家庭清洁剂别乱用,儿童哮喘需重视
创作:Epi汪 审核:Epi汪 2020年02月28日
  • 纳入加拿大出生队列中2022名儿童,在3-4月龄时调查家庭中26种清洁剂的使用频率,包括洗洁精、洗衣粉、消毒剂等,并根据量表计算FUS评分,
  • 家庭清洁剂使用频率更高者,其儿童在3岁时发生反复喘息、哮喘的风险增高,而特异性反应的风险增高无统计学意义;
  • 在女孩中的效应量均略微大于男孩;
  • 清洁剂使用频率与上述呼吸道疾病的症状严重程度存在潜在的正相关;
  • 家庭清洁剂的使用与儿童变应性呼吸道疾病可能存在关联,使用时应加以评估。
主编推荐语
Epi汪
全国疫情当前,部分居民大量购买消毒剂,尤其是酒精、84等,并在居家使用。但是应该注意到,这类清洁用品对儿童,尤其是婴幼儿具有一定的毒害作用。本研究发现,家庭清洁剂的使用频率太高,儿童在3岁时发生哮喘及其他特异性呼吸道疾病的风险增高。这其中潜在的原因较多,值得进一步研究。
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CMAJ [IF:7.744]

Association of use of cleaning products with respiratory health in a Canadian birth cohort

加拿大出生队列中清洁产品使用与呼吸系统疾病的关联

10.1503/cmaj.190819

2020-02-18, Article

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BACKGROUND: Comprehensive longitudinal studies are important for understanding the complex risk factors, pathways, exposures and interactions that lead to the development and persistence of asthma. We aimed to examine associations between use of household cleaning products in early life and childhood respiratory and allergic disease using data from the Canadian Healthy Infant Longitudinal Development (CHILD) Cohort Study.
METHODS: We summed responses from parental questionnaires that indicated the frequency of use of 26 household cleaning products in the homes of 2022 children from this birth cohort when they were 3–4 months of age to create a cumulative Frequency of Use Score (FUS). We used multivariable logistic regression models to assess whether frequent compared with less frequent use was associated with recurrent wheeze, atopy or asthma diagnosis, as defined by the questionnaire and clinical assessments at age 3 years. Data were collected between 2008 and 2015.
RESULTS: Children in homes with a higher frequency of use of cleaning products in infancy, as determined by an interquartile range increase, had higher odds of recurrent wheeze (adjusted odds ratio [OR] 1.35, 95% confidence interval [CI] 1.11–1.64), recurrent wheeze with atopy (adjusted OR 1.49, 95% CI 1.02–2.16) and asthma diagnosis (adjusted OR 1.37, 95% CI 1.09–1.70), but no increase in the odds of atopy at age 3 years (adjusted OR 1.14, 95% CI 0.96–1.35). Compared with the lowest tertile of FUS exposure, infants in the highest tertile had higher odds of acquiring asthma. Stratification of the results showed that females had higher ORs than males for all outcomes, although the p values for this sex difference did not reach statistical significance.
INTERPRETATION: Frequent use of household cleaning products in early life was associated with an increased risk for childhood wheeze and asthma but not atopy at age 3 years. Our findings add to the understanding of how early life exposures to cleaning products may be associated with the development of allergic airway disease and help to identify household behaviours as a potential area for intervention.

All Authors:
Jaclyn Parks,Lawrence McCandless,Christoffer Dharma,Jeffrey Brook,Stuart E Turvey,Piush Mandhane,Allan B Becker,Anita L Kozyrskyj,Meghan B Azad,Theo J Moraes,Diana L Lefebvre,Malcolm R Sears,Padmaja Subbarao,James Scott,Tim K Takaro

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