大气污染对小学生因呼吸系统症状和疾病缺课的影响

探讨大气污染对小学生因呼吸系统症状和疾病缺课的影响,为提高学生身体健康状况提供参考.方法 收集上海市浦东新区2015-2016学年小学生每日因呼吸系统症状和疾病缺课资料、大气污染和气象资料,利用基于广义相加模型的时间序列分析,同时控制时间长期趋势和温湿度影响,定量评价大气污染对小学生因呼吸系统症状和疾病缺课的影响.结果 2015-2016学年,浦东新区小学生因呼吸系统症状和疾病缺课率为0.07%,浦东新区PM2.5对小学生因呼吸系统症状和疾病缺课的最大单日效应出现在因病缺课当日,SO2最大单日效应出现在滞后2d,污染物质量体积指数每升高10 μg/m3,每日小学生因呼吸系统症状和疾病缺课人数分别增加1.43%(95%CI=0.25%~2.62%)和6.79%(95%CI=0.25%~13.32%).PM10和NO2对小学生因呼吸系统症状和疾病缺课影响的单日滞后和多日累积效应均无统计学意义(P值均>0.05).结论 浦东新区大气污染对小学生因呼吸系统症状和疾病缺课存在影响,大气污染防治仍需加强.     

Air pollution and heart rate variability among the elderly in Mexico City

BACKGROUND: Suspended particles and ozone have been associated with varying degrees of cardiac autonomic dysfunction. METHODS: In Mexico City, residents from a nursing home underwent heart rate variability analysis every other day for 3 months. Indoor and outdoor PM2.5 (particulate matter less than 2.5 mm in diameter) were measured daily at the nursing home. Levels of ozone and other atmospheric pollutants were obtained from a nearby automated monitoring station. RESULTS: Of the initial 42 screened participants, 34 (81%) were followed during the study period. The 24-hour average levels of indoor PM2.5 ranged from 15 to 67 micro g/m3, and outdoor PM2.5 ranged from 9 to 87 micro g/m3. Daily 1-hour maximum ozone levels ranged from 47 to 228 ppb. After adjusting for age and heart rate, we observed a strong decrease in the high frequency component of heart rate variability and the average 24-hour concentrations of PM2.5. Participants with hypertension had considerably larger reductions in their HF-HRV (high frequency-heart rate variability) component in relation to both ozone and PM2.5 exposure. CONCLUSIONS: Our results suggest that ambient levels of PM2.5 and ozone can reduce the high-frequency component of heart rate variability in elderly subjects living in Mexico City and that subjects with underlying hypertension are particularly susceptible to this effect.     

Air pollution and infant mortality in Mexico City

Historic air pollution episodes of the 1950s led to acute increases in infant mortality, and some recent epidemiologic studies suggest that infant or child mortality may still result from air pollution at current levels. To investigate the evidence for such an association, we conducted a time-series study of infant mortality in the southwestern part of Mexico City in the years 1993 to 1995 using mortality data from death registrations and air pollution measurements from a monitoring station we operated. Excess infant mortality was associated with the level of fine particles in the days before death, with the strongest association observed for the average concentration of fine particles during the period 3 to 5 days previously: a 10-microg m(-3) increase in the mean level of fine particles during these 3 days was associated with a 6.9% excess of infant deaths (95% confidence interval 2.5-11.3%). Infant mortality was also associated with the levels of nitrogen dioxide and ozone 3 to 5 days before death, but not as consistently as with particles.     

Air pollution and asthma among children in Seoul,Korea

BACKGROUND: As information about the health risks associated with air pollution has become available, attention has focused increasingly on susceptible persons such as children and persons with preexisting respiratory diseases, such as asthma. METHODS: We investigated the association between outdoor air pollution and asthma attacks among children under 15 years of age in Seoul, Korea. We estimated the relative risks of hospitalization associated with an interquartile range (IQR) increase in pollutant concentrations and used time series analysis of the counts by means of the generalized additive Poisson model. RESULTS: The estimated relative risk of hospitalization for asthma was 1.07 (95% confidence interval [CI] = 1.04-1.11) for particulate matters less than or equal to 10 microm in aerodynamic diameter (IQR = 40.4 microg/m3); 1.11 (95% CI = 1.06-1.17) for sulfur dioxide (IQR = 4.4 ppb); 1.15 (95% CI = 1.10-1.20) for nitrogen dioxide (IQR = 14.6 ppb); 1.12 (95% CI = 1.07-1.16) for ozone (IQR = 21.7 ppb); and 1.16 (95% CI = 1.10-1.22) for carbon monoxide (IQR = 1.0 ppm). CONCLUSIONS: These findings support the hypothesis that air pollution at levels below the current standards of Korea is harmful to sensitive subjects such as asthmatic children.     

