吸烟与室内空气污染的交互作用对慢性阻塞性肺部疾病影响的分析

目的 了解浙江省桐乡地区慢性阻塞性肺部疾病（COPD）患病率,分析吸烟与室内空气污染交互作用对COPD患病的影响。方法 随机抽取桐乡市崇福、洲泉、高桥、石门、乌镇5个乡镇所有30～79岁人群进行问卷、体格检查和肺功能检测。以第一秒用力肺活量最大值/肺活量最大值（FEV_1max/FVC_max）≤0.7确诊为COPD,运用logistic回归模型分析吸烟、室内空气污染与COPD的关系,评价吸烟与室内空气污染之间的相乘交互作用;采用引入Andersson等编制的Excel表计算相加交互作用。结果 桐乡市COPD总患病率为6.6%,调整年龄、文化程度、职业、婚姻、年收入、BMI、腰臀比等因素后,多因素logistic回归分析发现：男性人群中目前已戒烟人群、开始吸烟年龄<25岁人群患COPD危险性高;女性人群中吸烟量每天<15 g、吸烟时吸入口腔或咽喉部相对于从不吸烟人群,患COPD危险性均上升。交互作用分析显示：使用柴/炭/煤、煤饼、煤球等做饭燃料与当前或曾经经常吸烟存在相乘交互作用,女性人群做饭时未使用烟囱或排烟装置与当前或曾经经常吸烟存在相加交互作用。结论 桐乡地区COPD患病率接近全国平均水平,女性吸烟人群患COPD的危险性高于男性,居民通过改善厨房通风条件及排烟设施,使用清洁能源煤气、天然气、电做饭,积极控烟将有利于预防COPD的发生。     

肿瘤家族史和吸烟在肺癌发生中的交互作用研究

对肿瘤家庭聚集性的研究表明，遗传因素对包括肺癌在内的恶性肿瘤的发生具有重要影响。在肺癌流行病学研究方面，以往对吸烟和肿瘤家族史的单独研究相对较多，而对两者之间联合作用的研究较少。本研究拟对肿瘤家族史和吸烟与肺癌发生之间的关联及其交互作用进行深入探讨。     

吸烟与肥胖对糖尿病前期患病的交互作用

目的 分析40～79岁人群吸烟与肥胖对糖尿病前期（prediabetes mellitus, PDM）患病的交互作用。方法 采用多阶段随机抽样的方法,在荣昌区21个街道或镇开展调查,每个调查点随机抽取3～5个村或社区,每个村或社区随机抽取20～50名符合条件的调查对象,调查包括问卷调查、体格检查和血生化检测。PDM影响因素及吸烟与肥胖对PDM患病的交互作用采用软件R 4.1.1进行多因素logistic回归分析。结果 3 017例调查对象中,PDM患病率为38.98%。调整混杂因素后,吸烟（OR=1.570,95%CI:1.303～1.892）、肥胖（OR=1.391,95%CI:1.113～1.737）与PDM患病高风险相关。相乘交互作用分析发现,吸烟×肥胖对PDM存在相乘交互作用（OR=2.122,95%CI:1.251～3.601）;相加交互作用分析发现,吸烟且肥胖风险高于不吸烟且不肥胖者（OR=3.978,95%CI:2.543～6.224）,相加作用评价指标RERI、AP和SI分别为2.200(0.444～3.956)(P>0.05)、0.553(0.336～0.770...     

