儿童白血病的病例对照研究

为了探讨儿童白血病的主要病因,进行1:1配对病例对照研究,结果发现5个危险因素:住家附近有三废污染OR(95% CI)为2.84(1.14~7.10),极低频电磁场暴露OR为2.01(1.18~3.42),儿童X线暴露OR为4.53(1.68~12.21),儿童服用氯霉素OR为3.60(1.62~8.01),服解热镇痛类药物OR为1.93(1.09~3.42);1个保护因素:母亲孕期经常食用鱼、肉类食品OR为0.33(0.18~0.59)。总人群归因危险度表明人群中91%的病例可归因于上述危险因素;X线暴露与氯霉素对儿童白血病的发生有正的交互作用,其相对超额危险度为3.04。     

吉林地区儿童先天性心脏病影响因素的病例对照研究

目的 分析吉林地区儿童先天性心脏病(CHD)的非遗传影响因素,寻找降低吉林地区儿童CHD患病风险的针对性策略。方法 选择2019—2020年吉林省出生缺陷上报系统发现的符合纳入标准并愿意配合的70对CHD患儿及其母亲作为病例组,选择同性别、年龄、地区的140对健康儿童及其母亲作为对照组进行1∶2病例对照配对。应用多因素Logistic回归分析模型分析儿童CHD的影响因素。结果 病例组和对照组儿童的性别、年龄分布差异无统计学意义(P>0.05),多因素分析结果显示：早产(OR=6.224)、父亲孕前3个月内饮酒(OR=2.476)、母亲孕前BMI≥25(OR=8.372)是儿童CHD的危险因素(P<0.05),孕期服用复合维生素(OR=0.342)是儿童CHD的保护因素(P<0.05)。结论 早产、父亲孕前3个月内饮酒和母亲孕前BMI≥25是吉林地区儿童CHD发病的危险因素,应重点关注早产儿心脏功能,加强对备孕夫妇保健知识的宣传教育,鼓励其戒烟戒酒、控制体重,做好孕前和孕期保健。     

儿童重症结核影响因素病例对照研究

[目的]了解儿童重症结核致病的影响因素。[方法]采取以社区为基础的病例对照流行病学研究方法,筛选出儿童结脑等重症结核病例,根据病例的年龄、性别、来源地信息按1:3比例选取合适的对照,填写问卷调查表。采用Epi Info软件对资料进行卡方检验、单因素条件Logistic回归分析。[结果]纳入42例病例,126名对照。两组间家庭人口、家庭年总收入、家庭总居住面积、住宅状况、慢性疾病史,差异无统计学意义。肺结核病接触史和接触程度、与肺结核病人的关系、肺结核病史与儿童结脑等重症结核发病有统计学显著性关联。[结论家庭人口总数、家庭年总收入、家庭总居住面积、居住地状况、住宅状况、有无慢性病史等因素与儿童结脑等重症结核的发病无关。肺结核病人接触史、接触密切程度是儿童结脑等重症结核的影响因素。     

北京市郊区儿童哮喘病影响因素病例对照研究

目的了解北京市郊区儿童哮喘病相关影响因素,为采取相应干预措施提供依据。方法采用自行设计调查问卷抽取北京市郊区小学27 445名1~5年级小学生父母进行横断面调查,对按标准筛查出的370例哮喘病例组学生和868名对照组学生父母进行病因调查。结果病例组低出生体重、非足月出生、母乳喂养6个月、有哮喘家族史、有过敏家族史、有过敏症、被动吸烟和家中燃煤做饭且不排风的比例分别为8.4%,10.0%,69.7%,21.4%,26.2%,34.3%,77.0%和26.8%;对照组分别为4.2%,6.0%,75.7%,8.3%,17.7%,11.7%,70.6%和19.8%,差异均有统计学意义(P0.05);多因素Logistic回归分析结果表明,低出生体重、有哮喘家族史、有过敏家族史、有过敏症和家中燃煤做饭且不排风是北京市郊区儿童患哮喘的危险因素;母乳喂养6个月是北京市郊区儿童患哮喘的保护因素。结论应针对儿童易患哮喘病的危险因素制定相应的预防措施,提倡母乳喂养,以降低患哮喘的相对危险性。     

