中国非吸烟女性肺癌危险因素的病例-对照研究

目的探讨中国非吸烟女性患肺癌的危险因素。方法应用1∶2配对的病例对照方法,收集2001年9月~2004年2月在北京、上海和成都指定医院经病理诊断确诊的非吸烟女性新发肺癌住院病例157例,按照性别、年龄(±2岁)、不吸烟等配对因素选取医院对照和人群对照。利用统一调查表对调查对象进行面对面问卷调查,收集病例和对照有关危险因素的暴露史等情况。通过单因素分析和多因素条件Logistic回归分析筛选肺癌的主要危险因素。结果单因素分析发现28个暴露因素与非吸烟女性肺癌发生有关。多因素分析发现,被动吸烟指数≥50人年(OR=1·77,95%CI为1·07~2·92)、经常吃动物内脏(OR=1·85,95%CI为1·06~3·22)、职业接触粉尘(OR=2·47,95%CI为1·21~5·03)和工作场所通风不良(OR=4·02,95%CI为1·74~9·29)为非吸烟女性肺癌发生的危险因素;常吃蔬菜(OR=0·26,95%CI为0·12~0·59)、经常服用维生素(OR=0·53,95%CI为0·30~0·93)、结婚后家庭人均月收入≥500元(OR=0·50,95%CI为0·28~0·91)和初次生育年龄在24~30岁之间(OR=0·53,95%CI为0·32~0·90)为非吸烟女性肺癌发生的保护因素。趋势性检验发现,被动吸烟与非吸烟女性发生肺癌的相对危险度之间存在一定剂量反应关系。结论被动吸烟、职业接触粉尘、经常吃动物内脏和工作场所通风不良会增加非吸烟女性患肺癌的危险性。常吃蔬菜和经常服用维生素等因素可以降低非吸烟女性发生肺癌的危险性。     

2005-2014年中国儿童哮喘与过敏体质、家族史、被动吸烟病例对照研究的Meta分析

目的采用病例对照研究Meta分析了解2005-2014年中国儿童哮喘与过敏体质、家族史、被动吸烟的相关性。方法选取2005-2014年在权威杂志上发表的中国儿童哮喘与过敏体质、家族史、被动吸烟相关的文献报道作为研究材料,采用病例对照研究Meta分析的研究方法分析中国儿童哮喘与过敏体质、家族史及被动吸烟的相关性。结果 2005-2014年在中国期刊全文数据库和中国生物医学文献数据库中发表的关于过敏体质与中国儿童哮喘的病例对照研究中,过敏体质与中国儿童哮喘的总相关OR值达13.4,95%CI可信区间为4.27~18.64,家族史与中国儿童哮喘的总相关OR值达5.32,95%CI可信区间为2.41~23.62,被动吸烟与中国儿童哮喘的总相关OR值达3.19,95%CI可信区间为1.46~2.82。结论 2005-2014年中国儿童哮喘相关危险因素的病例对照研究Meta分析表明:过敏体质、家族史及被动吸烟是导致儿童哮喘发生的危险因素,且过敏体质是造成儿童哮喘的主要危险因素。     

