Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China.
Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China; Key Laboratory of Public Health Safety of the Ministry of Education, Key Lab of Health Technology Assessment, National Health and Family Planning Commission of the People's Republic of China, Shanghai Key Laboratory of Meteorology and Health, Shanghai 200032, China.
Environ Pollut. 2018 Jan;232:329-337. doi: 10.1016/j.envpol.2017.08.072. Epub 2017 Sep 29.
The urbanization and industrialization in China is accompanied by bad air quality, and the prevalence of asthma in Chinese children has been increasing in recent years. To investigate the associations between ambient PM levels and asthmatic and allergic diseases or symptoms in preschool children in China, we assigned PM exposure data from the Global Burden of Disease (GBD) project to 205 kindergartens at a spatial resolution of 0.1° × 0.1° in six cities in China (Shanghai, Nanjing, Chongqing, Changsha, Urumqi, and Taiyuan). A hierarchical multiple logistical regression model was applied to analyze the associations between kindergarten-level PM exposure and individual-level outcomes of asthmatic and allergic symptoms. The individual-level variables, including gender, age, family history of asthma and allergic diseases, breastfeeding, parental smoking, indoor dampness, interior decoration pollution, household annual income, and city-level variable-annual temperature were adjusted. A total of 30,759 children (average age 4.6 years, 51.7% boys) were enrolled in this study. Apart from family history, indoor dampness, and decoration as predominant risk factors, we found that an increase of 10 μg/m of the annual PM was positively associated with the prevalence of allergic rhinitis by an odds ratio (OR) of 1.20 (95% confidence interval [CI] 1.11, 1.29) and diagnosed asthma by OR of 1.10 (95% CI 1.03, 1.18). Those who lived in non-urban (vs. urban) areas were exposed to more severe indoor air pollution arising from biomass combustion and had significantly higher ORs between PM and allergic rhinitis and current rhinitis. Our study suggested that long-term exposure to PM might increase the risks of asthmatic and allergic diseases or symptoms in preschool children in China. Compared to those living in urban areas, children living in suburban or rural areas had a higher risk of PM exposure.
中国的城市化和工业化伴随着空气质量恶化,近年来中国儿童哮喘的患病率一直在上升。为了研究环境 PM 水平与中国学龄前儿童哮喘和过敏性疾病或症状之间的关系,我们将全球疾病负担(GBD)项目中的 PM 暴露数据分配到中国六个城市(上海、南京、重庆、长沙、乌鲁木齐和太原)的 205 个幼儿园,空间分辨率为 0.1°×0.1°。应用分层多逻辑回归模型分析幼儿园级 PM 暴露与个体哮喘和过敏症状个体水平结局之间的关系。个体水平变量包括性别、年龄、哮喘和过敏性疾病家族史、母乳喂养、父母吸烟、室内潮湿、室内装修污染、家庭年收入以及城市水平变量-年温度。共纳入 30759 名儿童(平均年龄 4.6 岁,51.7%为男孩)。除家族史、室内潮湿和装修是主要危险因素外,我们还发现,每年 PM 增加 10μg/m,患过敏性鼻炎的几率会增加 1.20 倍(95%置信区间 [CI] 1.11,1.29),患确诊哮喘的几率会增加 1.10 倍(95%置信区间 [CI] 1.03,1.18)。与居住在城市地区的儿童相比,居住在非城市(而非城市)地区的儿童暴露于更多的生物质燃烧引起的室内空气污染,PM 与过敏性鼻炎和当前鼻炎之间的比值比(OR)显著更高。本研究表明,长期暴露于 PM 可能会增加中国学龄前儿童哮喘和过敏性疾病或症状的风险。与居住在城市地区的儿童相比,居住在郊区或农村地区的儿童 PM 暴露风险更高。