母乳喂养与被动吸烟对儿童哮喘及哮喘样症状的交互作用

目的 探讨母乳喂养与被动吸烟的交互作用对儿童哮喘及哮喘样症状的影响.方法 采用整群随机抽样法在辽宁省7个城市各抽取1所小学和2所幼儿园,共25所小学和50所幼儿园,对所选学校所有在此居住满2年的31 049名儿童的喂养方式、居住环境、被动吸烟等情况及呼吸系统疾病与症状的信息进行收集.采用Glimmix回归模型分析母乳喂养与被动吸烟的交互作用对儿童哮喘及哮喘样症状(持续咳嗽、持续咳痰、喘鸣现患、过敏性鼻炎)的影响.结果 在调查的31 049名儿童中,年龄为(8.32±2.75)岁,母乳喂养的儿童有23 987名,母乳喂养率为77.26％;被动吸烟的儿童有11 820名,被动吸烟率为38.07％.母乳喂养的儿童哮喘、过敏性鼻炎阳性率分别为6.22％(1491/23 987)、4.67％(1120/23 987),非母乳喂养的儿童分别为7.70％(544/7062)、5.48％(387/7062).母乳喂养儿童发生哮喘(OR=0.79,95％ CI:0.72～0.88)、过敏性鼻炎(OR =0.85,95％CI:0.75～0.95)的风险较低.父亲吸烟的儿童喘鸣现患阳性率为7.89％(929/11 770),父亲未吸烟的儿童为5.37％(1036/19 279),父亲吸烟的儿童发生喘鸣现患(OR=1.51,95％CI:1.38 ～1.65)的风险较高.母亲吸烟的儿童持续咳嗽阳性率为18.96％(51/269),母亲未吸烟的儿童为9.51％(2926/30 780),母亲吸烟的儿童发生持续咳嗽(OR =2.23,95％ CI:1.64～3.03)的风险较高.家中其他任何人吸烟的儿童持续咳痰阳性率为5.69％(871/15 316),家中无人吸烟的儿童为3.50％(550/15 733),家中其他任何人吸烟的儿童发生持续咳痰(OR=1.67,95％CI:1.49～ 1.86)的风险较高.Glimmix回归模型分析显示,母乳喂养与被动吸烟对儿童哮喘及哮喘样症状存在交互影响:在父亲吸烟暴露下,母乳喂养的儿童发生哮喘的风险低于非母乳喂养儿童;在母亲吸烟暴露下,母乳喂养的儿童发生过敏性鼻炎的风险低于非母乳喂养儿童;在家中其他任何人吸烟暴露下,母乳喂养的儿童发生哮喘、过敏性鼻炎的风险低于非母乳喂养儿童(P值均＜0.05).结论 母乳喂养使被动吸烟的儿童发生哮喘及哮喘样症状的风险降低.     

甘肃省20~80岁汉族男性吸烟和饮酒的交互作用对γ-谷氨酰转肽酶的影响

目的 探讨甘肃省20~80岁汉族男性吸烟和饮酒的交互作用对γ-谷氨酰转肽酶（gamma-glutamyltransferase,GGT）的影响。方法 采用横断面研究方法,应用多阶段分层整群抽样,于2016年对甘肃省20~80岁汉族男性进行问卷调查、体格检查及实验室检测。采用分层分析和一般线性模型分析吸烟和饮酒的交互作用对GGT的影响。结果 共调查甘肃省男性1 646人。城镇和农村地区的吸烟年龄标化率分别是50.6%、49.2%,城镇和农村地区的饮酒年龄标化率分别是80.3%、74.5%。吸烟和饮酒对GGT存在正向交互作用（P=0.042）。在不吸烟者中,饮酒对GGT没有影响;戒烟时,饮酒≥ 61 g/d者GGT比不饮酒者高29.2（5.2~53.1）U/L;吸烟1~支/d时,饮酒≥ 61 g/d者GGT比不饮酒者高29.9（3.3~56.6）U/L;吸烟11~支/d时,饮酒≥ 61 g/d者GGT比不饮酒者高25.9（1.6~50.2）U/L;吸烟≥ 21支/d时,饮酒≥ 61 g/d者GGT比不饮酒者高86.8（12.9~160.7）U/L。结论 吸烟和饮酒对GGT存在正向交互作用,应注重控烟和限酒干预措施的同时实施。     

吸烟对室内空气污染的研究

目的了解吸烟对室内空气质量的影响及相关影响因素。方法对办公室内吸烟前以及吸烟后不同时间(5、10、15、30、60、90、120、150、180min)空气中CO、可吸入颗粒物(IP)、甲醛、总挥发性有机物(TVOC)浓度进行监测,并探讨通风状态以及吸烟人数对吸烟所致室内空气污染的影响。结果门窗关闭条件下,吸烟后5、10、15、30、60、90、120、150、180min,办公室内空气中CO、IP、甲醛、TVOC浓度均显著高于吸烟前(P<0.01)。CO未见超标。吸烟后120min,IP浓度降至标准限值。吸烟后180 min,甲醛、TVOC浓度仍然超标。门窗开启条件下,室内空气污染物浓度在吸烟后明显增加(P<0.01),但各指标均未超标,吸烟后30min基本恢复到吸烟前状态。门窗开启时,吸烟所致的室内空气污染物峰值浓度显著低于门窗关闭时(P<0.01)。吸烟人数与办公室污染物峰值浓度呈正相关(P<0.01)。结论吸烟导致严重的室内空气污染,污染程度随吸烟人数的增多而升高,通风可以有效降低污染程度。     

