Xing Yuhan, Wang Maggie H, Leung Ting-Fan, Wong Chun-Kwok, Roponen Marjut, Schaub Bianca, Li Jing, Wong Gary W K
Department of Paediatrics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China.
Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China.
Allergy. 2022 Oct;77(10):2949-2960. doi: 10.1111/all.15365. Epub 2022 May 18.
Asthma is one of the most common chronic diseases in childhood, and the prevalence has been increasing over the past few decades. One of the most consistent epidemiological findings is that children living in a farming or rural environment are protected from development of asthma and allergies, but the protective factors in rural China are not clear.
A community-based, cross-sectional epidemiological study was performed in a total of 17,587 children aged 5-8 years, 3435 from Hong Kong (urban) and 14,152 from Conghua (rural county in southern China). Asthma and allergic symptoms as well as environmental exposures were ascertained by using a standardized and validated questionnaire.
The prevalence of current wheeze was significantly lower in rural Conghua than that of urban Hong Kong (1.7% vs. 7.7%, p < 0.001). A lower rate of asthma ever was also reported in rural children compared with their urban counterparts (2.5% vs. 5.3%, p < 0.001). After adjusting for confounding factors, exposure to agricultural farming (adjusted odds ratio 0.74, 95% confidence interval: 0.56-0.97) and poultry (0.75, 0.59-0.96) were the most important factors associated with the asthma-protective effect in the rural area. Further propensity score-adjusted analysis indicated that such protection conferred by living in the rural environment was mainly attributable to poultry exposure.
We confirmed that the prevalence of asthma and atopic disorders was significantly lower in rural children when compared with their urban peers. Exposure to poultry and agricultural farming are the most important factors associated with asthma protection in the rural area.
哮喘是儿童期最常见的慢性病之一，在过去几十年中患病率一直在上升。最一致的流行病学发现之一是，生活在农业或农村环境中的儿童患哮喘和过敏症的几率较低，但中国农村的保护因素尚不清楚。
对17587名5至8岁儿童进行了一项基于社区的横断面流行病学研究，其中3435名来自香港（城市），14152名来自从化（中国南方的农村县）。通过使用标准化和经过验证的问卷确定哮喘和过敏症状以及环境暴露情况。
从化农村地区当前喘息的患病率显著低于香港城市地区（1.7%对7.7%，p<0.001）。农村儿童报告的哮喘既往患病率也低于城市儿童（2.5%对5.3%，p<0.001）。在调整混杂因素后，从事农业生产（调整后的优势比为0.74，95%置信区间：0.56-0.97）和接触家禽（0.75，0.59-0.96）是农村地区与哮喘保护作用相关的最重要因素。进一步的倾向评分调整分析表明，生活在农村环境中所带来的这种保护主要归因于接触家禽。
我们证实，农村儿童哮喘和特应性疾病的患病率显著低于城市同龄人。接触家禽和从事农业生产是农村地区与哮喘保护相关的最重要因素。