广州市12岁儿童氟斑牙影响因素病例对照研究

目的 对广东省广州市12岁儿童氟斑牙的影响因素进行研究,为氟斑牙的预防提供依据。方法 用1:2配对病例对照研究方法,选取38例氟斑牙儿童为病例,并选取与病例所在区、学校相同,性别相同的76名健康儿童为对照,组成病例-对照样本进行口腔健康问卷调查。结果 单因素分析结果显示,病例组与对照组间父亲文化程度、母亲文化程度、从电视/广播接受口腔卫生知识、饮用牛奶、使用含氟牙膏和刷牙次数差异有统计学意义,其OR值分别为6.75,7.86,0.67,0.41,0.64和1.20;多因素分析显示,饮用牛奶是儿童患氟斑牙的保护性因素。结论 广州市儿童应该加强牛奶的摄入,以减少氟斑牙的发生。     

儿童脑瘤危险因素的病例对照研究

采用１∶３配比的病例对照研究及Ｌｏｇｉｓｔｉｃ回归分析方法,对儿童脑瘤危险因素进行研究。单因素分析发现,儿童期头部外伤与儿童脑瘤有关,父母的文化程度是其保护因素。多因素分析发现,儿童头部外伤、父亲饮酒、母亲文化程度与儿童脑瘤的发生有关。其中母亲文化程度为保护因素,文化程度高的母亲其子女发生脑瘤的危险降低。     

广西壮族地区儿童虐待影响因素病例对照研究

目的 了解广西壮族地区中小学生儿童虐待(CA)发生的影响因素,为制定干预措施提供参考依据.方法 采用1∶1配对病例对照研究方法对在广西隆林和田东2个壮族聚居县随机抽取的136对受虐组和非受虐组学生及其家长进行问卷调查.结果 受虐组家长夫妻关系一般、不认同孩子不打不成材、不认同周围家长打孩子常见、有时了解孩子想法和感受、孩子有时、很少做家务、家长被其父母打骂持续时间到初中、高中或成年后、家长精神质为典型高型的比例分别为37.5%、63.2%、58.1%、43.4%、39.0%、9.5%、47.1%、22.0%、16.9%;非受虐组分别为25.0%、75.0%、71.3%、30.9%、52.2%、12.5%、32.4%、16.1%、5.9%,差异均有统计学意义(P＜0.05);多因素条件Logistic回归分析结果表明,家长被其父母打骂持续时间到初中、高中或成年后和家长精神质为典型高型是CA发生的危险因素;家长不认同孩子不打不成材、孩子有时、很少做家务是CA发生的保护因素.结论 家长是CA的决定因素,其个性特征、受虐经历、观念态度和亲子间交流程度对CA的发生有重要影响作用.     

儿童感染乙肝表面抗原的影响因素病例对照研究

[目的]探讨福建省15岁以下儿童感染乙肝表面抗原(HBsAg)的影响因素,为进一步控制乙肝流行提供依据。[方法]根据分层整群随机抽样,对儿童HBsAg携带率进行调查,抽取其中6个县(市、区),采用1:2病例对照研究设计,以HBsAg阳性儿童为病例,同性别、同自然村或街道和年龄上下相差不超过2岁的HBsAg阴性的儿童为对照。用SPSS 13.0软件包进行条件logistic单因素和多因素统计分析。[结果]儿童乙肝疫苗首针是否及时接种回归系数(β)=1.554,预防接种史β=-2.744,拔牙史β=2.974,家庭内乙肝病人或病毒携带者β=3.153。[结论]儿童有拔牙史、家庭内有乙肝病人或病毒携带者,是儿童感染HBsAg的危险因素;儿童乙肝疫苗首针及时接种、儿童有预防接种史是保护因素。     

成都市学龄前儿童肥胖影响因素的病例对照研究

[目的]了解成都市学龄前儿童肥胖的影响因素,为儿童肥胖的预防和控制提供基础资料。[方法]在成都市幼儿园随机选取50名年龄3￣6岁肥胖儿童,按1︰2的比例与100名同性别、同身高、同年龄的正常儿童配对,通过问卷调查方法进行儿童肥胖影响因素的病例对照研究。[结果]本次病例对照研究结果表明,遗传因素和环境因素对学龄前儿童肥胖均有影响。学龄前儿童肥胖危险因素主要是食量、出生巨大儿、父母BMI、进餐速度及运动时间。[结论]学龄前儿童肥胖的危险因素多与生活行为方式密切相关,因此应加强对家长和幼教人员的营养教育,增强其健康意识,培养儿童良好的饮食和运动习惯,从而达到有效地预防和控制儿童肥胖的目的。     

