Indoor environmental risk factors and seasonal variation of childhood asthma
Indoor environmental risk factors and seasonal variation of childhood asthma
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DOI：
10.1111/j.1399-3038.2009.00871.x
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发表时间：
2009-12-01
影响因子：
4.4
通讯作者：
Guo, Yueliang Leon
中科院分区：
文献类型：
--
作者：
Han, Yueh-Ying;Lee, Yung-Ling;Guo, Yueliang Leon
哮喘的季节性可能是由于不同的暴露。这项横断面研究旨在探讨室内环境因素与季节性儿童哮喘之间的关系。研究对象是2004年国际儿童哮喘和过敏研究（ISAAC）的参与者，这是一项基于人群的监测，包括台湾南部6-15岁的学龄儿童。病例包括1725名在过去12个月内出现哮喘症状的儿童，参考包括19，646名据报道没有哮喘病史的儿童。通过使用移动平均和主成分分析，哮喘儿童分为四个哮喘亚型：冬季，春季，夏季/秋季，常年。采用多因素Logistic回归分析室内环境因素对儿童哮喘发病季节性的影响。对于所有哮喘患病率，在冬季出现一个高峰，在夏季出现一个低谷。无论季节性如何，儿童哮喘的影响因素包括年龄较小，父母过敏，母亲怀孕期间吸烟，母乳喂养和感知空气污染。在调整了显著的危险因素后，水损害与所有哮喘亚型显著相关。蟑螂的存在与夏秋哮喘相关（校正比值比[aOR] = 1.65，95%置信区间[CI] = 1.12-2.55）。墙壁上可见的霉菌与冬季和春季哮喘的发生率增加相关（aOR = 1.53，95%CI = 1.26-1.85和aOR = 1.34，95%CI = 1.10-1.62）。被动吸烟与春、夏、秋哮喘有关。水损害是一个可能的风险，儿童哮喘全年。蟑螂和墙上可见的霉菌可能对台湾儿童哮喘的季节性起重要作用。合理的机制和过敏反应应进一步确定。消除这些过敏原是必要的，以帮助预防哮喘的发展。
Seasonality of asthma may result from varying exposures. This cross-sectional study was designed to examine the relationship between indoor environmental factors and seasonal childhood asthma. Study subjects were participants from the International Study of Asthma and Allergies in Childhood (ISAAC) in 2004, a population-based surveillance, which included school children aged 6-15 yr in south Taiwan. Cases included 1725 children who experienced asthma symptoms in the past 12 months and the references consisted of 19,646 children who reportedly have no asthma history. By using a moving average and principal component analysis, asthmatic children were grouped into four asthma subtypes: winter, spring, summer/fall, and perennial. Multivariate logistic regression was used to evaluate the effect of indoor environmental factors on seasonality of childhood asthma. For all asthma prevalence, a peak occurred in the winter and a nadir appeared in summer. Contributing factors of asthma for children, regardless of seasonality, included younger age, parental atopy, maternal smoking during pregnancy, breast feeding, and perceived air pollution. After adjusted for salient risk factors, water damage was significantly associated with all subtypes of asthma. Presence of cockroaches was related to the summer/fall asthma (adjusted odds ratio [aOR] = 1.65, 95% confidence interval [CI] = 1.12-2.55). Visible mold on the walls was associated with an increased occurrence of winter and spring asthma (aOR = 1.53, 95% CI = 1.26-1.85 and aOR = 1.34, 95% CI = 1.10-1.62, respectively). Passive smoking was shown to be related to spring and summer/fall asthma. Water damage is a possible risk for childhood asthma year-round. Cockroaches and visible mold on the walls may play essential roles for seasonality of childhood asthma in Taiwan. Plausible mechanisms and allergic effects should be further determined. Elimination of these allergens is necessary to help prevent the development of asthma.