Indoor environment and respiratory symptoms in children living in the Dutch-German borderland

OBJECTIVE: To investigate the relation between indoor environmental risk factors and respiratory symptoms in 7-8-year-old children living in the Dutch-German borderland. METHODS: A nested case-control study was conducted among children participating in a large longitudinal study on respiratory health. Parents of all 781 children with respiratory complaints and an equal number of randomly selected controls were asked to complete a questionnaire, including questions on indoor environment. RESULTS: The parents of 1191 children (76.2%) participated. Past exposure to environmental (OR = 2.73, 95% CI 1.14-6.67) as well as in utero exposure (OR = 2.28, 95% CI 1.15-4.53) to tobacco smoke, use of an unvented geyser for water heating (OR = 3.01, 95% CI 1.21-7.56), long-term exposure to dampness (OR = 2.98, 95% CI 1.10-8.28) or pets (OR = 2.18, 95% CI 1.39-3.42) increased the risk of asthmatic symptoms in 7-8-year-old children. A middle or low socio-economic status also increased the risk of asthmatic symptoms. An inverse association with asthmatic symptoms was seen for wall-to-wall carpeting (OR = 0.57, 95% CI 0.33-0.95) and insulation measures (OR = 0.46, 95% CI 0.25-0.83). Except for the presence of an unvented geyser, these environmental risk factors also presented a risk for coughing symptoms in children. CONCLUSION: This study showed an increased risk of respiratory symptoms in children exposed to several indoor environmental risk factors.     

Low-level ozone exposure and respiratory symptoms in infants

OBJECTIVE: Recent studies indicate that the U.S. Environmental Protection Agency (EPA) ozone standards may not protect sensitive individuals. In this study we examined respiratory effects of ozone in infants who may be vulnerable, particularly if they are children of asthmatic mothers. DESIGN: Women delivering babies at one of five hospitals in southwestern Virginia between 1994 and 1996 were invited to participate in a cohort study; 780 women enrolled. Ambient air quality data (ozone and particulate matter) were collected at a central monitoring site. PARTICIPANTS: This analysis is of 691 infants followed for approximately 83 days between 10 June and 31 August 1995 and/or 1996 ; they contributed a total of 52,421 infant-days of follow-up. Mothers were interviewed at enrollment and approximately biweekly to report infants' daily symptoms. Repeated measures logistic regression models were run separately for wheeze, difficulty breathing, and cough. Ozone metrics included 24-hr average, peak 1-hr, and maximum 8-hr average. Analyses were repeated for the 61 infants whose mothers had asthma. RESULTS: For every interquartile-range increase in same-day 24-hr average ozone, likelihood of wheeze increased 37% [95% confidence interval (CI), 2-84%]. Among infants of asthmatic mothers, same-day 24-hr average ozone increased likelihood of wheeze 59% (95% CI, 1-154%) and of difficulty breathing 83% (95% CI, 42-136%). Maximum 8-hr ozone and peak 1-hr ozone were associated with difficulty breathing, but not wheeze, in infants of asthmatic mothers. Ozone was not associated with cough. CONCLUSIONS: At levels of ozone exposure near or below current U.S. EPA standards, infants are at increased risk of respiratory symptoms, particularly infants whose mothers have physician-diagnosed asthma.     

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。     

陕西省安康市农村妇女呼吸道和眼部症状环境危险因素分析

目的研究环境危险因素与妇女呼吸道和眼睛症状发生的关系。方法选择陕西安康农村1575名妇女,进行健康调查和环境危险因素调查。结果调整了年龄和经济因素后,吸烟、被动吸烟、冬季从不开窗换气、煤和生物燃料并用与呼吸道症状发生的OR值分别为2.42、1.35、1.52、1.44;做饭年限、开始做饭年龄每增加1年,呼吸道症状发生的OR值分别为1.44和0.92。冬季从不开窗换气、煤和生物燃料并用与眼部症状发生的OR值分别为1.67和1.49;做饭年限、开始做饭年龄每增加1年,眼部症状发生的OR值分别为1.56和0.92;每天做饭时间每增加1小时,眼部症状发生的OR值为1.36。结论做饭时的污染物暴露是影响农村妇女呼吸道和眼部症状最主要的环境危险因素。     

