东莞市灰霾天气对小学生呼吸系统症状影响

目的了解广东省东莞市灰霾天气对小学生呼吸系统的影响,为治理东莞市灰霾污染和保护小学生健康提供依据。方法以随机抽样和整群抽样相结合的方式在东莞市选取2所小学,以14 d/次为一个随访周期,对371名小学生过去2周呼吸系统症状发生率进行调查,同时监测该区域灰霾天气污染数据,配合广义Poisson回归线型模型综合分析。结果单因素分析显示,灰霾对咳嗽、咳痰、2周内喘息和2周内咳嗽症状的OR值分别为0.996 3、0.971 7、0.920 1和0.955 5,除2周内喘息外差异均无统计学意义;3种大气污染物(PM₁₀、SO₂、NO₂)对2周内咳嗽症状的OR值分别为1.265 7、1.296 7和1.292 0;全因素模型分析显示灰霾对2周内喘息症状的OR值为1.104 5,SO₂被剔除模型,PM₁₀对呼吸系统症状OR值明显增大,NO₂对咳嗽和咳痰的OR值分别为1.390 4和0.653 1;滞后1期的灰霾和大气污染物的优势比均大于当期效应。结论东莞市灰霾天气对小学生呼吸系统具有损伤作用,且主要表现为各种大气污染物的综合效应,并具有迟发(后续)效应。     

兰州市城关区大气污染对儿童呼吸系统疾病和症状的影响

目的了解兰州市城关区大气污染对儿童呼吸系统疾病和症状的影响。方法于2013年9—11月,采用随机整群抽样的方法抽取兰州市城关区和榆中县的2 016名学龄期儿童(城关区1 087名,榆中县929名)为研究对象,采用美国流行病学标准问卷(ATS-DLD-78-C)进行呼吸系统疾病和症状发生情况调查。结果 2013年城关区大气SO2、NO2、PM2.5、PM10日均浓度均高于榆中县,差异有统计学意义(P0.05)。城关区儿童感冒时咳嗽、不感冒时咳嗽、感冒时咯痰、不感冒时咯痰、鼻炎、支气管炎、肺炎、哮喘等8种呼吸系统疾病和症状的发病危险性分别是榆中县的1.563、1.606、2.055、1.849、2.786、2.514、1.976、2.599倍,均有统计学意义(P0.05)。采用多因素logistic回归分析调整年龄、厨房燃料、冬季采暖方式等混杂因素后,与榆中县比较,城关区儿童感冒时咳嗽、不感冒时咳嗽、感冒时咯痰、鼻炎、支气管炎、肺炎等疾病和症状发生的危险性均较高,OR值(95%CI)分别为1.571(1.273~1.938),1.568(1.028~2.391),2.026(1.580~2.597),2.136(1.430~3.192),2.142(1.463~3.136),1.741(1.190~2.548),均有统计学意义(P0.05)。结论城关区儿童部分呼吸系统疾病和症状发生率高于榆中县,可能与城关区大气污染有关。     

和田市大气污染物特征及对儿童呼吸系统疾病住院人次数的影响

目的 探讨沙尘地区大气污染物变化特征及对儿童呼吸系统疾病的影响。方法 收集2016—2019年期间和田市气象资料和同期和田市三级甲等医院儿童呼吸系统疾病住院人次数,采用统计描述和Pearson相关分析等方法分析大气污染物变化特征和不同大气污染物对儿童呼吸系统疾病住院人次数的影响,建立自回归积分滑动平均模型(autoregressive integrated moving average,ARIMA)。结果 和田市4年间呼吸系统疾病患儿住院人次数为2 888例,儿童呼吸系统性疾病住院人次数、大气污染物浓度和沙尘天气均呈明显的周期性变化。各大气污染物与气象因素存在相关性,其中PM_2.5与PM₁₀相关性最大(r=0.953,P<0.01)。儿童上呼吸道感染与PM₁₀、PM_2.5呈正相关(r=0.433、0.358,均P<0.01);支气管炎住院人次数与PM₁₀、PM_2.5呈正相关(r=0.431、0.353,均P<0.01);肺炎与PM     

