包头市室内环境与儿童普通感冒的相关性
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摘要
为探讨包头市学龄前儿童普通感冒的患病率及其与现代住宅室内环境因素间的相关性, 2014年3~7月在包头市随机选取了37所幼儿园的4907名3~7岁儿童进行了一项横断面调研.结果显示,被调查儿童1年内经常患普通感冒(次数大于5次)的比例为4.8%,有过长时间感冒(1次感冒持续时间大于2周)的比例为6.1%.与低年龄段儿童(3~5岁)相比,高年龄段儿童(6~7岁)1年内患普通感冒次数大于5次的比例降低,且差异具有统计学意义(P<0.05).家庭成员有过敏史的儿童1年内患普通感冒次数大于5次和1次患普通感冒持续时间大于2周的频率较高,具有显著性差异(P<0.001).通过卡方检验及多元logistics回归方法分析发现:有家庭成员过敏史、室内有凝结水现象(表明通风量较低)出现都会导致学龄前儿童患普通感冒的次数和患病持续时间增加的风险;经常晒被褥则是儿童普通感冒的保护因素.本研究表明包头市现代住宅室内环境因素及生活方式与儿童普通感冒的患病率和持续时间均存在显著相关性.
The common cold is the most common disease in children and is associated with viruses, bacterial infections and low immunity in children. As a susceptible population, children are very sensitive to the common cold. The survey shows that children have an average of 6-8 times a year, usually lasting 7 to 15 days. However, there are few studies in this area in China. This paper discusses the relationship between the indoor environment in Baotou City and the preschool children's cold. This study is part of the China, Children, Homes, Health(CCHH) program, which aims to identify indoor risk factors associated with asthma and allergies in children. From March to July 2014, a cross-sectional study was conducted on 4709 children aged 3-7 years(74.0% response rate) randomly selected from 37 kindergartens in Baotou City. We found that a total of 4.8% had a high frequency(>5 colds per year) and 6.1% had long duration(≥2 weeks) of common cold in Baotou. A Chi-square test was used for univariate analysis of common cold-related risk factors. A P-value <0.05 was considered as significant. All statistical analysis was performed by SPSS 20.0. Low age children had more common cold than high age children(P<0.05). Children who received antibiotics and had a family history of allergies had more colds and longer durations(P<0.001). We analyzed the association between indoor exposure and the common cold. These associations were performed by multiple logistic regression after adjusting for six covariates, including gender, age, family allergy history, breastfeeding, birth patterns, and smoking environment. Odds ratios(ORs) with 95% confidence interval(95% CI) were calculated for the logistic regression models. Family allergy history and exposure to condensation were associated with frequent common cold and long duration of common cold. However, bedding that is often exposed to sunlight is negatively correlated with frequent colds(aOR, 95% CI: 0.67, 0.58 to 0.79) and prolonged colds(aOR, 95% CI: 0.59, 0.40 to 0.87). Family history of allergies and contact condensation may be a risk factor for the common cold, and exposure to bedding from the sun may be a protective factor. This study shows that in Baotou, the indoor environment and lifestyle of modern apartments are related to the frequency of the common cold in children and the duration of the cold. To prevent a child from catching a cold, it is important to reduce signs of moisture and often expose the bedding to the sun. Further follow-up studies of indoor environment could verify more about the influence of environmental exposure on the children's health.
The common cold is the most common disease in children and is associated with viruses, bacterial infections and low immunity in children. As a susceptible population, children are very sensitive to the common cold. The survey shows that children have an average of 6-8 times a year, usually lasting 7 to 15 days. However, there are few studies in this area in China. This paper discusses the relationship between the indoor environment in Baotou City and the preschool children's cold. This study is part of the China, Children, Homes, Health(CCHH) program, which aims to identify indoor risk factors associated with asthma and allergies in children. From March to July 2014, a cross-sectional study was conducted on 4709 children aged 3-7 years(74.0% response rate) randomly selected from 37 kindergartens in Baotou City. We found that a total of 4.8% had a high frequency(>5 colds per year) and 6.1% had long duration(≥2 weeks) of common cold in Baotou. A Chi-square test was used for univariate analysis of common cold-related risk factors. A P-value <0.05 was considered as significant. All statistical analysis was performed by SPSS 20.0. Low age children had more common cold than high age children(P<0.05). Children who received antibiotics and had a family history of allergies had more colds and longer durations(P<0.001). We analyzed the association between indoor exposure and the common cold. These associations were performed by multiple logistic regression after adjusting for six covariates, including gender, age, family allergy history, breastfeeding, birth patterns, and smoking environment. Odds ratios(ORs) with 95% confidence interval(95% CI) were calculated for the logistic regression models. Family allergy history and exposure to condensation were associated with frequent common cold and long duration of common cold. However, bedding that is often exposed to sunlight is negatively correlated with frequent colds(aOR, 95% CI: 0.67, 0.58 to 0.79) and prolonged colds(aOR, 95% CI: 0.59, 0.40 to 0.87). Family history of allergies and contact condensation may be a risk factor for the common cold, and exposure to bedding from the sun may be a protective factor. This study shows that in Baotou, the indoor environment and lifestyle of modern apartments are related to the frequency of the common cold in children and the duration of the cold. To prevent a child from catching a cold, it is important to reduce signs of moisture and often expose the bedding to the sun. Further follow-up studies of indoor environment could verify more about the influence of environmental exposure on the children's health.
