家庭室内潮湿暴露与儿童哮喘和过敏性湿疹的关系研究

目的调查不同特征儿童哮喘和过敏性湿疹的流行现状,并探索室内潮湿因素对儿童哮喘和过敏性湿疹的影响,为相关疾病的家庭预防提供理论依据。方法采用分层整群抽样的方法于2015年1月至12月在某市抽取3193名儿童作为研究对象,采用χ2检验和多因素logistic回归分析探讨家庭室内潮湿暴露与儿童哮喘和过敏性湿疹的关系。结果研究共纳入1474名男孩和1665名女孩,哮喘患病率为3.10%,过敏性湿疹患病率为38.52%,多因素logistic回归分析表明发霉的气味会使儿童哮喘患病风险增加1.42倍(OR[95%CI]:2.42 [1.40,5.31]),与儿童过敏性湿疹发生风险有关的因素包括家庭室内窗户水凝结(OR[95%CI]:1.34[1.10,1.64]),发霉气味(OR[95%CI]:3.13[2.10,4.67]),衣物/被褥潮湿(OR[95%CI]:1.49 [1.20,1.85])以及天花板可见湿渍(OR[95%CI]:2.06[1.54,2.76])。结论儿童哮喘和过敏性疾病受多种因素的影响,对家庭环境可控因素进行干预,降低室内潮湿危险因素的暴露,具有重要意义。     

沈阳市某区儿童湿疹发生情况及影响因素分析

了解儿童湿疹发生情况及影响因素,为有针对性地采取防治措施提供参考依据.方法 2017年5月随机选取沈阳市某区2所小学,对全部学生2 240名进行问卷调查(其中判定儿童是否患过湿疹需要经过医生诊断).结果 既往发生过湿疹的有838人,报告率为37.4%,其中男童为38.7%,女童为36.1%.6~<12月龄是儿童首发湿疹的高峰时期,1岁内发生湿疹的比例达70.1%.以往发生过湿疹的儿童现阶段经常发生感冒的频率明显增高,并且过敏性鼻炎、哮喘、食物过敏的报告率也明显升高.Logistic回归分析显示,母孕期心情不好(OR=1.32,95%CI=1.03~1.69)、父母文化程度越高(OR=1.60,95%CI=1.19~2.16)、父母亲为过敏体质(父亲OR=1.58,95%CI=1.07~2.33;母亲OR=1.41,95%CI=1.02~1.94)、有糖尿病家族史(OR=1.95,95%CI=1.41~2.68)、剖腹产(OR=1.33,95%CI=1.07~1.65)与儿童湿疹发生呈正相关.结论 儿童湿疹发生受母孕期心情和家庭因素、分娩方式的影响,发育早期预防儿童湿疹发生对将来降低其他过敏性疾病发生具有重要现实意义.     

广州地区儿童哮喘危险因素病例对照研究

目的探讨广州地区儿童哮喘的危险因素。方法从广州市海珠区、白云区和花都区8所小学7635名儿童中筛选出哮喘病患,按性别和年龄1∶1配对选取健康对照。通过家长问卷调查儿童家庭的社会经济特征、父母过敏和哮喘史及室内环境等因素。结果 Logistic回归分析显示,父亲、母亲有过敏史的儿童哮喘患病风险显著高于对照组,其OR值分别为5.05(95%CI:1.37～18.65)和5.38(95%CI:1.23～23.54),儿童自身过敏史与哮喘之间呈显著关联(OR=5.58,95%CI:1.53～20.36),室内新家具可显著增加儿童哮喘的患病风险(OR=6.42,95%CI:1.13～36.62)。结论父母过敏性疾病史、儿童自身过敏史和室内新家具是儿童哮喘的重要危险因素。     