沙尘暴对儿童呼吸系统症状的影响

目的探讨沙尘暴对儿童呼吸系统症状发生的影响。方法选取兰州市3所小学和敦煌市1所小学的3～5年级的1094名学生为研究对象,在2009年4月23日沙尘暴发生前1d发放调查问卷,连续跟踪调查7d,调查的主要内容为一般状况、个人情况和呼吸系统症状等。结果与沙尘暴发生前1d比较,沙尘暴发生当天儿童呼吸系统症状的发生率均不同程度地升高,其中鼻腔干燥、流涕、鼻塞、流鼻血、咽部干痒、咽痛、咳嗽、口苦、持续咳嗽、早晨咳嗽、户外咳嗽加重、咳嗽有痰及胸部憋闷症状发生率升高,差异均有统计学意义(P0.05)。沙尘暴过境后第1～5天,儿童呼吸系统症状发生率逐渐降低。多因素Logistic回归分析结果表明,沙尘暴发生前有身体不适、支气管炎、上呼吸道感染等病史的儿童沙尘暴期间呼吸系统症状发生的危险性升高,OR值分别为1.873、2.239和1.595。结论沙尘暴对儿童造成呼吸系统的急性损伤,且高发于既往有呼吸系统病史的儿童。     

北京市大气污染对学龄儿童呼吸系统疾病和症状的影响

目的了解北京市大气污染对儿童呼吸系统疾病和症状的影响,为保护儿童健康和治理空气污染提出依据。方法根据北京环境监测的结果,选择污染程度和类型不同的A、B、C3个区。在每区选择3所小学,按照整群抽样的方法,选取1～5年级的5749名小学生进行呼吸系统健康问卷调查。结果在大气质量较好的A区,儿童各呼吸系统疾病和症状的发生率均小于污染严重的B、C区,差异具有显著性(P<0.05)。而在污染类型不同的B、C区,儿童各呼吸系统疾病和症状的发生率相当(P>0.05)。经多因素Logistic回归分析发现,咳嗽、感冒时咳嗽、咯痰、感冒时咯痰以及咳嗽、咯痰等症状在B、C区儿童发生的危险性高于A区儿童。居室附近有交通要道的儿童中各呼吸系统疾病和症状的发生率高于居室附近没有交通要道的儿童。结论学龄儿童中一些呼吸系统症状的增加与北京市城区大气污染有关。     

兰州市榆中县学龄期儿童呼吸系统疾病和症状影响因素分析

目的分析兰州市榆中县学龄期儿童呼吸系统疾病和症状的影响因素,为更好保护儿童健康提供科学依据。方法于2013年9—11月采用随机整群抽样的方法,采用美国流行病学标准问卷(ATS-DLD-78-C)对榆中县某小学3~6年级929名学龄期儿童呼吸系统疾病和症状进行调查,并分析其影响因素。结果 929名学龄期儿童感冒时咳嗽、不感冒时咳嗽、持续咳嗽、感冒时咯痰、不感冒时咯痰、持续咯痰的发生率分别为43.2%,5.4%,1.6%,18.8%,2.9%和0.9%;鼻炎、支气管炎、肺炎、哮喘患病率分别为4.8%,5.8%,6.5%和0.9%。Logistic回归分析结果显示,影响儿童呼吸系统疾病和症状的危险因素包括厨房燃煤、家养宠物、住宅与交通干线距离近、被动吸烟、家庭哮喘史等(P0.05),冬季开窗通风和做饭时使用抽油烟机是保护因素(P0.05)。结论榆中县学龄期儿童呼吸系统健康受多种因素影响。     

太原市空气污染对小学生呼吸系统症状的急性影响

目的 了解太原市重工业造成的空气污染对儿童呼吸系统症状的急性影响,探讨儿童呼吸系统症状与空气污染的相关性.方法 于2008年7月1日-2009年6月30日以定群研究方法选择479名6～11岁儿童,通过填写小学生健康日志来记录每日呼吸系统症状.同时收集距学校1.5 km处空气监测点PM10、SO2、NO2、CO日均浓度.应用广义估计方程(GEE)建立空气污染与小学生呼吸系统症状的剂量反应关系,估计污染物危险度.结果 调整了个体水平的危险因素之后,SO2影响的估计值稳定.在滞后效应中,lag1～lag 3和lag 5危险度相对较高,SO2浓度每升高1个四分位数间距(63 μg/m3),儿童呼吸系统症状增加8％～17％.在累积效应中,危险度随累积天数的增加而上升,SO2浓度每升高1个四分位数间距,儿童呼吸系统症状增加25％～74％.累积效应大于滞后效应.调整了其他污染物的影响之后,SO2的危险度略有升高,分析结果仍有统计学意义.结论 大气SO2污染可能导致本次调查的小学生呼吸系统症状发生率上升.     

