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在一个对化学气味不耐受的社区样本中,心肺疾病风险增加:对女性健康和医疗保健利用的影响。

Increased cardiopulmonary disease risk in a community-based sample with chemical odor intolerance: implications for women's health and health-care utilization.

作者信息

Baldwin C M, Bell I R

机构信息

Respiratory Sciences Center, Department of Medicine, University of Arizona, Tucson, USA.

出版信息

Arch Environ Health. 1998 Sep-Oct;53(5):347-53. doi: 10.1080/00039899809605720.

Abstract

Chemical intolerance, or reported illness from odors of common environmental chemicals (e.g., car exhaust, pesticides), is emerging as an important environmental and public health-care issue. Epidemiologic methods provide relevant heuristic devices for studies of complex disorders, such as chemical intolerance. The authors examined personal and reported parental cardiopulmonary disease prevalence rates in a community sample of chemically intolerant and control individuals. A county government (Tucson, Arizona) employee and kin subset (N = 181; 113 households) completed standard health questionnaires. Investigators determined chemical intolerance (n = 41/181) from self-reports of individuals who felt "moderately" to "severely" ill from exposure to at least three of five chemicals (i.e., car exhaust, pesticides, paint, new carpet, and perfume) on a Chemical Odor Intolerance Index. The authors chose the control group (n = 57/181) on the basis of self-reports of "never" feeling ill on the Chemical Odor Intolerance Index. The chemically intolerant group, which primarily comprised women (78% versus 51% of controls, p < .05), was significantly more likely to report-and to have sought--medical attention for heart problems, bronchitis, asthma, and pneumonia. Reports of heart problems in the chemically intolerant index cases and the occurrence of heart disease in both of their parents were significant (Fisher's p < .05). The chemically intolerant individuals were also significantly more likely to report maternal histories of chest problems (e.g., inhalant allergens, tuberculosis) than controls. The findings of the study suggested that the chemically intolerant individuals (a preponderance of whom were women [sex-related risk]) were more likely to have (a) reported cardiopulmonary problems (i.e., greater health risk); (b) actively sought medical care for these problems (i.e., increased medical utilization); and (c) reported more parental illnesses-particularly heart disease, asthma, and diabetes (i.e., genetic risk). Additional community-based studies of chemical intolerance are needed.

摘要

化学物质不耐受,即因常见环境化学物质(如汽车尾气、农药)的气味而引发的疾病,正逐渐成为一个重要的环境与公共卫生保健问题。流行病学方法为研究诸如化学物质不耐受这类复杂病症提供了相关的启发式手段。作者在一个由化学物质不耐受个体和对照个体组成的社区样本中,调查了个人及所报告的父母患心肺疾病的患病率。一个县政府(亚利桑那州图森市)的员工及其亲属子集(N = 181;113户家庭)完成了标准健康问卷。研究人员根据个体在化学气味不耐受指数上的自我报告,确定化学物质不耐受情况(n = 41/181),这些个体表示接触五种化学物质(即汽车尾气、农药、油漆、新地毯和香水)中的至少三种后会感到“中度”至“重度”不适。作者根据在化学气味不耐受指数上“从未”感到不适的自我报告选择了对照组(n = 57/181)。化学物质不耐受组主要由女性组成(78%,而对照组为51%,p < .05),该组因心脏问题、支气管炎、哮喘和肺炎而去报告并寻求医疗护理的可能性显著更高。化学物质不耐受指数病例中关于心脏问题的报告以及他们父母双方患心脏病的情况都很显著(费舍尔检验p < .05)。与对照组相比,化学物质不耐受个体报告其母亲有胸部问题(如吸入性过敏原、肺结核)病史的可能性也显著更高。该研究结果表明,化学物质不耐受个体(其中大多数为女性[与性别相关的风险])更有可能(a)报告心肺问题(即更大的健康风险);(b)积极就这些问题寻求医疗护理(即医疗利用率增加);以及(c)报告更多父母的疾病——尤其是心脏病、哮喘和糖尿病(即遗传风险)。需要开展更多基于社区的化学物质不耐受研究。

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