农业暴露和哮喘风险：法国AGRICAN队列研究
2013/11/13
摘要
流行病学研究已经报道了农业人群呼吸道疾病风险的增加，但是“农场效应”的防护也由于哮喘而被报道。在AGRICAN队列研究中，自我报告医生诊断为哮喘者被按照过敏进行分析，该哮喘与终身暴露于13种农作物和5种家畜，农药暴露和童年在农场有关，考虑到性别、年龄、教育以及体重指数。在1246哮喘患者(8.0%)中，505例为过敏性的(3.3%)，719例非过敏性(4.6%)。经多因素分析，观察到过多的因素，仅针对过敏性哮喘，葡萄种植(OR=1.43, p=0.002)，水果种植(OR=1.58, p=0.001)，温室(OR=1.66, p=0.02)，草场(OR=1.35, p=0.009)，甜菜(OR=1.52, p=0.003)和养马(OR=1.35, p=0.04)。在草场、葡萄和水果种植中农药的使用和农药中毒史与过敏性哮喘显著相关， 在甜菜种植中与非过敏性哮喘显著相关。在出生后第一年生活在农场与家畜接触倾向于保护童年时期过敏性哮喘的发生(OR=0.72, p=0.07)但是与葡萄园、水果或蔬菜接触则有害(OR=1.44, p=0.07)。AGRICAN研究显示，农作物暴露，农药的使用和童年在农场，尤其是在葡萄种植，草场，甜菜，水果和蔬菜的种植增加过敏性哮喘的风险。
（林江涛 审校）
IntJHygEnvironHealth.2013Sep2.pii:S1438-4639(13)00118-1.doi:10.1016/j.ijheh.2013.08.006. [Epub ahead of print]
Agricultural exposure and asthma risk in the AGRICAN French cohort.
Baldi I, Robert C, Piantoni F, Tual S, Bouvier G, Lebailly P, Raherison C.
Abstract
Epidemiological studies have reported an increased risk of respiratory diseases in agricultural population, but a protective "farm-effect" has also been reported for asthma. In the AGRICAN cohort, self-reported doctor-diagnosed asthma was analyzed according to allergy, in relation with history of life-time exposure to 13 crops and 5 livestock, pesticide exposure and early life on a farm, taking into account sex, age, education and body mass index. Among the 1246 asthmatics (8.0%), 505 were allergic (3.3%) and 719 non-allergic (4.6%). In multivariate analysis, a significant excess was observed, only for allergic asthma, in vine-growing (OR=1.43, p=0.002), fruit-growing (OR=1.58, p=0.001), greenhouses (OR=1.66, p=0.02), grasslands (OR=1.35, p=0.009), beets (OR=1.52, p=0.003) and horses (OR=1.35, p=0.04). Pesticide use and history of pesticide poisoning were significantly associated with allergic asthma in grassland, vineyards and fruit-growing and with non-allergic asthma in beets. Living on a farm in the first year of life tended to be protective for childhood allergic asthma in farms with livestock (OR=0.72, p=0.07) but deleterious in farms with vineyards, fruit or vegetables (OR=1.44, p=0.07). In AGRICAN, an increased risk of allergic asthma was observed with crop exposure, pesticide use and early life on a farm, especially in vine-growing, grassland, beets, fruit and vegetable-growing.
IntJHygEnvironHealth.2013Sep2.pii:S1438-4639(13)00118-1.doi:10.1016/j.ijheh.2013.08.006. [Epub ahead of print]
