Association network survey of childhood asthma and environmental factors in Xinjiang
PENG Li1, CAO Chang-an2, WU Wei-qi1, WANG Yu-na3, LIANG Bao-pan1, CAO Su-zhen1, DUAN Xiao-li1
1. School of Energy and Environmental Engineering, Beijing University of Science and Technology, Beijing Key Laboratory of Industrial Typical Pollutant Resource Treatment, Beijing 100083, China; 2. Xiamen University, Xiamen 361104, Fujian, China; 3. Ili Normal University, Yining 835000, China
Abstract:To investigate the prevalence and risk factors of childhood asthma in Xinjiang, an online questionnaire survey was conducted among selected children under the age of 14 in Xinjiang in 2022, and information was obtained on the characteristics of 575 children and their families in the region, and logistic regression models were used to estimate the prevalence of asthma disease among children in Xinjiang and its association with family, parental and environmental factors. The results showed that the prevalence of asthma among children in the region was 4.7 per cent, which was a high prevalence. Maternal asthma, longer heating periods, longer opening of windows in spring and proximity to waste incineration plants or garbage dumps were significantly associated with a higher prevalence of asthma in children. Breastfeeding and physical activity were each significantly associated with a lower risk of asthma. Socioeconomic factors were not significantly associated with childhood asthma in Xinjiang.
[1] Soriano J B, Abajobir A A, Abate K H, et al. Global, regional, and national deaths, prevalence, disability~adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990~2015: a systematic analysis for the Global Burden of Disease Study 2015[J]. The Lancet Respiratory Medicine, 2017,5(9): 691-706. [2] 王婷婷,史浩楠,刘茜,等.乌鲁木齐学龄前儿童哮喘和喘息样呼吸困难情况及其影响因素分析[J]. 中国公共卫生, 2021,37(2):260-264. Wang T T, Shi H N, Liu Q, et al. Prevalence and influencing factors of asthma and wheezing among preschool children in Urumqi city: a cross-sectional survey[J]. School of Nursing and Health Management, 2021,37(2):260-264. [3] Woo A, Lee W S, Koh Y H, et al. Incidence of cancer after asthma development: 2independent population-based cohort studies[J]. The Journal of Allergy and Clinical Immunology, 2020,147:135-143. [4] 卜素贝,王砚玲,王芳,等.儿童哮喘及过敏性疾病相关的污染物检测分析[J]. 哈尔滨工业大学学报, 2020,52(12):157-163. Bu S B, Wang Y L, Wang F, et al. Pollutants detection and analysis associated with childhood asthma and allergic diseases[J]. Journal of Harbin Institute of Technology, 2020,52(12):157-163. [5] Jin X, Xu Z, Liang Y, et al. The modification of air particulate matter on the relationship between temperature and childhood asthma hospitalization: An exploration based on different interaction strategies[J]. Environmental Research, 2022,214(P2):113848. [6] 邓云天,熊文魁,朱芮,等.生命早期环境因素暴露与儿童哮喘关系的病例对照研究[J]. 