Obesity and other predictors of absenteeism in Philadelphia school children

BACKGROUND: Limited data indicate that obese children are absent from school more than their normal‐weight peers. We analyzed administrative data from a large urban school district to investigate the association of obesity and student sociodemographic characteristics with absenteeism. METHODS: We analyzed 291,040 records, representing 165,056 unique students (grades 1‐12). Obesity status was classified according to Centers for Disease Control and Prevention age‐ and sex‐specific percentiles for body mass index (BMI) and analyses were based on negative binomial regression. RESULTS: Overall rates of overweight and obesity were 17% and 20%, respectively, and the estimated absence rate was 17 absences per 180 student‐days. Obesity was weakly associated with increased school absences. The association was present mainly among the most obese students (BMI >99th percentile), who had an 11% greater absence rate compared to normal‐weight students. Compared to white students, Hispanics and African Americans had higher absence rates (14% and 10%, respectively), and Asians had lower absence rates (43%). Students eligible for free or reduced‐cost meals had 24% higher absence rates than those who were not eligible. CONCLUSIONS: Overweight and obesity do not seem strongly associated with school absence, except among extremely obese children. Race and poverty appear to affect absences to a greater extent than overweight and obesity. Additional research is needed to investigate the contribution of contextual factors in schools and neighborhoods. This study suggests that data routinely collected in schools could be used to track childhood obesity and to efficiently evaluate public health interventions designed to decrease childhood obesity.     

Air pollution impact on phagocytic capacity of peripheral blood macrophages and antioxidant activity of plasma among school children

Peripheral blood macrophages of school children from downtown Santiago, Chile--a highly polluted city--exhibited a lower phagocytic index with higher percentage of killing than those of the rural village of María Pinto. These findings were observed concomitantly with a lower antioxidant activity of plasma in Santiago students. No differences were observed in serum immunoglobulins (IgA, IgG, and IgM), secretory IgA in saliva, and complement component C3. White blood cell count was higher in María Pinto residents than in Santiago students, including those cells with phagocytic capacity. It is suggested that particulate air pollution may enhance macrophage activity with impairment of the antioxidant capacity of plasma.     

Cigarette use among Hispanic and non-Hispanic white school children, Albuquerque, New Mexico.

We conducted a survey of cigarette usage among Hispanic and non-Hispanic White school children in Albuquerque, New Mexico. The distributions of current, experimental, and never smokers were similar in the two groups. Among smokers, the average weekly cigarette consumption was 19 for Hispanic White males, 14 for non-Hispanic White males, 16 for non-Hispanic White females, and nine for Hispanic White females. Educational programs are needed to maintain the low-risk status of Southwestern Hispanics for cigarette-related diseases.     

Air pollution, airway inflammation, and lung function in a cohort study of Mexico City schoolchildren

BACKGROUND: The biological mechanisms involved in inflammatory response to air pollution are not clearly understood. OBJECTIVE: In this study we assessed the association of short-term air pollutant exposure with inflammatory markers and lung function. METHODS: We studied a cohort of 158 asthmatic and 50 nonasthmatic school-age children, followed an average of 22 weeks. We conducted spirometric tests, measurements of fractional exhaled nitric oxide (Fe(NO)), interleukin-8 (IL-8) in nasal lavage, and pH of exhaled breath condensate every 15 days during follow-up. Data were analyzed using linear mixed-effects models. RESULTS: An increase of 17.5 microg/m(3) in the 8-hr moving average of PM(2.5) levels (interquartile range) was associated with a 1.08-ppb increase in Fe(NO) [95% confidence interval (CI), 1.01-1.16] and a 1.07-pg/mL increase in IL-8 (95% CI 0.98-1.19) in asthmatic children and a 1.16 pg/ml increase in IL-8 (95% CI, 1.00-1.36) in nonasthmatic children. The 5-day accumulated average of exposure to particulate matter <2.5 microm in aerodynamic diamter (PM(2.5)) was significantly inversely associated with forced expiratory volume in 1 sec (FEV(1)) (p=0.048) and forced vital capacity (FVC) (p=0.012) in asthmatic children and with FVC (p=0.021) in nonasthmatic children. Fe(NO) and FEV(1) were inversely associated (p=0.005) in asthmatic children. CONCLUSIONS: Exposure to PM(2.5) resulted in acute airway inflammation and decrease in lung function in both asthmatic and nonasthmatic children.     

