生物燃料烟雾暴露人群肺功能受损分析——潮汕农村地区调查分析
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摘要
目的探究该地区生物燃料烟雾暴露与慢性咳嗽、咳痰增多以及对肺通气功能小气道功能损伤的情况,以及暴露指数与上述指标的相关性。方法以潮汕无空气污染的农村地区为研究对象,按村落分布情况随机整群抽样分析,选取年龄在50-80岁之间的常住人口577名,分为生物燃料暴露组(观察组) 420名,无生物燃料暴露组(对照组) 157名;采用单因素及多因素回归,分析生物燃料暴露与肺功能相关指标的相关性。结果生物燃料烟雾暴露组村民的咳嗽、咳痰症状均比非暴露组严重,每年咳嗽、咳痰超过3个月的村民人数比例较对照组高(χ~2=4. 869,P <0. 05;χ~2=5. 084,P <0. 05); FEV1占预计值%和FEV1/FVC指标暴露组显著低于对照组(P <0. 05),而FEV1占预计值%指标于组间无差异(P> 0. 05),在小气道功能比较中,PEF25、PEF50、PEF75、MMEF和MMEF占预计值%指标,在暴露组人群均低于对照组(P <0. 01);多因素分析中,生物燃料暴露指数对肺功能存在损伤影响,分别为FEV1/FVC(回归系数-0. 1)、FEV1占预计值%(回归系数-0. 2)、MMEF占预计值%(回归系数-0. 2)。结论生物燃料烟雾暴露可导致慢性咳嗽、咯痰增多以及肺通气功能和小气道功能损伤。
Objective To investigate the prevalence of biofuel fumes exposure with chronic cough,expectoration and the impairment of small airway function of pulmonary ventilation,and the correlation between exposure index and those parameters. Methods In rural areas without air pollution in Chaoshan area,the random cluster analysis was conducted based on the distribution of villages. 577 resident population aging from 50 to 80 years old were selected and divided into the observation group( n = 420) and the control group( n = 157). The correlation between biofuel exposure and lung function related indexes was analyzed by single factor and multiple factor regression. Results The symptoms of cough and sputum in villagers exposed to biofuels were more serious than those in the non-exposed group. The proportion of villagers who coughed and sputum more than 3 months each year was higher than that of the control group( χ~2= 4. 869,P < 0. 05; χ~2= 5. 084,P < 0. 05). The value of FEV1% Pre and FEV1/FVC was significantly lower in the observation group than in the control group( P < 0. 05),while FEV% showed no significant difference between the two groups( P > 0. 05). The value of PEF25,PEF50,PEF75,MMEF and MMEF% Pre was obviously lower in the observation group than in the control group. The multivariate analysis showed that the biomarker exposure index had impaired pulmonary function,which were FEV1/FVC( regression coefficient =-0. 1),FEV1%Pre( regression coefficient =-0. 2),and MMEF% Pre( regression coefficient =-0. 2). Conclusion Biofuels exposure can lead to chronic cough,increase expectoration,and damage pulmonary ventilation and airway function.
Objective To investigate the prevalence of biofuel fumes exposure with chronic cough,expectoration and the impairment of small airway function of pulmonary ventilation,and the correlation between exposure index and those parameters. Methods In rural areas without air pollution in Chaoshan area,the random cluster analysis was conducted based on the distribution of villages. 577 resident population aging from 50 to 80 years old were selected and divided into the observation group( n = 420) and the control group( n = 157). The correlation between biofuel exposure and lung function related indexes was analyzed by single factor and multiple factor regression. Results The symptoms of cough and sputum in villagers exposed to biofuels were more serious than those in the non-exposed group. The proportion of villagers who coughed and sputum more than 3 months each year was higher than that of the control group( χ~2= 4. 869,P < 0. 05; χ~2= 5. 084,P < 0. 05). The value of FEV1% Pre and FEV1/FVC was significantly lower in the observation group than in the control group( P < 0. 05),while FEV% showed no significant difference between the two groups( P > 0. 05). The value of PEF25,PEF50,PEF75,MMEF and MMEF% Pre was obviously lower in the observation group than in the control group. The multivariate analysis showed that the biomarker exposure index had impaired pulmonary function,which were FEV1/FVC( regression coefficient =-0. 1),FEV1%Pre( regression coefficient =-0. 2),and MMEF% Pre( regression coefficient =-0. 2). Conclusion Biofuels exposure can lead to chronic cough,increase expectoration,and damage pulmonary ventilation and airway function.
引文
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[13] THACHER J D,EMMELIN A,MADAKI A J,et al. Biomass fuel use and the risk of asthma in Nigerian children[J]. Respir Med,2013,107(12):1845-1851.
[14] DA SILVA L F,SALDIVA S R,SALDIVA P H,et al. Impaired lung function in individuals chronically exposed to biomass combustion[J]. Environ Res,2012,112:111-117.
[2] CARAVEDO M A,HERRERA P M,MONGILARDI N,et al. Chronic exposure to biomass fuel smoke and markers of endothelial inflammation[J]. Indoor Air,2016,26(5):768-775.
[3] PANJWANI A K,GHAZAL S,MAHAT R,et al. Assessment of risk factors against severity of COPD in non-smokers[J]. JNMA J Nepal Med Assoc,2013,52(191):479-482.
[4] SCHL? NSSEN V,MADSEN A M,SKOV S,et al. Does the use of biofuels affect respiratory health among male Danish energy plant workers?[J]. Occup Environ Med,2011,68(7):467-473.
[5] YANG P M,WANG C C,LIN Y C,et al. Development of novel alternative biodiesel fuels for reducing PM emissions and PM-related genotoxicity[J]. Environ Res,2017,156:512-518.
[6]安晶,包鹤龄,方利文.生物燃料烟雾暴露与中国居民慢性阻塞性肺疾病关系meta分析[J].中国公共卫生,2016,32(7):999-1004.
[7]徐欣欣,颜燕,易浩宇.生物燃料烟雾暴露对农村健康女性肺功能的影响[J].中国实用医刊,2010,37(12):26-27.
[8]石喆,胡国平,李冰,等.腺病毒感染对生物燃料烟雾所致豚鼠肺部炎症反应的作用[J].中华结核和呼吸杂志,2008,31(10):747-751.
[9]曾乐平,郭凯,雷德亮,等.室内生物燃料烟雾颗粒物污染与呼吸系统疾病的关系[J].现代生物医学进展,2009,9(4):786-789.
[10] LIBALOVA H,ROSSNER P,VRBOVA K,et al. Comparative analysis of toxic responses of organic extracts from diesel and selected alternative fuels engine emissions in human lung BEAS-2B cells[J]. Int J Mol Sci,2016,17(11):E1833.
[11] MEHUS A A,REED R J,LEE V S,et al. Comparison of acute health effects from exposures to diesel and biodiesel fuel emissions[J]. J Occup Environ Med,2015,57(7):705-712.
[12] SHVEDOVA A A,YANAMALA N,MURRAY A R,et al. Oxidative stress,inflammatory biomarkers,and toxicity in mouse lung and liver after inhalation exposure to 100%biodiesel or petroleum diesel emissions[J]. J Toxicol Environ Health A,2013,76(15):907-921.
[13] THACHER J D,EMMELIN A,MADAKI A J,et al. Biomass fuel use and the risk of asthma in Nigerian children[J]. Respir Med,2013,107(12):1845-1851.
[14] DA SILVA L F,SALDIVA S R,SALDIVA P H,et al. Impaired lung function in individuals chronically exposed to biomass combustion[J]. Environ Res,2012,112:111-117.