Chinese General Practice ›› 2019, Vol. 22 ›› Issue (12): 1405-1412.DOI: 10.12114/j.issn.1007-9572.2018.00.426

• Monographic Research • Previous Articles     Next Articles

Analysis between Indoor Environment and Childhood Asthma and Family Nursing Interventions in Chongqing 

  

  1. Respiratory Center,Children's Hospital of Chongqing Medical University/The Ministry of Education Key Laboratory of Child Development Disease Research/China International Science and Technology Cooperation Base of Child Development and Critical Disorders/Chongqing Key Laboratory of Pediatrics,Chongqing 400014,China
    *Corresponding author:YUAN Xiaoping,Co-chief superintendent nurse;E-mail:1440916724@qq.com
  • Published:2019-04-20 Online:2019-04-20

重庆地区室内环境与儿童支气管哮喘的相关性研究

  

  1. 400014重庆市,重庆医科大学附属儿童医院呼吸中心  儿童发育疾病研究教育部重点实验室  儿童发育重大疾病国家国际科技合作基地  儿科学重庆市重点实验室
    *通信作者:袁小平,副主任护师;E-mail:1440916724@qq.com
  • 基金资助:
    基金项目:重庆市渝中区软科学研究项目(X3422);2013—2014年度国家临床重点专科建设项目(国卫办医涵[2013]544号)

Abstract: Background Bronchial asthma(asthma) is widely considered to be caused by gene and environment,while environmental factors are the major ones in the rising incidence of asthma because gene changes slowly.World Health Organization(WHO) reported that 44% of asthma diseases were caused by environmental factors,such as indoor fuel and second-hand smoking.Family history and allergens are well-known risk factors for asthma.Other factors triggering asthma has been rarely studied,such as indoor humidity,indoor air pollution,bedding,pillow core material and cleanliness,application of range hood and dust cover.Objective To investigate the influence of indoor environment on the incidence of asthma in children in Chongqing,and to provide evidence for interventions in family nursing.Methods Children with asthma diagnosed and treated in respiratory center of Children's Hospital of Chongqing Medical University from May to July 2017 were selected.Controls(being diagnosed with no asthma) were matched with cases(being diagnosed with asthma) for age and sex accorded to 1∶1 ratio.This study developed“Questionnaire of Related Factors of Children with Asthma”from Swedish Dampness in Buildings and Health(DBH) with adjustment and supplement of Chinese residential features.Questionnaire included general data,indoor environment(material of pillow core and quilt,cleaning frequency of pillow core and sheet,cleaning of dust cover,frequency of flowers contact,mold growth,water leakage,condensed water,frequency of humidifiers use,passive smoking during pregnancy and in kids,material of ground and wall,ventilation frequency,kitchen fuel,lampblack machine cleaning,air-conditioning filter cleaning,pets feeding,contact frequency of stuffed toys,and exposure frequency of cockroaches and mice).Logistic regression were used to analyze the correlation variables.Results We totally distributed 750 questionnaires,730 returned and 18 unqualified,resulting in a 94.9% of valid recovery rate,and with 356 cases in each group.The results of statistical analysis indicated that material of pillow core and quilt,cleaning frequency of pillow core and sheet,contact frequency of flowers,mold growth,water leakage,condensed water,passive smoking during pregnancy and in kids,contact frequency of stuffed toys,and exposure frequency of cockroaches and mice were significantly correlated with the incidence of asthma(P<0.05).Conclusion Unfavorable indoor environment(material of pillow core and quilt,cleaning frequency of pillow core and sheet,contact frequency of flowers,mold growth,water leakage,condensed water,passive smoking during pregnancy and in kids,contact frequency of stuffed toys,and exposure frequency of cockroaches and mice) would bring negative impact on respiratory health in children.More attention is needed and active interventions should be taken to improve the existing risk factors and reduce the incidence of asthma in children by lessening indoor environmental pollution.

Key words: Asthma, Child, Indoor environment, Correlation study, Chongqing

摘要: 背景 现普遍认为支气管哮喘(简称哮喘)是基因和环境交互作用的结果,由于基因改变的缓慢性,越来越多的证据表明哮喘的发病率和病死率是暴露于现代室内环境中的过敏原和刺激物所致,WHO报道,44%的哮喘疾病由室内燃料、二手烟等环境因素引起。目前研究表明家族哮喘史、过敏原等是哮喘众所周知的危险因素。除此之外,诱发哮喘发病的因素还有很多:如室内环境潮湿、室内空气污染、被褥、枕芯材质及清洁程度、吸油烟机及防尘罩等的使用情况却少有研究。目的 探讨重庆市室内环境与儿童哮喘发病的相关性,为哮喘儿童家庭护理的干预措施提供依据。方法 选取2017年5—7月重庆医科大学附属儿童医院呼吸中心诊治的哮喘患儿作为病例组,根据性别、年龄按1∶1匹配选取2017年8—9月于本院呼吸中心诊治的非哮喘儿童作为对照组。在瑞典Dampness in Buildings and Health (DBH)问卷的基础上结合实际住宅特征进行调整补充,拟定“儿童支气管哮喘相关因素调查问卷”,问卷内容包含一般资料、室内环境(枕芯、被褥材质,枕芯、床单清洗频率,防尘罩清洗,鲜花接触频率,霉菌生长、漏水、冷凝水,加湿器使用频率,母孕期或儿童被动吸烟,地面材料,墙壁类型,开窗通风频率,厨房燃料、吸油烟机、空调过滤器清洗,宠物饲养,毛绒玩具接触频率,蟑螂/老鼠接触频率)。采用Logistic回归分析分析室内环境与儿童哮喘的相关性。结果 共发放问卷750份,收回730份,剔除不合格问卷18份,有效问卷712份,有效回收率为94.9%。最终病例组入选356例,对照组入选356例。多因素Logistic回归分析结果显示,枕芯材质、被褥材质、枕芯清洗频率、床单清洗频率、鲜花接触频率、霉菌生长、漏水、冷凝水,母孕期被动吸烟、儿童被动吸烟、蟑螂/老鼠接触频率与儿童哮喘有相关性(P<0.05)。结论 不良室内环境对儿童哮喘有一定的影响,枕芯材质、被褥材质、枕芯清洗频率、床单清洗频率、鲜花接触频率、霉菌生长、漏水、冷凝水、母孕期被动吸烟、儿童被动吸烟、蟑螂/老鼠接触与儿童哮喘相关,积极采取干预措施改善存在的危险因素,减少室内环境污染,可降低儿童哮喘的发病率。

关键词: 哮喘, 儿童, 室内环境, 相关性研究, 重庆