鞍山市大气污染对儿童呼吸系统健康的影响

目的探讨空气污染对儿童呼吸系统健康的危害.方法于2002年4月,在鞍山市轻、中、重污染区随机抽取小学和幼儿园各1所,学校内的所有学生作为调查对象(共1951人),调查不同污染区的儿童健康状况及室内外环境.结果鞍山市儿童持续咳嗽、持续咯痰、哮喘、哮喘现患、喘鸣及喘鸣样症状的发生率分别为9.48%,4.82%,1.33%,0.92%,6.30%,4.97%.幼儿哮喘、哮喘现患,喘鸣、喘鸣样症状发生率均高于学龄儿童;性别间差异无统计学意义.重污染区儿童持续咳嗽和持续咯痰的发生率高于轻污染区儿童的发生率(P＜0.05).随着住房与交通干线距离的接近,儿童呼吸系统疾病的发生率也呈增高趋势.易感因素与室外空气污染的联合作用较强,呼吸系统各种疾病的发生率均以受大气污染影响的易感儿童为高,无大气污染影响的非易感儿童发生率为低.结论室外空气污染是儿童呼吸系统健康的影响因素.     

大气污染致慢性呼吸道疾病机制研究

许多证据表明大气污染与慢性呼吸道疾病有关,其中以颗粒物的影响最为人们所关注。无论是儿童还是成人,呼吸系统疾病与大气污染程度都密切相关,这也是当前研究的热点。大气污染对呼吸系统疾病的影响机制包括氧化应激、炎症反应、遗传损伤等;本文就大气颗粒物PM2.5导致慢性呼吸道疾病发病机制的最新进展进行综述。     

空气污染对中小学生呼吸系统健康状况影响

目的研究空气污染对中小学生呼吸系统健康影响,筛选主要影响因素。方法运用环境流行病学方法,在兰州市大气污染程度不同的3个区整群抽样选取8~20岁共约1200名中小学生为研究对象,以面询式调查问卷进行呼吸系统疾病和症状调查,并对其影响因素进行回顾性分析。结果2005年采暖期,兰州市污染水平与中小学生咳嗽及咳痰、喷嚏及流涕症状发生率及上呼吸道感染发病率均表现为西固区〉城关区〉榆中区,且差异均有统计学意义（P〈0.05）。非条件Logistic回归分析表明,引起呼吸道不适症状和发病的主要因素有大气污染、吸烟、室内空气污染,呈显著正相关。结论大气污染、主动及被动吸烟、室内空气污染是中小学生呼吸系统症状和疾病发生的主要因素。     

沈阳市大气污染与慢性病患病率的关系

对沈阳市不同污染区进行了一次慢性病患病率和多种环境因素相关的调查研究。在进行多因素分析后，看到吸烟是慢性呼吸道病的第一位病因。室内污染指数使慢性气管炎和ＣＯＰＤ分别升高１．５（１．３～２．５）及１．４（１．０～１．９）倍，室外污染在调控年龄、文化和上述诸因素后仍使慢性呼吸系统病和心脑血管病ＯＲ值升高至１．４（１．０～２．１）和１．７（１．１～２．６）。３区在急慢性发病及医疗费支出等方面均有显著差异。经多因素调控后的室外污染对ＣＯＰＤ及心脑血管病患病率的ＯＲ值与在另一研究（大气污染与死亡率生态学分析）中所得的ＲＲ值相近似，为室外污染的病因分数（ＰＡＲ）提供了依据．     

南宁市大气污染与呼吸系统疾病的关系

目的探讨南宁市大气污染与呼吸系统疾病的关系。方法根据南宁市1991—2002年大气中主要污染物如总悬浮颗粒物(TSP)、降尘、二氧化硫(SO2)、氮氧化物(NOx)的监测值计算上海大气质量指数并进行评价分级,再与呼吸系统疾病死亡率及同期自治区人民医院慢性阻塞性肺疾病人院病人构成比进行综合分析。结果南宁市大气属煤烟型污染,大气的主要污染物为TSP、降尘、SO2、NOx工业区呼吸系统疾病死亡率是城区的1．4～2．4倍,城区略高于郊区,在污染较重的1991-1995年,呼吸系统疾病死亡率也最高,同期该院慢性阻塞性肺疾病人院水平亦较高。结论南宁市大气污染是呼吸系统疾病死亡及高发的主要环境病因。     

