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。

Interaction effects of breastfeeding and air pollution on respiratory diseases and symptoms in children

Objective To investigate the interaction effects of breastfeeding and air pollutants on children's respiratory diseases and symptoms. Methods The study was a cross-sectional study of respiratory health effects of exposure to ambient air pollutants.Based on the results of air pollution measurements taken between 2006 and 2008,the seven cities of Shenyang,Dalian,Anshan,Fushun,Benxi,Liaoyang and Yingkou in Liaoning province were selected as study sites. Results A total of 10 822 children were investigated in the study,a total of 9 318 questionnaires were returned,the response rate was 86.1%.Daily average concentration of four pollutants PM₁₀,SO₂,NO₂,O₃ were analyzed,daily average concentration of PM₁₀,SO₂ exceeded the national standards and day average concentrations of PM₁₀,SO₂ exceed international standards in all of the 25 districts,daily average concentration of NO₂ exceed the national standard in 36% districts.There were 7 319 breastfed children and 1 999 non-breastfed children,and the breastfed boys were more than girls (P<0.05); non-breastfed children compared with breastfed children,atmospheric pollutants PM₁₀,SO₂,NO₂,O₃ per one unit increased in children with persistent cough,the risk of continued sputum showed an increasing trend (P<0.05).Breastfeeding and atmospheric pollutants PM₁₀,SO₂,NO₂,O₃ on wheezing of children existed statistically significant interaction(P<0.20). Conclusion This study provides evidence that there is a significant interaction effects between breastfeeding and air pollutants on some respiratory diseases and symptoms in children.