郑州市空气污染与儿童医院呼吸系统日门诊量的相关性

目的探讨空气污染与儿童医院呼吸系统门诊量间的关系。方法应用时间序列分析广义线性模型,对2013—2014年郑州市儿童医院呼吸系统门诊量、郑州市大气监测点的空气污染监测资料及郑州市气象资料进行大气污染与儿童医院呼吸系统门诊量的相关性分析。结果 Spearman秩相关分析得PM_(10)、PM_(2.5)、NO_2和SO_2与呼吸系统门诊量呈正相关(P0.01);PM_(10)浓度每增10μg/m~3,当日呼吸系统门诊量增加0.72%;PM_(2.5)浓度每增加10μg/m~3,当日呼吸系统门诊量增加0.90%;NO_2浓度每增10μg/m~3,当日呼吸系统门诊量增加7.73%,在累积滞后(0～5) d时效应最强,超额危险度(ER)为9.88%;SO_2浓度每增10μg/m~3,当日呼吸系统门诊量增加2.92%,且在累积滞后(0～3) d时效应最强,ER为3.22%。结论郑州市的空气污染物能增加儿童医院呼吸系统门诊量。     

广州市灰霾天气对城区居民心血管疾病影响的时间序列分析

目的 探讨灰霾天气(haze)和PM10、PM2.5、SO_2、NO_2浓度对心血管疾病日门诊量的影响,为进一步制定有效的环境法规、保护易感人群提供依据.方法 收集广州市中心城Ⅸ某医院心血管疾病日门诊量资料及同时期大气污染物浓度、气象监测资料,采用时间序列的自回归模型,在控制了长期趋势、短期趋势、气象因素等混杂因素的基础上,分析广州中心城区2006年1月1日-2008年12月31日灰霾天气及空气污染物与居民心血管疾病发病的关系.结果 自回归模型显示,2008年的门诊量水平高于2006年.每年4和12月的门诊量高于1月,工作日都高于休息日;灰霾的水平与医院心血管门诊病人量呈正相关,灰霾天气每增加1 d,医院门诊病人量就上升2.12个单位;前第2天的灰霾的水平(lag2)对当天的疾病水平是负影响.而残差部分表明前1 d和前3 d的疾病门诊残留量(AR1、AR3)对当天的门诊残留量是正影响(分别增加52.25%,26.1%),前2d的疾病门诊残留量(AR2)对当天的门诊残留最是负影响(下降17%).另外,各种空气污染物(PM10、PM2.5、SO_2、NO_2)之间呈现一定正相关性,并且具有滞后现象.结论 由悬浮颗粒物、气象因素和气体污染物产生的灰霾天气是心血管疾病发病的环境病因,而单个空气污染物指标对心血管门诊病人量的影响被灰霾污染的综合效应所弱化.

Abstract：

Objective To explore the effects of atmospheric haze and air pollutants(PM 10, PM2.5). SO_2, NO_2 on hospital visits for cardiovascular diseases. Methods The relationship among atmospheric haze, air pollution and the outpatients data of Guangzhou for cardiovascular disease had been investigated by collecting the air pollution data, the meteorological data and cardiovascular diseases' outpatients data in Guangzhou city from January 1, 2006 to December 31,2008 . The time-series analysis by auto-regression model was used, controlling for long-term trends, seasonal patterns and meteorological variables. Results Auto-regression model showed that the number of outpatients in 2008 was higher than that in 2006.The number was larger in April and December compared with that in January, and it was higher on Monday, Tuesday, Wednesday, Thursday and Friday than on Saturday, Sunday. There was a positive correlation between the haze level and cardiovascular outpatients. The number of hospital outpatients increased by 2.12 units with each additional day of the atmospheric haze. The haze level (lag2) of the former second day had a negative impact on the intraday data of outpatients. The residual parts showed that outpatients' residual data (AR1, AR3) of the former first and third day had a positive effect on intraday outpatients' residual data (increased by 52.25%, 26.1%), while the outpatients' residual data of the former second day (AR2) had a negative effect on outpatients' residual data of the present day (decreased by 17%). In addition, a variety of air pollutants (PM10, PM2.5, SO_2, and NO_2) showed some positive correlation, and had hysteresis. Conclusion The atmospheric haze, generated from suspended paniculate, meteorological factor and gaseous pollutants, is the environmental pathogenic factor for the cardiovascular diseases, while the effects of single air pollutant on the hospital visit for cardiovascular diseases can be weakened by the haze pollution.     