教育程度和吸烟交互作用与高血压的相关研究

目的探究教育程度和吸烟状态交互作用对高血压患病的影响。方法采用概率比例抽样方法,于2012年对江苏省昆山市≥18岁居民进行问卷调查与体格检查。样本数据通过复杂加权后进行统计分析,采用多因素logistic回归探究高血压病与诸因素的关联强度及交互作用。结果共调查38 425人,检出高血压患者8 239例。通过复杂加权后,高血压患病率(95%CI)为17.2%(16.8%~17.6%),男性为17.2%(16.6%~17.7%),女性为17.3%(16.7%~17.8%)。检出吸烟者9 657例,吸烟率(95%CI)为23.21%(22.74%~23.66%),男性为46.65%(45.85%~47.45%),女性为1.4%(1.2%~1.6%)。调整混杂因素后,较低的教育程度(OR=1.25,95%CI:1.13~1.38)、吸烟(OR=1.22,95%CI:1.11~1.34)与高血压患病率间存在统计学关联;吸烟状态和教育程度交互作用与高血压患病率间有统计学关联(χ2=5.048,P=0.025)。结论吸烟及教育程度均与高血压患病有关,文化程度较低伴吸烟者高血压患病率较高。     

吸烟、饮酒及其交互作用对糖尿病发病的影响

目的:探讨吸烟和饮酒及其交互作用对糖尿病发病的影响.方法:研究数据为中国瑞慈医疗集团2010—2016年所有体检者的医疗记录.利用此数据进行回顾性队列研究.通过问卷调查进行资料收集,包括基本情况调查、身体测量和生化指标检测3个部分.采用相乘模型和相加模型分析吸烟与饮酒及其交互作用对糖尿病发病的影响.结果:根据筛选标准纳...     

吸烟与低密度脂蛋白胆固醇交互作用对瓣膜性心脏病的影响

目的 探讨吸烟与低密度脂蛋白胆固醇(LDL-C)交互作用对瓣膜性心脏病(VHD)的影响。方法 选择在山东省医学科学院心脑血管病防治研究中心进行体检的健康体检者3 438例,以是否患有VHD为依据分为病例组464例、对照组2 974例。对比两组基线特征(包括性别、年龄、吸烟史、饮酒史、体育锻炼情况等)、BMI、心脏杂音及LDL-C。采用单因素与多因素logistic回归法分析吸烟与LDL-C对VHD发生的影响。结果 病例组年龄、吸烟比例、心脏杂音比例、LDL-C高于对照组(P<0.05),两组性别、饮酒、体育锻炼比例及BMI比较差异无统计学意义(P>0.05)。多因素logistic回归分析结果显示,吸烟、LDL-C均是VHD的危险因素(P<0.05)。对吸烟、LDL-C进行哑变量设置,分为四组,以不吸烟且LDL-C正常为对照组进行比较,调整混杂因素,多因素logistic回归分析结果显示,与对照组相比,不吸烟且LDL-C升高组患病风险增加了1.881倍,吸烟且LDL-C正常组患病风险增加了1.970倍,吸烟且LDL-C升高组的患病风险增加了6.867倍。吸烟、LDL-...     

空气污染物与绿化环境暴露水平对心肌梗塞死亡交互作用的病例交叉研究

目的 探索空气污染物与绿化暴露水平对心梗死亡的发生所产生的交互作用。方法 主要收集天津市2017—2019年因心梗死亡的个案病例,估计每名病例环境因素的暴露水平,采用条件logistic回归模型,分析空气污染物与绿化暴露水平对心梗死亡的发生所产生的交互作用。结果 在不同的季节,空气污染物浓度、气象因素和绿化环境暴露水平存在着差异（P＜0.001）。在单污染物模型中,每升高10 μg/m3的NO2（lag2期）,可使心梗死亡发生的风险升高0.4%（OR = 1.004,95%CI:1.000～1.008）。在多污染物模型中,每升高10 μg/m3的NO2（lag2期）、PM2.5（lag2期）和PM10（lag6期）,可使心梗死亡发生的风险升高1.1%（OR = 1.011,95%CI:1.005～1.018）、0.4%（OR = 1.004,95%CI:1～1.008）和0.3%（OR = 1.003,95%CI: 1.000～1.006）。对于滞后期lag1、lag2、lag6和lag7的暴露水平来说,颗粒污染物［可入肺颗粒物（PM1）、PM2.5 和PM10］与绿化环境暴露水平对心梗死亡的发生具有拮抗作用。结论 绿化环境可以起到降低颗粒污染物升高心梗死亡风险的作用,为指导人们有效的防护空气污染的危害,减轻颗粒污染物对心梗以及其他心血管疾病的发生和死亡提供依据。     