中山市居室内被动吸烟对儿童哮喘及哮喘样症状的影响

目的探讨中山市居室内被动吸烟对儿童哮喘及哮喘样症状的影响。方法于2016年3—7月在中山市城区采用随机整群抽样方法抽取小学和初中各5所,共有效调查11 611名儿童,采用国际统一的标准问卷[美国胸科协会制定的标准呼吸卫生调查表(ATS)]调查所选学生的哮喘及哮喘样症状及家庭室内被动吸烟等情况,分析被动吸烟对儿童哮喘和哮喘样症状的影响。结果中山市儿童的持续咳嗽、持续咯痰、喘鸣、哮喘和哮喘现患的检出率分别为2.85%(331/11 611),1.20%(139/11 611),6.93%(805/11 611),5.70%(662/11 611)和1.46%(169/11 611),有30.9%(3 588/11 611)的儿童暴露于二手烟。室内被动吸烟、母亲吸烟、母亲妊娠期被动吸烟和两岁前被动吸烟均对儿童哮喘和哮喘样症状有不同程度的影响(P0.05);家庭成员每日吸烟量≥5支的儿童哮喘现患率(OR=3.66,95%CI:1.68~8.01)和喘鸣发生率(OR=1.76,95%CI:1.04~2.97)均高于非吸烟组,差异均有统计学意义(P0.05)。多因素非条件logistic回归分析显示,两岁前被动吸烟是儿童哮喘及哮喘样症状的危险因素(OR值为1.51~2.03),室内被动吸烟是儿童持续咯痰的危险因素(OR=1.61,95%CI:1.11~2.35),均有统计学意义(P0.05)。结论中山市室内被动吸烟是儿童哮喘及哮喘样症状的危险因素,尤其是两岁前被动吸烟。     

儿童哮喘及过敏性疾病室内环境因素病例对照研究

[目的]探讨与儿童哮喘及过敏性疾病有关的室内环境因素。[方法]采用1︰1配对的病例对照研究方法,问卷调查152例儿童哮喘、过敏性紫癜、变应性鼻炎、湿疹的患者以及与152例非病例儿童室内环境因素,采用单因素和多因素条件Logistic回归模型进行数据分析。[结果]单因素条件及多因素条件Logistic回归分析结果均显示,病例组有住房装修史、室内油烟污染、厨房无排烟设备的频率高于对照组,并且在两组之间差异有统计学意义(P﹤0.01),OR值分别为3.05,7.04,2.03。对照组床褥经常晾晒的比例高于病例组,且差异有统计学意义(P﹤0.05,OR值为0.46)。[结论]住房装修、室内油烟污染及厨房无排烟设备可能会增加患儿童哮喘及过敏性疾病的危险性,床褥经常晾晒可降低儿童哮喘及过敏性疾病的发生。     

凉山彝族自治州学龄前儿童过敏性湿疹的环境影响因素研究

目的探讨凉山彝族自治州学龄前儿童过敏性湿疹的环境影响因素,为后期进行预防干预措施提供依据。方法选取2015年5月-2016年5月四川省凉山州第一人民医院儿科患过敏性湿疹的1～6岁学龄前儿童470例和没有湿疹患病史的儿童486例,采用自行设计的问卷进行调查,采用SPSS 17. 0进行统计学分析。结果儿童年龄越小,湿疹发病风险越低(OR=0. 67,95%CI=0. 50～0. 91)。有过敏性疾病家族史(OR=2. 80,95%CI=1. 90～4. 14)、房屋通风不良(OR=3. 75,95%CI=2. 82～5. 00)、房屋类型为公寓(OR=1. 50,95%CI=1. 12～1. 99)、衣物或被褥受潮(OR=1. 69,95%CI=1. 21～2. 3)、住所发现蟑螂(OR=2. 26,95%CI=1. 69～3. 01)、孩子出生前后房屋进行过装修(OR=1. 49,95%CI=1. 09～2. 0)和家里有时/从不打扫(OR=2. 37,95%CI=1. 60～3. 51)是患过敏性湿疹的危险因素。结论有过敏性湿疹家族史、房屋通风不良、住宅类型为公寓、衣物或被褥受潮、发现蟑螂和家里有时/从不打扫、孩子出生前后房屋进行过装修都是儿童患过敏性湿疹的危险因素。     

