Li Sai, Cao Suzhen, Duan Xiaoli, Zhang Yaqun, Gong Jicheng, Xu Xiangyu, Guo Qian, Meng Xin, Zhang Junfeng
School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China.
Gansu Provincial Design and Research Institute of Environmental Science, Lanzhou, China.
J Thorac Dis. 2022 May;14(5):1725-1737. doi: 10.21037/jtd-21-1380.
The prevalence of asthma and allergic diseases has increased rapidly in Chinese cities over the past decades. Few studies have examined the potential role of household mold in asthma and allergies in Chinese cities.
A cross-sectional survey in 4,691 school-age children was performed in Lanzhou and Wuhan. The two cities represent distinct climate conditions, as Lanzhou, located in northwestern China, has dry and cold winter and relatively cool summer whereas Wuhan, located in central-southern China, has hot and humid summer and mild winter temperatures. Two schools were randomly selected from a suburb and an urban area of each city, respectively. Data were collected using a modified Chinese version of the American Thoracic Society (ATS) standard respiratory health questionnaire for children, regarding asthma, substance allergy, allergic rhinitis, presence of mold in residence, and household characteristics. Logistic regression models were applied to identify the odds ratios of childhood asthma and allergies with regard to mold.
The prevalence rates of asthma, substance allergy, allergic rhinitis, and mold, were all higher in Wuhan than in Lanzhou. We observed significant associations of household mold with increased prevalence for both asthma [odds ratio (OR) =2.399, 95% confidence interval (95% CI): 1.309-4.398], substance allergy (OR =1.729, 95% CI: 1.282-2.332) and allergic rhinitis (OR =1.969, 95% CI: 1.491-2.600), with spatial heterogeneity across urban versus suburban schools. The mold effect was modified by age group and breast-feeding status.
Across two climatically distinct cities, household mold exposure was significantly associated with an increased risk for asthma and allergies. Younger children and children from the suburbs were more likely to be affected by mold. Whether breastfeeding enhanced or weakened the mold effects were inconsistent across the cities and across the health outcomes.
在过去几十年中，中国城市哮喘和过敏性疾病的患病率迅速上升。很少有研究探讨家庭霉菌在中国城市哮喘和过敏中的潜在作用。
在兰州和武汉对4691名学龄儿童进行了横断面调查。这两个城市代表了不同的气候条件，位于中国西北部的兰州冬季干燥寒冷，夏季相对凉爽，而位于中国中南部的武汉夏季炎热潮湿，冬季气温温和。分别从每个城市的一个郊区和一个市区随机选取两所学校。使用经修改的中文版美国胸科学会（ATS）儿童标准呼吸健康问卷收集数据，内容涉及哮喘、物质过敏、过敏性鼻炎、住所内霉菌情况以及家庭特征。应用逻辑回归模型确定儿童哮喘和过敏与霉菌相关的比值比。
武汉哮喘、物质过敏、过敏性鼻炎和霉菌的患病率均高于兰州。我们观察到家庭霉菌与哮喘患病率增加[比值比（OR）=2.399，95%置信区间（95%CI）：1.309 - 4.398]、物质过敏（OR =1.729，95%CI：1.282 - 2.332）和过敏性鼻炎（OR =1.969，95%CI：1.491 - 2.600）均存在显著关联，且城市学校与郊区学校存在空间异质性。霉菌效应因年龄组和母乳喂养状况而有所改变。
在两个气候不同的城市中，家庭接触霉菌与哮喘和过敏风险增加显著相关。年龄较小的儿童和郊区儿童更容易受到霉菌影响。母乳喂养对霉菌效应是增强还是减弱，在不同城市和不同健康结局中并不一致。
