The prevalence and incidence of sick building syndrome in Chinese pupils in relation to the school environment: a two-year follow-up study.
The prevalence and incidence of sick building syndrome in Chinese pupils in relation to the school environment: a two-year follow-up study.
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DOI：
10.1111/j.1600-0668.2011.00726.x
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发表时间：
2011-12
期刊：
影响因子：
5.8
通讯作者：
X. Zhang;Zhuohui Zhao;Tobias Nordquist;Dan Norbäck
中科院分区：
文献类型：
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作者：
X. Zhang;Zhuohui Zhao;Tobias Nordquist;Dan Norbäck
关于病态建筑综合征（SBS）的发病率研究很少。我们研究了中国小学生SBS的两年变化与父母哮喘/过敏（遗传）、自身特应性、教室温度、相对湿度（RH）、绝对湿度（AH）、拥挤度、CO_2、NO_2和SO_3的关系。共有1993人参加了基线，1143人在两年后留在同一教室。基线时粘膜症状和全身症状的患病率分别为33%和28%，随访期间患病率增加（P < 0.001）。27%的人报告说，离开学校时至少有一种症状得到改善。遗传和自身特应性是基线时SBS和SBS发生率的预测因子。在基线时，SO_4与全身症状（OR=1.10/100 μg/m³）、粘膜症状（OR=1.12/100 μg/m³）和皮肤症状（OR=1.16/100 μg/m³）相关。NO水平与粘膜症状相关（OR=1.13/10 μg/m³），离开学校后症状改善（OR=1.13/10 μg/m³）。温度、RH、AH和CO_2与SBS患病率呈负相关。SBS的发病率或缓解与任何暴露无关，除了SO暴露与新的皮肤症状之间的负相关。总之，遗传和特应性与SBS的发病率和患病率有关，但测量的SBS暴露的作用尚不清楚。实际意义我们发现高水平的二氧化碳表明通风不足和高水平的二氧化硫和二氧化氮，室内和室外。所有学校都只有自然通风。在中国，依靠开窗作为通风工具是困难的，因为增加通风将降低室内CO_2的水平，但增加室内NO_2和SO_2的水平。病态建筑综合征（SBS）的患病率研究可能无法确定因果关系，需要在中国和世界其他地区进行更多的SBS纵向研究。应在学校引入机械通风和空气过滤的概念，在规划新学校时，应避免靠近交通繁忙的道路。
UNLABELLED There are few incidence studies on sick building syndrome (SBS). We studied two-year change of SBS in Chinese pupils in relation to parental asthma/allergy (heredity), own atopy, classroom temperature, relative humidity (RH), absolute humidity (AH), crowdedness, CO₂, NO₂, and SO₂. A total of 1993 participated at baseline, and 1143 stayed in the same classrooms after two years. The prevalence of mucosal and general symptoms was 33% and 28% at baseline and increased during follow-up (P < 0.001). Twenty-seven percent reported at least one symptom improved when away from school. Heredity and own atopy were predictors of SBS at baseline and incidence of SBS. At baseline, SO₂ was associated with general symptoms (OR=1.10 per 100 μg/m³), mucosal symptoms (OR=1.12 per 100 μg/m³), and skin symptoms (OR=1.16 per 100 μg/m³). NO₂ was associated with mucosal symptoms (OR=1.13 per 10 μg/m³), and symptoms improved when away from school (OR=1.13 per 10 μg/m³). Temperature, RH, AH, and CO₂ were negatively associated with prevalence of SBS. Incidence or remission of SBS was not related to any exposure, except a negative association between SO₂ and new skin symptoms. In conclusion, heredity and atopy are related to incidence and prevalence of SBS, but the role of the measured exposures for SBS is more unclear. PRACTICAL IMPLICATIONS We found high levels of CO₂ indicating inadequate ventilation and high levels of SO₂ and NO₂, both indoors and outdoors. All schools had natural ventilation, only. Relying on window opening as a tool for ventilation in China is difficult because increased ventilation will decrease the level of CO₂ but increase the level of NO₂ and SO₂ indoors. Prevalence studies of sick building syndrome (SBS) might not be conclusive for causal relationships, and more longitudinal studies on SBS are needed both in China and other parts of the world. The concept of mechanical ventilation and air filtration should be introduced in the schools, and when planning new schools, locations close to heavily trafficked roads should be avoided.