学龄前儿童哮喘分布特征及母乳喂养保护作用

阐明中国长江中下游三省3~6岁学龄前儿童哮喘的分布及母乳喂养对哮喘的保护作用,为降低学龄前儿童过敏性疾病的发病率提供参考.方法 2017年10__11月,以幼儿园为单位对湖北、安徽和江苏三省共11座城市的27 200名学龄前儿童家长进行问卷调查,描述儿童哮喘和母乳喂养情况.结果 调查地区学龄前儿童哮喘检出率为4.0%,男女童分别为5.0%,2.9%;3,4,5,6岁分别为3.2%,3.7%,4.4%,4.9%.从未母乳喂养3 448名,占12.7%;主要母乳喂养7 630名,占28.1%;纯母乳喂养1~5个月比例为50.0%,≥6个月仅为10.2%.纯母乳喂养1~5个月对哮喘(OR=0.88,95%CI=0.77~0.89)具有保护作用,调整混杂因素后仍具有统计学意义.调整混杂因素后,以过敏性结膜炎分层,对于无过敏性结膜炎史的4岁学龄前儿童,纯母乳喂养≥6个月对哮喘具有保护作用(OR=0.63,95%CI=0.40~0.99);以湿疹分层,对有湿疹史的4岁学龄前儿童,纯母乳喂养≥6个月对哮喘具有保护作用(OR=0.52,95%CI=0.27~0.99).结论 纯母乳喂养对学龄前儿童哮喘具有保护作用.对无过敏性结膜炎和有湿疹史的4岁儿童,纯母乳喂养≥6个月对哮喘保护性更好.     

黄岛区学龄前儿童不明原因中枢神经系统症状调查

目的探讨学龄前儿童不明原因一般中枢神经系统(CNS)症状发生现状及其可能的危险因素。方法通过问卷对青岛市黄岛区主要幼儿园720名3~6岁儿童进行调查,主要收集不良建筑物综合征(SBS)样症状、儿童个人信息、家庭住宅室内环境、幼儿园环境及室外环境等信息。结果被调查儿童不明原因CNS症状发生率为26.6%;多因素分析结果显示,三合板(OR=2.10,95%CI=1.30~3.41)、模压板家具(OR=2.45,95%CI=1.51~4.00)、靠近交通干道(OR=1.63,95%CI=1.04~2.54)、经常使用抗生素(OR=2.53,95%CI=1.47~4.35)及化学物质过敏(OR=1.14,95%CI=1.07~1.21)是不明原因CNS症状的危险因素,而湿拖把拖地(OR=0.45,95%CI=0.22~0.92)则是保护因素。结论学龄前儿童不明原因CNS症状发生率较高,家庭居室内家具材质、室内空气中的颗粒物质、交通污染、儿童自身疾病及过敏性体质是其可能的危险因素。     

乌鲁木齐市住宅室内潮湿表征与儿童哮喘及过敏性疾病的相关性

[目的]研究乌鲁木齐市儿童哮喘及过敏性疾病与住宅室内潮湿的关系,为进一步提出有效预防儿童哮喘及过敏性疾病的措施提供科学依据。[方法]2011年10—12月,采取多阶段整群抽样的方法,对乌鲁木齐市7个行政区的5 650名1~8岁儿童进行问卷调查。调查问卷包括基本信息,儿童及家长的健康情况,住宅和建筑特征以及室内潮湿表征4个部分。应用卡方检验和非条件logistic回归方法估计室内潮湿表征与儿童哮喘及过敏性疾病的关联。[结果]有效问卷共4 618份,应答率81.7%,男童占53.7%。共有20.8%的住户报告"窗户凝结水",其次是"水损"(15.1%),"湿斑"(14.1%)和"霉点"(8.6%)。在所调查的疾病中,46.4%的儿童报告曾经出现鼻炎;近12个月里,42.7%的儿童出现鼻炎,25.3%出现喘息;医生诊断哮喘和鼻炎的报告率分别为3.7%和8.7%。室内潮湿与儿童哮喘及过敏性疾病显著相关,其中,"湿斑"与近12个月喘息症状显著相关[OR=1.57;95%置信区间(CI):1.27~1.95];"霉点"与医生诊断哮喘(OR=2.18;95%CI:1.30~3.67);"窗户凝结水"(OR=1.62;95%CI:1.09~2.40)和"水损"(OR=1.93;95%CI:1.35~2.76)与近12个月湿疹等均呈现正相关;且近12个月里出现的喘息、鼻炎和湿疹症状,其OR值随着潮湿表征评分的升高而增大。[结论]乌鲁木齐市住宅室内潮湿可能是儿童哮喘及过敏性疾病的潜在危险因素。     

