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。     

沈阳市某地区大气污染与儿童呼吸系统疾病门诊人次的关系

目的 探讨沈阳市主要的大气污染物与儿童呼吸系统疾病门诊人次的关系.方法 由沈阳市环境监测站和沈阳242医院分别获得该市皇姑区2004年11月1日-2005年3月31日(采暖期)大气污染物(PM10、SO2、NOx)的日均浓度资料和儿童呼吸系统疾病(上呼吸道感染、气管炎、肺炎)日门诊人次资料,采用直线回归模型进行相关回归分析,并分析大气污染物对男女儿童门诊人次的影响.结果 研究地区大气中PM10、SO2和NOx日均浓度与儿童上呼吸道感染、气管炎和肺炎日门诊人次呈正相关关系.儿童上呼吸道感染日门诊人次与PM10、SO2和NOx日均浓度的相关系数分别为0.758、0.700和0.584;儿童气管炎日门诊人次与PM10、SO2和NOx日均浓度的相关系数分别为0.564、0.559和0.578;儿童肺炎日门诊人次与PM10、SO和NOx日均浓度的相关系数分别为0.549、0.589和0.570.研究期间,PM10浓度上升10μg/m3时,儿童上呼吸道感染和肺炎门诊率分别上升1.192%和0.380%,当NOx浓度上升10μg/m3时,儿童气管炎门诊率上升0.270%.此外,随着PM10和NOx浓度的升高,女童上呼吸道感染、肺炎和气管炎门诊人次的增加多于男童.结论 沈阳市大气中PM10、SO2、NOx浓度的升高能造成儿童呼吸系统疾病患病人数的增加;与男童相比,女童的呼吸系统更易受到大气污染物的影响.     

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。     

煤烟型大气污染对儿童呼吸系统疾病及症状影响研究

采用现场流行病学调查 ,对太原市大气污染程度不同的 3个地区的小学生进行了健康问卷调查和五官检查 ,研究结果表明 :重 (中 )污染区儿童鼻炎、咽喉炎、扁桃体炎发病率分别大于相对清洁区 ,3个研究区域比较差异有极显著性 (P <0 0 1) ;儿童呼吸道症状的发生率和呼吸道疾病患病率表现为重污染区和中污染区较为接近 ,但明显高于相对清洁区 ,且有显著性差异 (P <0 0 5 )。Logistic分析结果显示儿童咳嗽、咳痰症状发生的危险性表现为重度污染区是相对清洁区的 1 6 4～ 2 92倍 ,中度污染区是相对清洁区的 1 83～2 2 7倍。儿童呼吸系统疾病发生的危险性表现为重度污染区是相对清洁区的 2 6 2～ 5 6 8倍 ,中度污染区是相对清洁区的 1 40～ 4 46倍。提示太原市煤烟型大气污染对儿童呼吸系统产生了一定危害     

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。     

母乳喂养与大气污染对儿童呼吸系统疾病和症状影响的交互效应

目的 探讨母乳喂养与大气污染对儿童呼吸系统疾病和症状影响的交互效应。方法 采用横断面研究,在辽宁省7个城市即沈阳、大连、鞍山、抚顺、本溪、营口、辽阳共25个行政区随机抽取50所幼儿园,采用国际统一的标准问卷ATS(American Thoracic Society)调查表对所选幼儿园的所有儿童进行有关母乳喂养、生活环境以及儿童呼吸系统疾病情况的调查。根据各行政区环境监测中心提供的2006-2008年大气污染物(PM₁₀、SO₂、NO₂、O₃)浓度计算日平均浓度。结果 本次研究共调查10 822人,共回收有效问卷9 318份,应答率为86.1%,符合上机进行统计分析的要求。共分析四个污染物PM₁₀、SO₂、NO₂、O₃的日平均浓度,统计的25个行政区中PM₁₀、SO₂的日平均浓度不同程度地超出国家标准,100%的行政区PM₁₀、SO₂日平均浓度超出WHO标准,36%的行政区NO₂日平均浓度超出国家标准。母乳喂养儿童7 319人,非母乳喂养儿童1 999人,其中接受母乳喂养的男童多于女童(P<0.05);非母乳喂养儿童与母乳喂养儿童相比,大气污染物PM₁₀、SO₂、NO₂、O₃每增加一个单位,儿童患有持续咳嗽、持续咳痰的危险性均呈增加趋势(P<0.05);母乳喂养与大气污染物PM₁₀、SO₂、NO₂、O₃对儿童喘鸣现患存在交互作用且有统计学意义(P<0.20)。结论 母乳喂养和大气污染对儿童呼吸系统疾病和症状的影响存在显著的交互效应。     

