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中国重庆室内环境与生活方式对儿童呼吸健康的影响。

Effects of indoor environment and lifestyle on respiratory health of children in Chongqing, China.

作者信息

Li Wenyan, Liu Qin, Chen Yiwen, Yang Bo, Huang Xin, Li Yueyue, Zhang Junfeng Jim

机构信息

School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China.

Nicholas School of the Environment and Duke Global Health Institute, Duke University, Durham, NC, USA.

出版信息

J Thorac Dis. 2020 Oct;12(10):6327-6341. doi: 10.21037/jtd.2020.03.102.

DOI:10.21037/jtd.2020.03.102
PMID:33209472
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7656398/
Abstract

BACKGROUND

The prevalence of certain respiratory diseases of children in China appears to be on the rise in recent decades. This study aims to explore residential environmental factors that may affect respiratory diseases and lung function of children and to assess the effects of lifestyle (diet and exercise) on lung function.

METHODS

The study was conducted in Chongqing, southwest of China in June, 2017. Information on respiratory diseases was obtained from 2,126 primary school children through a family questionnaire by purposive sampling. In addition, a random sample of 771 children participating in the family-questionnaire was selected for physical measurements and lung function test as well as lifestyle questionnaire survey. Chi-square test and multivariate logistic regressions were used to analyze the relationship between indoor environment and children's respiratory diseases. The effects of indoor environment and lifestyle on lung function indices were analyzed by t-test, variance analysis, and univariate and multivariate linear regression methods.

RESULTS

Among residential environmental factors, indoor ventilation and air circulation were significant associated with children's respiratory health outcomes. The use of air conditioning for more than 8 h/day in summer was a risk factor for asthma with an adjusted odds ratio (AOR) of 1.99, bronchitis (AOR =1.62), and allergic rhinitis (AOR =1.51). Ventilation for less than 12 h per day during summer increased the risk for allergic rhinitis (AOR =1.40). Children living in homes with an opened kitchen had the risk of developing allergic rhinitis 1.51 times higher than children living in homes with a closed kitchen. Indoor dampness and mold were significantly associated with increased risks for childhood asthma (AOR =2.16), bronchitis (AOR =1.55) and allergic rhinitis (AOR =1.55). The frequent use of hygienic incense and mosquito coils also increased the risk for asthma (AOR =2.58) and bronchitis (AOR =1.42) in children. The multiple linear regression results showed that frequent use of air fresheners reduced children's peak expiratory flow (PEF) and small airway function (FEF) after potential influencing factors were adjusted for. Analyses of lifestyle variables showed that increased lung function (FVC, FEV, FEV) was associated with increasing consumption of vegetable and fruit as well as increasing time of physical exercise.

CONCLUSIONS

This study identified the following residential risk factors for children's respiratory diseases in Chongqing: poor indoor ventilation, home dampness and mold presence, and frequent use of hygienic incense and mosquito coils. Frequent use of air fresheners is associated with reduced lung function in children. High frequency consumption of vegetables, fruits and dairy products as well as daily exercise for more than 1 hour have positive effects on children's lung development.

摘要

背景

近几十年来,中国儿童某些呼吸道疾病的患病率似乎呈上升趋势。本研究旨在探讨可能影响儿童呼吸道疾病和肺功能的居住环境因素,并评估生活方式(饮食和运动)对肺功能的影响。

方法

该研究于2017年6月在中国西南部的重庆进行。通过目的抽样,通过家庭问卷从2126名小学生中获取呼吸道疾病信息。此外,从参与家庭问卷调查的771名儿童中随机抽取样本,进行身体测量、肺功能测试以及生活方式问卷调查。采用卡方检验和多因素logistic回归分析室内环境与儿童呼吸道疾病之间的关系。通过t检验、方差分析以及单因素和多因素线性回归方法分析室内环境和生活方式对肺功能指标的影响。

结果

在居住环境因素中,室内通风和空气流通与儿童的呼吸道健康结果显著相关。夏季每天使用空调超过8小时是哮喘的危险因素,调整后的优势比(AOR)为1.99,支气管炎(AOR = 1.62)和过敏性鼻炎(AOR = 1.51)。夏季每天通风少于12小时会增加过敏性鼻炎的风险(AOR = 1.40)。生活在厨房开放家庭中的儿童患过敏性鼻炎的风险是生活在厨房封闭家庭中儿童的1.51倍。室内潮湿和霉菌与儿童哮喘(AOR = 2.16)、支气管炎(AOR = 1.55)和过敏性鼻炎(AOR = 1.55)风险增加显著相关。频繁使用卫生香和蚊香也会增加儿童患哮喘(AOR = 2.58)和支气管炎(AOR = 1.42)的风险。多元线性回归结果显示,在调整潜在影响因素后,频繁使用空气清新剂会降低儿童的呼气峰值流速(PEF)和小气道功能(FEF)。生活方式变量分析表明,肺功能(FVC、FEV、FEV)的增加与蔬菜和水果摄入量的增加以及体育锻炼时间的增加有关。

结论

本研究确定了重庆儿童呼吸道疾病的以下居住危险因素:室内通风不良、家中潮湿和霉菌存在以及频繁使用卫生香和蚊香。频繁使用空气清新剂与儿童肺功能下降有关。高频率食用蔬菜、水果和乳制品以及每天锻炼超过1小时对儿童肺部发育有积极影响。

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