引文
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2 Stein R A.Hopes and challenges for the common cold.Int J Clin Pract,2017,71,doi:10.1111/ijcp.12921
3 Worrall G.Common cold.Can Fam Phys,2011,57:1289
4 Allan G M,Arroll B.Prevention and treatment of the common cold:Making sense of the evidence.Can Med Assoc J,2014,186:190-199
5 Thompson M,Vodicka T A,Blair P S,et al.Duration of symptoms of respiratory tract infections in children:Systematic review.Br Med J,2013,347:f7027
6 Norb?ck D,Lu C,Zhang Y P,et al.Common cold among pre-school children in China-Associations with ambient PM10 and dampness,mould,cats,dogs,rats and cockroaches in the home environment.Environ Int,2017,103:13-22
7 Liu Z J,Li A G,Hu Z P,et al.Study on the potential relationships between indoor culturable fungi,particle load and children respiratory health in Xi’an,China.Build Environ,2014,80:105-114
8 Fisk W J,Eliseeva E A,Mendell M J.Association of residential dampness and mold with respiratory tract infections and bronchitis:Ameta-analysis.Environ Health,2010,9:72
9 Zhang H B,Xie J C,Yoshino H,et al.Thermal and environmental conditions in Shanghai households:Risk factors for childhood health.Build Environ,2016,104:35-46
10 Liu W W,Zhong W D,Wargocki P.Performance,acute health symptoms and physiological responses during exposure to high air temperature and carbon dioxide concentration.Build Environ,2017,114:96-105
11 Wang H,Li B Z,Yu W,et al.Early-life exposure to home dampness associated with health effects among children in Chongqing,China.Build Environ,2015,94:327-334
12 Zhang Y P,Baizhan L I,Huang C,et al.Ten cities cross-sectional questionnaire survey of children asthma and other allergies in China.Chin Sci Bull,2013,58:4182-4189
13 Wang L F,Huang X Y,Sundell J,et al.Impact of home humidifier on children’s eczema(in Chinese).Chin Sci Bull,2016,61:1721-1727[王丽芳,黄晓影,Sundell J,等.住宅内加湿器使用对儿童湿疹患病率的影响.科学通报,2016,61:1721-1727]
14 Wang L F,Huang X Y,Zhang Y P,et al.Relationship between indoor environment and children’s pneumonia in Baotou,Inner Mongolia(in Chinese).Build Sci,2016,32:124-130[王丽芳,黄晓影,张寅平,等.包头市室内环境与儿童肺炎的相关性.建筑科学,2016,32:124-130]
15 Arroll B.Common cold.Am Fam Phys,2011,84:1390-1391
16 Sun C J,Huang C,Liu W,et al.Home dampness-related exposures increase the risk of common colds among preschool children in Shanghai,China:Modified by household ventilation.Build Environ,2017,124:31-41
17 Yuan G B,Wang J J,Zhang F M.Analysis on climatic characteristics of Baotou area(in Chinese).Meteor J Inner Mongolia,2007,4:21-23[袁国波,王建军,张凤梅.包头地区气候特征简析.内蒙古气象,2007,4:21-23]
18 Mou Z,Peng L,Hua J,et al.Time series study on the temperature and humidity of Shanghai and the number of people visiting the cold(in Chinese).Chin J Health Stat,2013,30:237-239[牟喆,彭丽,花静,等.上海市温湿度与感冒就诊人次的时间序列研究.中国卫生统计,2013,30:237-239]
19 Ye W,Zhang X,Gao J,et al.Indoor air pollutants,ventilation rate determinants and potential control strategies in Chinese dwellings:Aliterature review.Sci Total Environ,2017,586:696-729
20 Hashemi A,Khatami N.The effects of air permeability,background ventilation and lifestyle on energy performance,indoor air quality and risk of condensation in domestic buildings.Sustainability,2015,7:4022-4034
21 Sun Y,Zhang Y,Sundell J,et al.Dampness at dorm and its associations with allergy and airways infection among college students in China:A cross-sectional study.Indoor Air,2009,19:174-182
22 Gartner L M,Morton J,Lawrence R A,et al.Breastfeeding and the use of human milk.Pediatrics,2012,129:e827