2005-2014年中国儿童哮喘与过敏体质、家族史、被动吸烟病例对照研究的Meta分析

目的采用病例对照研究Meta分析了解2005-2014年中国儿童哮喘与过敏体质、家族史、被动吸烟的相关性。方法选取2005-2014年在权威杂志上发表的中国儿童哮喘与过敏体质、家族史、被动吸烟相关的文献报道作为研究材料,采用病例对照研究Meta分析的研究方法分析中国儿童哮喘与过敏体质、家族史及被动吸烟的相关性。结果 2005-2014年在中国期刊全文数据库和中国生物医学文献数据库中发表的关于过敏体质与中国儿童哮喘的病例对照研究中,过敏体质与中国儿童哮喘的总相关OR值达13.4,95%CI可信区间为4.27~18.64,家族史与中国儿童哮喘的总相关OR值达5.32,95%CI可信区间为2.41~23.62,被动吸烟与中国儿童哮喘的总相关OR值达3.19,95%CI可信区间为1.46~2.82。结论 2005-2014年中国儿童哮喘相关危险因素的病例对照研究Meta分析表明:过敏体质、家族史及被动吸烟是导致儿童哮喘发生的危险因素,且过敏体质是造成儿童哮喘的主要危险因素。     

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.     

Asthma,eczema, and reports on pollen and cat allergy among pupils in Shanxi province,China

Objectives To study self-reported asthma, eczema, and pollen and furry pet allergy among pupils (9–20 years) in Shanxi province, China, in relation to dietary and environmental factors. Methods A standardised questionnaire was distributed to pupils in two primary and two secondary schools, one in Taiyuan city (3.0 milj. inhabitants), the others in Qingxu county, a rural area 30 km outside Taiyuan. Totally, 2,116 pupils (90%) participated. Results Fifty percent were girls, 61% had been growing up on the countryside, 18% lived in Taiyuan now, 1.7% had ever had asthma, 0.8% had doctor’s diagnosed asthma, 1.4% pollen allergy, 1.7% cat allergy, and 0% had dog allergy. Multiple logistic regression was applied, controlling for age, gender, diet, indoor exposures, rural childhood, and current urban residency. Girls had less eczema (OR = 0.51; 95%CI 0.28–0.92). Pupils in the city had more eczema (OR = 5.05; 95% CI 1.11–23.3). Those with a rural childhood had less asthma (OR = 0.17; 95% CI 0.05–0.60), eczema (OR = 0.15; 95% CI 0.13–0.66) and pollen/cat allergy (OR = 0.50; 95%CI 0.25–0.99). None of the indoor variables was related to asthma or allergy. Children with frequent fruit consumption had less asthma (OR = 0.40; 95% CI 0.19–0.82) and pollen/cat allergy (OR = 0.49; 95% CI 0.29–0.84). Those with frequent fish consumption had less asthma (OR = 0.32; 95% CI 0.11–0.97). Those with frequent hamburgers consumption had more asthma (OR = 2.05; 95% CI 1.09–3.87) and eczema (OR = 1.85; 95% CI 1.12–3.04). Conclusion Asthma, eczema, and pollen or pet allergy was uncommon, compared with western countries and other areas in China. Pupils with a rural childhood had less asthma and allergy, which is consistent with the “hygiene hypothesis”. Fruit and fish consumption may reduce, and fast food consumption may increase the risk for asthma. Finally, the higher prevalence of asthma and eczema among younger children, born in the 1990s, indicates a cohort effect similar to that observed in western countries.     