室内空气污染与儿童哮喘病例-对照调查

目的 探讨室内空气污染与儿童哮喘的关系.方法 采用国际儿童哮喘研究(ISAAC)统一调查方案,在北京市顺义区25所小学生普查的基础上,筛选6～10岁儿童哮喘阳性病例403例,对照806例,进行病例-对照调查.结果 被动吸烟和家庭燃煤取暖、烹调等可增加儿童哮喘的危险性.母亲怀孕期家中有1、2～3和3人以上亲属在母亲面前吸烟,则儿童哮喘的危险性可分别增加10%、20%和2.3倍(OR 1.1,95% CI:0.8～1.5;OR 1.2,95% CI:0.9～1.6;OR 3.3,95% CI:1.9～5.9);孩子出生后家中有1、2 ～3和3人以上在孩子面前吸烟可分别增加儿童哮喘危险性30%、40%和1.6倍(OR 1.3,95% CI:1.0～1.8;OR 1.4,95% CI:1.1～2.0;OR 2.6,95% CI:1.5～4.4);家庭燃煤取暖和烹调可增加儿童哮喘危险性50%和60%(OR 1.5,95% CI:1.1～1.9;OR 1.6,95% CI:0.8～2.8);在厨房烹调时,偶尔使用或不使用排风扇,可增加危险性40%和60%(OR 1.4,95% CI:09～2.1.OR 1.6.95% CI:1.2～2.1).结论 被动吸烟和家庭燃煤取暖烹调均是增加儿童哮喘的主要危险因素.     

母乳喂养与被动吸烟对儿童哮喘及哮喘样症状的交互作用

目的 探讨母乳喂养与被动吸烟的交互作用对儿童哮喘及哮喘样症状的影响.方法 采用整群随机抽样法在辽宁省7个城市各抽取1所小学和2所幼儿园,共25所小学和50所幼儿园,对所选学校所有在此居住满2年的31 049名儿童的喂养方式、居住环境、被动吸烟等情况及呼吸系统疾病与症状的信息进行收集.采用Glimmix回归模型分析母乳喂养与被动吸烟的交互作用对儿童哮喘及哮喘样症状(持续咳嗽、持续咳痰、喘鸣现患、过敏性鼻炎)的影响.结果 在调查的31 049名儿童中,年龄为(8.32±2.75)岁,母乳喂养的儿童有23 987名,母乳喂养率为77.26％;被动吸烟的儿童有11 820名,被动吸烟率为38.07％.母乳喂养的儿童哮喘、过敏性鼻炎阳性率分别为6.22％(1491/23 987)、4.67％(1120/23 987),非母乳喂养的儿童分别为7.70％(544/7062)、5.48％(387/7062).母乳喂养儿童发生哮喘(OR=0.79,95％ CI:0.72～0.88)、过敏性鼻炎(OR =0.85,95％CI:0.75～0.95)的风险较低.父亲吸烟的儿童喘鸣现患阳性率为7.89％(929/11 770),父亲未吸烟的儿童为5.37％(1036/19 279),父亲吸烟的儿童发生喘鸣现患(OR=1.51,95％CI:1.38 ～1.65)的风险较高.母亲吸烟的儿童持续咳嗽阳性率为18.96％(51/269),母亲未吸烟的儿童为9.51％(2926/30 780),母亲吸烟的儿童发生持续咳嗽(OR =2.23,95％ CI:1.64～3.03)的风险较高.家中其他任何人吸烟的儿童持续咳痰阳性率为5.69％(871/15 316),家中无人吸烟的儿童为3.50％(550/15 733),家中其他任何人吸烟的儿童发生持续咳痰(OR=1.67,95％CI:1.49～ 1.86)的风险较高.Glimmix回归模型分析显示,母乳喂养与被动吸烟对儿童哮喘及哮喘样症状存在交互影响:在父亲吸烟暴露下,母乳喂养的儿童发生哮喘的风险低于非母乳喂养儿童;在母亲吸烟暴露下,母乳喂养的儿童发生过敏性鼻炎的风险低于非母乳喂养儿童;在家中其他任何人吸烟暴露下,母乳喂养的儿童发生哮喘、过敏性鼻炎的风险低于非母乳喂养儿童(P值均＜0.05).结论 母乳喂养使被动吸烟的儿童发生哮喘及哮喘样症状的风险降低.     