The effects of ambient air pollution on school absenteeism due to respiratory illnesses

We investigated the relations between ozone (O3), nitrogen dioxide (NO2), and respirable particles less than 10 microm in diameter (PM10) and school absenteeism in a cohort of 4th-grade school children who resided in 12 southern California communities. An active surveillance system ascertained the numbers and types of absences during the first 6 months of 1996. Pollutants were measured hourly at central-site monitors in each of the 12 communities. To examine acute effects of air pollution on absence rates, we fitted a two-stage time-series model to the absence count data that included distributed lag effects of exposure adjusted for long-term pollutant levels. Short-term change in O3, but not NO2 or PM10, was associated with a substantial increase in school absences from both upper and lower respiratory illness. An increase of 20 ppb of O3 was associated with an increase of 62.9% [95% confidence interval (95% CI) = 18.4-124.1%] for illness-related absence rates, 82.9% (95% CI = 3.9-222.0%) for respiratory illnesses, 45.1% (95% CI = 21.3-73.7%) for upper respiratory illnesses, and 173.9% (95% CI = 91.3-292.3%) for lower respiratory illnesses with wet cough. The short-term effects of a 20-ppb change of O3 on illness-related absenteeism were larger in communities with lower long-term average PM10 [223.5% (95% CI = 90.4-449.7)] compared with communities with high average levels [38.1% (95% CI = 8.5-75.8)]. Increased school absenteeism from O3 exposure in children is an important adverse effect of ambient air pollution worthy of public policy consideration.     

深圳市中小学生因病缺课分布特征

分析深圳市中小学生2011-2016学年因病缺课分布特征,为学校传染病风险防控提供参考.方法 从“深圳市学生健康监测信息系统”收集2011-2016学年学生因病缺课数据,利用R软件Lattice包制作发生频数热力图进行分析.结果 2011-2016学年“深圳市学生健康监测信息系统”共收集因病缺课个案915 659例.按天分布热力图显示,总体上中小学生因病缺课发生数全年不均衡,发生热点多集中于上半年,最密集的月份是3月.因病缺课发生最多的病因是“感冒或流感”(61.79%).不同病因个案按天分布特点可归纳为4种类型,即按月集中型(包括感冒或流感、胃肠道疾病、腮腺炎和手足口病)、全年波动型(包括气管炎或肺炎、水痘、眼病和牙病)、全年平均型(伤害和风疹)和半年差异型(耳鼻喉疾病和“未诊断”个案).结论 上半年是因病缺课高发时期,尤其是3月.根据疾病发生特点采取针对性的控制措施,可以有效减少因病缺课人次数.     

Urinary metal concentrations among mothers and children in a Mexico City birth cohort study

Personal care product use is a potential source of metals exposure among children, but studies have been limited. We measured urinary concentrations of 10 metals (aluminum, arsenic [As], barium [Ba], cadmium, cobalt [Co], lead [Pb], manganese [Mn], molybdenum [Mo], nickel, and zinc [Zn]) in third trimester pregnant women (n?=?212) and their children at 8–14 years of age (n?=?250). Demographic factors (child sex, age, socioeconomic status, and maternal education), body mass index (BMI) z-score, and child personal care product use in the 24?h prior to urine collection were examined as predictors of urinary metal concentrations. Metals were detected in 80–100% of urine samples, with significant differences in maternal versus childhood levels. However, metal concentrations were not strongly correlated within or between time points. In linear regression models including all demographic characteristics, BMI z-score, and specific gravity, age was associated with higher Co (6% [95% CI: 2, 10]), while BMI z-score was associated with lower Mo (-6% [95% CI: -11, -1). In addition, significantly higher metal concentrations were observed among users of colored cosmetics (Mo: 42% [95% CI: 1, 99]), deodorant (Ba: 28% [3, 58]), hair spray/hair gel (Mn: 22% [3, 45]), and other toiletries (As: 50% [9, 108]), as well as with an increasing number of personal care products used (As: 7% [3, 11]) after adjustment for child sex, age, total number of products used, and specific gravity. However, significantly lower metal concentrations were noted for users of hair cream (As and Zn: -20% [-36, -2] and -21% [-35, -2], respectively), shampoo (Pb: -40% [-62, -7]), and other hair products (Pb: -44% [-65, -9]). We found that personal care product use may be a predictor of exposure to multiple metals among children. Further research is recommended to inform product-specific exposure source identification and related child health risk assessment efforts.     

