婴幼儿呼吸系统健康的家庭室内环境影响因素研究

发布时间：2018-09-10 11:49

【摘要】：研究背景和研究目的：近年来,室内空气污染的健康效应问题逐渐引起了各国公共卫生学家的关注。室内污染问题在世界各地比较普遍,在发展中国家尤为突出,严重危害人们的身体健康。呼吸系统是空气中主要污染物等有害物质进入人体的主要途径和首当其冲的受害系统。婴幼儿正处于生长发育的重要时期,免疫系统及呼吸系统发育仍未完全,是易受空气质量变化影响的敏感人群。本研究目的在于了解上海某城区婴幼儿呼吸系统健康状况；分析家庭室内环境因素与婴幼儿呼吸系统健康的关系；探索影响婴幼儿呼吸系统健康的家庭室内环境影响因素的健康教育干预措施,为制订婴幼儿呼吸系统健康问题的预防和控制策略提供理论依据。研究方法：根据被调查城区地理位置的特点,可以分为内环、中环、外环3个居住区域,以分层整群抽样的方法,在每个居住区域中分别选取2家社区卫生服务中心,其儿保门诊半年内前来进行常规检查的0-3岁婴幼儿作为研究对象。对于半年内多次前来检查的小年龄婴儿以第一次调查为准。参考国际标准化《儿童呼吸系统疾病流行病学调查问卷》(ATS-DLD-78-C),拟定本地化的《婴幼儿呼吸系统健康状况与家庭环境调查问卷》,由经过专门培训的门诊医生发放问卷,通过家长自填,对婴幼儿呼吸系统症状与疾病的发生情况、家庭室内环境污染情况(包括居住条件、装潢情况、家庭室内吸烟、家庭成员其他活动、空调使用、燃料使用)以及其他相关影响因素情况进行调查。采用Epidata3.1建立数据库并录入数据,采用SPSS13.0进行数据整理与分析。以构成比描述被调查对象一般情况；以报告率描述婴幼儿呼吸系统健康状况；以χ2检验、logistic回归分析对各类家庭室内环境因素、其他相关影响因素与婴幼儿呼吸系统健康的关系进行分析。结果：本研究共发放问卷1424份,回收问卷1296份,经审核1266份为有效问卷,有效应答率为88.90%。其中男孩662人,女孩604人；最大年龄47月,最小年龄1月,平均年龄(16.41+11.96)月,男、女孩年龄差异无统计学意义(P0.05),不同城区年龄差异有统计学意义(P0.01)。持续咳嗽、持续咳痰、喘息、哮喘、支气管炎的报告率分别为2.2%、1.3%、19.1%、8.2%、17.6%。经医生诊断患有哮喘、支气管炎的婴幼儿,均以在本年10月～次年3月间诊断为主,发病严重程度均为轻度最多。除持续咳嗽外,持续咳痰、喘息、哮喘、支气管炎的报告率均为男孩高于女孩,喘息男女孩差异有统计学意义(P0.01)；除喘息外,持续咳嗽、持续咳痰、哮喘、支气管炎的报告率均为3岁组最高,各年龄组持续咳嗽、哮喘、支气管炎的报告率差异有统计学意义(P0.01)。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、早期过敏史,同时调整了表中所列的其他家庭室内环境因素后,持续咳痰的危险因素为：燃料使用(P0.05)；喘息的危险因素为：居住条件、空调使用、燃料使用(P0.05或P0.01)；各家庭室内环境因素与持续咳嗽均未见联系(P0.05)。哮喘的危险因素为：空调使用、燃料使用(P0.05)；支气管炎的危险因素为：燃料使用(P0.01)。结论：婴幼儿呼吸系统症状与疾病的报告率存在性别、年龄差异,男孩高于女孩,高年龄组高于低年龄组。各类家庭室内环境因素对婴幼儿呼吸系统健康存在着一定的影响,家长们应引起重视,积极采取措施应对可以改变或改善的危险因素,减少室内污染,保护婴幼儿呼吸系统的健康。
[Abstract]:Research background and research purposes:
In recent years, the health effects of indoor air pollution have gradually attracted the attention of public health scientists all over the world. Indoor pollution is a common problem in the world, especially in developing countries, which seriously endangers people's health. Infants are at an important stage of growth and development, and their immune and respiratory systems are not yet fully developed. They are sensitive to changes in air quality.
The purpose of this study is to understand the health status of infants'respiratory system in a certain urban area of Shanghai, to analyze the relationship between indoor environmental factors and infant respiratory system health, and to explore the health education intervention measures for influencing the indoor environmental factors of infants' respiratory system health, so as to make the prediction of infants'respiratory system health problems. The prevention and control strategy provides theoretical basis.
Research methods:
According to the characteristics of the geographical location of the investigated urban area, it can be divided into three residential areas: inner ring, middle ring and outer ring. By stratified cluster sampling method, two community health service centers were selected in each residential area. The infants aged 0-3 who were routinely examined in the outpatient department of children's insurance six months ago were studied. The first age survey is based on the first survey.
Referring to the International Standardized Respiratory Disease Epidemiology Questionnaire for Children (ATS-DLD-78-C), a localized Respiratory Health Status and Family Environment Questionnaire for Infants and Young Children was developed. Questionnaires were distributed by specially trained out-patient doctors, and the incidence of respiratory symptoms and diseases in infants and young children, family rooms were filled out by parents. The environmental pollution (including living conditions, decoration, indoor smoking, other activities of family members, air conditioning, fuel use) and other related factors were investigated.
Epidata 3.1 was used to establish a database and input data, and SPSS 13.0 was used to collate and analyze the data. The relationship between smoking system and health was analyzed.
Result:
In this study, 1 424 questionnaires were sent out and 1 296 questionnaires were retrieved, with an effective response rate of 88.90%. There were 662 boys and 604 girls. The oldest age was 47 months, the youngest age was 1 month, and the average age was 16.41+11.96 months. There was no significant difference in age between boys and girls (P 0.05). 0.01).
The reported rates of persistent cough, persistent sputum, wheezing, asthma and bronchitis were 2.2%, 1.3%, 19.1%, 8.2% and 17.6% respectively. The reporting rates of boys were higher than girls, and there was significant difference between boys and girls with wheezing (P 0.01); except for wheezing, the reporting rates of persistent cough, persistent sputum, asthma and bronchitis were the highest in the 3-year-old group, and the reporting rates of persistent cough, asthma and bronchitis were statistically significant (P 0.01).
After adjusting for age, sex, living area, parental education, family history of respiratory diseases and allergies, preterm birth, low birth weight, breastfeeding, and early allergies, the risk factors for persistent cough were fuel use (P 0.05), and the risk factors for wheezing were: living. Conditions, air conditioning use, fuel use (P 0.05 or P 0.01); household indoor environmental factors were not associated with persistent cough (P 0.05). Risk factors for asthma were air conditioning use, fuel use (P 0.05); and risk factors for bronchitis were fuel use (P 0.01).
Conclusion:
The incidence of respiratory symptoms and diseases in infants and young children was different in sex and age. Boys were higher than girls, and older children were higher than younger children.
All kinds of indoor environmental factors have a certain impact on the health of infants'respiratory system. Parents should pay attention to them and take active measures to deal with the risk factors that can be changed or improved, reduce indoor pollution and protect the health of infants' respiratory system.
【学位授予单位】：复旦大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R725.6

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