务农和非务农农村人群新发哮喘情况及环境与职业对哮喘的影响
2011/08/30
摘要
背景：包括环境暴露在内的诸多因素已经证实与哮喘患病率增加有关，但这些因素很少在纵向研究中进行验证。
目的：我们在务农学生中研究儿童期和成人期环境因素是否为随后哮喘发作的一个决定因素。
方法：在1964名务农学生和407名非务农学生中，通过每年邮寄问卷调查和电话随访，选取1994年至1998年间的哮喘新发病例。研究对象年龄为16～26岁。对于每例受试对象，我们从无哮喘的队列研究（基于实例设计）中选取对照，所有研究对象均接受访谈和临床检查。
结果：共发现122名新发哮喘患者。在多元回归模型中，吸烟者的新发哮喘优势比为3.3 (95% CI, 1.7-6.3)，猪、乳制品和焊接暴露者的新发哮喘优势比分别为3.4 (95% CI, 1.6-7.0)、2.5 (95% CI, 1.1-5.3)和7.0 (95% CI, 1.2-41.6)，基线状态支气管高反应性患者的新发哮喘优势比为11.7 (95% CI, 2.4-56.4)。出生和生长在农村能显著降低哮喘风险优势比(0.5 [95% CI, 0.3-0.98])，但对特应性无影响。
结论：猪、乳制品、焊接、吸烟和支气管高反应性是非过敏性哮喘的危险因素。出生和生长在农村能降低随后的哮喘风险。这些结果支持如下理论：儿童早期环境暴露能影响免疫和炎症反应，降低后期哮喘风险。
（刘国梁 审校）
J Allergy Clin Immunol. 2011 Jul 11. [Epub ahead of print]
New-onset asthma and the effect of environment and occupation among farming and nonfarming rural subjects.
Omland O, Hjort C, Pedersen OF, Miller MR, Sigsgaard T.
Source
Institute of Public Health, Department of Occupational and Environmental Medicine, University of Aarhus, Aarhus, Denmark; Department of Occupational Medicine, Aalborg Hospital, Århus University Hospital, Aalborg, Denmark.
Abstract
BACKGROUND: Many factors, including environmental exposures, have been related to the increase in the prevalence of asthma, but only few have been tested for in longitudinal studies.
OBJECTIVE: We studied farming students to determine whether their environment during childhood and as adults was a factor determining subsequent onset of asthma.
METHODS: From 1994 to 1998, new cases of asthma were identified by means of an annual posted questionnaire followed by a telephone interview in a prospective cohort consisting of 1964 farming-school students and 407 nonfarming subjects aged 16 to 26 years. For each case, we selected a control subject from the cohort with no asthma in a case-based design, and all underwent an interview and a clinical examination.
RESULTS: We found 122 new cases of asthma. In a multiple regression model the odds ratio for new asthma was 3.3 (95% CI, 1.7-6.3) for smoking; 3.4 (95% CI, 1.6-7.0), 2.5 (95% CI, 1.1-5.3), and 7.0 (95% CI, 1.2-41.6) for exposure to swine, dairy production, and welding, respectively; and 11.7 (95% CI, 2.4-56.4) for bronchial hyperresponsiveness at baseline. Being born and raised on a farm significantly reduced the risk odds ratio (0.5 [95% CI, 0.3-0.98]), whereas atopy had no influence.
CONCLUSION: Exposure to swine and dairy confinements, welding, smoking, and bronchial hyperresponsiveness are risk factors for nonallergic asthma, and being born and raised on a farm reduces the subsequent risk. These findings support the theory that immune and inflammatory responses can be influenced by environmental exposure to early childhood, reducing the risk of asthma later in life.
J Allergy Clin Immunol. 2011 Jul 11. [Epub ahead of print]
背景：包括环境暴露在内的诸多因素已经证实与哮喘患病率增加有关，但这些因素很少在纵向研究中进行验证。
目的：我们在务农学生中研究儿童期和成人期环境因素是否为随后哮喘发作的一个决定因素。
方法：在1964名务农学生和407名非务农学生中，通过每年邮寄问卷调查和电话随访，选取1994年至1998年间的哮喘新发病例。研究对象年龄为16～26岁。对于每例受试对象，我们从无哮喘的队列研究（基于实例设计）中选取对照，所有研究对象均接受访谈和临床检查。
结果：共发现122名新发哮喘患者。在多元回归模型中，吸烟者的新发哮喘优势比为3.3 (95% CI, 1.7-6.3)，猪、乳制品和焊接暴露者的新发哮喘优势比分别为3.4 (95% CI, 1.6-7.0)、2.5 (95% CI, 1.1-5.3)和7.0 (95% CI, 1.2-41.6)，基线状态支气管高反应性患者的新发哮喘优势比为11.7 (95% CI, 2.4-56.4)。出生和生长在农村能显著降低哮喘风险优势比(0.5 [95% CI, 0.3-0.98])，但对特应性无影响。
结论：猪、乳制品、焊接、吸烟和支气管高反应性是非过敏性哮喘的危险因素。出生和生长在农村能降低随后的哮喘风险。这些结果支持如下理论：儿童早期环境暴露能影响免疫和炎症反应，降低后期哮喘风险。
（刘国梁 审校）
J Allergy Clin Immunol. 2011 Jul 11. [Epub ahead of print]
New-onset asthma and the effect of environment and occupation among farming and nonfarming rural subjects.
Omland O, Hjort C, Pedersen OF, Miller MR, Sigsgaard T.
Source
Institute of Public Health, Department of Occupational and Environmental Medicine, University of Aarhus, Aarhus, Denmark; Department of Occupational Medicine, Aalborg Hospital, Århus University Hospital, Aalborg, Denmark.
Abstract
BACKGROUND: Many factors, including environmental exposures, have been related to the increase in the prevalence of asthma, but only few have been tested for in longitudinal studies.
OBJECTIVE: We studied farming students to determine whether their environment during childhood and as adults was a factor determining subsequent onset of asthma.
METHODS: From 1994 to 1998, new cases of asthma were identified by means of an annual posted questionnaire followed by a telephone interview in a prospective cohort consisting of 1964 farming-school students and 407 nonfarming subjects aged 16 to 26 years. For each case, we selected a control subject from the cohort with no asthma in a case-based design, and all underwent an interview and a clinical examination.
RESULTS: We found 122 new cases of asthma. In a multiple regression model the odds ratio for new asthma was 3.3 (95% CI, 1.7-6.3) for smoking; 3.4 (95% CI, 1.6-7.0), 2.5 (95% CI, 1.1-5.3), and 7.0 (95% CI, 1.2-41.6) for exposure to swine, dairy production, and welding, respectively; and 11.7 (95% CI, 2.4-56.4) for bronchial hyperresponsiveness at baseline. Being born and raised on a farm significantly reduced the risk odds ratio (0.5 [95% CI, 0.3-0.98]), whereas atopy had no influence.
CONCLUSION: Exposure to swine and dairy confinements, welding, smoking, and bronchial hyperresponsiveness are risk factors for nonallergic asthma, and being born and raised on a farm reduces the subsequent risk. These findings support the theory that immune and inflammatory responses can be influenced by environmental exposure to early childhood, reducing the risk of asthma later in life.
J Allergy Clin Immunol. 2011 Jul 11. [Epub ahead of print]
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