中山市居室内被动吸烟对儿童哮喘及哮喘样症状的影响

目的探讨中山市居室内被动吸烟对儿童哮喘及哮喘样症状的影响。方法于2016年3—7月在中山市城区采用随机整群抽样方法抽取小学和初中各5所,共有效调查11 611名儿童,采用国际统一的标准问卷[美国胸科协会制定的标准呼吸卫生调查表(ATS)]调查所选学生的哮喘及哮喘样症状及家庭室内被动吸烟等情况,分析被动吸烟对儿童哮喘和哮喘样症状的影响。结果中山市儿童的持续咳嗽、持续咯痰、喘鸣、哮喘和哮喘现患的检出率分别为2.85%(331/11 611),1.20%(139/11 611),6.93%(805/11 611),5.70%(662/11 611)和1.46%(169/11 611),有30.9%(3 588/11 611)的儿童暴露于二手烟。室内被动吸烟、母亲吸烟、母亲妊娠期被动吸烟和两岁前被动吸烟均对儿童哮喘和哮喘样症状有不同程度的影响(P0.05);家庭成员每日吸烟量≥5支的儿童哮喘现患率(OR=3.66,95%CI:1.68~8.01)和喘鸣发生率(OR=1.76,95%CI:1.04~2.97)均高于非吸烟组,差异均有统计学意义(P0.05)。多因素非条件logistic回归分析显示,两岁前被动吸烟是儿童哮喘及哮喘样症状的危险因素(OR值为1.51~2.03),室内被动吸烟是儿童持续咯痰的危险因素(OR=1.61,95%CI:1.11~2.35),均有统计学意义(P0.05)。结论中山市室内被动吸烟是儿童哮喘及哮喘样症状的危险因素,尤其是两岁前被动吸烟。     

武汉地区肺癌新病例危险因素病例对照研究

目的：探讨武汉地区肺癌主要危险因素。方法：对183例肺癌患者和183例对照进行1：1配比病例对照研究，并用Logistic回归对所获资料举行单因素和多因素分析。结果：单因素分析结果表明，呼吸系统疾病史(慢性支气管炎病史OR＝2．90，其他呼吸系统疾病OR＝3．65)，吸烟(OR＝2．33)、家庭被动吸烟(OR＝1．69)、工作场所被动吸烟(OR＝1．72)、处于精神压抑(OR＝2．07)是武汉地区肺癌主要危险因素；在单因素分析基础上，多因素分析结果仅发现慢性支气管炎(OR＝2．92)、吸烟(OR＝4．09)、工作场所被动吸烟(OR＝1．95)为肺癌主要危险因素。结论：调查结果提示，武汉地区肺癌应针对慢性支气管炎、吸烟和工作场所被动吸烟因素开展一级预防。     

孕妇被动吸烟与小于胎龄儿关系的Meta分析

目的 探讨孕妇孕期被动吸烟与小于胎龄儿之间的关系,分析不同孕期和不同地点被动吸烟的效应.方法 利用Meta分析方法综合分析国内外8篇关于孕妇孕期被动吸烟与小于胎龄儿关系的回顾性研究文献.结果 孕妇孕期被动吸烟与小于胎龄儿之间的粗合并效应值OR=1.45(95%CI:1.05～2.01),调整合并效应值OR=1.76(95%CI:1.15～2.69);孕妇孕早期被动吸烟的合并效应值OR=1.85(95%CI:1.25～2.72),孕中晚期被动吸烟的合并效应值OR=2.12(95%CI:1.43～3.13);家庭和工作中被动吸烟与小于胎龄儿之间的关系均没有统计学意义.结论 孕妇孕期被动吸烟可增加发生小于胎龄儿的危险性.除了家庭和工作环境外,还应注意其他环境的被动吸烟.     