上海交通大学学报(医学版), 2023,43(1): 44-51. Zheng Y T, Xiong W K, Zhu R, et al. A case-control study of the relationship between early-life environmental exposure and childhood asthma[J]. Journal of Shanghai Jiao tong University: Medical Science, 2023,43(1):44-51. [7] Abbafati C, Abbas K M, Abbasi M, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990~2019: a systematic analysis for the Global Burden of Disease Study 2019[J]. LANCET, 2020,396(10262):1562. [8] 王婷婷,赵卓慧,姚华,等.住房特征及室内环境与乌鲁木齐儿童哮喘、过敏性疾病及肺炎的相关性[J]. 科学通报, 2013,58(25):2573-2581. Wang T T, Zhao Z H, Yao H, et al. The correlation between housing characteristics and indoor environment with asthma, allergic diseases, and pneumonia in children in Urumqi[J]. Science Bulletin, 2013,58(25):2573-2581. [9] 史亚妮,董继元,刘玉荣.兰州市空气污染对儿童呼吸疾病的影响[J]. 中国环境科学, 2020,40(4):1792-1799. Shi Y N, Dong J Y, Liu Y R. Study on the effect of air pollution on respiratory diseases among children in Lanzhou[J]. China Environmental Science, 2020,40(4):1792-1799. [10] Cao S Z, Wen D S, Li S, et al. Changes in children's asthma prevalence over two decades in Lanzhou: effects of socioeconomic, parental and household factors[J]. Journal of Thoracic Disease, 2020, 12(10):6365-6378. [11] 孙妍妍,鲁建江,尹晓文,等.室内颗粒物污染对儿童哮喘的影响[J]. 环境与健康杂志, 2017,34(3):210-213. Sun Y Y, Lu J J, Yin X W, et al. Relationship between indoor particulate matter pollution and childhood asthma: a case-control study[J]. Journal of Environment and Health, 2017,34(3):210-213. [12] Tang H H, Teo M S, Sly P D, et al. The intersect of genetics, environment, and microbiota in asthma-perspectives and challenges[J]. The Journal of allergy and clinical immunology, 2021,147(3):781-793. [13] 王硕敏,胡一凡,周炳贤,等.中国儿童哮喘与居室内环境相关性的系统评价[J]. 中国循证医学杂志, 2023,23(3):327-333. Wang S M, Hu Y F, Zhou B X, et al. Association between indoor environment and risk of asthma in Chinese children:a systematic review[J]. Chinese Journal of Evidence Based Medicine, 2023,23(3):327-333. [14] Xiao S Y, Ngo A L, Mendola P, et al. Household mold, pesticide use, and childhood asthma: A nationwide study in the U.S[J]. International Journal of Hygiene and Environmental Health, 2021,233:113694. [15] 富妍妍,刘伟,徐丽媛.郊区和城区空气污染物浓度差异及与儿童哮喘患病情况的关系[J]. 中国儿童保健杂志, 2022,30(11):1262-1266. Fu Y Y, Liu W, Xu L Y. Difference in air pollutant concentration between suburbs and urban areas and its correlation with the severity of asthma in children[J]. Chinese Journal of Child Health Care, 2022, 30(11):1262-1266. [16] 刘蒙,伍晓艳,耿梦龙,等.学龄前儿童哮喘分布特征及母乳喂养保护作用[J]. 中国学校卫生, 2020,41(9):1379-1383. Liu M, Wu X Y, Geng M L, et al. Distribution characteristics of asthma in preschool children and the protective effect of breastfeeding[J]. Chinese Journal of School Health, 2020,41(9):1379-1383. [17] Humphreys B R, McLeod L, Ruseski J E. Physical activity and health outcomes: evidence from Canada[J]. Health Econ, 2014,23(1):33-54. [18] 杨依云,尚星辰,陈荣,等.体育锻炼对哮喘儿童肺功能、有氧能力和生活质量的影响:一项随机对照试验的Meta分析[J]. 湖北体育科技, 2021,40(5):435-441. Yang Y Y, Shang X C, Chen R, et al. Effects of Physical Exercise on Lung Function, Aerobic Capacity and Quality of Life in Asthmatic Children: a Meta Analysis of a Randomized Controlled Trial[J]. Hubei Sports Science, 2021,40(5):435-441. [19] Antoñón M, Pernía-Sánchez J V, Cancho-Soto T, et al. Asthma control in children, socioeconomic inequality and health care[J]. Anales de pediatría, 2023,23:2341-2879. [20] Chen E, Hanson M D, Paterson L Q, et al. Socioeconomic status and inflammatory processes in childhood asthma: The role of psychological stress[J]. The Journal of Allergy and Clinical Immunology, 2006,117(5):1014-1020. [21] 王行之,吴诚,张娟,等.