Ernst P, Demissie K, Joseph L, Locher U, Becklake M R
Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada.
Am J Respir Crit Care Med. 1995 Aug;152(2):570-5. doi: 10.1164/ajrccm.152.2.7633709.
Differential access and utilization of medical care by the poor and rich may contribute to differences in asthma prevalence. We therefore studied the relationship of socioeconomic status (SES) to various indicators of asthma in the Canadian context of universal access to medical care. Information on respiratory symptoms, demographics, and home exposures of 1,111 primary school children was collected by questionnaire. Parental occupation was used to establish SES. Exercise-induced bronchospasm (EIB) after a 6-min free-running test was our measure of airways responsiveness and was available for 989 children. As compared with children from the most advantaged homes, children from the least advantaged homes were more likely to present EIB (OR: 2.26, 95% CI: 1.12 to 4.58) and to report night cough (OR: 2.30, 95% CI: 1.04 to 5.06) and cough with mucus (OR: 3.15, 95% CI: 1.06 to 9.33), while there was no significant excess of the report of wheeze or diagnosed asthma. Among factors potentially linked to SES, the presence of a cat at home (OR: 1.63, 95% CI: 1.02 to 2.61) and lower respiratory infection before 2 yr of age were associated with an excess of EIB (OR: 1.71, 95% CI: 1.16 to 2.52). Our results suggest that unidentified environmental factors contribute to the excess asthma morbidity in poor children.
贫困人群和富裕人群在医疗服务获取和利用上的差异可能导致哮喘患病率的不同。因此，在加拿大全民享有医疗服务的背景下，我们研究了社会经济地位（SES）与哮喘各项指标之间的关系。通过问卷调查收集了1111名小学生的呼吸道症状、人口统计学信息及家庭暴露情况。用父母职业来确定社会经济地位。通过6分钟自由跑步测试后的运动诱发性支气管痉挛（EIB）作为我们衡量气道反应性的指标，989名儿童有该数据。与家境最优越的儿童相比，家境最贫困的儿童更易出现运动诱发性支气管痉挛（比值比：2.26，95%可信区间：1.12至4.58），更易报告夜间咳嗽（比值比：2.30，95%可信区间：1.04至5.06）和咳痰咳嗽（比值比：3.15，95%可信区间：1.06至9.33），而喘息报告或确诊哮喘并无显著增加。在可能与社会经济地位相关的因素中，家中养猫（比值比：1.63，95%可信区间：1.02至2.61）以及2岁前下呼吸道感染与运动诱发性支气管痉挛增加相关（比值比：1.71，95%可信区间：1.16至2.52）。我们的结果表明，不明环境因素导致贫困儿童哮喘发病率过高。