Housing characteristics, home environmental factors and respiratory health in 14,729 Chinese children

BACKGROUND: Very few studies have assessed the relative impact of housing characteristics and home environmental factors on asthma and asthma-related symptoms in Chinese children who have lower rates of asthma. To our knowledge few studies have assessed respiratory symptoms and allergies in this context. METHODS: To assess the effects of housing characteristics, pet keeping, home decorations and other indoor environmental factors on respiratory health of Chinese children. We studied a population of 14,729 children (1-13 years old) from 12 districts in Liaoning province, Northeast China. Information on respiratory health, housing characteristics, and environmental pollutions were obtained by a standard questionnaire from the American Thoracic Society. RESULTS: Housing conditions, house adjacent to traffic or not, house with or without pollution source nearby, pet keeping, presence of pests and mold/water damage in the home, home decorations and exposure to environmental tobacco smoke (ETS) were associated with doctor-diagnosed asthma and asthma-related symptoms both in boys and girls. The vulnerability towards exposure to housing conditions and environmental factors differed between males and females. Among boys, the risk of respiratory morbidity appeared to be reduced in households with larger surface areas and more rooms; use of a ventilation device was strongly protective against persistent phlegm (OR=0.68; 95%CI: 0.48, 0.96). Asthma-related symptoms were more associated with different pets among girls than among boys. The presence of a cat in the household was associated with doctor-diagnosed asthma (OR=1.89; 95% CI, 1.11-3.20), current wheeze (OR=2.64; 95% CI, 1.52-4.59), persistent cough (OR=1.84; 95% CI, 1.18-2.87) and persistent phlegm (OR=2.17; 95% CI, 1.21-3.87) only among girls. CONCLUSION: Living within the vicinity of a source of pollution, traffic, pet keeping, home decorations, pests, mold and ETS are important determinants of children's respiratory health in China.     

Prenatal and postnatal risk factors for mental retardation among children in Bangladesh

This study evaluated the contribution of prenatal, perinatal, neonatal, and postnatal factors to the prevalence of cognitive disabilities among children aged 2-9 years in Bangladesh. A two-phase survey was implemented in 1987-1988 in which 10,299 children were screened for disability. In multivariate analyses, significant independent predictors of serious mental retardation in rural and urban areas included maternal goiter (rural odds ratio (OR) = 5.14, 95% confidence interval (CI): 1.23, 21.57; urban OR = 4.82, 95% CI: 2.73, 8.50) and postnatal brain infections (rural OR = 29.24, 95% CI: 7.17, 119.18; urban OR = 13.65, 95% CI: 4.69, 39.76). In rural areas, consanguinity (OR = 15.13, 95% CI: 3.08, 74.30) and landless agriculture (OR = 6.02, 95% CI: 1.16, 31.19) were also independently associated with the prevalence of serious mental retardation. In both rural and urban areas, independent risk factors for mild cognitive disabilities included maternal illiteracy (OR = 2.48, 95% CI: 0.86, 7.12), landlessness (OR = 4.27, 95% CI: 1.77, 10.29), maternal history of pregnancy loss (OR = 2.61, 95% CI: 0.95, 7.12), and small for gestational age at birth (OR = 3.86, 95% CI: 1.56, 9.55). Interventions likely to have the greatest impact on preventing cognitive disabilities among children in Bangladesh include expansion of existing iodine supplementation, maternal literacy, and poverty alleviation programs as well as prevention of intracranial infections and their consequences. Further population-based studies are needed to confirm and understand the association between consanguinity and serious cognitive disability.     

某市2019年中小学生近视现状及影响因素分析

目的 调查某市2019年中小学生近视现状,探讨影响因素,为制定相应保护措施提供依据。 方法 采用横断面调查方法,按分层整群抽样,抽取12所学校学生2568人,检测学生视力,问卷调查影响因素,描述中小学生视力现状,对影响因素进行卡方分析,采用非条件logistic回归分析危险因素。 结果 郊县和城区不同年龄别学生的近视率呈现一致的上升趋势,但郊县的近视率略高于城区。年龄和遗传史,对城区和郊县学生近视都有影响。不同的是,城区学生,危险因素还包括性别（OR=1.460, 95%CI:1.087~1.961）、课后读写时长（OR=1.406, 95%CI:1.143~1.728）。郊县学生,危险因素还包括每天使用移动电子设备（OR=1.414, 95%CI:1.125~1.777）、住校（OR=1.590, 95%CI:1.132~2.234）。 结论 该市中小学生近视现患率高,郊县高于城区。城区与郊县学生近视的危险因素不同,郊县学生面临更多且可干预的危险因素,包括每天使用移动电子设备、住校。采取积极有效的预防措施,通过学校、社会、家庭共同努力,为学生创造健康良好的学习和成长环境。     