The relationships between ambient air pollutants and childhood asthma and eczema are modified by emotion and conduct problems

PurposeThis study examined the hypothesis that emotion and conduct problems (ECPs) may modify the relationships between ambient air pollutants and childhood asthma and eczema.MethodsIn the cross-sectional study, 4209 French schoolchildren (aged 10–12 years) were investigated between March 1999 and October 2000. Ambient air pollutants exposures were estimated with dispersion modeling. Health outcomes and ECPs were evaluated by validated questionnaires, completed by the parents. Marginal models were used to analyze the relationships of exposures to ambient air pollutants and/or ECPs to asthma phenotypes and current eczema, adjusting for potential confounders.ResultsIn our population, interactions were found between ECPs and exposures to ambient air pollutants (benzene, carbon monoxide, nitrogen dioxide, nitrogen oxides, particulate matter with an aerodynamic diameter below 10 μm, volatile organic compounds) (P < .20). In addition, ECPs were related to current wheezing (adjusted prevalence odds ratio [aOR], 2.35; 95% confidence interval [CI], 1.59–3.47), current doctor-diagnosed asthma (aOR, 1.82; 95% CI, 1.25–2.66), and current eczema (aOR, 2.21; 95% CI, 1.61–3.02). Children with ECPs had 1.17–1.51 times higher aORs for the associations between ambient air pollutants and asthma phenotypes and current eczema than those without ECPs.ConclusionsECPs may modify the relationships between ambient air pollutants and childhood asthma and eczema.     

Modelling asthma epidemics on the relationship between air pollution and asthma emergency visits in Barcelona, Spain

We have investigated different methods of controlling for asthma epidemics in the time series regression of the relationship between air pollution and asthma emergency visits in Barcelona, Spain. The relationship between air pollution and asthma emergency room visits was modelled using autoregressive Poisson models. We examined the effect of using no control by epidemics, and modelling asthma epidemics with a single dummy variable, six dummy variables, and a dummy variable for each epidemic day. Air pollution coefficients increased when controlling asthma epidemics with six dummy variables instead of a single variable. They further increased when autocorrelation was allowed for. Standard errors were relatively unaffected when either the epidemics or the autocorrelation were included in the model. Black smoke, nitrogen dioxide and ozone were statistically significant associated to asthma emergency visits after using six dummy variables to control for asthma epidemics. We have shown that different models, including different confounding variables, give markedly different estimates of the effect of a pollutant on health. Care is needed in the interpretation of such models, and careful reporting so it is clear how the confounding variables have been modelled.     

Interactions between particulate air pollution and temperature in air pollution mortality time series studies

In many community time series studies on the effect of particulate air pollution on mortality, particulate air pollution is modeled additively. In this study, we investigated the interaction between daily particulate air pollution and daily mean temperature in Cook County, Illinois and Allegheny County, Pennsylvania, using data for the period 1987-1994. This was done through the use of joint particulate air pollution-temperature response surfaces and by stratifying the effect of particulate air pollution on mortality by temperature. Evidence that the effect of particulate air pollution on mortality may depend on temperature is found. However, the results were sensitive to the number of degrees of freedom used in the confounder adjustments, the particulate air pollution exposure measure, and how the effects of temperature on mortality are modeled. The results were less sensitive to the estimation method used--generalized linear models and natural cubic splines or generalized additive models and smoothing splines. The results of this study suggest that in community particulate air pollution mortality time series studies the possibility of an interaction between daily particulate air pollution and daily mean temperature should be considered.     