运动对哮喘的影响及哮喘患儿运动处方研究进展[J]. 中国实用儿科杂志, 2021,36(9):714-720. Wang X Z, Wu C, Zhang J, et al. Research progress in the effect of exercise on asthma and the exercise prescription for asthmatic children[J]. Chinese Journal of Practical Pediatrics, 2021,36(9):714-720. [22] Lochte L, Nielsen K G, Petersen P E, et al. Childhood asthma and physical activity: a systematic review with meta-analysis and graphic appraisal tool for epidemiology assessment[J]. BMC Pediatr, 2016, 16(1):50. [23] 夏琴,李仕群,王波,等.南川地区儿童哮喘发病危险因素分析[J]. 重庆医学, 2016,45(5):632-633. Xia Q, Li S Q, Wang B, et al. Analysis on risk factors of children asthma in Nanchuan area[J]. Chongqing Medicine, 2016,45(5):632-633. [24] 康紫薇,张正勇,刘琳,等.基于MODIS的新疆地表温度时空变化特征分析[J]. 地理研究, 2022,41(4):997-1017. Kang Z W, Zhang Z Y, Liu L, et al. Spatio-temporal variation characteristics of land surface temperature in Xinjiang based on MODIS[J]. Geographical Research, 2022,41(4):997-1017. [25] 张美,马香萍,张季红,等.采暖期及非采暖期大气污染物与儿科呼吸系统常见疾病门急诊日均就诊人次数的相关性研究[J]. 中国全科医学, 2018,21(11):1290-1295. Zhang M, Ma X P, Zhang J H, et al. Correlation of Air Pollutant Concentrations with the Number of Average Daily Hospital Pediatric Emergency Outpatient Visits due to Common Respiratory Disease during Heating and Non-heating Periods[J]. Chinese General Practice, 2018,21(11):1290-1295. [26] Ferris B G. The American review of respiratory disease[J]. American Review of Respiratory Disease, 1978,118(2):1-120. [27] 金克,多力坤·木扎帕尔,马香萍,等.乌鲁木齐市儿童哮喘患病情况调查及相关因素分析[J]. 临床儿科杂志, 2012,30(6):559-561. Jin K, Mu D, Ma X P, et al. The prevalence and related factors of asthma in Urumqi[J]. Journal of Clinical Pediatrics, 2012,30(6):559-561. [28] Norbäck D, Lu C, Wang J, et al. Asthma and rhinitis among Chinese children—Indoor and outdoor air pollution and indicators of socioeconomic status (SES)[J]. Environment International, 2018,115:1-8. [29] Meng X, Cao S Z, Li S, et al. Household environmental factors and children's respiratory health: comparison of two cross-sectional studies over 25 years in Wuhan, China[J]. Journal of Thoracic Disease, 2021,13(7):4589-4600. [30] 肖惠迪,书文,李梦龙,等.中国2011~2018年儿童哮喘患病率Meta分析[J]. 中国学校卫生, 2020,41(8):1208-1211. Xiao H D, Shu W, Li M L, et al. Prevalence of childhood asthma in China from 2011 to 2018:a Meta-analysis[J]. Chinese Journal of School Health, 2020,41(8):1208-1211. [31] 刘传合,洪建国,尚云晓,等.中国16城市儿童哮喘患病率20年对比研究[J]. 中国实用儿科杂志, 2015,30(8):596-600. Liu C H, Hong J G, Shang Y X, et al. Comparison of asthma prevalence in children from 16 cities of China in 20 years[J]. Chinese Journal of Practical Pediatrics, 2015,30(8):596-600. [32] Gonçalves C, Wandalsen G. Lanza F. et al. Repercussions of preterm birth on symptoms of asthma, allergic diseases and pulmonary function, 6-14 years later[J]. Allergologia et Immunopathologia, 2016, 44(6):489-496. [33] Bui D S, Perret J L, Walters E H, et al. Association between very to moderate preterm births, lung function deficits, and COPD at age 53 years: analysis of a prospective cohort study[J]. The Lancet Respiratory medicine, 2022,10(5):478-484. [34] 翟博雅,陈筱青.