室内污染对儿童呼吸系统疾病的影响

在我国四个城市选择了10～15岁的小学生,观察了儿童的活动模式以及燃煤所造成的室内污染对儿童呼吸系统疾病的影响。对750名儿童活动的时间分配调查表明,儿童每天在室内度过的时间约占81％(冬季)和75％(夏季)。生活于燃煤家庭的儿童对RP、SO_2和CO的个体时间加权平均接触水平高于燃气家庭。同样,某些呼吸系统疾病患病率也是前者高于后者。     

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.     

大气污染与儿科呼吸系统疾病住院人数关系

目的 探讨深圳市主要大气污染物与儿科呼吸系统疾病住院人数的关系.方法 收集深圳市某医院2006年1月1日-2006年12月31日儿科呼吸系统疾病(上呼吸道感染、肺炎)住院人数资料,结合同时期环境监测和气象资料,进行直线相关回归分析,分析大气污染物对儿科呼吸系统疾病住院人数的影响.结果 大气中的可吸入颗粒物(PM_(10))、NO_2和O_3月浓度与儿童上呼吸道感染住院人数呈正相关(r为0.650,0.820和0.766,P＜0.05);大气中的NO_2和O_3月浓度与儿童肺炎住院人数呈正相关(r为0.719和0.692,P＜0.05).PM_(10)浓度每增加10μg/m~3,儿科上呼吸道感染住院人数增加0.135%;NO_2浓度每增加10μg/m~3,儿科上呼吸道感染和肺炎住院人数分别增加0.254%和1.129%;O_3浓度每增加10μg/m~3时,儿科上呼吸道感染和肺炎住院人数分别增加0.173%和0.794%.结论 深圳市大气污染物PM_(10)、NO_2和O_3污染对儿童呼吸系统造成一定的损伤,并导致相应疾病住院人数的增加,可能与NO_2和O_3的关系尤为密切.     

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.     

Effects of Air Pollution on Children's Respiratory Health in Three Chinese Cities

During the winter of 1988–1989, parents of 2,789 elementary-school students completed standardized questionnaires. The students were 5–14 y of age and were from three urban districts and one suburban district of three large Chinese cities. The 4-y average ambient levels of total suspended particles in the three cities differed greatly during the period 1985–1988: Lanzhou, 1,067 μmlg/m³; urban Wuhan, 406 μmlg/m³; Guangzhou, 296 μmlg/m³; and suburban Wuhan, 191 μmlg/m³. The authors constructed unconditional logistic-regression models to calculate odds ratios and 95% confidence intervals for prevalences of several respiratory symptoms and illnesses, adjusted for district, use of coal in the home, and parental smoking status. There was a positive and significant association between total suspended particle levels and the adjusted odds ratios for cough, phlegm, hospitalization for diseases, and pneumonia. This association was derived from only the 1,784 urban children and, therefore, the authors were unable to extrapolate it to the suburban children. The results also indicated that parental smoking status was associated with cough and phlegm, and use of coal in the home was associated only with cough prevalence (α = 0.05).     