被动吸烟与儿童哮喘关系的病例对照研究

【目的】探讨被动吸烟与儿童哮喘的关系。【方法】应用1：1配对的病例对照研究方法，调查和分析儿童及其母亲在孕期被动吸烟情况与儿童哮喘的关系。【结果】131对对照病例，经条件Logistic回归分析，父亲吸烟、吸烟年限、吸烟量与子女的哮喘有关，并随着吸烟年限及吸烟量的增加，子女哮喘的危险性增加，父亲既吸烟又饮酒增加儿童哮喘的危险性。在母亲孕期父亲是否在孕妇面前吸烟，都会增加子女哮喘的危险性，且随着吸烟频度及吸烟量的增加，子女哮喘的危险性也增加。提示孕妇及儿童暴露于香烟烟雾环境，都会增加儿童哮喘的危险性。【结论】向父母宣传被动吸烟对哮喘儿童的危害性，争取家庭合作，控制被动吸烟对预防儿童哮喘意义重大。     

室内空气污染与儿童哮喘病例一对照调查

目的探索室内空气污染与儿童哮喘的关系（本课题为北京顺义区儿童哮喘调查的分题之一）。方法采用国际儿童哮喘研究（ISAAC）统一调查方案，在北京顺义区25所小学生普查的基础上，筛选6-10岁儿童哮喘阳性病例403例，对照806例，进行病例．对照调查。结果被动吸烟和家庭燃煤取暖、烹调等可增加儿童哮喘的危险性。母亲怀孕期家中有1人、2-3人和3人以上亲属在母亲面前吸烟，使儿童哮喘的危险性可分别增加10％、20％和2．3倍（OR1．1，95％CI：0．8-1．5，OR1．2，95％CI：0．9-1．6 OR3．3，95％CI：1．9-5．9）；孩子出生后家中有1人、2-3人和3人以上在孩子面前吸烟可分别增加儿童哮喘危险性30％、40％和1．6倍（OR1．3，95％CI：1．0-1．8，OR1．4，95％CI：1．1-2．0，OR2．6，95％CI：1．5-4．4）；家庭燃煤取暖和烹调可增DnJL童哮喘危险性50％和60％（OR1．5，95％CI：1．1-1．9，OR1．6，95％CI：0．8-2．8）；在厨房烹调时，偶尔使用或不使用排风扇，可增加危险性40％和60％（OR1．4，95％CI：0．9-2．1，OR1．6，95％CI：1．2-2．1）。结论被动吸烟和家庭燃煤取暖烹调均足增加儿童哮喘的主要危险因素。     

非吸烟女性被动吸烟与肺癌发生的Meta分析研究

目的　探讨非吸烟女性中 ,被动吸烟与肺癌的关系。方法　通过计算机检索CBM、Medline、中国期刊网、英国国家医学图书馆等 ,并结合文献追溯的方法 ,收集国内外于 1990～ 2 0 0 2年间公开发表的关于非吸烟女性被动吸烟与肺癌的研究文献 ,采用随机效应模型 ,对各研究结果进行Meta分析 ,计算其合并比值比。结果　纳入合并分析的文章共有 14篇 ,合并结果表明 :被动吸烟年限与肺癌的关系无显著意义 ;不同年龄段的被动吸烟与肺癌发病的关系均不显著 (P >0 .0 5 ) ,未成年期和成年期 (婚后 )被动吸烟与肺癌合并OR值分别为 0 .814 1(95 %CI :0 .60 68～ 1.0 92 2 )和 0 .9988(95 %CI :0 .82 0 1～ 1.2 164 ) ;而成年期暴露于丈夫 (配偶 )的合并OR 1.2 784(95 %CI 1.0 3 2 0～ 1.5 83 8) ,关联具有显著意义 ,成年期暴露于工作场所的环境烟草烟雾与肺癌发生的 OR 为 1.0 2 44 (95 % CI:0 .83 2 5～ 1.2 60 6) ,但关联无显著意义。结论　在非吸烟女性中 ,被动吸烟与肺癌的关系仍不明确 ,需要进一步研究和探讨。     

