Cortes-Ramirez Javier, Wilches-Vega Juan D, Paris-Pineda Olga M, Rod J E, Ayurzana Lkhagvadulam, Sly Peter D
School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.
Children's Health and Environment Program, University of Queensland, Brisbane, Australia.
Heliyon. 2021 Apr 22;7(4):e06820. doi: 10.1016/j.heliyon.2021.e06820. eCollection 2021 Apr.
Children are more vulnerable to environmental exposures determinant of respiratory diseases due to their dynamic developmental physiology. Whereas social determinants of health are also associated with a higher risk of these diseases in children exposed to environmental risk factors, most studies incorporate them as covariates in the statistical analysis rather than focusing on specific vulnerable populations. In this study a systematic review searched and selected studies of respiratory diseases in children with socioeconomic disadvantage to identify the environmental risk factors associated with these diseases. The review followed the PRISMA protocol to identify eleven eligible studies of children with socioeconomic conditions that included low income and low socioeconomic status, overcrowding, adults with low education level and Indigenous status. Infectious respiratory diseases, asthma, rhinitis and mortality due to respiratory diseases were associated with risk factors such as biomass fuel use, tobacco smoking, particulate matter, coal dust and other pollutants including ozone, nitrogen dioxide and sulphur dioxide. The most common associations were between respiratory infections and household air pollution and asthma with indoor and outdoor air pollution. The findings support previous reports on these associations and suggest that specific vulnerabilities such as indigenous children and living with adults with low socioeconomic status and education level increase the risk of respiratory diseases. These populations can be given special attention to prioritize public health interventions to lower the burden of disease of respiratory diseases in children.
由于儿童动态的发育生理，他们更容易受到决定呼吸系统疾病的环境暴露的影响。虽然健康的社会决定因素也与暴露于环境风险因素的儿童患这些疾病的较高风险相关，但大多数研究将它们作为统计分析中的协变量，而不是关注特定的弱势群体。在本研究中，一项系统综述检索并选择了有关社会经济处于不利地位儿童的呼吸系统疾病的研究，以确定与这些疾病相关的环境风险因素。该综述遵循PRISMA协议，确定了11项关于社会经济状况儿童的合格研究，这些状况包括低收入、低社会经济地位、过度拥挤、低教育水平的成年人以及原住民身份。传染性呼吸系统疾病、哮喘、鼻炎和呼吸系统疾病导致的死亡与生物质燃料使用、吸烟、颗粒物、煤尘以及包括臭氧、二氧化氮和二氧化硫在内的其他污染物等风险因素相关。最常见的关联是呼吸道感染与家庭空气污染之间以及哮喘与室内和室外空气污染之间的关联。这些发现支持了先前关于这些关联的报告，并表明特定的弱势群体，如原住民儿童以及与社会经济地位和教育水平较低的成年人生活在一起，会增加患呼吸系统疾病的风险。可以特别关注这些人群，以便优先开展公共卫生干预措施，减轻儿童呼吸系统疾病的负担。
