母乳喂养与大气污染对儿童呼吸系统疾病和症状影响的交互效应

中国儿童保健杂志 ›› 2013, Vol. 21 ›› Issue (10): 1016-1019.

母乳喂养与大气污染对儿童呼吸系统疾病和症状影响的交互效应

赵洋¹,刘玉芹¹,刘苗苗¹,王达¹,任万辉²,高峰²,董光辉¹

1 中国医科大学公共卫生学院卫生统计教研室,辽宁沈阳 110001; 2 沈阳市环境监测中心站,辽宁沈阳 110016

收稿日期:2013-01-07 发布日期:2013-10-06 出版日期:2013-10-06
通讯作者: 董光辉,E-mail:ghdong@mail.cmu.edu.cn
作者简介:赵洋(1988-),女,硕士研究生,主要研究方向为环境流行病学。
基金资助:
中华环境保护基金项目(CEPF2008-123-1-5)

Interaction effects of breastfeeding and air pollution on respiratory diseases and symptoms in children

ZHAO Yang¹,LIU Yu-qin¹,LIU Miao-miao¹,WANG Da¹,REN Wan-hui²,GAO Feng²,DONG Guang-hui¹

1 Department of Biostatistics and Epidemiology,China Medical University,Shenyang,Liaoning 110001,China; 2 Environmental Monitoring Station of Shenyang,Shenyang,Liaoning 110016,China

Received:2013-01-07 Online:2013-10-06 Published:2013-10-06
Contact: DONG Guang-hui,E-mail:ghdong@mail.cmu.edu.cn

摘要/Abstract

摘要： 目的探讨母乳喂养与大气污染对儿童呼吸系统疾病和症状影响的交互效应。方法采用横断面研究,在辽宁省7个城市即沈阳、大连、鞍山、抚顺、本溪、营口、辽阳共25个行政区随机抽取50所幼儿园,采用国际统一的标准问卷ATS(American Thoracic Society)调查表对所选幼儿园的所有儿童进行有关母乳喂养、生活环境以及儿童呼吸系统疾病情况的调查。根据各行政区环境监测中心提供的2006-2008年大气污染物(PM₁₀、SO₂、NO₂、O₃)浓度计算日平均浓度。结果本次研究共调查10 822人,共回收有效问卷9 318份,应答率为86.1%,符合上机进行统计分析的要求。共分析四个污染物PM₁₀、SO₂、NO₂、O₃的日平均浓度,统计的25个行政区中PM₁₀、SO₂的日平均浓度不同程度地超出国家标准,100%的行政区PM₁₀、SO₂日平均浓度超出WHO标准,36%的行政区NO₂日平均浓度超出国家标准。母乳喂养儿童7 319人,非母乳喂养儿童1 999人,其中接受母乳喂养的男童多于女童(P<0.05);非母乳喂养儿童与母乳喂养儿童相比,大气污染物PM₁₀、SO₂、NO₂、O₃每增加一个单位,儿童患有持续咳嗽、持续咳痰的危险性均呈增加趋势(P<0.05);母乳喂养与大气污染物PM₁₀、SO₂、NO₂、O₃对儿童喘鸣现患存在交互作用且有统计学意义(P<0.20)。结论母乳喂养和大气污染对儿童呼吸系统疾病和症状的影响存在显著的交互效应。

关键词: 母乳喂养, 大气污染, 呼吸系统疾病, 儿童

Abstract: Objective To investigate the interaction effects of breastfeeding and air pollutants on children's respiratory diseases and symptoms. Methods The study was a cross-sectional study of respiratory health effects of exposure to ambient air pollutants.Based on the results of air pollution measurements taken between 2006 and 2008,the seven cities of Shenyang,Dalian,Anshan,Fushun,Benxi,Liaoyang and Yingkou in Liaoning province were selected as study sites. Results A total of 10 822 children were investigated in the study,a total of 9 318 questionnaires were returned,the response rate was 86.1%.Daily average concentration of four pollutants PM₁₀,SO₂,NO₂,O₃ were analyzed,daily average concentration of PM₁₀,SO₂ exceeded the national standards and day average concentrations of PM₁₀,SO₂ exceed international standards in all of the 25 districts,daily average concentration of NO₂ exceed the national standard in 36% districts.There were 7 319 breastfed children and 1 999 non-breastfed children,and the breastfed boys were more than girls (P<0.05); non-breastfed children compared with breastfed children,atmospheric pollutants PM₁₀,SO₂,NO₂,O₃ per one unit increased in children with persistent cough,the risk of continued sputum showed an increasing trend (P<0.05).Breastfeeding and atmospheric pollutants PM₁₀,SO₂,NO₂,O₃ on wheezing of children existed statistically significant interaction(P<0.20). Conclusion This study provides evidence that there is a significant interaction effects between breastfeeding and air pollutants on some respiratory diseases and symptoms in children.

