, Acosta-Pérez Edna, Canino Glorisa, Celedón Juan C
Division of Pulmonary Medicine, Allergy and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, PA, USA.
Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.
Respir Med. 2015 Aug;109(8):975-81. doi: 10.1016/j.rmed.2015.05.011. Epub 2015 May 27.
Although community violence may influence asthma morbidity by increasing stress, no study has assessed exposure to gun violence and childhood asthma. We examined whether exposure to gun violence is associated with asthma in children, particularly in those reporting fear of leaving their home.
Case-control study of 466 children aged 9-14 years with (n = 234) and without (n = 232) asthma in San Juan, Puerto Rico. Lifetime exposure to gun violence was defined as hearing a gunshot more than once. We also assessed whether the child was afraid to leave his/her home because of violence. Asthma was defined as physician-diagnosed asthma and wheeze in the prior year. We used logistic regression for the statistical analysis. All multivariate models were adjusted for age, gender, household income, parental asthma, environmental tobacco smoke, prematurity and residential distance from a major road.
Cases were more likely to have heard a gunshot more than once than control subjects (n = 156 or 67.2% vs. n = 122 or 52.1%, P < 0.01). In a multivariate analysis, hearing a gunshot more than once was associated with asthma (odds ratio [OR] = 1.8, 95% confidence interval [CI] = 1.1-1.7, P = 0.01). Compared with children who had heard a gunshot not more than once and were not afraid to leave their home because of violence, those who had heard a gunshot more than once and were afraid to leave their home due to violence had 3.2 times greater odds of asthma (95% CI for OR = 2.2-4.4, P < 0.01).
Exposure to gun violence is associated with asthma in Puerto Rican children, particularly in those afraid to leave their home. Stress from such violence may contribute to the high burden of asthma in Puerto Ricans.
尽管社区暴力可能通过增加压力影响哮喘发病率，但尚无研究评估枪支暴力暴露与儿童哮喘的关系。我们研究了枪支暴力暴露是否与儿童哮喘相关，尤其是那些表示害怕离开家的儿童。
对波多黎各圣胡安466名9至14岁的儿童进行病例对照研究，其中234名患有哮喘，232名未患哮喘。终身枪支暴力暴露定义为不止一次听到枪声。我们还评估了儿童是否因暴力而害怕离开家。哮喘定义为医生诊断的哮喘和前一年的喘息。我们使用逻辑回归进行统计分析。所有多变量模型均根据年龄、性别、家庭收入、父母哮喘、环境烟草烟雾、早产和与主干道的居住距离进行了调整。
病例组比对照组更有可能不止一次听到枪声（156例或67.2%对122例或52.1%，P<0.01）。在多变量分析中，不止一次听到枪声与哮喘相关（优势比[OR]=1.8，95%置信区间[CI]=1.1-1.7，P=0.01）。与那些听到枪声不超过一次且不因暴力而害怕离开家的儿童相比，那些听到枪声不止一次且因暴力而害怕离开家的儿童患哮喘的几率高3.2倍（OR的95%CI=2.2-4.4，P<0.01）。
在波多黎各儿童中，枪支暴力暴露与哮喘相关，尤其是那些害怕离开家的儿童。这种暴力带来的压力可能导致波多黎各人哮喘负担沉重。
