基于问卷调查的室内居住环境和行为因素与婴幼儿呼吸系统健康的关系

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[目的]分析室内居住环境和行为因素与婴幼儿呼吸系统健康的关系。[方法]采用分层整群抽样的方法,选取2011年3月1日—8月31日在上海市6个社区卫生服务中心儿保门诊进行常规检查的1 266名0~3岁婴幼儿,采用基于美国胸科协会推荐的问卷所修改的婴幼儿呼吸系统健康状况与家庭环境调查问卷对婴幼儿主要照看者进行调查,问卷内容包括婴幼儿呼吸系统症状、患病情况、居室环境污染以及其他相关影响因素。[结果]婴幼儿持续咳嗽、持续咳痰、喘息、哮喘、支气管炎、肺炎的报告率分别为2.2%、1.3%、19.1%、8.2%、17.6%、12.2%。调整了年龄、性别、居住区域、父母亲教育程度、呼吸系统疾病和过敏家族史、早产、出生低体重、母乳喂养和早期过敏史等相关混杂因素后,各室内居住环境和行为因素与持续咳嗽均未见联系;居住条件越差,报告喘息和肺炎患病的危险越大(OR=1.128,95%CI:1.000~1.325;OR=1.240,95%CI:1.078~1.426);空调清洁程度越差,报告哮喘患病的危险越大(OR=1.252,95%CI:1.028~1.526);燃料产生污染越多,报告持续咳痰、哮喘、支气管炎和肺炎患病的危险越小(OR=0.194,95%CI:0.044~0.855;OR=0.515,95%CI:0.279~0.950;OR=0.422,95%CI:0.251~0.707;OR=0.531,95%CI:0.304~0.928)。[结论]各类室内居住环境和行为因素可能与婴幼儿呼吸系统健康存在着一定的相关性。 [Objective] To analyze the relationship between indoor living environment and behavior factors and respiratory system health in infants and young children. [Methods] By stratified cluster sampling method, 1 266 infants and children 0-3 years old who were routinely inspected in childbirth clinics of 6 community health service centers in Shanghai from March 1 to August 31, 2011 were selected. A survey of key caregivers of infants and young children using a questionnaire based on the health status of the respiratory system of infants and young children as modified by a questionnaire recommended by the American Thoracic Society was conducted. The questionnaire included infants respiratory symptoms, illness, indoor environmental pollution and other Related factors. [Results] The prevalences of persistent cough, persistent sputum, wheezing, asthma, bronchitis and pneumonia in infants and young children were 2.2%, 1.3%, 19.1%, 8.2%, 17.6% and 12.2% respectively. After adjusting for related confounding factors such as age, gender, residential area, parental education, respiratory disease and family history of allergy, premature birth, low birth weight, history of breastfeeding and early allergy, the indoor living environment and behavioral factors were associated with persistent cough (OR = 1.128, 95% CI: 1.000-1.325; OR = 1.240, 95% CI: 1.078-1.426); the worse the living conditions, the worse the living conditions were reported; (OR = 1.252, 95% CI: 1.028-1.526); the more the fuel was contaminated, the more persistent the sputum was reported, and the less the risk of asthma, bronchitis and pneumonia (OR = 0.194, 95% CI: 0.044 to 0.855; OR = 0.515, 95% CI: 0.279 to 0.950; OR = 0.422, 95% CI: 0.251 to 0.707; OR = 0.531, 95% CI: 0.304 to 0.928). [Conclusion] All kinds of indoor living environment and behavior factors may have some correlation with respiratory system health of infants and children.
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