大气污染对学龄儿童呼吸系统健康的影响(二)

目的：探讨影响儿童呼吸系统健康的主要因素，为控制主要危险因素提供依据。方法：在辽宁省大气污染程度不同的三个城市，采用整群抽样的方法每个城市大气轻重污染区抽取6000名小学1，6年级的学龄儿童，进行儿童呼吸系统健康状况的调查。结果：呼吸系统症状的阳性率以本溪和沈阳儿童较高，高于大连和对照区儿童，但哮喘这种过敏性疾病以大连儿童患病率高，对影响儿童呼吸系统健康的因素进行logistic回归分析。发现影响本溪，沈阳儿童呼吸系统健康的主要危险因素为大气污染程度，父母亲呼吸系统疾病史及家庭成员吸烟，而影响大连儿童呼吸系统健康的主要因素是父母亲呼吸系统疾病史，大气污染不是主要因素。结论：大气污染是导致儿童呼吸系统损害的危险因素之一。环境，遗传的交互作用而使部分儿童易患呼吸系统疾病，故要注意遗传易感性，保护易感人群。     

煤烟型大气污染对淮南市中小学生呼吸系统的影响

目的探讨煤烟型大气污染对中小学生呼吸系统健康的影响,为大气污染的预防控制提供依据。方法采用分层整群抽样的方法,抽取淮南市燃煤污染区3所中学和5所小学的1892名学生进行呼吸道症状与呼吸系统疾病现况调查,以同城农村的2所中学及2所小学的917名学生为对照。结果城区学生呼吸系统总症状、咳嗽、咳痰、咽痛、气喘等呼吸道症状,感冒、鼻炎、咽炎、扁桃体炎、急性支气管炎等呼吸系统疾病的检出率均显著高于农村学生(P<0.01或P<0.05);呼吸系其他症状与疾病差异均无统计学意义(P值均>0.05)。结论煤烟型大气污染可引起中小学生呼吸系统症状和疾病的检出率增高,是导致儿童呼吸系统损害的危险因素。     

北京市空气质量与每日居民死亡关系的研究

目的 客观评价媒烟和机动车污染并存的复合大气污染对居民健康的影响，为北京市治理和防治大气污染措施的制定和效果评价提供依据。方法 运用时间序列的泊松回归分析研究1998年1月1日至2000年6月31日期间北京市城区和近郊区（也称城八区）大气污染与居民每日死亡的关系。结果 在控制了气温，气湿和气压等因素后，泊松回归分析显示；空气质量指数（AQI）在冬，夏两季对居民每日死亡均有显著影响。对慢性阻塞性肺疾患（COPD）影响最大，其次是呼吸系统疾病，再次为心，脑血管疾病，未见对恶性肿瘤有影响；大气污染在冬季（11月至次年3月）对居民每日死亡的影响大于夏季（4-10月）。夏季的平均AQI为77.4,AQI每增加10，COPD和呼吸系统疾病的每日死亡人数分别增加2.23%和1.78%；冬季的平均AQI为129.6,AQI每增加10，呼吸系统疾病每日死亡人数增加3.52%，其中COPD增加3.68%；心，脑血管疾病增加2.01%和1.74%。总死亡增加1.69%。其中因病死亡增加1.73%。对不同年龄组居民每日死亡影响的分析也发现空气污染在冬季对居民死亡的影响大于夏季，而且对55岁及以上人群影响显著。结论 北京市大气污染对居民的每日死亡影响显著，冬季的影响大于夏季，大气污染对COPD等呼吸系统疾病影响较大。对55岁以上人群影响显著。     