山东省枣庄市支气管哮喘患病情况调查及相关因素分析

目的调查枣庄市2003年哮喘患病率及相关因素。方法采取分层随机整群抽样调查的方法,选择6个点,抽样人口16725人,应检15834人,实检10610人。结果调查检出支气管哮喘患者128例,全市总患病率为1.21%,儿童患病率为2.02%,成人患病率为0.90%,儿童患病率明显高于成人患病率(χ2=21.39,P<0.01)。男女患病率分别为1.08%、1.32%,男女比为1∶1.22。儿童哮喘首次发病年龄7岁前占77.97%,成人哮喘15岁前首次发病者占36.23%。相关因素分析显示,上呼吸道感染(OR=17.81,95%CI12.25～25.89)、冷空气刺激(OR=3.43,95%CI2.41～4.90)、油烟及刺激性气体(OR=2.56,95%CI1.80～3.63)、吸入变应原(OR=2.74,95%CI1.80～4.17)为主要诱因;哮喘患者有过敏史者65.63%(OR=21.69),有哮喘家族史者25.78%(OR=73.96)。结论调查获得了枣庄市哮喘患病率和相关因素,儿童哮喘患病率明显高于成人;全部患者在儿童期首次发病约占2/3;因此,应在儿童期进行哮喘筛查诊断,并给予早期干预。     

Prevalence and duration of breastfeeding in Asturias

OBJECTIVE: To estimate the prevalence and duration of breastfeeding, and factors associated with them, in Asturias (Spain). METHODS: A cross-sectional study was carried out. A stratified random sample of 453 infants was drawn on a population of 4,326 infants aged 0-8 months at the time of the study. Sociodemographic data, and information on pre- and perinatal care were obtained through a telephone survey in which mothers were also asked whether they were breastfeeding on the day of the telephone call. A univariate logistic regression model was used to estimate the prevalence curve of breastfeeding according to infant age, and multiple logistic regression was used to determine the associations between the prevalence and covariates. The discontinuity index (DI) and the cumulative breastfeeding index (CBI) were also estimated as indicators of duration. RESULTS: A total of 418 telephone calls were made. The prevalence of initial exclusive breastfeeding was 51.4% (95% CI: 46.6-56.2%) which decreased to 14.9% at day 90 and to 8.7% at day 120. The DIs were 28.6% at day 30 and 71% at day 90. In the multivariate analysis the prevalence of exclusive breastfeeding was higher among mothers living in a rural or suburban area (OR = 5.69 and OR = 3.55, respectively), than among those living in urban areas. The prevalence was also higher among mothers with a university degree (OR = 3.90; 95% CI: 1.77-8.58), and among those who had been seen by a midwife during pregnancy (OR = 2.13; 95% CI: 1.04-4.38). A negative correlation was found between exclusive breastfeeding and the newborn having received food supplements during the first hours after birth (OR = 0.43; 95% CI: 0.20-0.95). CONCLUSIONS: The prevalence of breastfeeding in Asturias, and especially its duration, is much lower than that recommended by the World Health Organization. Mothers living in urban areas do not follow the most appropriate patterns of breastfeeding.     

室内颗粒物污染对儿童哮喘影响的病例对照研究

目的探讨室内大气颗粒物对儿童哮喘的影响。方法于2012—2013年采用病例-对照研究方法,对武汉市82名儿童居室内环境污染情况等进行问卷调查,对室内颗粒物浓度进行检测。结果病例组儿童室内PM_(10)平均浓度高于对照组(P0.05)。将两种颗粒物质量浓度划分为0μg/m~3~、100μg/m~3~、150μg/m~3~、200μg/m~3~不同等级,以0μg/m~3~为参照组,随着污染物浓度的升高,儿童哮喘发生的OR值逐渐升高;在调整混杂因素后,其OR值仍呈增加趋势,尤其是PM_(10)浓度在200μg/m~3以上时,调整后OR值为27.05(95%CI:1.52~482.94)。结论室内PM_(2.5)和PM_(10)对儿童哮喘有影响,且存在剂量-反应关系。     