Respiratory symptoms in children of Upper Silesia, Poland: Cross-sectional study in two towns of different air pollution levels

In children aged 7–9 years residing in the town of Chorzow (C) and in the town of Mikolow (M), located 30 km apart (Upper Silesia, the industrial part of Poland), respiratory symptoms were ascertained according to the parental answers to WHO-Questionnaire. Mean annual concentrations of air pollutants are higher in Chorzow than in Mikolow, and recent mean values of 24 hr measurements over November 1992–January 1993 confirmed the between-town gradient (p < 0.001) for particulates (C:166 g/m³; M:129 g/m³ SO₂) (C:153 g/m³ M:92 g/m³) and NO₂) (C:69 g/m³ M:26 g/m³) In Chorzow 24.8% (n = 1,142) and in Mikolow 25.6% (n = 480) of all eligible children aged 7–9 years were examined. Both groups (C and M) were similar in terms of sex, family history of asthma and cough lasting for 3 months (C:31.6%; M:32.3%). Frequency of the following respiratory symptoms statistically significantly (p < 0.05) differed between two groups: chest wheezing (C:21.4%; M:17.1%) and attacks of asthmatic dyspnea (C:10.3%; M:6.2%). Also, the diagnosis of asthma by physician was more prevalent in Chorzow (C:3.5%; M:1.3%; p < 0.05). Logistic regression analysis showed that after controlling for family history of asthma, environmental tobacco smoke and housing condition, the place of residence (C versus M) was statistically significantly associated with attacks of asthmatic dyspnea (p < 0.05) and a borderline significance of this factor was found in relation to wheezing (p = 0.06) and physician-diagnosed asthma (p = 0.07). The survey provided the estimate of the prevalence of chronic respiratory symptoms in children living in the most polluted urban area of Poland. Although the design of the study precludes more specific etiologic conclusions on environmental exposures the apparently higher prevalence of symptoms in children living in a more polluted town deserves further investigation.     

天津市大气污染对儿童呼吸系统疾病影响的病例交叉研究

目的  探求大气污染对天津市儿童呼吸系统疾病的影响,为疾病的预防与控制提供依据。 方法  利用单污染物和多污染物条件Logistic回归模型,来估计空气污染物浓度和儿童呼吸系统疾病发病之间的关系。 结果  单污染物条件Logistic回归模型显示,大气中NO₂、PM_2.5、PM₁₀、CO的超额危险度(excess risk rate,ER)及其95%CI分别为2.823%(2.581~3.065)、0.476%(0.382~0.569)、0.437%(0.368~0.506)、22.263%(15.449~29.478)。多污染物条件Logistic回归分析显示：在寒冷季节,NO₂暴露对儿童呼吸系统疾病的影响效应最大,ER及其95%CI为7.395%(6.595~8.202)。 结论  NO₂、PM₁₀、PM_2.5、CO日平均浓度的升高可以增高儿童呼吸系统疾病的发生风险。     

Indoor nitrogen dioxide pollution and respiratory symptoms of schoolchildren

Summary The influence of indoor nitrogen-dioxide exposure on respiratory symptoms of schoolchildren was investigated in a case-control study. The election method used was useful in obtaining symptomatic children, but insufficient in defining cases and controls without additional information. No relationship between indoor NO₂ and respiratory symptoms was found. Bias may have been present, especially because of the high mobility of the study population. Attempts to estimate historical exposure were inaccurate. Therefore the results do not exclude that an association between indoor NO₂ and respiratory symptoms exists.     

空气细颗粒物对交通警察肺通气功能及呼吸道症状的影响

目的 研究空气细颗粒物(PM2.5)暴露对交通警察呼吸道症状及肺通气功能的影响.方法 使用个体采样器测定上海市区107名男性外勤交通警察(高暴露组)及101名居民(一般暴露组)PM2.5的暴露情况,问卷调查获得交通警察和居民的基本情况、呼吸道症状,测定用力呼气肺活量(FVC)、第1秒用力呼气容积(FEV1.0)、FEV1.0/FVC%和最大呼出流速(PEF).比较交通警察和居民PM2.5暴露及呼吸道症状、肺通气功能的差异,对交通警察按工龄分组,研究工龄对肺通气功能的影响,并对肺通气功能降低与颗粒物暴露水平的进行相关分析.结果 交通警察和居民细颗粒物24 h个体平均暴露浓度为分别(115.4±46.17)和(74.94±40.09)μg/m3,高暴露组PM2.5暴露水平明显高于一般暴露组,差异有统计学意义(P＜0.01).高暴露组咳嗽、咳痰、咽部不适及气喘、气短和鼻部不适的发生率明显高于一般暴露组,差异有统计学意义(P＜0.05,P＜0.01),高暴露组肺通气功能指标FVC实测/FVC预计%和FEV 1.0实测/FEV1.0预计%的异常率分别为25.23%和12.15%,一般暴露组FVC实测/FVC预计%和FEV1.0实测/FEV1.0预计%的异常率分别为11.88%和2.97%,两组比较,差异有统计学意义(P＜0.05,P＜0.01),且高暴露组FVC实测/FVC预计%、FEV1.0实测/FEV1.0预计%异常率随工龄延长呈现升高的趋势.结论 长期暴露于较高水平的PM2.5会危害人体呼吸系统健康,导致呼吸道症状增多,降低肺通气功能.     

