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[目的]比较重庆市主城区不同大气污染水平地区的学龄儿童呼吸系统健康的差异。[方法]根据2010—2015年重庆市环保局网站的空气污染指数选取重庆市主城区污染区和清洁区。按照整群抽样的方法,随机选择分别位于清洁区、污染区的2所小学3~4年级的儿童,共487人为研究对象,进行肺功能检测,采用美国流行病学标准问卷(AST-DLD-78-C)对儿童呼吸系统疾病和症状发生情况进行调查。[结果]污染区环境大气污染物PM_(10)、PM_(2.5)在4个季节的平均浓度和年平均浓度均高于清洁区(P<0.05),污染区NOX在春、冬季和年平均浓度高于清洁区(P<0.05),污染区SO_2冬季浓度高于清洁区(P<0.05)。清洁区和污染区调查对象的男女比例分别为1.11∶1与1∶1.16。两区在家庭月收入、家庭采暖方式、厨房排烟系统、养猫/狗/鸟、房屋1年内装修等情况上的差异具有统计学意义(P<0.05)。运用单因素非条件logistic回归模型控制年龄、厨房排烟系统、家庭月收入等混杂因素后,污染区儿童感冒时咯痰(OR=2.54;95%CI:1.64~3.94)、支气管炎(OR=2.05;95%CI:1.18~3.55)的危险性仍高于清洁区儿童(P<0.05)。清洁区女童和男童的用力肺活量、1 s用力呼气容积均高于污染区(P<0.05)。多因素非条件logistic回归分析显示,污染区儿童感冒时咳痰(OR=2.63;95%CI:1.69~4.09),支气管炎(OR=2.19;95%CI:1.26~3.83)发生率高于清洁区(P<0.05)。[结论]重庆市污染区学龄儿童呼吸系统疾病及症状的发生率高于清洁区,肺功能水平有差异,证明大气污染对儿童呼吸系统健康可能带来了一定影响。
[Objective] To compare the differences of respiratory health among school-age children in different levels of urban air pollution in Chongqing. [Method] According to the air pollution index of Chongqing Environmental Protection Bureau website from 2010 to 2015, the contaminated area and clean area in the main urban area of Chongqing were selected. According to the method of cluster sampling, we randomly selected 487 children from Grade 3 to Grade 4 in the primary and secondary schools in the clean area and contaminated area, respectively, for pulmonary function tests. The American Epidemiological Questionnaire (AST-DLD- 78-C) Investigate the incidence of respiratory disease and symptoms in children. [Result] The average concentrations and annual average concentrations of PM_ (10) and PM_ (2.5) in the four seasons in the polluted area were higher than those in the clean area (P <0.05). The NOX in the polluted area was lower in spring, winter and average (P <0.05). The SO 2 concentration in the contaminated area was higher than that in the clean area in winter (P <0.05). The ratio of men and women in the clean area and polluted area was 1.11: 1 and 1: 1.16 respectively. There was a significant difference between the two districts in family monthly income, family heating mode, kitchen exhaust system, cats / dogs / birds, house decoration within one year and so on (P <0.05). After using univariate non-conditional logistic regression model to control the confounding factors such as age, kitchen exhaust system and family monthly income, children in the contaminated area had sputum (OR = 2.54; 95% CI: 1.64-3.94), bronchitis 2.05; 95% CI: 1.18 ~ 3.55) were still higher than those in clean area (P <0.05). The forced expiratory volume of girls and boys in the clean area was higher than that in the contaminated area (P <0.05). Multivariate non-conditional logistic regression analysis showed that the incidence of bronchitis (OR = 2.19; 95% CI: 1.26-3.83) was higher in children with contaminated area than in those with cold (OR = 2.63; 95% CI: 1.69-4.09) Area (P <0.05). [Conclusion] The incidence of respiratory diseases and symptoms of school-age children in the polluted area of Chongqing is higher than that in the clean area. There is a difference in the level of lung function, which proves that air pollution may have an impact on the respiratory health of children.