Rethinking race/ethnicity, income, and childhood asthma: racial/ethnic disparities concentrated among the very poor

OBJECTIVE: Past studies of the prevalence of childhood asthma have yielded conflicting findings as to whether racial/ethnic disparities remain after other factors, such as income, are taken into account. The objective of this study was to examine the association of race/ethnicity and family income with the prevalence of childhood asthma and to assess whether racial/ethnic disparities vary by income strata. METHODS: Cross-sectional data on 14,244 children aged <18 years old in the 1997 National Health Interview Survey were examined. The authors used logistic regression to analyze the independent and joint effects of race/ethnicity and income-to-federal poverty level (FPL) ratio, adjusting for demographic covariates. The main outcome measure was parental report of the child having ever been diagnosed with asthma. RESULTS: Bivariate analyses, based on weighted percentages, revealed that asthma was more prevalent among non-Hispanic black children (13.6%) than among non-Hispanic white children (11.2%; p<0.01), but the prevalence of asthma did not differ significantly between Hispanic children (10.1%) and non-Hispanic white children (11.2%; p=0.13). Overall, non-Hispanic black children were at higher risk for asthma than non-Hispanic white children (adjusted odds ratio [OR]=1.20; 95% confidence interval [CI] 1.03, 1.40), after adjustment for sociodemographic variables, including the ratio of annual family income to the FPL. Asthma prevalence did not differ between Hispanic children and non-Hispanic white children in adjusted analyses (adjusted OR=0.85; 95% CI 0.71, 1.02). Analyses stratified by income revealed that only among children from families with incomes less than half the FPL did non-Hispanic black children have a higher risk of asthma than non-Hispanic white children (adjusted OR=1.99; 95% CI 1.09, 3.64). No black vs. white differences existed at other income levels. Subsequent analyses of these very poor children that took into account additional potentially explanatory variables did not attenuate the higher asthma risk for very poor non-Hispanic black children relative to very poor non-Hispanic white children. CONCLUSIONS: Non-Hispanic black children were at substantially higher risk of asthma than non-Hispanic white children only among the very poor. The concentration of racial/ethnic differences only among the very poor suggests that patterns of social and environmental exposures must overshadow any hypothetical genetic risk.     

Decline of ambient air pollution levels and improved respiratory health in Swiss children

The causality of observed associations between air pollution and respiratory health in children is still subject to debate. If reduced air pollution exposure resulted in improved respiratory health of children, this would argue in favor of a causal relation. We investigated whether a rather moderate decline of air pollution levels in the 1990s in Switzerland was associated with a reduction in respiratory symptoms and diseases in school children. In nine Swiss communities, 9,591 children participated in cross-sectional health assessments between 1992 and 2001. Their parents completed identical questionnaires on health status and covariates. We assigned to each child an estimate of regional particles with an aerodynamic diameter < 10 microg/m3 (PM10) and determined change in PM10 since the first survey. Adjusted for socioeconomic, health-related, and indoor factors, declining PM10 was associated in logistic regression models with declining prevalence of chronic cough [odds ratio (OR) per 10-microg/m3 decline = 0.65, 95% confidence interval (CI), 0.54-0.79], bronchitis (OR = 0.66; 95% CI, 0.55-0.80), common cold (OR = 0.78; 95% CI, 0.68-0.89), nocturnal dry cough (OR = 0.70; 95% CI, 0.60-0.83), and conjunctivitis symptoms (OR = 0.81; 95% CI, 0.70-0.95). Changes in prevalence of sneezing during pollen season, asthma, and hay fever were not associated with the PM10 reduction. Our findings show that the reduction of air pollution exposures contributes to improved respiratory health in children. No threshold of adverse effects of PM10 was apparent because we observed the beneficial effects for relatively small changes of rather moderate air pollution levels. Current air pollution levels in Switzerland still exceed limit values of the Swiss Clean Air Act; thus, children's health can be improved further.