Zhang Lizhou, Liabsuetrakul Tippawan
School of Humanities and Management, Guangdong Medical University, Dongguan, 523808, China.
Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand.
BMC Public Health. 2024 Dec 20;24(1):3548. doi: 10.1186/s12889-024-20970-3.
Living near waste incineration plants (WIPs) may have adverse effects on health associated with quality of life (QOL) among local residents. This study was undertaken to measure the QOL of residents living near WIPs in China, identify the association between residential distance from the WIPs and QOL, and assess the mediating effect of respiratory symptoms on the association between residential distance and QOL.
A cross-sectional study was conducted in communities surrounding three municipal WIPs in Dongguan, China. The QOL using the WHOQOL-BREF and respiratory symptoms using the Medical Research Council Questionnaire (MRCQ) on Respiratory Symptoms were measured in 881 residents (454 living 3 km of their local WIP vs. 427 living 3-8 km from the WIP). Differences in respiratory symptoms and QOL in two separate items and four domains were analyzed. The associations of distance with respiratory symptoms and QOL were evaluated by multiple linear regression and logistic regression, respectively. Mediating effect of respiratory symptoms on the association between distance and QOL were tested using mediation analysis.
Compared with the 3-8 km group, residents in the 0-3 km group had significantly lower scores in the physical health domain (β= - 2.02, p = 0.027), social relationships domain (β= - 2.47, p = 0.016) and environment domain (β= - 3.55, p < 0.001). There were no significant associations between distance and psychological domain, overall QOL, and satisfaction with health after adjusting for other variables. Residents in the 0-3 km group were more likely to report respiratory symptoms than residents in the 3-8 km group (OR = 1.46, 95%CI 1.09-1.96, p = 0.011). Respiratory symptoms had a significant effect on physical health (β= - 7.48, p < 0.001), social relationships (β= - 5.02, p < 0.001) and environment domains (β= - 7.28, p < 0.001). Respiratory symptoms fully mediated the association of residential distance on physical health (31.7%), and partially mediated the associations of residential distance on social relationships (18.8%) and environment domains (17.3%).
Residential distance from a WIP was significantly associated with QOL, and the association between residential distance and QOL was mediated by respiratory symptoms. Future longitudinal studies on adverse respiratory health effects of exposure to WIP emissions are required using objective assessments.
居住在垃圾焚烧厂（WIPs）附近可能会对当地居民的健康产生与生活质量（QOL）相关的不利影响。本研究旨在测量中国垃圾焚烧厂附近居民的生活质量，确定居民与垃圾焚烧厂的居住距离与生活质量之间的关联，并评估呼吸道症状在居住距离与生活质量之间关联中的中介作用。
在中国东莞三个城市垃圾焚烧厂周边社区进行了一项横断面研究。对881名居民（454名居住在距离当地垃圾焚烧厂3公里以内，427名居住在距离垃圾焚烧厂3 - 8公里处）使用世界卫生组织生活质量简表（WHOQOL - BREF）测量生活质量，使用医学研究理事会呼吸症状问卷（MRCQ）测量呼吸道症状。分析了两个单独项目和四个领域中呼吸道症状和生活质量的差异。分别通过多元线性回归和逻辑回归评估距离与呼吸道症状和生活质量的关联。使用中介分析测试呼吸道症状在距离与生活质量关联中的中介作用。
与3 - 8公里组相比，0 - 3公里组居民在身体健康领域（β = - 2.02，p = 0.027）、社会关系领域（β = - 2.47，p = 0.016）和环境领域（β = - 3.55，p < 0.001）的得分显著更低。在调整其他变量后，距离与心理领域、总体生活质量和对健康的满意度之间没有显著关联。0 - 3公里组居民比3 - 8公里组居民更有可能报告呼吸道症状（OR = 1.46，95%CI 1.09 - 1.96，p = 0.011）。呼吸道症状对身体健康（β = - 7.48，p < 0.001）、社会关系（β = - 5.02，p < 0.001）和环境领域（β = - 7.28，p < 0.001）有显著影响。呼吸道症状完全介导了居住距离与身体健康之间的关联（31.7%），部分介导了居住距离与社会关系（18.8%）和环境领域（17.3%）之间的关联。
与垃圾焚烧厂的居住距离与生活质量显著相关，居住距离与生活质量之间的关联由呼吸道症状介导。未来需要使用客观评估方法对接触垃圾焚烧厂排放物对呼吸道健康产生的不利影响进行纵向研究。
