北京城、郊区儿童哮喘及相关过敏疾患的室内环境因素比较

目的 探讨与儿童哮喘及相关过敏疾患发生相关的室内环境影响因素.方法 采用整群抽样方法,在北京市城区与郊区各选择7所小学的一至四年级学生4612名,使用国际间儿童哮喘及过敏性疾病对比研究标准问卷,调查室内环境因素对儿童哮喘及相关过敏疾患发生的影响.结果 实际分析4060名儿童,其中城区1992名,郊区2068名.城区儿童近12个月喘息、过敏性鼻炎及特应性湿疹的发生率分别为3.1%(61/1992)、5.3%(106/1992)和1.1%(22/1992);郊区为1.3%(27/2068)、3.1%(65/2068)和1.0%(22/2068).城区儿童12个月喘息及过敏性鼻炎的发生率高于郊区,差异有统计学意义(x2值分别为14.77、11.93,P＜0.01).城区儿童既往患有哮喘及湿疹的发生率分别为5.3%(105/1992)、29.4%(586/1992),郊区分别为1.7%(35/2068)、13.8%(285/2068),城区高于郊区,差异有统计学意义(x2值分别为39.03、147.22,P值均＜0.01).尽管两区儿童所处的室内环境因素分布比例比较相近,但被动吸烟及家庭装修对两区儿童哮喘及相关过敏疾患的发生影响不同:被动吸烟对郊区儿童既往哮喘发生的OR=2.70,95%CI=1.17～6.23.而在城区未发现显著影响(OR=1.06,95%CI=0.71～1.58);84.0%(1673/1992)的城区儿童家庭装修过,郊区为80.0%(1655/2068),家庭装修对城区儿童既往湿疹发生的OR=1.57,95%CI=1.17～2.10,在郊区未发现显著影响(OR=1.06,95%CI=0.76～1.48).结论 北京市城区学龄儿童哮喘及相关过敏疾患的发生率显著高于郊区,室内环境因素中被动吸烟、家庭装修对两区儿童哮喘及相关过敏疾患发生的影响可能不同.

The comparison of the indoor environmental factors associated with asthma and related allergies among school-child between urban and suburban areas in Beijing

Objective To study the indoor environmental factors associated with the prevalence of asthma and related allergies among school children.Methods A cluster sampling method was used and the ISAAC questionnaire was conducted.A total of 4612 elementary students under Grade Five of 7 schools were enrolled in the survey for the impact of indoor environmental factors on the prevalence of asthma and related allergies in several urban and suburban schools of Beijing.Results A total of 4060 sample were finally analyzed including 1992 urban and 2068 suburban.The prevalence of wheeze, allergic rhinoconjunctivitis and atopic eczema in the past 12 months was 3.1% (61/1992) ,5.3% (106/1992) ,1.1% (22/1992) among urban children while 1.3% (27/2068) ,3.1% (65/2068), 1.0% (22/2068) among suburban children respectively.The prevalence of wheeze and allergic rhinoconjunctivitis of the past 12 months in urban were both significantly higher than that in suburban ( χ2 = 14.77, 11.93, P ＜ 0.01 ).The incidences of having asthma and eczema ever among urban children (5.3% (105/1992) ,29.4% (586/1992))were significantly ( χ2 = 39.03, 147.22, P ＜ 0.01 ) higher than that among suburban ( 1.7% ( 35/2068 ), 13.8%(285/2068)).Atlthough the distributions of indoor environmental factors were similar in both areas, passivesmoking and interior decoration had different influence on the prevalence of asthma and related allergies among school children in the two areas.The significant impact of passive smoking on having asthma ever among suburban children was observed ( OR = 2.70,95% CI = 1.17 - 6.23 ) while no significant result in urban ( OR = 1.06,95% CI = 0.71 - 1.58 ); the percentage of interior decoration was 84.0% ( 1673/1992 )among urban children and 80.0% (1655/2068)among suburban children, there was significant impact of interior decoration on the prevalence of having eczema ever among urban children ( OR = 1.57,95% CI =1.17-2.10) but no significant results were found in suburban sample (OR= 1.06,95% CI =0.76-1.48).Conclusion The prevalence of asthma and related allergies among school children is much higher in urban areas than that in suburban areas and the indoor environmental factors such as passive smoking and interior decoration may differently explain the prevalence of asthma and related allergies in the two areas.