Pulmonary function and respiratory symptoms in forest firefighters

This study evaluated effects on respiratory health of forest firefighters exposed to high concentrations of smoke during their work shift. This is the first study of cross-shift-respiratory effects in forest firefighters conducted on the job. Spirometric measurements and self-administered questionnaire data were collected before and after the 1992 firefighting season. Seventy-six (76) subjects were studied for cross-shift and 53 for cross-season analysis. On average, the cross-season data were collected 77.7 days after the last occupational smoke exposure. The cross-shift analysis identified significant mean individual declines in FVC, FEV₁ and FEF_25–75. The preshift to midshift decreases were 0.089 L. 0. 190 L. and 0.439 L/sec. respectively, with preshift to postshift declines of 0.065 L. 0.150 L. and 0.496L/sec. Mean individual declines for FVC, FEV₁ and FEF_25–75 of 0.033 L. 0.104 L. and 0.275 L/sec. respectively, also were noted in the cross-season analysis. The FEV₁ changed significantly (p < 0.05). The use of wood for indoor heat also was associated with the declines in FEV₁. Although annual lung function changes for a small subset (n = 10) indicated reversibility of effect, this study suggests a concern for potential adverse respiratory effects in forest firefighters. Am. J. Ind. Med. 31:503–509, 1997. © 1997 Wiley-Liss. Inc.     

泰安市中学生抑郁症状与行为影响因素分析

目的 了解泰安市中学生抑郁症状流行特征及相关行为影响因素,为中学生抑郁症状的预防提供科学依据。方法 采用多阶段分层整群随机抽样方法,2020年抽取泰安市13所学校共3 509名中学生,使用学生健康行为调查表和流调中心抑郁量表对其进行匿名问卷调查。结果 泰安市中学生抑郁症状检出率为22.34%,女生、男生的抑郁症状检出率分别为25.32%、19.00%。多因素logistic回归分析显示,遭受校园欺凌、被家长打骂、有网络成瘾倾向、过去12个月打架次数≥2次、从来不吃或有时吃早餐、女生均是抑郁症状的危险因素(OR值分别为8.072、3.070、2.964、2.755、2.330和1.805、1.578,P值均<0.05);而从不饮酒、未尝试吸烟、睡眠充足、1周至少1 d中高强度运动、不住校则是抑郁症状的保护因素(OR值分别为0.602、0.628、0.637、0.706和0.723、0.696,P值均<0.05)。结论 泰安市中学生抑郁症状普遍存在,抑郁症状与遭受校园欺凌、被家长打骂、尝试吸烟、饮酒、规律早餐、运动和睡眠等诸多行为特征和行为习惯相关。     

Urinary dialkylphosphate metabolites and health symptoms among farmers in Thailand

Using a cross-sectional study, we investigated urinary DAPs levels and health symptoms related to the type of crop cultivation and farm tasks among 84 farmers in Phayao Province of northern Thailand. The results showed that the average of ∑DAPs levels was 10.93 ± 19.64 μg/g creatinine (range 1.48–163.90 μg/g creatinine). The compound found the most was DEP, followed by DETP, DEDTP, DMP, DMTP, and DMDTP, respectively. The type of crop cultivation may be associated with an increasing prevalence of respiratory tract, muscle system, and skin irritation. Farm tasks were associated with an increasing prevalence of muscle system and skin irritation. It was difficult to assess adverse health symptoms associated with urinary DAPs in low levels of exposure; therefore, further investigation is needed using more sensitive biomarkers and more sensitive health symptom measurement.     