23 Duijts L,Jaddoe V W,Hofman A,et al.Prolonged and exclusive breastfeeding reduces the risk of infectious diseases in infancy.Pediatrics,2010,126:e18
24 Malta A L.The optimal duration of exclusive breastfeeding for physical growth.Nutr Perspect J Counc Nutr,2015,38:21
25 Arlian L G,Morgan M S.Biology,ecology,and prevalence of dust mites.Immunol Allergy Clin,2003,23:443
26 Nankervis H,Smith E V,Boyle R J,et al.House dust mite reduction and avoidance measures for treating eczema.Cochrane Databast Syst Rev,2015,1:CD008426
27 Lombardi C,Fiocchi A,Raffetti E,et al.Cross-sectional comparison of the characteristics of respiratory allergy in immigrants and Italian children.Pediatr Allergy Immunol Pulmonol,2014,25:473-480
28 Zhang H M,Wang Y M,Shen C J,et al.Biases and their control in veterinary epidemiological researches(in Chinese).Chin Anim Health Insp,2016,33:67-71[张海明,王幼明,沈朝建,等.兽医流行病学研究中的偏倚及其控制.中国动物检疫,2016,33:67-71]
29 Ren T,Zhan S Y,Shen X,et al.Biases and confounding in epidemiological researches(in Chinese).Chin J Epidemiol,2004,25:811-813[任涛,詹思延,沈霞,等.流行病学研究中的偏倚与混杂.中华流行病学杂志,2004,25:811-813]
30 Bornehag C G,Sundell J,Sigsgaard T.Dampness in buildings and health(DBH):Report from an ongoing epidemiological investigation on the association between indoor environmental factors and health effects among children in Sweden.Indoor Air,2004,14:59-66
31 Naydenov K,Melikov A,Markov D,et al.A comparison between occupants‘and inspectors’reports on home dampness and their association with the health of children:the ALLHOME study.Build Environ,2008,43:1840-1849
32 Sun Y,Sundell J.Life style and home environment are associated with racial disparities of asthma and allergy in Northeast Texas children.Sci Total Environ,2011,409:4229-4234
2 Stein R A.Hopes and challenges for the common cold.Int J Clin Pract,2017,71,doi:10.1111/ijcp.12921
3 Worrall G.Common cold.Can Fam Phys,2011,57:1289
4 Allan G M,Arroll B.Prevention and treatment of the common cold:Making sense of the evidence.Can Med Assoc J,2014,186:190-199
5 Thompson M,Vodicka T A,Blair P S,et al.Duration of symptoms of respiratory tract infections in children:Systematic review.Br Med J,2013,347:f7027
6 Norb?ck D,Lu C,Zhang Y P,et al.Common cold among pre-school children in China-Associations with ambient PM10 and dampness,mould,cats,dogs,rats and cockroaches in the home environment.Environ Int,2017,103:13-22
7 Liu Z J,Li A G,Hu Z P,et al.Study on the potential relationships between indoor culturable fungi,particle load and children respiratory health in Xi’an,China.Build Environ,2014,80:105-114
8 Fisk W J,Eliseeva E A,Mendell M J.Association of residential dampness and mold with respiratory tract infections and bronchitis:Ameta-analysis.Environ Health,2010,9:72
9 Zhang H B,Xie J C,Yoshino H,et al.Thermal and environmental conditions in Shanghai households:Risk factors for childhood health.Build Environ,2016,104:35-46
10 Liu W W,Zhong W D,Wargocki P.Performance,acute health symptoms and physiological responses during exposure to high air temperature and carbon dioxide concentration.Build Environ,2017,114:96-105
11 Wang H,Li B Z,Yu W,et al.Early-life exposure to home dampness associated with health effects among children in Chongqing,China.Build Environ,2015,94:327-334
12 Zhang Y P,Baizhan L I,Huang C,et al.Ten cities cross-sectional questionnaire survey of children asthma and other allergies in China.Chin Sci Bull,2013,58:4182-4189
