Goren A I
Institute for Environmental Research, Ministry of the Environment and Sackler School of Medicine, Tel-Aviv University, Israel.
J Expo Anal Environ Epidemiol. 1993;3 Suppl 1:211-27.
During spring 1984, second and fifth grade schoolchildren living in three Haifa Bay areas on the eastern Mediterranean coast, with different levels of air pollution, were studied. The parents of these children filled out ATS-NHLI (American Thoracic Society and the National Heart and Lung Institute) health questionnaires and the children performed PFT (Pulmonary Function Tests). A trend of higher prevalence of most reported respiratory symptoms was found for schoolchildren growing up in the medium and high polluted areas as compared with the low pollution area. Logistic models fitted for the respiratory conditions that differed significantly among the three residential areas also included background variables that could be responsible for these differences. Relative risks for respiratory conditions calculated from these models were in the range of 1.38 and 1.81 for children from the polluted area as compared to 1.00 for the low polluted area. All the measured values of PFT were within the normal range, with no consistent reduction in PFT for any residential area. During spring 1989, seventh graders (second graders in 1984) were reexamined and a new cohort of fifth grade children was studied, using the same techniques as in 1984. A very significant rise in the prevalence of most reported respiratory symptoms and diseases was observed among both fifth and seventh grade schoolchildren in 1989 compared to 1984, especially in the low and medium polluted areas and less in the polluted area. Changes over time in PFT in the older cohort were similar in the three areas. PFT of fifth graders in 1984 and in 1989 were very similar. The most significant factor in logistic models fitted for the prevalence of respiratory conditions among the studied schoolchildren in 1989, was the subjective attitude of their parents towards the deleterious effects of air pollution on their children's health, and the subjective estimate of their children's exposure to pollution rather than measured exposure. A huge campaign carried out during the survey against the main polluters in the Haifa Bay area caused both public concern and apparently reporting bias.
1984年春季，对生活在地中海东海岸海法湾三个空气污染程度不同地区的二、五年级学童进行了研究。这些孩子的家长填写了美国胸科学会和国家心肺研究所的健康问卷，孩子们进行了肺功能测试。结果发现，与低污染地区相比，在中度和高度污染地区长大的学童，大多数报告的呼吸道症状患病率呈上升趋势。针对三个居住地区之间有显著差异的呼吸道疾病拟合的逻辑模型，还纳入了可能导致这些差异的背景变量。根据这些模型计算得出，污染地区儿童呼吸道疾病的相对风险在1.38至1.81之间，而低污染地区为1.00。所有肺功能测试测量值均在正常范围内，任何居住地区的肺功能测试值均无持续下降。1989年春季，对七年级学生（1984年的二年级学生）进行了复查，并使用与1984年相同的技术对新一批五年级学生进行了研究。与1984年相比，1989年五、七年级学童中大多数报告的呼吸道症状和疾病患病率都有非常显著的上升，尤其是在低污染和中度污染地区，在高污染地区上升幅度较小。三个地区年龄较大队列的肺功能测试随时间的变化情况相似。1984年和1989年五年级学生的肺功能测试非常相似。在针对1989年所研究学童呼吸道疾病患病率拟合的逻辑模型中，最重要的因素是其父母对空气污染对孩子健康有害影响的主观态度，以及对孩子接触污染情况的主观估计，而非实际测量的接触情况。在调查期间针对海法湾地区主要污染源开展的大规模宣传活动，既引起了公众关注，也显然导致了报告偏差。