支气管肺发育不良与儿童哮喘关系研究进展[J]. 中国实用儿科杂志, 2019,34(3):244-248. Zhai B Y, Chen X Q. Research progress on the relationship between bronchopulmonary dysplasia and childhood asthma[J]. Chinese Journal of Practical Pediatrics, 2019,34(3):244-248 [35] Wilson K, Gebretsadik T, Adgent M A, et al. The association between duration of breastfeeding and childhood asthma outcomes[J]. Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology, 2022,129(2):205-211. [36] 刘蒙,陶芳标.母乳喂养对儿童哮喘的保护作用及肠道双歧杆菌的影响[J]. 中国学校卫生, 2020,41(1):150-153. Liu M, Tao F B. The protective effect of breastfeeding on childhood asthma and the effect of intestinal bifidobacteria[J]. Chinese Journal of School Health, 2020,41(1):150-153. [37] Lossius A K, Magnus M C, Lunde J, et al. Prospective Cohort Study of Breastfeeding and the Risk of Childhood Asthma[J]. The Journal of Pediatrics, 2018,195:182-189. [38] Habibi M, Laamiri F Z, Aguenaou H, et al. The impact of maternal socio-demographic characteristics on breastfeeding knowledge and practices: An experience from Casablanca, Morocco[J]. International Journal of Pediatrics and Adolescent Medicine, 2018,5(2):39-48. [39] Chen E, Shalowitz M U, Story R E, et al. Parents' Childhood Socioeconomic Circumstances Are Associated With Their Children's Asthma Outcomes[J]. Pediatrics, 2018,142(Supplement 4):255-255. [40] 贺苗,董菊,吴萍萍,等.儿童哮喘控制与家庭功能及家庭管理方式的相关性[J]. 中国学校卫生, 2019,40(10):1573-1576. He M M, Dong J, Wu P P, et al. The correlation between childhood asthma control and family function and family management methods[J]. Chinese Journal of School Health, 2019,40(10):1573-1576. [41] 张静,殷勇.儿童哮喘家庭教育现状[J]. 中国实用儿科杂志, 2020,35(3):237-241. Zhang J, Yin Y. Present status of family education on cough in children[J]. Chinese Journal of Practical Pediatrics, 2020,35(3):237-241. [42] Jiang Y, Farrell A K, Tobin E T, et al. Socioeconomic status, financial stress, and glucocorticoid resistance among youth with asthma: Testing the moderation effects of maternal involvement and warmth[J]. Brain, behavior, and immunity, 2021,96:92-99. [43] 张娣,陈学刚,赵直.乌鲁木齐市采暖期大气污染物浓度时空变化分析[J]. 环境科学与技术, 2021,44(10):187-195. Zhang D, Chen X G, Zhao Z. Analysis on Temporal and Spatial Variation of Air Pollutant Concentration During Heating Period in Urumqi, China[J]. Environmental Science & Technology, 2021,44(10): 187-195. [44] Rupakheti D, Yin X F, Rupakheti M, et al. Spatio-temporal characteristics of air pollutants over Xinjiang, northwestern China[J]. Environmental Pollution, 2021,268:0269-7491. [45] 赵辉,郑有飞,徐静馨,等.乌鲁木齐市大气污染物浓度的变化特征[J]. 环境化学, 2015,34(11):2118-2126. Zhao H, Zheng Y F, Xu J X, et al. Variation characteristics of air pollutant concentrations in Urumqi[J]. Environmental Chemistry, 2015,34(11):2118-2126. [46] 李盛,王金玉,李普,等.沙尘天气的呼吸系统健康效应及机制研究进展[J]. 