哮喘联盟

   摘要
   小时候的成长环境对哮喘发病似乎有持久的影响。本研究假设与农村生活相关的环境因素有利于降低农村人口的哮喘患病率，目的在于通过对成长地的评估，来探讨哮喘的城乡梯度特征。以北欧人群为基础的呼吸系统健康(RHINE)研究，其受试对象包括了1945-1973年出生于丹麦、挪威、瑞典、爱尔兰及爱沙尼亚的人群。本次分析涵盖了RHINE研究中11,123名受试者的问卷调查数据。
   成长地分为六类：养殖牲畜的农场、不养殖牲畜的农场、农村地区的村庄、小镇、城郊及市中心。运用Cox回归分析，并对相关混杂因素进行校正后，来评估成长地与哮喘发病之间的关系。成长于养殖牲畜的农场的受试者比成长于市中心的受试者哮喘患病率更低，分别为8%和11%，HR 0.72 (95% CI: 0.57-0.91)；且六种不同城市化水平的成长地呈现出显著的城乡梯度特征(p = 0.02)。而对迟发型哮喘来说，仅在女性、抽烟者中有明显的城乡梯度特征。对喘息与成长地的关系进行分析，得出的结果类似。
   结论：本研究提示，成长于养殖牲畜的农场对哮喘有保护性作用，而且北欧人群中哮喘呈现出城乡梯度特征。
 

（杨冬 审校）
IntJEnvironResPublicHealth. 2015Dec30;13(1).pii:E93.doi:10.3390/ijerph1301009.


 

The Urban-Rural Gradient In Asthma: A Population-Based Study in Northern Europe.
 

Timm S1, Frydenberg M2, Janson C3, Campbell B4, Forsberg B5, Gislason T6,7, Holm M8, Jogi R9, Omenaas E10, Sigsgaard T11, Svanes C12,Schlünssen V13,14.
 

Abstract
The early life environment appears to have a persistent impact on asthma risk. We hypothesize that environmental factors related to rural life mediate lower asthma prevalence in rural populations, and aimed to investigate an urban-rural gradient, assessed by place of upbringing, for asthma. The population-based Respiratory Health In Northern Europe (RHINE) study includes subjects from Denmark, Norway, Sweden, Iceland and Estonia born 1945-1973. The present analysis encompasses questionnaire data on 11,123 RHINE subjects. Six categories of place of upbringing were defined: farm with livestock, farm without livestock, village in rural area, small town, city suburb and inner city. The association of place of upbringing with asthma onset was analysed with Cox regression adjusted for relevant confounders. Subjects growing up on livestock farms had less asthma (8%) than subjects growing up in inner cities (11%) (hazard ratio 0.72 95% CI 0.57-0.91), and a significant urban-rural gradient was observed across six urbanisation levels (p = 0.02). An urban-rural gradient was only evident among women, smokers and for late-onset asthma. Analyses on wheeze and place of upbringing revealed similar results. In conclusion, this study suggests a protective effect of livestock farm upbringing on asthma development and an urban-rural gradient in a Northern European population.
 

IntJEnvironResPublicHealth. 2015Dec30;13(1).pii:E93.doi:10.3390/ijerph1301009.