江苏海安地区40岁以上人群支气管哮喘患病率及影响因素

目的探究海安地区40岁以上人群支气管哮喘患病率及其发病的流行病学特征。方法采用分层随机抽样法对江苏海安地区40岁以上常住居民进行问卷调查及肺功能测定,分析哮喘患病情况及流行病学特征。结果研究共收集有效问卷2237份,发现支气管哮喘患者116例,发病率为5.19%;哮喘患病率与性别、年龄、家族史、主被动吸烟、职业暴露、幼年存在肺部疾病史、存在呼吸道过敏史、接触烹饪油烟有关(P<0.05);多因素logistic回归分析显示,男性(OR=0.637,95%CI:0.499~0.691)是哮喘患病的保护因素,高龄(OR=1.438,95%CI:1.207~1.972)、主动吸烟(OR=1.795,95%CI:1.423~2.399)、被动吸烟(OR=2.098,95%CI:1.423~2.399)、职业暴露(OR=3.446,95%CI:2.175~6.290)、幼年存在肺部疾病史(OR=2.228,95%CI:1.337~4.491)、存在呼吸道过敏史(OR=2.287,95%CI:1.535~5.219)是影响哮喘患病的危险因素(P<0.05)。结论海安地区40岁以上人群支气管哮喘患病率偏高,高龄、主被动吸烟、职业暴露、幼年存在肺部疾病史、存在呼吸道过敏史与哮喘患病有关。临床需加强高危人群哮喘防治工作,从而降低哮喘的发病。     

Prevalence of asthma and wheeze in relation to passive smoking in Japanese children

PURPOSE: Evidence remains inconclusive as to whether environmental tobacco smoke is a risk factor for allergic disorders in childhood. The present large-scale cross-sectional study examined the relationship between passive smoking at home and the prevalence of allergic disorders in Japanese schoolchildren. METHODS: Study subjects were 23,044 children aged 6 to 15 years in Okinawa. Outcomes were based on diagnostic criteria from the International Study of Asthma and Allergies in Childhood. Adjustment was made for sex, age, region of residence, number of siblings, paternal and maternal history of asthma, atopic eczema, or allergic rhinitis, as well as paternal and maternal educational level. RESULTS: The prevalence of wheeze, asthma, atopic eczema, and allergic rhinoconjunctivitis in the previous 12 months was 10.7%, 7.6%, 6.8%, and 7.7%, respectively. Current heavy passive smoking and 7.0 or more pack-years of smoking in the household were independently related to an increased prevalence of wheeze and asthma, especially in children 6 to 10 years of age and children with a positive parental allergic history. There was no dose-response relationship between pack-years of smoking in the household and atopic eczema or allergic rhinoconjunctivitis. CONCLUSIONS: Our findings suggested that environmental tobacco smoke might be associated with an increased prevalence of wheeze and asthma in Japanese children.     

诱发儿童哮喘的家庭环境危险因素分析

目的:分析儿童哮喘发病家庭环境的危险因素。方法:选择2009年1月～2011年1月在医院门诊及住院诊断为哮喘患儿400例,以同时期来医院治疗的非呼吸道疾病患儿403例为对照,采用问卷调查法调查与儿童哮喘有关的因素。结果:单因素分析显示,家族哮喘史、家族过敏史、过敏性体质、饲养动物、被动吸烟、使用空调、接触花粉、父母的受教育程度、经常情绪低落的比例哮喘组明显高于对照组,差异有统计学意义(P<0.01)。多因素非条件Logisitc回归分析显示家族哮喘史、过敏史、父母的受教育程度、被动吸烟、饲养动物5个因素差异有统计学意义(P<0.05)。结论:家族哮喘史、过敏史、父母的受教育程度、被动吸烟、饲养动物是儿童哮喘的危险因素,提示平时及时控制纠正与哮喘发生或发作的相关危险因素对儿童哮喘的预防与控制具有重要的实际意义。     

