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大氣污染對小學生健康的影響

陳樹昶 徐虹 劉衛艷 徐珊珊 呂燁 張文輝

陳樹昶, 徐虹, 劉衛艷, 徐珊珊, 呂燁, 張文輝. 大氣污染對小學生健康的影響[J]. 中國學校衛生, 2021, 42(10): 1560-1563,1567. doi: 10.16835/j.cnki.1000-9817.2021.10.028
引用本文: 陳樹昶, 徐虹, 劉衛艷, 徐珊珊, 呂燁, 張文輝. 大氣污染對小學生健康的影響[J]. 中國學校衛生, 2021, 42(10): 1560-1563,1567. doi: 10.16835/j.cnki.1000-9817.2021.10.028
CHEN Shuchang, XU Hong, LIU Weiyan, XU Shanshan, LYU Ye, ZHANG Wenhui. The influence of air pollution on the health of primary school students[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2021, 42(10): 1560-1563,1567. doi: 10.16835/j.cnki.1000-9817.2021.10.028
Citation: CHEN Shuchang, XU Hong, LIU Weiyan, XU Shanshan, LYU Ye, ZHANG Wenhui. The influence of air pollution on the health of primary school students[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2021, 42(10): 1560-1563,1567. doi: 10.16835/j.cnki.1000-9817.2021.10.028

大氣污染對小學生健康的影響

doi: 10.16835/j.cnki.1000-9817.2021.10.028
基金項目: 

杭州市科技計劃項目 20191203B142

詳細信息
    作者簡介:

    陳樹昶(1965-),男,江蘇淮安人,碩士,主任醫師,主要研究方向為環境、食品與營養衛生及實驗室管理

  • 中圖分類號: R122 G478

The influence of air pollution on the health of primary school students

  • 摘要:   目的  了解大氣污染物濃度增高對學齡兒童疾病、癥狀和因病缺課產生的影響,為防止大氣污染對學生健康的危害提供參考。  方法  于2014—2017年每年冬季,對杭州某小學792名四年級學生進行健康問卷調查,每日連續開展發病和癥狀監測。采用基于Pearson回歸的廣義相加模型分析單污染物濃度增高引起的健康影響,多因素Logistic回歸模型分析家庭、居住環境與大氣污染物濃度增加對學生健康的綜合影響。  結果  415名(52.4%)小學生有既往病史,265名(33.5%)有過敏史。調查期間,PM2.5、PM10、SO2和NO2的平均質量體積濃度分別為(81.0±2.8)(122.2±3.9)(17.9±0.6)(68.9±1.4)μg/m3。PM2.5、PM10和NO2滯后3 d時對學生發生疾病和因病缺課的影響最為明顯,各污染物每增加10 μg/m3,發生疾病風險RR值分別為1.02(1.01~1.02),1.04(1.03~1.06)和1.03(1.02~1.04)。SO2滯后5 d對學生健康影響最為顯著。父親本科及以上文化水平與小學生冬季發生疾病(OR=0.83)和癥狀(OR=0.84)呈負相關;1年內家具更換(OR=1.78)、寵物飼養(OR=1.94)、1年內反復呼吸道感染(OR=1.82)、1年前過敏性鼻炎(OR=2.24)、冠心病/高血壓家族史(OR=1.46)、室內活動時間(OR=1.02)、大氣PM10濃度(OR=1.09)與小學生冬季產生癥狀呈正相關(P值均 < 0.05)。  結論  大氣污染物濃度增高對小學生發生疾病、癥狀以及因病缺課有影響且存在滯后效應。父親本科及以上文化水平是學生健康的保護因素,室內環境污染和室外大氣污染均可導致學生疾病和癥狀的發生。
  • 表  1  杭州市2014—2017年氣象指標和大氣污染物的相關性(r值,n=188)

    Table  1.   Correlation between meteorological indicators and air pollution during 2014-2017(r, n=188)

    指標 平均相對濕度 日平均風速 PM2.5 PM10 SO2 NO2
    平均溫度 0.58* 0.00 0.06 -0.01 -0.22* 0.07
    平均相對濕度 -0.09 -0.03 -0.18* -0.44* -0.08
    日平均風速 -0.35* -0.40* -0.14 -0.54*
    PM2.5 0.94* 0.46* 0.64*
    PM10 0.53* 0.67*
    SO2 0.32*
    ??注:*P < 0.05。
    下載: 導出CSV

    表  2  杭州市大氣污染物濃度對小學生健康影響的滯后效應[RR值(RR值95%CI),n=792]

    Table  2.   Lag effect of air pollution on primary school students' health in Hangzhou[RR(RR 95%CI), n=792]