家庭因素与儿童孤独症的病例对照研究

目的:探讨家庭因素在儿童孤独症发生中的作用。方法:符合DSM-Ⅳ孤独症诊断标准的80名儿童孤独症者为病例组,具有可比性的160名正常儿童为对照组,进行1∶2配对病例对照研究。结果:与对照组儿童比较,病例组儿童父母的文化程度和职业层次较高,家庭的亲密度、娱乐性得分较低,而矛盾性得分较高(P<0.05);单亲或重组家庭,主要由(外)祖父母照顾、过分溺爱、放任自流、让孩子独自玩耍、家长不予理睬是儿童孤独症的促进因素,而经常与孩子玩耍、带孩子看书、讲故事,让孩子和其他小朋友一起玩耍是儿童孤独症的抑制因素。结论:儿童孤独症的发生与家庭诸多因素有关,应加强对儿童抚养人孤独症防治知识的普及,创造和谐稳定的生活环境,采取适当的教养方式,减少儿童孤独症的发生。     

Prenatal exposure to perfluoroalkyl substances,immune-related outcomes,and lung function in children from a Spanish birth cohort study

BackgroundPrenatal exposure to perfluoroalkyl substances (PFASs) has been associated with impaired immune and respiratory health during childhood but the evidence is inconsistent and limited for lung function. We studied the association between prenatal PFASs exposure and immune and respiratory health, including lung function, up to age 7 years in the Spanish INMA birth cohort study.MethodsWe assessed four PFASs in maternal plasma samples collected during the 1st trimester of pregnancy (years: 2003–2008): perfluorohexane sulfonate (PFHxS), perfluorooctane sulfonate (PFOS), perfluorooctanoate (PFOA), and perfluorononanoate (PFNA). Mothers reported the occurrence (yes/no) of lower respiratory tract infections, wheezing, asthma, and eczema in the previous 12 months at 1.5 and 4 years of the child (n = 1188) and at 7 years (n = 1071). At ages 4 (n = 503) and 7 (n = 992) years lung function was assessed using spirometry tests.ResultsThe most abundant PFASs were PFOS and PFOA (geometric means: 5.80 and 2.31 ng/mL, respectively). The relative risk of asthma during childhood per each doubling in PFNA concentration was 0.74 (95 CI%: 0.57, 0.96). The relative risk of eczema during childhood per every doubling in PFOS concentration was 0.86 (95 CI%: 0.75, 0.98). Higher PFOA concentrations were associated with lower forced vital capacity and lower forced expiratory volume in 1 s z-scores at 4 years [β (95 CI %): −0.17 (−0.34, −0.01) and −0.13 (−0.29, 0.03), respectively], but not at 7 years.ConclusionThis longitudinal study suggests that different PFASs may affect the developing immune and respiratory systems differently. Prenatal exposure to PFNA and PFOS may be associated with reduced risk of respiratory and immune outcomes, particularly asthma and eczema whereas exposure to PFOA may be associated with reduced lung function in young children. These mixed results need to be replicated in follow-up studies at later ages.     

The influence of large-scale airborne particle decline and traffic-related exposure on children's lung function

Between 1991 and 2000, ambient air pollution in East Germany changed to resemble West German pollution levels: The concentration of total suspended particles (TSPs) decreased on a broad scale while traffic increased. During that time, we analyzed total lung capacity (TLC) and airway resistance (R(aw)) of East and West German children. We tested children 5-7 years of age (n = 2,574) with cooperation-independent body plethysmography in repeated cross sections. We used random-effect models to determine the mutually adjusted association between lung function and short-term and chronic particle exposure and its interaction with living near a busy road. Annual averages of TSPs declined from 77 to 44 microg/m2; averages on the day of investigation declined from 133 to 30 microg/m2. Differences in lung function between East and West German children vanished during the investigation time. The association of TSPs with R(aw) and TLC was stronger in children living > 50 m away from busy roads. East German children from this group had an R(aw) 2.5% higher [95% confidence interval (CI), 0.0-5.1%] per 40-microg/m2 increase of daily TSP averages. TLC decreased by 6.2% (95% CI, 0.04-11.6%) per 40-microg/m2 increase in annual mean TSPs, and this effect was equally pronounced in East and West Germany. TSP exposure decreased on a broad scale between 1991 and 2000. Lower concentrations of TSPs were associated with better measures of lung function in 6-year-old children. For children living near busy roads, this effect was diminished.     