Prognostic factors of severe asthma in Puerto Rico

Asthma in Puerto Rico is a serious Public Health Problem. This study extends our cross-sectional self-reported asthma prevalence survey of 3,000 volunteers. The purpose of the present study was to analyze the importance of known prognostic factors of asthma severity among 486 self-reported participants. Patients with more than one visit to the emergency room in the previous 12 months due to asthma exacerbations were classified as cases of "severe asthma", and those asthmatic patients who did not visit emergency rooms were classified as "non-severe asthmatic subjects". Severe cases and non-severe asthmatic subjects were compared regarding age, sex, family history of asthma, presence of household pets, and in the previous 12 months: history of hospitalization due to asthma, respiratory infections, tobacco smoking, exposure to passive smoking, and avoidance of passive smoking. Crude and logistic regression adjusted odds ratio was used as a measure of association between each prognostic factor, and the outcome namely severe asthma, while adjusting for all confounders simultaneously. The results clearly showed that previous hospitalizations due to asthma (OR = 7.3, p < 0.0001) and frequent of respiratory infection (OR = 2.5, p = 0.0003) were prognostic factors associated with increased asthma severity. A statistically significant, two percent less likelihood to have severe asthma for each year of age was found. Weak associations were found between asthma severity and male gender, family history of asthma, passive smoking, and presence of household pets. Avoidance of environmental tobacco exposure (passive smoking) was found to be an important and statistically significant protective factor associated with a 47% less likelihood for severe asthma. In conclusion, appropriate management of patients with history of hospitalization due to asthma is very important. The correct management of respiratory infection in asthmatic patients may result in a reduction of up to 60 percent of the odds of having asthma severe enough to require emergency treatment, and may reduced by 86.3 percent hospitalizations.     

细胞间黏附分子-1基因多态性与儿童哮喘患病易感性的关系

[目的]研究细胞间黏附分子-1（ICAM-1）基因Lys469Glu和A,．g241Gty位点多态性与儿童哮喘易感性的关系。[方法]对北京某郊区40所小学中的25所进行整群抽样,以1—5年级小学生为研究对象,由家长填写调查问卷。从这些学生中抽取293例病例和668例对照为研究样本,再以问卷调查环境影响因素。采集口腔黏膜细胞提取DNA,采用聚合酶链反应．限制性片段长度多态性方法分析ICAM-1基因多态性,用Logistic回归分析不同基因型与儿童哮喘患病易感性的关系。[结果]ICAM-1Lys469Glu位点变异基因型（AG或GG）和杂合基因型AG均明显降低患哮喘的危险性（P〈0．05）,OR值均为0．73。病例组变异的G等位基因频率为28．5％,对照组为33．0％,两者比较,P=0．058。在有被动吸烟的样本人群中,携带AG或GG基因型的个体患哮喘的危险性是携带州基因型的个体的0．73倍（95％CI为0．52～1．02,P=0．066）o在烧煤做饭和家中有较多老鼠时,携带AG或GG基因型的人发生哮喘的危险性也明显降低（P〈0．05）,OR值分别为0．57（95％a：0．33～0．97）和0．65（95％CI：0．46～0．93）。未发现ICAM-1基因Arg241Gly多态性与儿童哮喘患病的关联。[结论]ICAM-1 Lys469Glu的变异可能与儿童哮喘易感性有关联,并且降低患哮喘的危险性。     

Prediction of asthma in young adults using childhood characteristics: Development of a prediction rule