本溪市儿童呼吸系统健康状况及其影响因素

目的 调查工业城市——本溪市大气污染对儿童呼吸系统健康的影响,筛选可能产生呼吸系统损害的各种因素,以提出防治措施,保护易感人群。方法 根据环保部门提供的大气污染数据,选择轻、重2个污染区,并分别选取1、6年级学龄儿童各3000名,男、女各半,以发放调查表的方式进行呼吸系统健康状况调查。结果 轻、重污染区TSP浓度分别为0.59 mg/m3和1.02 mg/m3,差异有显著性(P<0.05);SO2分别为0.17 mg/m3和0.19 mg/m3。重污染区儿童的咳嗽、咯痰、咳嗽咯痰、持续咳嗽咯痰等症状的阳性率均高于轻污染区儿童(P<0.05)。重污染区儿童的支气管炎、哮喘性支气管炎、肺炎的患病率也高于轻污染区儿童(P<0.05)。用非条件logistic回归模型计算了几种呼吸系统症状和疾病的OR值及95%,可信区间,通过调整大气污染区、年龄、性别、家庭用煤、父母吸烟、通风设施、父母亲呼吸系疾病史等因素,在控制了其他因素后,重污染区儿童患呼吸系统疾病和症状的危险性显著高于轻污染区(P<0.05或P<0.01)。父母亲呼吸系疾病史、家庭成员吸烟也是危险因素之一。结论 大气污染能够引起儿童呼吸系统健康的损害。     

慢性呼吸系统疾病患者的自我保护

通常情况下,所谓的慢性呼吸系统疾病,其相对应的主要症状就是咳、喘、痰。导致这一疾病出现的主要因素有:吸烟以及大气污染等,而这些因素的存在,会很大程度上促进呼吸系统疾病的发病率的提高,包括:肺癌以及支气管哮喘等。近年来,慢性阻塞性肺疾病发病率更是持续上升。     

Effect of outdoor and indoor nitrogen dioxide on respiratory symptoms in schoolchildren

BACKGROUND: Nitrogen dioxide (NO(2)), an oxidant gas that contaminates both outdoor and indoor air, is considered to be a potential risk factor for asthma. We investigated concurrently the effects of outdoor and indoor NO(2) on the prevalence and incidence of respiratory symptoms among children. METHODS: A cohort study was carried out over 3 years on 842 schoolchildren living in seven different communities in Japan. Indoor NO(2) concentrations over 24 hours were measured in both winter and summer in the homes of the subjects, and a 3-year average of the outdoor NO(2) concentration was determined for each community. Respiratory symptoms were evaluated every year from responses to questionnaires. RESULTS: The prevalence of bronchitis, wheeze, and asthma significantly increased with increases of indoor NO(2) concentrations among girls, but not among boys. In neither boys nor girls were there significant differences in the prevalence of respiratory symptoms among urban, suburban, and rural districts. The incidence of asthma increased among children living in areas with high concentrations of outdoor NO(2). Multiple logistic regression analysis showed that a 10 parts per billion (ppb) increase of outdoor NO(2) concentration was associated with an increased incidence of wheeze and asthma (odds ratios [OR] = 1.76, 95% CI : 1.04-3.23 and OR = 2.10, 95% CI : 1.10-4.75, respectively), but that no such associations were found with indoor NO(2) concentration (OR = 0.73, 95% CI : 0.45-1.14 and OR = 0.87, 95% CI : 0.51-1.43, respectively). CONCLUSIONS: These findings suggest that outdoor NO(2) air pollution may be particularly important for the development of wheeze and asthma among children. Indoor NO(2) concentrations were associated with the prevalence of respiratory symptoms only among girls. Girls may be more susceptible to indoor air pollution than boys.     

Association of indoor and outdoor air pollutant level with respiratory problems among children in an industrial area of Delhi, India

The authors conducted this prospective study at the Shahdara industrial area of Delhi, India. They examined the effects of indoor and outdoor air pollutant levels on respiratory health in 394 children aged 7 to 15 years. The majority of children had a history of respiratory problems, including cough (62.7%), sputum production (24.4%), shortness of breath (32.0%), wheezing (25.6%), common cold (44.4%), and throat congestion (43.1%). The association of indoor and outdoor air pollutant levels showed that outdoor SO2 and NO2 was significantly higher than indoor SO2 and NO2 levels, whereas the mean indoor level of suspended particulate matter (SPM) was significantly higher than outdoor SPM level. Indoor SPM level also was significantly higher in homes of children with a history of respiratory illness than homes of children having no history of respiratory illness. Results suggest that both indoor and outdoor particulate exposure may be important risk factors in the development of respiratory illness in children.     