机动车尾气暴露与儿童神经行为功能关系

目的探讨机动车尾气暴露及相关因素对儿童神经行为功能的影响,并寻找神经行为功能受点人群。方法在福建省泉州市某区选择机动车尾气污染水平不同的2所小学,整群选取二、三年级学生进行问卷调查和神经行为功能测试,最终选择861名研究对象进行分析;采用卡方自动交互检测法(CHAID)分析儿童神经行为功能的主要影响因素及各因素之间可能存在的交互作用。结果二年级有被动吸烟的女童和二年级有被动吸烟且生活在污染区的男童神经行为功能受影响率最高,分别为72.55%和67.24%;机动车尾气暴露是影响三年级儿童神经行为功能的首要因素。结论机动车尾气及被动吸烟暴露的儿童应该被视为重点关注和保护人群;避免在居室内吸烟、减少机动车尾气污染等措施有利于儿童神经行为功能发育。     

A case-control study on the effect of exposure to different substances on the development of COPD

PURPOSE: The purpose of this study was to examine the effect of exposure to different substances on the development of chronic obstructive pulmonary disease (COPD). METHODS: The case group consisted of 74 housewives. These were female patients who never smoked who had a diagnosis of COPD and were seen at the Cumhuriyet University Hospital in Sivas, Turkey, between January 1, 2001, and March 31, 2002. The control group consisted of 74 housewives; this group consisted of healthy women who never smoked who came to the hospital as visitors and who did not have the diagnosis of COPD. The control group was chosen by group matching of the age distribution of the women in the case group and the regions and the neighborhoods where they lived. All of the women in the case and control groups were evaluated with a questionnaire for exposure to wood ashes, biomass, and cigarette smoke in closed areas. RESULTS: No difference was found in the groups for exposure to wood ashes (p > 0.05). Logistic regression analysis resulted in the following odds ratio of COPD estimate for women with > or = 30 years biomass exposure, 6.61 (95% Confidence interval [CI]: 2.17-20.18); for women with > or = 30 years cigarette smoke exposure, 4.96 (95% CI: 1.65-14.86). CONCLUSION: A statistically significant correlation was found between the effect of > or = 30 years of exposure to biomass and cigarette smoke exposure and the development of COPD.     

Prenatal exposure to perfluroalkyl substances and children's IQ: The Taiwan maternal and infant cohort study

BackgroundPerfluoroalkyl substances (PFASs) are a group of fluorinated organic substances that are widely used in consumer products and are often detectable in human tissues. Human studies on prenatal exposure to PFASs and neurodevelopment in children are few and inconsistent.MethodsIn the Taiwan Maternal and Infant Cohort Study, we collected serum samples from pregnant women during the third trimester and measured concentrations of 9 PFASs using a high performance liquid chromatography system. A subsample of their children was assessed with full scale intelligence quotient (FSIQ), verbal IQ (VIQ) and performance IQ (PIQ) at both age 5 (n = 120) and 8 years (n = 120). We used multivariate linear regression models to examine prenatal PFAS exposure in relation to IQ scores at each age period.ResultsPrenatal perfluoroundecanoic acid (PFUnDA) concentrations were inversely associated with children's PIQ scores at age 5 years, with an adjusted coefficient (β) of −1.6 (95% confidence interval [CI]: (−3.0, −0.2). When children reached 8 years, most of the prenatal PFASs showed inverse association with children's FSIQ, VIQ and PIQ scores. Among them, prenatal perfluorononanoic acid (PFNA) reached significance. Children with higher prenatal PFNA levels had lower VIQ with an adjusted β of −2.1 (95% CI: −3.9, −0.2).ConclusionsWe found two prenatal PFAS exposure, both long-chain PFASs, in association with decreased IQ test scores in children. Our findings suggest more studies on long-chain PFASs and children's neurodevelopment.     