Ambient Air Pollution and Chronic Respiratory Morbidity in Delhi

The authors conducted a cross-sectional study among residents of Delhi to determine the role of ambient air pollution in chronic respiratory morbidity in Delhi. The authors selected a random, stratified sample (N = 4,171) of permanent residents who were 18+ y of age and who lived near 1 of the 9 permanent air quality monitoring stations in the city. Air-quality data for the past 10 y were obtained; data were based on the differences in total suspended particulates, and the study areas were categorized into lower- and higher-pollution zones. A standardized questionnaire was administered, clinical examination was carried out, and spirometry followed. The authors assessed chronic respiratory morbidity by (a) prevalence of chronic respiratory symptoms (i.e., chronic cough, phlegm, breathlessness, and wheezing) and airway diseases (i.e., chronic obstructive pulmonary disease/chronic bronchitis and bronchial asthma); and (b) lung function results in asymptomatic nonsmoking subjects in the two pollution zones. A multiple logistic regression identified the determinants of chronic symptoms. Smoking, male sex, increasing age, and lower socioeconomic status were strong independent risk factors for occurrence of chronic respiratory symptoms. In the comparison of nonsmoking residents of lower- and higher-pollution zones—stratified according to socioeconomic levels and sex—chronic cough, chronic phlegm, and dyspnea (but not wheezing) were significantly more common in the higher-pollution zone in only some of the strata. Furthermore, prevalence rates of bronchial asthma, chronic obstructive pulmonary disease, and chronic bronchitis among residents in the two pollution zones were not significantly different. Nonetheless, lung function of asymptomatic nonsmokers was consistently and significantly better among both male and female residents of the lower-pollution zone.     

Indoor Air Pollution and Respiratory Health in Urban and Rural China

Abstract

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 randorn 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 μg/m³) and rural Anqing (248 μg/m³), but much higher in Beijing (557 μg/m³).Median indoor concentrations of SO 2 were similar in all three areas (Beijing: 14 μg/m³,Anqing City: 25 μg/m³,rural Anqing: 20 μg/m³).     

Ambient Air Pollution and Socioeconomic Status in China

Background: Air pollution disparities by socioeconomic status (SES) are well documented for the United States, with most literature indicating an inverse relationship (i.e., higher concentrations for lower-SES populations). Few studies exist for China, a country accounting for 26% of global premature deaths from ambient air pollution.Objective: Our objective was to test the relationship between ambient air pollution exposures and SES in China.Methods: We combined estimated year 2015 annual-average ambient levels of nitrogen dioxide (NO2) and fine particulate matter [PM ≤2.5μm in aerodynamic diameter (PM2.5)] with national demographic information. Pollution estimates were derived from a national empirical model for China at 1-km spatial resolution; demographic estimates were derived from national gridded gross national product (GDP) per capita at 1-km resolution, and (separately) a national representative sample of 21,095 individuals from the China Health and Retirement Longitudinal Study (CHARLS) 2015 cohort. Our use of global data on population density and cohort data on where people live helped avoid the spatial imprecision found in publicly available census data for China. We quantified air pollution disparities among individual’s rural-to-urban migration status; SES factors (education, occupation, and income); and minority status. We compared results using three approaches to SES measurement: individual SES score, community-averaged SES score, and gridded GDP per capita.Results: Ambient NO2 and PM2.5 levels were higher for higher-SES populations than for lower-SES population, higher for long-standing urban residents than for rural-to-urban migrant populations, and higher for the majority ethnic group (Han) than for the average across nine minority groups. For the three SES measurements (individual SES score, community-averaged SES score, gridded GDP per capita), a 1-interquartile range higher SES corresponded to higher concentrations of 6–9μg/m3 NO2 and 3–6μg/m3 PM2.5; average concentrations for the highest and lowest 20th percentile of SES differed by 41–89% for NO2 and 12–25% for PM2.5. This pattern held in rural and urban locations, across geographic regions, across a wide range of spatial resolution, and for modeled vs. measured pollution concentrations.Conclusions: Multiple analyses here reveal that in China, ambient NO2 and PM2.5 concentrations are higher for high-SES than for low-SES individuals; these results are robust to multiple sensitivity analyses. Our findings are consistent with the idea that in China’s current industrialization and urbanization stage, economic development is correlated with both SES and air pollution. To our knowledge, our study provides the most comprehensive picture to date of ambient air pollution disparities in China; the results differ dramatically from results and from theories to explain conditions in the United States. https://doi.org/10.1289/EHP9872     