环境与健康杂志, 2019,36(1):78-82. Li S, Wang J Y, Li P, et al. Health effects and mechanisms of dust weather on human respiratory system:a review of recent studies[J]. Journal of Environment and Health, 2019,36(1):78-82. [47] Xu Y, Raja S, Ferro A R, et al. Effectiveness of heating, ventilation and air conditioning system with HEPA filter unit on indoor air quality and asthmatic children's health[J]. Building and Environment, 2009,45(2): 330-337. [48] Huang S, Garshick E, Weschler L B, et al. Home environmental and lifestyle factors associated with asthma, rhinitis and wheeze in children in Beijing, China[J]. Environmental Pollution, 2020,256(C): 113426. [49] 湛孝东,吴华,胡慧敏,等.空调器隔尘网富集尘螨过敏原的研究[J]. 中国血吸虫病防治杂志, 2015,27(6):612-614,633. Zhan X D, Wu H, Hu H M, et al. Research on dust mite allergen gathered from filters of air-conditioners[J]. Chinese Journal of Schistosomiasis Contro, 2015,27(6):612-614,633. [50] 武艳,荣嘉惠,Irvan L.空调通风系统对室内微生物气溶胶的影响[J]. 科学通报, 2018,63(10):920-930. Wu Y, Rong J H, Irvan L. Influence of air conditioning and mechanical ventilation(ACMV) systems on indoor microbial aerosols[J]. Chinese Science Bulletin, 2018,63(10):920-930. [51] Liu Y, Zhang Y, Shi Y, et al. Characterization of fungal aerosol in a landfill and an incineration plants in Guangzhou, southern China: the link to potential impacts[J]. Science of The Total Environment, 2020, 764:14928. [52] 程轲,季婉婉,郝炜伟,等.城市生活垃圾露天焚烧排放PM2.5中重金属污染特征及其暴露健康风险[J]. 环境科学, 2019,40(10): 4337-4344. Cheng K, Ji W W, Hao W W, et al. Characteristics of Heavy Metal Pollutants of PM2.5 from Open Burning of Municipal Solid Waste (MSW) and the Associated Exposure Health Risks[J]. Environmental Science, 2019,40(10):4337-4344. [53] Cochran S J, Acosta L, Divjan A, et al. Spring is associated with increased total and allergenic fungal concentrations in house dust from a pediatric asthma cohort in New York City[J]. Building and Environment, 2022,226:109711. [54] Eijkemans M, Mommers M, Remmers T, et al. Physical activity and asthma development in childhood: Prospective birth cohort study[J]. Pediatric Pulmonology, 2020,55:76-82. [55] 车小燕,刘玉琳,杨姝晖,等.儿童哮喘运动方案的最佳证据总结[J]. 护理学报, 2022,29(11):41-46. Che X Y, Liu Y L, Yang S H, et al. Best Evidence Summary of Exercise Program for Children with Asthma[J]. Journal of Nursing (China), 2022,29(11):41-46. [56] Vahlkvist S, Inman M D, Pedersen S. Effect of asthma treatment on fitness, daily activity and body composition in children with asthma[J]. Allergy, 2010,65:1464-1471. [57] 陈琼,王风琴,孙欣.有氧运动改善哮喘儿童运动能力和生活质量的实验研究[J]. 广州体育学院学报, 2020,40(5):125-128. Chen Q, Wang Y Q, Sun X. Aerobic exercise improved exercise capacity and quality of life in asthmatic children[J]. Journal of Guangzhou Sport University, 2010,65:1464-1471. [58] Stoodley I, Williams L, Thompson C, et al. Evidence for lifestyle interventions in asthma[J]. Breathe, 2019,15(2):50-61. [59] 刘芳,刘怡然,刘琳.运动康复训练对支气管哮喘儿童运动能力和生活质量干预效果的系统评价[J]. 中国当代儿科杂志, 2021, 23(10):1050-1057. Liu F, Liu Y R, Liu L. Effect of exercise rehabilitation on exercise capacity and quality of life in children with bronchial asthma:a systematic review[J]. Chinese Journal of Contemporary Pediatrics, 2021,23(10):1050-1057.