Estimation of parental resistance in evaluating the effect of chemical substances on children's health

Proceeding from the experimental study carried out on the model of aniline methemoglobinemia, it was shown that the animals with low aniline-related resistance also had aniline low-resistant posterity during two following generations and vice versa high-resistant animals had the more aniline-resistant posterity. It was determined both by methemoglobin levels and by the number of animals with different methemoglobin levels. According to the degree of aniline-induced methemoglobinemia the correlation among three generations of animals was established.     

长期接触氯气对工人肺功能影响的调查

氯气是氯碱化工生产中主要的有毒刺激性气体,大剂量氯气引起的急性中毒早已为人们所认识,而长期低浓度接触对人体影响的报道则不多,为了进一步了解长期低浓度氯气对作业人员呼吸道的影响,我们对某化工厂从事氯气作业人员进行了肺功能检查,现将调查资料总结如下。     

Comprehension and perceptions of study participants upon receiving perfluoroalkyl substance exposure biomarker results

Background

Measurement of environmental biomarkers in biomedia is increasingly used as a method of exposure characterization in human population studies. Reporting the results of biomarker measurements back to study participants has been controversial, including questions of ethics and whether the study participants would want to receive and would understand the results.

血清全氟化合物与成人高血压发病风险的关系

目的 通过分析美国国家健康和营养调查数据（National Health and Nutrition Examination Survey, NHANES）探讨全氟化合物（Perfluoroalkyl substances, PFAS）暴露与成人高血压发生风险的关系。方法 本研究人群选自NHANES 2003—2012年5个调查周期中20～85岁成年人,采用多因素logistic回归评估血清PFAS与成人高血压发生风险的关联。结果 共纳入6 509例参与者,其中女性3 300例（50.7%）,平均年龄（50.0±18.0）岁。高血压患者1 584例（24.3%）。与非高血压者相比,高血压患者血清全氟辛酸（Perfluorooctanoic acid, PFOA）和全氟辛烷磺酸（Perfluorooctane sulfonic acid, PFOS）浓度较高。校正年龄、性别、种族、教育水平、吸烟、饮酒、收入与贫困基线比值、体力活动、体质指数、糖尿病及心血管疾病的多因素logistic回归模型发现,与最低四分位数浓度相比,最高四分位数血清PFOA浓度（OR=1.37, 95%CI: 1.09～1.72, Ptrend =0.002）和血清PFOS浓度（OR=1.38, 95%CI: 1.09～1.75, Ptrend =0.013）增加高血压发生风险。结论 本研究发现血清PFOA和PFOS与成人高血压发生密切相关,这一发现提示PFAS暴露是高血压发生的重要危险因素。     

化学物质经皮职业暴露评估模型的对比研究

将新加坡的Dermal Exposure模型、美国工业卫生协会(AIHA)的skin Perm模型和美国国家职业安全与卫生研究院(NIOSH)的Finite Dose Skin Permeation Calculator模型进行实例比较研究,探讨这三种皮肤暴露评估模型的科学合理性和适用范围。新加坡的Dermal Exposure模型为半定量模型,评估结果可以直接根据LD50进行比较,简单易用,适用于半定量评估。AIHA模型和NIOSH模型均可进行经皮吸收剂量的定量模拟,可以用工作场所空气浓度限值转换当量评估其暴露程度。二者均可以进行瞬时暴露和持续暴露情况下的模拟,以皮肤瞬时接触对硫磷为实例进行模拟,结果显示两种定量评估模型的评估结果在一定程度上具有一致性。但二者也存在一定差异,AIHA模型简单方便,但在暴露时间、暴露频次等暴露场景方面设计固定,未体现温度、风速、蒸气压等暴露因素,无法适用灵活多变的实际暴露过程,主要适用于简单的定量评估。NIOSH模型综合考虑了温度、风速、蒸气压、暴露时间、吸收时间、暴露频次、暴露量、暴露方式等多方面因素,模拟暴露场景接近于实际,适用范围广泛,评估结果的准确性较高。