Okui Tasuku
Medical Information Center, Kyusyu University Hospital, 3-1-1, Maidashi Higashi-ku, Fukuoka city 812-8582, Japan.
Environ Anal Health Toxicol. 2021 Dec;36(4):e2021027-0. doi: 10.5620/eaht.2021027. Epub 2021 Dec 8.
Although it has been known that the prevalence of asthma tends to be higher among children in the metropolitan areas of Japan, trends of the prevalence with respect to the regional urbanization level has not been investigated in recent years. We investigated trends in the prevalence of asthma among children and air pollutant concentrations by regional urbanization levels using data from the School Health Statistics Survey in Japan from 2006 to 2019. We calculated the age-standardized prevalence of asthma for each year, gender, regional urbanization level, and annual percent change (APC). In addition, the slope index of inequality (SII) and relative index of inequality (RII) were calculated for evaluating disparity in age-standardized asthma prevalence depending on regional urbanization levels. Moreover, we calculated the mean of the annual average values by regional urbanization levels for sulfur dioxide (SO2), nitrogen dioxide (NO2), suspended particulate matter (SPM), carbon monoxide (CO), and photochemical oxidant (Ox) from 2006 to 2018. We found that the age-standardized prevalence significantly decreased in the periods in the metropolis for males and females, and the degree of the decrease was largest in the metropolis. Conversely, the age-standardized prevalence increased in towns and villages, and the APC was greater than zero. In addition, both the SII and RII showed significant decreasing trends in the study period, and the regional disparity shrank over the years. Moreover, concentrations of the air pollutants were highest in the metropolis throughout the years except for Ox, whereas the difference in the concentrations of NO2, SPM, and CO decreased between the metropolis and the other areas over the years. In conclusion, disparity in asthma prevalence depending on regional urbanization level decreased from 2006 to 2019, and there is a possibility that regional difference in trend of the air pollutants is related to the result.
虽然已知日本大都市地区儿童哮喘患病率往往较高，但近年来尚未对哮喘患病率与区域城市化水平之间的趋势进行调查。我们利用2006年至2019年日本学校健康统计调查的数据，按区域城市化水平调查了儿童哮喘患病率趋势和空气污染物浓度。我们计算了每年、性别、区域城市化水平和年度百分比变化（APC）的年龄标准化哮喘患病率。此外，还计算了不平等斜率指数（SII）和不平等相对指数（RII），以评估年龄标准化哮喘患病率在区域城市化水平方面的差异。此外，我们计算了2006年至2018年按区域城市化水平划分的二氧化硫（SO2）、二氧化氮（NO2）、悬浮颗粒物（SPM）、一氧化碳（CO）和光化学氧化剂（Ox）年平均值的均值。我们发现，大都市地区男性和女性的年龄标准化患病率在研究期间显著下降，且下降幅度在大都市地区最大。相反，城镇和乡村的年龄标准化患病率上升，APC大于零。此外，SII和RII在研究期间均呈现显著下降趋势，多年来区域差异缩小。此外，除Ox外，大都市地区全年空气污染物浓度最高，而多年来大都市地区与其他地区之间NO2、SPM和CO浓度的差异有所减小。总之，2006年至2019年，哮喘患病率在区域城市化水平方面的差异有所下降，空气污染物趋势的区域差异有可能与这一结果相关。