Air pollution and health effects: A study of medical visits among children in Santiago, Chile.

Many epidemiological studies conducted in the last several years have reported associations between exposure to airborne particulate matter, measured as PM10 (<10 microm in diameter), and daily morbidity and mortality. However, much of the evidence involves effects on the elderly population; there is less evidence about the effects of particulates on children, especially those under 2 years of age. To examine these issues, we conducted time-series analyses of 2 years of daily visits to primary health care clinics in Santiago, Chile, where counts were computed for either upper or lower respiratory symptoms and for cohorts of children 3-15 years of age and below age 2. Daily PM10 and ozone measurements and meteorological variables were available from instruments located in downtown Santiago. The multiple regression analysis indicates a statistically significant association between PM10 and medical visits for lower respiratory symptoms in children ages 3-15 and in children under age 2. PM10 is also associated with medical visits related to upper respiratory symptoms in the older cohort, while ozone is associated with visits related to both lower and upper respiratory symptoms in the older cohort. For children under age 2, a 50- microg/m3 change in PM10 (the approximate interquartile range) is associated with a 4-12% increase in lower respiratory symptoms. For children 3-15 years of age, the increase in lower respiratory symptoms ranges from 3 to 9% for a 50- microg/m3 change in PM10 and 5% per 50 ppb change in ozone. These magnitudes are similar to results from studies of children undertaken in Western industrial nations.     

南京市中小学生2019—2021学年因病缺课监测分析

  目的  分析2019—2021学年南京市中小学生因病缺课情况,为进一步做好校园新型冠状病毒肺炎(以下简称“新冠肺炎”)疫情和常见传染病预防工作提供参考。  方法  利用“江苏省学生健康监测系统”,收集并整理2019—2021学年南京市中小学生因病缺课监测数据,比较不同学年和学段学生因病缺课率,症状和病因构成以及时间分布。  结果  2019—2021学年南京市中小学生总体因病缺课率分别为0.25%,0.39%和0.73%(χ2=392 611.44,P < 0.01);各学年小学因病缺课率均高于其他学段(χ2值分别为47 783.45,20 935.07,13 459.63,P值均 < 0.01)。各学年因病缺课症状构成排名前2位是发热和咳嗽,病因构成是感冒和胃肠道疾病。2021学年因意外伤害缺课排位有所上升,居缺课疾病排位第4。2019和2021学年因病缺课高峰均在11—12和3—4月,2020学年受新冠肺炎疫情影响第2高峰延至6月。  结论  南京市中小学生因病缺课率逐年上升,小学生是重点关注人群。呼吸道和胃肠道疾病是校内常见病预防重点,冬春季是流行高发期。加强因病缺课监测对新冠肺炎疫情常态化下校内常见传染病防控具有重要意义。     

The relationship of school absenteeism with body mass index, academic achievement, and socioeconomic status among fourth-grade children

BACKGROUND: Data from a school‐based study concerning fourth‐grade children's dietary recall accuracy were linked with data from the South Carolina Department of Education (SCDE) through the South Carolina Budget and Control Board Office of Research and Statistics (ORS) to investigate the relationships of children's school absenteeism with body mass index (BMI), academic achievement, and socioeconomic status (SES). METHODS: Data for all variables were available for 920 fourth‐grade children during 2 school years (2005–2006, 2006–2007). Number of school days absent for each child and eligibility for free/reduced‐price school meals (SES measure) were provided to ORS by SCDE. Children's weight and height were measured by research staff; age/sex‐specific BMI percentile was calculated and grouped into categories. For academic achievement, Palmetto Achievement Challenge Tests scores were provided by the school district. The associations of absenteeism with BMI, academic achievement, SES, and school year were investigated with logistic binomial models using the modified sandwich variance estimator to adjust for multiple outcomes within schools. RESULTS: The relationships between absenteeism and each of BMI percentile category and SES were not significant (all coefficient p values > .118). The relationship between absenteeism and academic achievement was inversely significant (p value < .0001; coefficient = ?.087). CONCLUSIONS: These results support the inverse relationship between absenteeism and academic achievement that was expected and has been found by other researchers. The lack of significant results concerning the relationships between absenteeism and both BMI and SES differs from earlier, limited research. More research to investigate these relationships is needed.