怀柔区企事业单位女职工更年期症状与保健需求调查

目的:了解怀柔区妇女更年期症状及保健需求,为妇幼保健机构开展更年期健康教育提供依据。方法:随机抽取怀柔区部分企事业单位更年期女职工330人,采用自行设计的封闭式问卷进行调查,对所得资料录入SPSS 10.0统计软件对数据进行分析。结果:妇女更年期症状主要为记忆力减退、潮热盗汗、烦躁易激动、月经紊乱、犹豫焦虑、心悸多疑等,约20%的妇女症状明显;更年期妇女获取健康知识的途径主要为电视、报刊杂志和健康讲座,分别占63.5%、59.8%和57.6%。78%的妇女对更年期保健知识具有强烈的需求,并希望获得医疗保健机构医务人员的帮助和指导。结论:妇女更年期保健知识亟待提高,医疗保健机构应加强妇女更年期的健康教育,以提高妇女更年期健康知识水平和生活质量。     

Informing randomized clinical trials of respiratory syncytial virus vaccination during pregnancy to prevent recurrent childhood wheezing: A sample size analysis

BackgroundEarly RSV illness is associated with wheeze-associated disorders in childhood. Candidate respiratory syncytial virus (RSV) vaccines may prevent acute RSV illness in infants. We investigated the feasibility of maternal RSV vaccine trials to demonstrate reductions in recurrent childhood wheezing in general paediatric populations.MethodsWe calculated vaccine trial effect sizes that depended on vaccine efficacy, allocation ratio, rate of early severe RSV illness, risk of recurrent wheezing at age 3, and increased risk of RSV infection on recurrent wheezing. Model inputs came from systematic reviews and meta-analyses. For each combination of inputs, we estimated the sample size required to detect the effect of vaccination on recurrent wheezing.ResultsThere were 81 scenarios with 1:1 allocation ratio. Risk ratios between vaccination and recurrent wheezing ranged from 0.9 to 1.0 for 70% of the scenarios. Among the 57 more plausible scenarios, the lowest sample size required to detect significant reductions in recurrent wheezing was 6196 mother-infant pairs per trial arm; however, 75% and 47% of plausible scenarios required >31,060 and >100,000 mother-infant pairs per trial arm, respectively. Studies with asthma endpoints at age 5 will likely need to be larger.DiscussionClinical efficacy trials of candidate maternal RSV vaccines undertaken for licensure are unlikely to demonstrate an effect on recurrent wheezing illness due to the large sample sizes likely needed to demonstrate a significant effect. Further efforts are needed to plan for alternative study designs to estimate the impact of maternal RSV vaccine programs on recurrent childhood wheezing in general populations.     

Job hazards and respiratory symptoms in Hispanic female domestic cleaners

Abstract

The occupational hazards and respiratory symptoms of domestic cleaners in USA are largely unknown. We conducted a cross-sectional study among 56 Hispanic female domestic cleaner on their health status and frequency of cleaning products used and tasks performed. While women used multi-use products (60.0%) and toilet bowl cleaners (51.8%) most days of the week, many (39.3%) reported not using personal protective equipment while cleaning. Itchy/watery eyes (61.8%) and itchy nose (56.4%) were the most frequently reported symptoms. A history of physician-diagnosed asthma was reported by 14.3% while 33.9% had symptoms of bronchial hyperresponsiveness (BHR). In conclusion, this vulnerable population has high prevalence of physician-diagnosis asthma and BHR symptoms and is potentially exposed to myriad occupational hazards. Further research exploring associations between products use, cleaning tasks and respiratory symptoms is warranted.     

我国抗菌药使用现状及防止不合理使用应对措施

  目的  探索农村居民胃肠感染相关症状与抗菌药物使用的关系,为胃肠感染症状的正确应对措施提供理论指导。  方法  采用随机整群抽样法,于2016年5月选取安徽省3个区域（南部、中部和北部）6个市12个县24个行政村的居民进行入户访谈。  结果  收集有效问卷3 622份,应答率为98.6 %。近1年胃肠道感染症状出现的平均人次为0.62,出现率为23.7 %（860人）;出现胃肠感染症状的居民中有73.3 %（770人）采取卫生服务利用,其中有74.6 %（455人）使用抗菌药物,62.2 %（479人）就医,25.5 %（196人）自行购药/服药,12.3 %（95人）采取 ≥ 2种卫生服务利用。胃肠感染症状与是否就医及这部分居民是否使用抗菌药物有关（P < 0.05）,且症状个数与抗菌药物使用比例呈正相关（P < 0.05）。  结论  胃肠感染症状是影响抗菌药物使用的重要因素,是未来该领域研究的新方向。     