Indoor air pollution and respiratory health in urban and rural China

During the summer of 1999, information about respiratory health outcomes and relevant covariates was collected from 3,709 Chinese adults in Beijing, Anqing City, and rural communities in Anqing Prefecture. Indoor PM10 and SO2 were measured in a random sample of selected households. Using logistic regression and controlling for important covariates (excluding PM10 and SO2) and familial intraclass correlation, highly significant differences were found between study areas in the prevalences of chronic cough, chronic phlegm, wheeze, and shortness of breath, but not physician-diagnosed asthma. Generally, the lowest prevalence of respiratory symptoms was observed in Anqing City, a higher prevalence in rural Anqing, and the highest prevalence in Beijing. Median indoor concentrations of PM10 were similar in Anqing City (239 microg/m3) and rural Anqing (248 microg/m3), but much higher in Beijing (557 microg/m3). Median indoor concentrations of SO2 were similar in all three areas (Beijing: 14 microg/m3, Anqing City: 25 microg/m3, rural Anqing: 20 microg/m3).     

Childhood respiratory symptoms, hospital admissions, and long-term exposure to airborne particulate matter

The effects of long-term exposure to air pollution on respiratory symptoms and respiratory hospitalization (for asthma, bronchitis or pneumonia) were assessed in a cross-sectional study of children (ages 7--11 years, N=667) living in a moderately industrialized city in Central Slovakia. Individual health, residence and family history data obtained through the CESAR study were coupled, using Geographic Information System (GIS) technologies, with total suspended particulate (TSP) exposure estimates derived from dispersion modeling of almost all local stationary sources. These data were used to assess, at the intra-city level and child-specific level, the potential for TSP as a risk factor for respiratory disease in children. TSP, PM10, and PM2.5 monitored ambient concentrations are highly correlated in the study location. Modeled TSP concentrations resulting from local source emissions are dominated by a large wood processing facility, suggesting variation in exposures among children. The prevalence of respiratory non-asthmatic symptoms and hospitalizations was associated with increased TSP. No association between long-term exposure to TSP and asthma diagnosis or wheeze symptoms was found. Logistic regression modeling indicated a significant increase in hospital admissions for asthma, bronchitis or pneumonia associated with increasing air pollution (OR 2.16, CI, 1.01--4.60), doctor-diagnosed bronchitis (OR 1.53, CI, 1.02-2.30), and parent-reported chronic phlegm (OR 3.43, CI, 1.64--7.16), expressed as odds for a 15 microg/m3 increase in estimated TSP exposure, and these increases are not due to differences in socio-economic, health care or other identified factors.     

Asthmatic symptoms among pupils in relation to winter indoor and outdoor air pollution in schools in Taiyuan, China

BACKGROUND: There are few studies on associations between children's respiratory heath and air pollution in schools in China. The industrial development and increased traffic may affect the indoor exposure to air pollutants in school environment. Moreover, there is a need to study respiratory effects of environmental tobacco smoke (ETS) and emissions from new building materials in homes in China. OBJECTIVES: We studied the associations between pupils' asthmatic symptoms and indoor and outdoor air pollution in schools, as well as selected home exposures, in a coal-burning city in north China. METHODS: A questionnaire survey was administered to pupils (11-15 years of age) in 10 schools in urban Taiyuan, collecting data on respiratory health and selected home environmental factors. Indoor and outdoor school air pollutants and climate factors were measured in winter. RESULTS: A total of 1,993 pupils (90.2%) participated; 1.8% had cumulative asthma, 8.4% wheezing, 29.8% had daytime attacks of breathlessness. The indoor average concentrations of sulfur dioxide, nitrogen dioxide, ozone, and formaldehyde by class were 264.8, 39.4, 10.1, and 2.3 microg/m3, respectively. Outdoor levels were two to three times higher. Controlling for possible confounders, either wheeze or daytime or nocturnal attacks of breathlessness were positively associated with SO2, NO2, or formaldehyde. In addition, ETS and new furniture at home were risk factors for wheeze, daytime breathlessness, and respiratory infections. CONCLUSIONS: Indoor chemical air pollutants of mainly outdoor origin could be risk factors for pupils' respiratory symptoms at school, and home exposure to ETS and chemical emissions from new furniture could affect pupils' respiratory health.     

