[室内空气质量与哮喘儿童家长的行为习惯]

Larramendy Magnin S, Desssome B, Moret L

Département de médecine générale, faculté de médecine de Nantes, 1, rue Gaston-Veil, 44035 Nantes cedex, France.

Service d'évaluation médicale et d'épidémiologie, pôle hospitalo-universitaire santé publique, santé au travail et pharmacie (PHU11), hôpital Saint-Jacques, CHU de Nantes, 44093 Nantes cedex, France.

Rev Epidemiol Sante Publique. 2017 Sep;65(5):337-347. doi: 10.1016/j.respe.2017.05.005. Epub 2017 Sep 6.

BACKGROUND

Indoor air pollution can worsen asthma in children. Better knowledge of factors determining parents' reception of recommendations to limit pollution of indoor air in the homes of asthmatic children would be helpful to improve implementation.

METHOD

A descriptive study evaluating practices known to have an impact on the quality of air in homes was conducted among parents of asthmatic children aged 3 to 16 years. From May to September 2013, parents answered anonymous self-administered questionnaires in waiting rooms of generalist practitioners, in the Nantes University pneumology pediatric outpatient clinic, and as part of therapeutic education sessions conducted by the Asthma-44 Network.

RESULTS

There were 190 exploitable questionnaires: 88.2% of parents reported never smoking in the home; 48.4% used home fragrance in the living room at least once a week; 77.8% opened their children's bedroom windows more than 10minutes at least once a day; 32.6% used several cleaning products or bleach once or twice a week. Good practices concerning smoking in housing were applied less in homes where the child was monitored only by a general practitioner (OR=0.08; CI[0.02-0.34]). Good practices on the use of perfume were statistically linked to having an intermediate level occupation (OR=2.31; CI[1.01-5.32]) and being followed by the university hospital, by the asthma network or by a general practitioner if the child had already consulted a pneumo-pediatrician or an allergist (OR=0.24; CI[0.07-0.81]). Good ventilation practices forchildren's bedrooms were statistically linked to residing in a rural rather than urban setting (OR=4.72; CI[1.0-22.16]).

CONCLUSION

Practices observed in parents of asthmatic children differ little from those of the general population. Recommendations on how to limit sources of chemical pollutants, with the exception of smoking, are still poorly applied. Specialist consultations and specific training for general practitioners should improve the penetration of public health messages to this vulnerable population.

背景

室内空气污染会加重儿童哮喘。更好地了解决定父母接受限制哮喘儿童家庭室内空气污染建议的因素，将有助于提高建议的实施效果。

方法

对3至16岁哮喘儿童的父母进行了一项描述性研究，评估已知对家庭空气质量有影响的行为。2013年5月至9月，父母在全科医生候诊室、南特大学儿科肺病门诊以及哮喘-44网络开展的治疗教育课程中，回答匿名的自填问卷。

结果

共190份可用于分析的问卷：88.2%的父母报告在家中从不吸烟；48.4%的父母每周至少在客厅使用一次室内芳香剂；77.8%的父母每天至少有一次打开孩子卧室窗户超过10分钟；32.6%的父母每周使用一两次多种清洁产品或漂白剂。在仅由全科医生监测孩子的家庭中，关于住房内吸烟的良好行为较少被采用（比值比=0.08；可信区间[0.02 - 0.34]）。使用香水的良好行为在统计学上与中等职业水平相关（比值比=2.31；可信区间[1.01 - 5.32]），并且如果孩子已经咨询过儿科肺病医生或过敏症专科医生，由大学医院、哮喘网络或全科医生随访的家庭中使用香水的良好行为更多（比值比=0.24；可信区间[0.07 - 0.81]）。儿童卧室良好的通风行为在统计学上与居住在农村而非城市环境相关（比值比=4.72；可信区间[1.0 - 22.16]）。