粤东地区小儿呼吸道感染病原中首次检出人类偏肺病毒

目的分析人类偏肺病毒(hMPV)在粤东地区的感染情况及所致疾病的临床特点。方法(1)应用TemPCR技术对120例呼吸道感染患儿的鼻咽分泌物扩增多种病原体,并应用多重荧光微球技术检测hMPV等病毒核酸;(2)分析hMPV感染患儿的临床资料。结果120份标本中hMPV阳性6份(5%),占常见病毒阳性者的24%,占100例其他常见呼吸道病毒检测阴性患儿的6%。6株hMPV特异性核酸扩增片段核酸测序结果与GenBank中人类偏肺病毒AF371337(NL00-1)株的基因同源性>95%。6例hMPV阳性患儿中,临床表现为毛细支气管炎4例、喘息型肺炎1例、上呼吸道感染1例。结论hMPV是粤东地区小儿呼吸道感染的重要病毒性病原体之一,其感染主要引起小儿喘息性疾病。     

南京中学生健康危险行为与抑郁症状关系

目的 了解江苏省南京市中学生健康危险行为和抑郁症状分布情况,并探讨两者之间的关联。方法 采用青少年心理健康状况调查表,于2010年9-10月随机抽取南京市5所学校2 118名中学生进行问卷调查。结果 调查的2 118名中学生中,具有1、2、3项及以上健康危险行为的中学生分别为21.6%、6.0%、4.4%;抑郁症状检出率为46.0%,其中轻度、中度、重度抑郁症状检出率分别为29.4%、13.4%、3.3%;高中生、有健康危险行为的学生抑郁症状检出率均高于初中生、无健康危险行为的学生,差异均有统计学意义(P<0.05);多因素logistic回归分析显示,随着健康危险行为项数的增加,抑郁症状检出率呈上升趋势(χ_趋势²=58.9,P<0.05),调整人群归因危险度百分比(PARc%)为14.8%。结论 健康危险行为是罹患抑郁症状的危险因素,应引起学校、家庭和社会的重视。     

Asthma and other respiratory symptoms in New Zealand pine processing sawmill workers

BACKGROUND: To study respiratory symptoms in pine sawmill workers. METHODS: A respiratory health questionnaire was administered to 772 pine sawmill workers and the association between symptoms and job-title-based exposure was studied. RESULTS: Asthma in exposed workers (18%, n = 704) was more common than in the general population (12.1%, n = 592; adjusted OR (95% CI): 1.6 (1.1-2.3)). Asthma was also more common in the low exposure group (15.6%, n = 294) and high exposure groups (high exposure to 'green dust'; 20.4%, n = 212 and high exposure to 'dry dust'; 18.8%, n = 198) than in the non-exposed workers (9.2%, n = 65). Adjusted odds ratios were 1.9 (0.7-4.9), 2.7 (0.9-7.6), and 2.1 (0.8-5.7), respectively. Adjusted odds ratios for symptoms of cough were 2.7 (1.2-6.5) for the low, 5.2 (2.1-13.0) for the high 'green dust' and 3.3 (1.4-7.9) for the high 'dry dust' exposure groups. Moreover, eye and nose irritations were significantly more prevalent in the high and low exposure groups. CONCLUSIONS: Working in pine sawmilling is associated with an increased prevalence of asthma and cough symptoms and eye and nose irritation.     

The relation between the number of symptoms and other health indicators in working men and women

Simple symptom counts are widely used Indicators of ill-healthin health survey research. However, there has only been littleresearch aimed at a better understanding of symptom counts.The purpose of this study was to explore the number of symptoms(a summary score derived from 10 unspecific self-reported symptoms)in a ‘healthy’ population. We reanalysed data ona sample of 850 employed men and women (Berne Workplace HealthProject). Stepwise ordinal logistic regression analysis wasused to study the relation of the number of symptoms to contextual,person-related, behavioural, and health-related variables. Inneither men nor women were any of the sociodemographic Indicatorssignificantly associated with the number of symptoms. Of thework-related variables, low job discretion and adverse workenvironment were significantly associated with the number ofsymptoms and there was a statistical trend for high job demands.In women, dissatisfaction with salary was the only work-relatedvariable which was significant. The private context, on theother hand, seemed to be more influential for women than formen and there was a statistical trend for strain at home. Amongthe person-related factors studied, age and emotional problemswere significantly associated to the number of symptoms in bothmen and women. Psychological ill-health and negative futureorientation were significant only in men and immersion onlyin women. Physical inactivity in leisure time was the only behaviouralvariable found to be significantly associated to the numberof symptoms. Among the health-related factors, poor self-ratedhealth was significant for both gender groups, while obesitywas significant only in men. Only categories of variables beinghypothesized to be unfavourable in terms of health were associatedwith a higher number of symptoms. Most of the associations foundseem to be theoretically meaningful. Despite methodologicalprovisos, our findings support a conception of the number ofsymptoms as an indicator of general ill-health.     