OBJECTIVE: To develop an easily applicable prediction rule for asthma in young adulthood using childhood characteristics. METHODS: A total of 1,055 out of 1,328 members of a Dutch birth cohort were followed from 2 to 21 years of age. Univariate and multivariate logistic regression analyses were used to evaluate the predictive value of childhood characteristics on asthma at 21 years of age. A prognostic function was developed, and the area under the receiving operating characteristic (ROC) curve was used to estimate the predictive ability of the prognostic models. RESULTS: Of the 693 responding subjects, 86 (12%) were diagnosed with asthma. Independent prognostic factors at ages 2 and 4 years were female gender (odds ratios (OR) 1.9 and 2.1; 95% confidence intervals (CI) 1.2-3.2 and 1.3-2.5), smoking mother (OR 1.6 and 1.6; CI 1.0-2.7 and 1.0-2.6), lower respiratory tract illness (OR 1.9 and 2.4; CI 1.0-3.6 and 1.4-4.0), and atopic parents (OR 2.1 and 1.9; CI 1.3-3.4 and 1.2-3.1). The predictive power of both models was poor; area under ROC curve was 0.66 and 0.68, respectively. CONCLUSION: Asthma in young adulthood could not be predicted satisfactorily based on childhood characteristics. Nevertheless, we propose that this method is further tested as a tool to predict development of asthma.     

女性被动吸烟与冠心病

Thirty-four women CHD cases (22 cases diagnosed by coronary arteriography and 12 myocardial infarction) and 68 of non-CHD controls (34 hospital based and 34 population based), matched on age (within five years), race, residence, occupation (and case is to control as 1:2), were interviewed regarding the smoking habits of themselves and their husbands. The odds ratio (i.e. OR) of non-smoking women CHD associated with having a smoking husband are 3.00-3.52, OR 95% CI do not include 1. Significant dose-response relationships between OR of women's CHD and their husband's cigarette consumption, duration of passive smoking and cumulative quantity of passive smoking were found in the study. The logistic regression model analysis with other CHD risk factors showed that the relationship with CHD and passive smoking still existed. It was found that the metabolism of HDL-cholesterol and apolipoproteins with passive smokers was abnormal.     

儿童铅暴露与哮喘发病风险的病例对照研究

背景:环境中某些因素会明显影响儿童哮喘的发生以及转归。铅是显著影响儿童生长发育的主要环境因素之一。目的:探讨儿童不同程度铅暴露水平与哮喘发病风险之间的关系。方法:使用成组的病例对照研究方法,主要采用问卷调查方式对调查数据进行单因素和多因素条件Logistic回归分析。结果:哮喘儿童血铅水平明显高于正常健康儿童,而不同哮喘发作程度儿童的血铅水平无显著差异。单因素Logistic回归分析结果显示,有9个因素与儿童哮喘有关联;多因素条件Logistic回归分析显示5个因素被纳入方程,分别为儿童过敏史和特异性体质(OR为15.76)、家族哮喘病史(OR为11.59)、家族同居人员吸烟(OR为4.02)、儿童血铅水平(OR为3.17)和父母铅职业暴露(OR为1.98)。结论:哮喘儿童与健康儿童血铅水平存在差异,且铅暴露可能增加儿童哮喘的发病风险。     

Effects of environment and passive smoking on the respiratory health of children.

A cross-sectional survey was conducted to evaluate the possible effects of outdoor air pollution and of parental smoking on the respiratory health of children. A total of 3092 primary schoolchildren living in two polluted areas (an industrial town, Civitavecchia, and the city of Rome) and in a rural area, were chosen. A self-administered questionnaire was filled in by the parents of 2929 children (94.2%). A broad spectrum of respiratory symptoms and illnesses were taken as outcome variables. The frequency of most outcome variables was higher among children from the polluted areas than among those growing up in the non-polluted area (e.g. asthma: odds ratio (OR) = 1.4 for Civitavecchia, OR = 1.3 for Rome). Exposure to any passive smoking increased OR of having night cough (OR = 1.8), snoring (OR = 1.4), and respiratory infections during the first 2 years of life (OR = 1.3). A further increase in risk was observed in children whose mothers smoked or if both parents were smokers (asthma, OR = 1.5). When the separate and joint effects of the two exposures were studied, the patterns of OR did not suggest synergism between the two factors. The study indicates that both air pollution and passive smoking cause an increase in respiratory symptoms in children, although there would seem to be no additional effects of the two exposures together.