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马来西亚 Tasik Chini 的原住民肺部功能相关因素:一项横断面研究。

Factors related with lung functions among Orang Asli in Tasik Chini, Malaysia: a cross-sectional study.

机构信息

Department of Public Health Medicine, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, 56000, Malaysia.

出版信息

BMC Public Health. 2024 Jul 5;24(1):1791. doi: 10.1186/s12889-024-19296-x.

Abstract

BACKGROUND

Orang Asli lifestyle and household setting may influence their health status especially respiratory system and lung functions. This cross-sectional study was carried out to investigate the status of lung functions of Orang Asli community and the associated factors.

METHODS

Data collection was carried out from November 2017 until May 2018 among 211 Orang Asli respondents aged 18 years old and above, who lived in five villages in Tasik Chini, Pahang. All respondents who fulfilled the inclusion criteria were recruited in this study. Interview-guided questionnaire was administered, and spirometry test that include Forced Expiratory Volume in one second (FEV, Forced Vital Capacity (FVC), and Peak Expiratory Flow Rate (PEFR) was carried out. Data were analyzed using SPSS software version 23.0. In the first stage, descriptive analysis was done to describe the characteristics of the respondents. In the second stage, bivariable analysis was carried out to compare proportions. Finally, multiple logistic regression was performed to assess the effects of various independent predictors on spirometry parameters.

RESULTS

The respondents' age ranged from 18 to 71 years old in which 50.2% of them were female. The majority ethnicity in Tasik Chini was Jakun tribe (94.3%). More than half of the respondents (52.1%) were current smoker, 5.2% were ex-smoker and 41.7% were non-smoker. More than half of them (62.1%) used woodstove for cooking, compared to only 37.9% used cleaner fuel like Liquefied Petroleum Gas (LPG) as a fuel for everyday cooking activity. The lung function parameters (FEV and FVC) were lower than the predictive value, whereas the ratio of Forced Expiratory Volume in one second and Forced Vital Capacity (FEV/FVC) (%) and PEFR were within the predictive value. The FEV levels were significantly associated with age group (18-39 years old) (p = 0.002) and presence of woodstove in the house (p = 0.004). FVC levels were significantly associated with presence of woodstove in the house (p = 0.004), whereas there were no significant associations between all factors and FEV/FVC levels.

CONCLUSIONS

FEV levels were significantly associated with age group 18-39 years old, whereas FVC levels were significantly associated with the presence of woodstove in the house. Thus, environmental interventions such as replacing the use of woodstove with LPG, need to be carried out to prevent further worsening of respiratory health among Orang Asli who lived far from health facilities. Moreover, closer health monitoring is crucial especially among the younger and productive age group.

摘要

背景

马来原住民的生活方式和家庭环境可能会影响他们的健康状况,尤其是呼吸系统和肺部功能。本横断面研究旨在调查马来原住民社区的肺部功能状况及其相关因素。

方法

数据收集于 2017 年 11 月至 2018 年 5 月期间进行,共有 211 名 18 岁及以上居住在彭亨州 Tasik Chini 五个村庄的马来原住民受访者参与。所有符合纳入标准的受访者均被纳入本研究。采用访谈引导式问卷进行调查,并进行了包括一秒用力呼气容积(FEV)、用力肺活量(FVC)和呼气峰流速(PEFR)在内的肺功能测试。使用 SPSS 软件版本 23.0 对数据进行分析。在第一阶段,进行描述性分析以描述受访者的特征。在第二阶段,进行了两变量分析以比较比例。最后,进行了多变量逻辑回归分析,以评估各种独立预测因素对肺功能参数的影响。

结果

受访者的年龄在 18 至 71 岁之间,其中 50.2%为女性。Tasik Chini 的主要族群是杰昆部落(94.3%)。超过一半的受访者(52.1%)是当前吸烟者,5.2%是前吸烟者,41.7%是非吸烟者。他们中有一半以上(62.1%)使用柴火炉做饭,相比之下,只有 37.9%使用更清洁的燃料,如液化石油气(LPG)作为日常烹饪活动的燃料。肺功能参数(FEV 和 FVC)低于预测值,而一秒用力呼气容积与用力肺活量的比值(FEV/FVC)(%)和呼气峰流速处于预测值范围内。FEV 水平与年龄组(18-39 岁)显著相关(p=0.002),与家中有柴火炉显著相关(p=0.004)。FVC 水平与家中有柴火炉显著相关(p=0.004),而与 FEV/FVC 水平之间没有显著关联。

结论

FEV 水平与 18-39 岁年龄组显著相关,而 FVC 水平与家中有柴火炉显著相关。因此,需要进行环境干预,例如用 LPG 取代柴火炉的使用,以防止远离医疗机构的马来原住民的呼吸健康状况进一步恶化。此外,特别是在年轻和生产年龄段,更需要密切的健康监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9608/11225401/0a0830439692/12889_2024_19296_Fig1_HTML.jpg

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