Investigating the relationship between environmental factors and respiratory health outcomes in school children using the forced oscillation technique

The environmental factors which may affect children’s respiratory health are complex, and the influence and significance of factors such as traffic, industry and presence of vegetation is still being determined. We undertook a cross-sectional study of 360 school children aged 5–12 years who lived on the outskirts of a heavy industrial area in Western Australia to investigate the effect of a range of environmental factors on respiratory health using the forced oscillation technique (FOT), a non-invasive method that allows for the assessment of the resistive and reactive properties of the respiratory system. Based on home address, proximity calculations were used to estimate children’s exposure to air pollution from traffic and industry and to characterise surrounding green space. Indoor factors were determined using a housing questionnaire. Of the outdoor measures, the length of major roads within a 50 m buffer was associated with increased airway resistance (Rrs₈). There were no associations between distance to industry and FOT measures. For the indoor environment the presence of wood heating and gas heating in the first year of life was associated with better lung function. The significance of both indoor and outdoor sources of air pollution and effect modifiers such as green space and heating require further investigation.     

绝经相关症状及疾病的非激素治疗

绝经意味着卵巢功能的衰竭,其所致雌激素缺乏、内分泌失衡可产生一系列绝经相关问题或疾病,如围绝经期综合征、泌尿生殖道萎缩、绝经后骨质疏松症等,代谢综合征与心血管疾病的风险明显增加,此严重影响广大中老年妇女的身心健康和生活质量。近年来,除激素补充治疗(hormone replacement therapy,HRT)外,选择性5羟色胺再摄取抑制剂、中药、植物药及植物雌激素等非激素治疗方法也被用于绝经症状和疾病,尤其对于那些不能应用或不愿意接受激素补充治疗的女性。本文对目前非激素治疗的有效性和安全性作一分析。     

2013年沈阳市农村老年人抑郁症状现状及其影响因素分析

目的 了解沈阳市农村地区老年人抑郁症状现状及其影响因素,为维持和改善农村地区老年人心理健康提供科学依据。 方法 采用随机整群抽样方法,于2013年对抽取的沈阳市苏家屯的一个村中居住5年及以上、未患老年痴呆的65岁以上老人开展面访调查,收集其抑郁症状、认知功能状态、人口学特征、健康状况、个人生活方式及社会心理因素等方面的信息。采用logistic回归分析其影响因素。结果 沈阳市农村地区老年人抑郁症状检出率为21.2%。二分类logistic回归分析结果显示,农村地区,与老年人抑郁症状有关的影响因素依次为自立(不好vs.好:OR=3.84,95%CI:1.64~9.03),慢性病罹患(有vs.无:OR=3.81,95%CI:1.80~8.07),娱乐活动参与(否vs.是:OR=3.72,95%CI:2.06~6.74),婚姻状况(离异/未婚/分居/丧偶vs.已婚/同居:OR=3.13,95%CI:1.67~5.88),担心跌倒(是vs.否:OR=2.79,95%CI:1.37~5.67),子女孝顺(否vs.是:OR=2.34,95%CI:1.19~4.62),睡眠质量(不好vs.好:OR=2.27,95%CI:1.27~4.08),经常看电视(否vs.是:OR=2.15,95%CI:1.14~4.03)。结论 2013年沈阳市农村无认知功能障碍老人的抑郁症状水平较高,其主要影响因素为健康状况和社会心理因素,人口学特征亦对其有一定影响。