空气污染与广州市儿童呼吸系统健康关联的横断面研究

目的 研究空气污染与学龄儿童呼吸系统健康的关联.方法 于2006年选择广州市海珠区、白云区和花都区分别代表空气污染程度为高、中、低的污染区,抽取这3个区8所小学3年级和4年级小学生.通过标准化问卷调查这些儿童的家庭、社会经济状况和呼吸道症状及疾病史等.采用卡方检验、方差分析和logistic回归等方法分析不同空气污...     

Adverse effect of air pollution on respiratory health of primary school children in Taiwan.

This study is a part of the Study On Air Pollution and Health In Taiwan (SOAP&HIT), an ongoing research project involving cooperation of several universities in Taiwan. In this study, the objective was to evaluate the effects of ambient air pollution on respiratory symptoms and diseases of school children, in addition to considering indoor air pollution. Six communities were selected: one community located in a rural area (Taihsi), two in urban areas (Keelung and Sanchung), and the other three in petrochemical industrial areas (Toufen, Jenwu, and Linyuan). We sampled 5,072 primary school students in six communities from the main study population of SOAP&HIT. Respiratory health was assessed by evaluation of the children's respiratory symptoms and diseases using a parent-completed questionnaire. Data were analyzed using logistic regression analysis to compute odds ratios of adverse effect. The school children in the urban communities had significantly more respiratory symptoms (day or night cough, chronic cough, shortness of breath, and nasal symptoms) and diseases (sinusitis, wheezing or asthma, allergic rhinitis, and bronchitis) when compared with those living in the rural community. However, only nasal symptoms of children living in the petrochemical communities were more prevalent than in those living in the rural community. Although the association with ambient air pollution is suggestive, the cross-sectional study cannot confirm a causal relationship; thus further studies are needed.     

学龄儿童呼吸系统病症影响因素分析

目的 了解学龄儿童呼吸系统常见病症的影响因素。方法 采用呼吸系统健康问卷对马鞍山市6所小学所有在校学生进行回顾性调查，同时收集学生家庭居住环境、家庭背景等资料。采用Logistic回归分析模型，对学龄儿童呼吸系统病症的可能影响因素进行分析。结果 相对污染区学校和家周围有交通要道的学生各种呼吸系统病症的发生均高于对照区学校和家周围无交通要道的学生；室内空气污染因素如平时不开或很少开窗通风、家人吸烟、冬季取暖、儿童与别人共用卧室等对儿童呼吸系统病症也有不同程度的影响；母亲化水平以及性别、年龄等自身因素对儿童呼吸系统病症的发生也有一定的作用。结论 儿童呼吸系统疾病的发生受多因素的综合作用，空气污染因素、自身因素、家庭因素都对其产生一定程度的影响，在儿童的生活和学习中应加以有效的预防。     

Indoor air pollution and acute lower respiratory infections in the first two years of life

The relationship between outdoor air pollution and acute respiratory infections (ARI) was previously documented. There are recent indications for connection between indoor air pollution and ARI in infants and young children. The aim of this study was to identify the relationship of indoor air pollutants to acute lower respiratory infection (ALRI) in children (< 2 years). The indoor air pollutants concentrations were measured in the homes of the sample. The sample consisted of 115 children (< 2 years) representing the control group (24), ALRI but no pneumonia (24), pneumonia (30), severe pneumonia or very severe disease (37). Air sampling was performed to measure the concentration of total suspended particulates (TSP), SO2 and CO. These pollutants were found in higher concentrations in cases' homes (52.46 +/- 19.68 microg/m3, 298.15 +/- 669.37 microg/m3, and 1.92 +/- 3.60 ppm) than in controls' homes (31.92 +/- 8.76 microg/m3, not detected, and 0.33 +/- 1.63 ppm respectively). Whereas SO2 was detected only in houses using kerosene, TSP and CO were detected with the different types of cooking fuels. Their mean concentrations were highest for biomass (88.86 +/- 13.30 microg/m3 and 9.29 +/- 2.50 ppm) and lowest for gas (40.78 +/- 15.25 microg/m3 and 0.76 +/- 2.19 ppm). Measures to improve indoor air quality are highly required.