【作者】 刘健；

【导师】 陈杰；

【作者基本信息】 中国医科大学 ， 劳动卫生与环境卫生学， 2006， 硕士

【摘要】 目的 严重的大气污染是目前最主要的环境与公共卫生问题之一。据世界卫生组织(WHO)估计,每年因空气污染致死的人数约有300万,约占全球总死亡人数5500万的5%,城市空气污染造成每年约80万人死亡、世界人口总健康寿命减少约4,600,000年。目前,空气污染对人体健康的影响研究是国际上热门的前沿课题之一,国内外关于空气污染对成人呼吸健康影响的研究结果差异较大,原因是空气污染物浓度较低,观察时间短,加之人口流动性大,难于找到暴露一剂量关系。辽宁省城市空气污染物浓度梯度变化大,是一个较理想的“天然暴露实验室”,并且一般家庭的住房结构单一、居住面积较小,饮食习惯独特、每天都要烹饪食物,产生大量的油烟烟雾是室内空气污染的主要原因之一。本研究通过对辽宁省城市居民呼吸系统病症的患病水平、分布规律进行调查,来阐明空气污染对居民呼吸健康危害的特征及相关因素的特征。 研究对象和方法 根据近10年(1991年-2000年)大气污染状况,我们从辽宁省选出不同污染水平的6个城市:沈阳、鞍山、本溪、丹东、辽阳和盘锦。又根据10年污染物(TSP)平均浓度在6城市各确定重污染区、中度污染区和相对清洁区。在轻、中、重污染区分别各随机选取一所小学和幼儿园,将所选学校学生的父母和祖父母确定为研究对象,样本量大约4万人。采用美国胸科学会(American Thoracic Society,ATS)调查表进行调查,内容包括学生父母和祖父母的一般情况、家庭环境状况、呼吸系统症状和疾病、既往疾病史、职业史、吸烟和饮酒状况、居住环境及家族史等。 用统计软件包SAS(Version 6.12 SAS institute inc,Cary,NC,USA)来更多还原

【Abstract】 Air pollution is one of the most serious problems of public health today. Estimated by the WHO, air pollution causes about 3 million deaths each year, directly or indirectly, which account for about 5 percent of annual global deaths. At present, the relationship between air pollution and the development of respiratory diseases is a hot subject which attracts global attention. However, researches focusing on it have achieved results of great diversity, which may result from the difficulty to define a stable exposure - dose relationship among studies. In Liaoning Province, air pollution levels have significant variety among cities, thus make it an ideal "laboratory" for researches. Water and heat are supplied by district heating systems and coal or coal gas is used for cooking. Cooking smoke serves as a major source for indoor air pollution. We found it necessary to investigate the risk factors such as smoking, indoor decoration, indoor combustion (e.g. , gas cooking, coal heating) and ventilation on the respiratory health of people living in Northern China.Subjects and methodsThe study population comprised 36,704 people from six cities in Northern China ( e. g. , Shenyang, Anshan, Benxi, Dandong, Liaoyang, Panjin). In each city, 3 areas were selected to represent a severely polluted area, a moderately polluted area and lightly polluted area. Within each area, a kindergarten and an elementary school were selected in the proximity of the air monitoring sites (less than 1000 meters). Students in kindergartens and elementary schoolwere subjects of this study, their parents and grandparents were also enrolled. The survey instrument included a standardized questionnaire adapted from the A-merican Thoracic Society Epidemiologic Standardization Project questionnaire, which had been slightly modified according to the Chinese population. The questionnaire was composed of followings: age, sex, breast -feeding, years of residence , characteristics of house, indoor decoration, method of cooking and heating , place of kitchen, house ventilation devices (if any) , cooking smoke, history and current status of children ￡ respiratory illnesses and symptoms, parental education levels, parental occupation, parental smoking and parental respiratory health history and so on.The data were analyzed using SAS statistical softare (version 6. 12;SAS Institute, Inc. , Cary, NC). The odds ratio ( OR) was used as a measure of effect between the outcome and exposure. We calculated adjusted ORs and 95% confidence intervals ( CI) in logistic regression analysis. Cochran - Mantel -Haensel ^2 test was used to determine the existence of linear trend in the variables.Results and conclusionTSP, SO2 concentrations have gradually decline in recent years, while the level of NOx is fluctuating. Air pollution is still s serious problem, not accord with the national standard.The prevalence of respiratory symptoms in males in six Liaoning cities was;cough, 3.45%;persistent cough, 5.37%;asthma, 0.92%;wheeze, 2.41%. In female, the rate was;cough, 1. 16%;persistent cough, 2. 16%;asthma, 0. 82%;wheeze, 1. 81%. The prevalence was high in spring and winter, while low in May to September.We found respiratory allergy increased in association with the home being adjacent to traffic. Pollution source around house was a risk factor for persistent cough, wheeze, and wheeze symptom. Exposure to furry pets was associated with higher reporting of persistent cough and persistent phlegm, and there was a positive and significant association between house decoration and the adjustedodds ratios for asthma symptom and wheeze. House coal use was not associated with health outcomes except for persistent phlegm. Smoking and passive smoking" were associated with higher reporting of respiratory morbidity. The level of N02 was a risk factor for higher morbidity.更多还原