    污染物 滯后天數/d 疾病 癥狀 因病缺課
    PM2.5 0 0.99(0.99~1.00)* 0.99(0.99~0.99)* 0.99(0.98~0.99)*
    1 1.00(0.99~1.00) 0.99(0.98~0.99)* 0.98(0.97~0.99)*
    2 1.01(1.01~1.02)* 1.00(1.00~1.01) 1.00(0.99~1.02)
    3 1.02(1.01~1.02)* 1.01(1.00~1.01)* 1.02(1.01~1.03)*
    4 1.02(0.98~1.07) 0.97(0.94~1.01) 1.02(0.94~1.12)
    5 1.00(0.99~1.00) 1.00(0.99~1.00) 1.00(1.00~1.01)
    6 1.00(1.00~1.01) 1.01(1.00~1.01)* 1.01(1.00~1.02)
    PM10 0 1.00(0.99~1.00) 0.99(0.98~0.99)* 0.97(0.96~0.99)*
    1 1.02(1.01~1.04)* 0.99(0.98~1.00)* 1.00(0.98~1.03)
    2 1.02(1.01~1.03)* 0.99(0.98~1.00)* 1.00(0.97~1.02)
    3 1.04(1.03~1.06)* 1.01(1.00~1.02)* 1.04(1.02~1.07)*
    4 1.39(0.66~2.95) 0.64(0.33~1.16) 1.48(0.34~6.37)
    5 0.98(0.96~0.93)* 0.97(0.95~0.98)* 0.97(0.94~1.00)
    6 1.02(1.00~1.03)* 0.98(0.98~0.99)* 1.00(0.98~1.02)
    SO2 0 0.95(0.92~0.97)* 0.94(0.92~0.96)* 0.91(0.97~0.95)*
    1 0.97(0.93~1.00) 0.91(0.88~0.94)* 0.86(0.79~0.93)*
    2 1.02(0.98~1.06) 0.94(0.91~0.98)* 0.96(0.89~1.04)
    3 1.10(1.00~1.17)* 1.05(0.99~1.10) 1.15(1.01~1.31)*
    4 1.09(0.90~1.31) 0.89(0.77~1.04) 1.10(0.70~1.59)
    5 1.31(1.14~1.50)* 1.21(1.08~1.35)* 1.52(1.17~1.97)*
    6 0.95(0.88~1.03) 0.83(0.77~0.89)* 0.80(0.68~0.94)
    NO2 0 0.99(0.98~0.99)* 0.99(0.98~0.99)* 0.98(0.97~0.99)*
    1 1.01(1.00~1.02) 0.97(0.96~0.98)* 0.98(0.96~1.00)
    2 1.02(1.01~1.03)* 1.02(1.01~1.02)* 1.02(1.01~1.04)*
    3 1.03(1.02~1.04)* 1.00(1.00~1.01) 1.03(1.02~1.05)*
    4 0.92(0.76~1.11) 1.12(0.96~1.30) 0.91(0.63~1.31)
    5 0.99(0.98~1.00)* 0.99(0.99~1.00)* 1.00(0.98~1.01)
    6 1.00(0.99~1.01) 1.01(1.01~1.02)* 1.01(0.99~1.02)
    ??注:*P < 0.05。
    下載: 導出CSV

    表  3  杭州市多污染物及影響因素對小學生疾病與癥狀效應分析(n=792)

    Table  3.   Effect of multiple pollution and influencing factors on diseases and symptoms(n=792)

    影響因素 疾病 癥狀
    OR值(OR值95%CI) P OR值(OR值95%CI) P
    父親文化本科及以上 0.83(0.69~0.99) 0.04 0.84(0.71~0.98) 0.03
    1年內家具更換 - - 1.78(1.05~3.02) 0.03
    寵物飼養 - - 1.94(1.20~3.14) 0.01
    1年內反復呼吸道感染 2.06(1.31~3.23) < 0.01 1.82(1.13~2.93) 0.01
    1年前過敏性鼻炎 2.48(1.69~3.66) < 0.01 2.24(1.51~3.31) < 0.01
    冠心病/高血壓家族史 - - 1.46(1.06~2.01) 0.02
    室內活動時間 - - 1.02(1.00~1.05) 0.03
    PM10 1.01(1.00~1.02) 0.01 1.09(1.07~1.11) < 0.01
    NO2 1.03(1.01~1.04) 0.01 0.90(0.87~0.92) < 0.01
    ??注:變量賦值包括父親文化程度(本科以下=0,本科及以上=1);1年內家具更換、寵物飼養、1年內反復呼吸道感染、1年前過敏性鼻炎、冠心病/高血壓家族史(否=0,是=1);室內活動時間、PM10、NO2為連續變量。
    下載: 導出CSV
    客厅的yin乱A片
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  • 收稿日期:  2021-04-25
  • 修回日期:  2021-05-28
  • 網絡出版日期:  2021-10-25
  • 刊出日期:  2021-10-25

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