Impact of smoking on asthma symptoms, healthcare resource use, and quality of life outcomes in adults with persistent asthma

Background Smoking habits of asthmatics are similar to those of the general population. However, little attention has been paid to the associations between smoking and asthma-related outcomes. Objective To evaluate relationships between cigarette smoking, asthma symptoms, and asthma-related resource utilization in subjects with persistent asthma. Method A stratified, random sample of adults from France, Germany, and the UK with persistent asthma were surveyed in 2001 through 2004. Statistical analyses compared asthma symptoms and healthcare resource utilization for cigarette smokers compared with those for non-smokers. Results Analyses included 1109 subjects with persistent asthma symptoms in 2001–2003 and 852 subjects with persistent asthma symptoms in 2004. Using multivariate analysis of data from eligible subjects in 2004 that did not have concomitant chronic obstructive pulmonary disease and adjusting for subjects’ baseline and demographic characteristics, cigarette smokers were more likely to experience nighttime symptoms (OR 1.46, 95% CI 1.07, 1.97 P = 0.015) and were more likely to use healthcare resources than were non-smokers (P ≤ 0.004). Findings were similar in a secondary analysis of subjects ≤55 years of age. Conclusions Cigarette smoking appears to be associated with more asthma symptoms and more ED visits and hospitalizations in adults with persistent asthma.     

Acute effects of air pollution on pediatric asthma exacerbation: evidence of association and effect modification

We investigated the short-term effects of particulate matter with aerodynamic diameter <10 μg/m³ (PM₁₀), sulfur dioxide (SO₂), nitrogen dioxide (NO₂) and ozone (O₃) on pediatric asthma emergency admissions in Athens, Greece over the period 2001–2004. We explored effect modification patterns by season, sex, age and by the presence of desert dust transported mainly from the Sahara area.We used daily time-series data provided by the children's hospitals and the fixed monitoring stations. The associations were investigated using Poisson regression models controlling for seasonality, weather, influenza episodes, day of the week and holiday effects.A 10 μg/m³ increase in PM₁₀ was associated with a 2.54% increase (95% confidence interval (CI): 0.06%, 5.08%) in the number of pediatric asthma hospital admissions, while the same increase in SO₂ was associated with a 5.98% (95% CI: 0.88%, 11.33%) increase. O₃ was associated with a statistically significant increase in asthma admissions among older children in the summer. Our findings provide limited evidence of an association between NO₂ exposure and asthma exacerbation. Statistically significant PM₁₀ effects were higher during winter and during desert dust days, while SO₂ effects occurred mainly during spring.Our study confirms previously reported PM₁₀ effects on emergency hospital admissions for pediatric asthma and further provides evidence of stronger effects during desert dust days. We additionally report severe effects of SO₂, even at today's low concentration levels.     

宁波市气象因素与空气污染对死亡影响的交互作用研究

目的 探讨宁波市气象因素与空气污染交互作用对居民死亡的影响,为相关部门制定减少气象因素与空气污染对人群健康危害的措施提供科学依据。 方法 使用宁波市2014—2018年死因及环境监测数据,对气象因素、空气污染物和死亡人数进行相关分析,运用分布式滞后非线性模型(DLNM)估计空气污染及气象因素对死亡的影响,利用超额相对风险(RERI)来评估它们之间潜在的交互作用。 结果 2014—2018年期间宁波市非意外总死亡共188 039例,日平均气温为17.5 ℃ ,大气NO2日平均浓度39.2 μg /m3,PM2.5日平均浓度39.7 μg /m3。基础模型拟合结果显示,在对居民每日非意外死亡、呼吸系统疾病死亡和循环系统疾病死亡中,日平均气温和NO2之间均存在明显的协同交互作用,其RERI值及95%值 CI分别为0.66 (0.53 ~ 1.02)、1.50 (0.95 ~ 2.96)和2.50 (1.20 ~ 6.84),而日平均气温与PM2.5仅在对居民每日非意外总死亡及呼吸系统疾病死亡的影响中存在拮抗交互作用,其RERI值及95%值 CI分别为- 0.29(0.00 ~ - 0.63),- 0.61(- 0.09 ~ - 1.31),差异均具有统计学意义(P＜0.05)。 结论 日平均气温对NO2、PM2.5的死亡效应可能存在修饰作用,且在不同类型的疾病死亡中表现不同。     

商场与超市室内空气微生物污染状况调查

目的:了解中国南北方城市商场与超市室内空气微生物的污染状况及主要影响因素。方法:于2007年-2009年选择中国北方廊坊市和南方韶关市的商场、超市,按冬夏两季用安德森六级空气微生物采样器采集室内空气中的细菌和真菌培养计数。结果:南方城市韶关室内空气细菌与真菌总数冬夏差异较小;北方城市廊坊室内空气细菌总数夏季高于冬季,室内空气真菌总数冬夏差异较小。结论:季节变化对商场和超市室内空气微生物浓度有一定影响。在高温高湿的夏季,北方城市廊坊室内空气细菌污染较重。