13 Wang L F,Huang X Y,Sundell J,et al.Impact of home humidifier on children’s eczema(in Chinese).Chin Sci Bull,2016,61:1721-1727[王丽芳,黄晓影,Sundell J,等.住宅内加湿器使用对儿童湿疹患病率的影响.科学通报,2016,61:1721-1727]
14 Wang L F,Huang X Y,Zhang Y P,et al.Relationship between indoor environment and children’s pneumonia in Baotou,Inner Mongolia(in Chinese).Build Sci,2016,32:124-130[王丽芳,黄晓影,张寅平,等.包头市室内环境与儿童肺炎的相关性.建筑科学,2016,32:124-130]
15 Arroll B.Common cold.Am Fam Phys,2011,84:1390-1391
16 Sun C J,Huang C,Liu W,et al.Home dampness-related exposures increase the risk of common colds among preschool children in Shanghai,China:Modified by household ventilation.Build Environ,2017,124:31-41
17 Yuan G B,Wang J J,Zhang F M.Analysis on climatic characteristics of Baotou area(in Chinese).Meteor J Inner Mongolia,2007,4:21-23[袁国波,王建军,张凤梅.包头地区气候特征简析.内蒙古气象,2007,4:21-23]
18 Mou Z,Peng L,Hua J,et al.Time series study on the temperature and humidity of Shanghai and the number of people visiting the cold(in Chinese).Chin J Health Stat,2013,30:237-239[牟喆,彭丽,花静,等.上海市温湿度与感冒就诊人次的时间序列研究.中国卫生统计,2013,30:237-239]
19 Ye W,Zhang X,Gao J,et al.Indoor air pollutants,ventilation rate determinants and potential control strategies in Chinese dwellings:Aliterature review.Sci Total Environ,2017,586:696-729
20 Hashemi A,Khatami N.The effects of air permeability,background ventilation and lifestyle on energy performance,indoor air quality and risk of condensation in domestic buildings.Sustainability,2015,7:4022-4034
21 Sun Y,Zhang Y,Sundell J,et al.Dampness at dorm and its associations with allergy and airways infection among college students in China:A cross-sectional study.Indoor Air,2009,19:174-182
22 Gartner L M,Morton J,Lawrence R A,et al.Breastfeeding and the use of human milk.Pediatrics,2012,129:e827
23 Duijts L,Jaddoe V W,Hofman A,et al.Prolonged and exclusive breastfeeding reduces the risk of infectious diseases in infancy.Pediatrics,2010,126:e18
24 Malta A L.The optimal duration of exclusive breastfeeding for physical growth.Nutr Perspect J Counc Nutr,2015,38:21
25 Arlian L G,Morgan M S.Biology,ecology,and prevalence of dust mites.Immunol Allergy Clin,2003,23:443
26 Nankervis H,Smith E V,Boyle R J,et al.House dust mite reduction and avoidance measures for treating eczema.Cochrane Databast Syst Rev,2015,1:CD008426
27 Lombardi C,Fiocchi A,Raffetti E,et al.Cross-sectional comparison of the characteristics of respiratory allergy in immigrants and Italian children.Pediatr Allergy Immunol Pulmonol,2014,25:473-480
28 Zhang H M,Wang Y M,Shen C J,et al.Biases and their control in veterinary epidemiological researches(in Chinese).Chin Anim Health Insp,2016,33:67-71[张海明,王幼明,沈朝建,等.兽医流行病学研究中的偏倚及其控制.中国动物检疫,2016,33:67-71]
29 Ren T,Zhan S Y,Shen X,et al.Biases and confounding in epidemiological researches(in Chinese).Chin J Epidemiol,2004,25:811-813[任涛,詹思延,沈霞,等.流行病学研究中的偏倚与混杂.中华流行病学杂志,2004,25:811-813]
30 Bornehag C G,Sundell J,Sigsgaard T.Dampness in buildings and health(DBH):Report from an ongoing epidemiological investigation on the association between indoor environmental factors and health effects among children in Sweden.Indoor Air,2004,14:59-66
31 Naydenov K,Melikov A,Markov D,et al.A comparison between occupants‘and inspectors’reports on home dampness and their association with the health of children:the ALLHOME study.Build Environ,2008,43:1840-1849
32 Sun Y,Sundell J.Life style and home environment are associated with racial disparities of asthma and allergy in Northeast Texas children.Sci Total Environ,2011,409:4229-4234