Key words: breastfeeding, air pollutants, respiratory track diseases, children

中图分类号:

R725.6

赵洋,刘玉芹,刘苗苗,王达,任万辉,高峰,董光辉. 母乳喂养与大气污染对儿童呼吸系统疾病和症状影响的交互效应[J]. 中国儿童保健杂志, 2013, 21(10): 1016-1019.

ZHAO Yang,LIU Yu-qin,LIU Miao-miao,WANG Da,REN Wan-hui,GAO Feng,DONG Guang-hui. Interaction effects of breastfeeding and air pollution on respiratory diseases and symptoms in children[J]. journal1, 2013, 21(10): 1016-1019.

参考文献

[1] 吴金贵,唐传喜,庄祖嘉,等.上海城区交通与燃气炉相关室内空气污染对儿童青少年呼吸系统疾病和症状的影响研究[J].环境与健康杂,2010,27(3):244-247.
[2] 迟克强,毛定安.母乳喂养与疾病关系的研究新进展[J].中国儿童保健杂志,2010,18(3):234-236.
[3] Elliott L,Henderson J,Northstone K,et al.Prospective study of breast-feeding in relation to wheeze,atopy,and bronchial hyperresponsiveness in the Avon Longitudinal Study of Parents and Children (ALSPAC)[J].J Allergy Clin Immunol,2008,122(1):49-54.
[4] Silvers KM,Frampton CM,Wickens K,et al.Breast feeding protects against adverse respiratory outcomes at 15 months of age[J].Matern Child Nutr,2009,5(3):243-250.
[5] Woodward A,Douglas RM,Graham NM,et al.Acute respiratory illness in Adelaide children:breast feeding modifies the effect of passive smoking[J].J Epidemiol Community Health,1990,44(3):224-230.
[6] Wold AE,Adlerberth I.Breast feeding and the intestinal microflora of the infant-implications for protection against infectious diseases[J].Adv Exp Med Biol,2000,478:77-93.
[7] Hertz-Picciotto I,Baker RJ,Yap PS,et al.Early childhood lower respiratory illness and air pollution[J].Environ Health Perspect,2007,115(10):1510-1518.
[8] Orazzo F,Nespoli L,Ito K,et al.Air pollution,aeroallergens,and emergency room visits for acute respiratory diseases and gastroenteric disorders among young children in six Italian cities[J].Environ Health Perspect,2009,117(11):1780-1785.
[9] Peat JK,Allen J,Oddy W,et al.Breastfeeding and asthma:appraising the controversy[J].Pediatr Pulmonol,2003,35(5):331-334.
[10] Al-Makoshi A,Al-Frayh A,Turner S,et al.Breastfeeding practice and its association with respiratory symptoms and atopic disease in 1-3-year-old children in the city of Riyadh,Central Saudi Arabia[J].Breastfeed Med,Doi:10.1089/bfm.2011.0137.
[11] 伍燕珍,张金良,赵秀阁,等.我国大气污染与儿童呼吸系统疾病和症状的关系[J].环境与健康杂志,2009,26(6):471-477.
[12] Kim BJ,Hong SJ.Ambient air pollution and allergic diseases in children[J].Korean J Pediatr,2012,55(6):185-192.
[13] Belderbos ME,Houben ML,van Bleek GM,et al.Breastfeeding modulates neonatal innate immune responses:a prospective birth cohort study[J].Pediatric Allergy and Immunology,2012,23:65-74.
[14] Rautava S,Walker WA.Academy of breastfeeding medicine founder's lecture 2008:breastfeeding-an extra uterine link between mother and child[J].Breastfeed Med,2009,4:3-10.
[15] Romina L,Jimena BH,Federico RL,et al.Breastfeeding prevents severe disease in full term female infants with acute respiratory infection[J].The Pediatric Infectious Disease Journal,2009,28(2):131-134.
[16] Wright AL,Holberg CJ,Taussig LM,et al.Factors influencing the relation of infant feeding to asthma and recurrent wheeze in childhood[J].Thorax,2001,56(3):192-197.
[17] Dixon DL,Griggs KM,Forsyth KD,et al.Lower interleuk in 8 levels in airway aspirates from breastfed infants with acute bronchiolitis[J].Pediatr Allergy Immuno,2010,21(4):691-696.