短期雾霾暴露对成人系统性炎症的影响及橙汁干预

目的 研究短期雾霾暴露对成人系统性炎症的影响,并观察橙汁干预效果.方法 在2015年11月至12月雾霾空气污染天气频发期间,将22名大学生自愿者随机分为雾霾暴露组和橙汁干预组(每天中午和晚上分别给予橙汁200mL),连续3周记录和评估两组自愿者的雾霾暴露水平,并测定实验开始前和暴露3周后的血细胞计数、血中各种炎症标志物水平.结果 暴露开始前,两组自愿者的血细胞计数、血清炎性标志物差异均无统计学意义(P＞0.05);连续暴露3周后,与暴露前相比雾霾暴露组和橙汁干预组自愿者血中白细胞计数、淋巴细胞百分数等无明显差异(P＞0.05),但血清炎性标志物水平hs-CRP明显高于暴露前(P＜0.05),并且橙汁干预组血中血清炎性标志物hs-CRP水平均明显低于雾霾暴露组,差异有统计学意义(P＜0.05).结论 短期雾霾暴露能明显增加人体的炎症标志物水平,并且橙汁干预能显著改善雾霾暴露所致炎性标志物升高状况.     

Indoor environment and respiratory symptoms in children living in the Dutch-German borderland

OBJECTIVE: To investigate the relation between indoor environmental risk factors and respiratory symptoms in 7-8-year-old children living in the Dutch-German borderland. METHODS: A nested case-control study was conducted among children participating in a large longitudinal study on respiratory health. Parents of all 781 children with respiratory complaints and an equal number of randomly selected controls were asked to complete a questionnaire, including questions on indoor environment. RESULTS: The parents of 1191 children (76.2%) participated. Past exposure to environmental (OR = 2.73, 95% CI 1.14-6.67) as well as in utero exposure (OR = 2.28, 95% CI 1.15-4.53) to tobacco smoke, use of an unvented geyser for water heating (OR = 3.01, 95% CI 1.21-7.56), long-term exposure to dampness (OR = 2.98, 95% CI 1.10-8.28) or pets (OR = 2.18, 95% CI 1.39-3.42) increased the risk of asthmatic symptoms in 7-8-year-old children. A middle or low socio-economic status also increased the risk of asthmatic symptoms. An inverse association with asthmatic symptoms was seen for wall-to-wall carpeting (OR = 0.57, 95% CI 0.33-0.95) and insulation measures (OR = 0.46, 95% CI 0.25-0.83). Except for the presence of an unvented geyser, these environmental risk factors also presented a risk for coughing symptoms in children. CONCLUSION: This study showed an increased risk of respiratory symptoms in children exposed to several indoor environmental risk factors.     

Respiratory symptoms associated with sulfur dioxide exposure

Summary Exposures to sulfur dioxide (SO₂) have been associated with progressive, dose-dependent bronchoconstriction in sensitive individuals. The clinical significance of such changes remains poorly characterized. We studied subjective responses following exposure to low level concentrations of SO₂ (< 1 ppm) in a group of 10 healthy and 10 asthmatic subjects. The number and severity of complaints associated with SO₂ increased with concentrations in both healthy and asthmatic subjects. Asthmatics indicated progressive lower respiratory complaints, such as wheezing, chest tightness, dyspnea and cough with increasing levels of SO₂ while healthy subjects complained more frequently of upper airway complaints such as taste and odor with increasing levels of SO₂. Exercise increased the frequency of lower airway symptoms in asthmatics but led to no increases in symptoms in healthy subjects.From the Pulmonary Section, Yale University School of Medicine, P.O. Box 3333, 333 Cedar Street, and the John B. Pierce Foundation Laboratories, New Haven, CT 06510 (203) 785-4165Presented in part at the International Conference on Indoor Air Pollution August 10–24, 1984