太原市儿童急性呼吸系统症状与大气中颗粒物等环境因素的关系

目的探讨空气污染与儿童呼吸系统症状的关系。方法于2005年应用病例交叉设计对太原市254名7～11岁儿童呼吸系统症状与大气中PM10浓度等相关环境因素进行相关分析。结果儿童呼吸系统症状发生2、3d前空气中PM10浓度每增加10μg/m3,儿童咳嗽的概率分别增加0.070、0.175倍;咽痛增加0.160、0.212倍。症状发生3d前空气中PM10浓度每增加10μg/m3,流涕发生的概率增加0.085倍;发生鼻塞的概率增加0.11倍。症状发生3d前平均风速每增加10m/s,患鼻塞概率增加0.098倍。结论儿童呼吸系统症状(咳嗽、流涕、鼻塞和咽痛)发生率的增加与大气中PM10浓度的上升有关联。     

我国大气污染与儿童肺功能的关系

目的 描述我国主要的大气污染物(TSP、SO2、NOx)与儿童肺功能各指标[儿童用力肺活量(FVC)、1秒用力呼气容积(FEV1)、最大呼气中段流速(MMEF)]的相关关系.方法 收集整理国内1985-2006年1月公开发表的关于大气污染与儿童肺功能研究的文献,选择研究人群中包括7～15岁儿童,报告了当地大气质量的监测结果,肺功能测定过程采取了严格质量控制措施,并且结果以实测值均数表示的文献共11篇,分析我国城市主要大气污染物浓度与儿童FVC和FEV1的相关关系,并分别比较对男女儿童的影响.结果 最终入选的文献涉及我国7个城市的研究结果,其中,6个城市的研究发现大气污染严重的地区儿童的肺功能指标低于污染较轻的地区,且差异有统计学意义.上述研究中,大气中TSP平均浓度范围为0.084～0.835 mg/m3;SO2为0.013～0.929 mg/m3;NOx为0.044～0.229 mg/m3.相关分析发现研究地区大气的TSP和SO2浓度与儿童FVC和FEV1,NOx浓度与儿童的MMEF呈显著的负相关关系.儿童FVC与TSP浓度和SO2浓度的对数的相关系数分别为-0.797(t=-4.384,P=0.001)和-0.693(t=-4.190,P＜0.001);儿童FEV1与TSP浓度和SO2浓度的对数的相关系数分别为-0.886(t=-5.392,P=0.001)和-0.685(t=-4.101,P=0.001);儿童MMEF与NOx浓度的相关系数为-0.973(t=-5.993,P=0.027).分析还发现,随着大气TSP或SO2浓度的升高,女童FVC和FEV1的降低比男童多.结论 我国大气中TSP和SO2浓度能造成儿童大气道功能的下降,NOx浓度则主要影响儿童的小气道功能;与男童相比,女童肺功能更易受到大气污染物的影响.     

我国厨房操作间空气污染与健康关系的研究进展

厨房是餐饮烹调活动的场所，燃料燃烧时所产生的多种燃烧产物和烹调食用油加热产生含有多种化合物的油烟会造成厨房空气污染，影响厨房工作人员的健康，其卫生问题已经引起人们的关注。由于我国与国外的烹调方式有很大不同，故我们只对我国厨房空气污染的来源、空气污染对人体的危害及改善厨房空气污染的措施等方面研究现状作一综述。     

上海市大气二氧化硫污染与常见呼吸道症状的关系

本研究选择上海市区飘尘污染轻,而二氧化硫污染程度不同的3个地区,通过准历史性前瞻的流行病学调查方法,采用多因素回归分析探讨二氧化硫污染对人体呼吸道常见症状发生的作用。结果表明,现有上海大气二氧化硫污染对呼吸系统的不利影响是存在的,大气二氧化硫年平均浓度每增加60μg/m~3时,咳嗽和气急发生的优势比为1.31和1.71。