杨程+杨兴堂+沈先标

摘要：目的 通过对小学生健康状况的调查及肺功能的测定，结合冬季社区空气质量检测，了解空气污染对小学生健康状况的影响。

方法 选择宝山区内1所小学，对全部学生610人进行健康影响问卷调查，在参加调查的学生中再随机抽取163名学生展开肺功能测试。

结果 调查期间，空气质量非达标日26 d，空气质量达标日35 d，空气质量指数日均值为102.4±48.9；学生疾病或症状发生的每日均值为（21±18）例。肺功能结果中，1秒用力呼气量女生在非达标日和达标日差异有统计学意义，呼气峰值流速（PEF）、25%用力呼气流量（V25）、V75男生和女生在达标日和非达标日差异均有统计学意义。

结论 在本地区，冬季不良空气质量对小学生呼吸系统有一定的影响。

关键词： 儿童； 大气污染； 健康调查； 肺功能； 呼吸系统 中图分类号： R 122 文献标志码： A

Abstract： Objective By investigating the health status of primary school pupils and determinating their lung functions， and in combination with th winter community air quality， to evaluate the air pollutions effect on the health status of the pupils in this area.

Methods A randomized cluster sampling method was used to select a primary school in the district， and all the 610 pupils in this school were investigated by questionnaires. Then， of the pupils， 163 were randomly selected for the test of lung functions.

Results During the survey， there were 26 days when there was poor air quality and 35 days when the air was in a good condition. The daily mean AQI was 102.4±48.9 and the daily mean number of pupils with disease or symptoms were 21±18. According to the pulmonary function examination results， in the FEV1 item girls showed statistical differences between the two tests of standard achieved day and standard non-achieved day. In addition， there were statistical differences found in both girls and boys in PEF、V25、V75 item.

Conclusion In this region， the poor air quality in winter has certain impact on primary school pupilsrespiratory system.

Keywords： children； air pollution； health survey； lung function； respiratory system

大量研究已證实，大气环境中的各种污染物会导致人群呼吸系统和循环系统疾病[1-8]的发生，全人群普遍易感。相较于北方重污染区，上海空气污染程度相对较低，但污染物成分有较大的差异。随着近年来机动车保有量的急剧增加以及作为特大型港口城市货轮的燃油污染，呈现出煤烟型污染和机动车尾气污染并存，一次性污染和光化学污染共存的现象。上海已成为混合型空气污染的代表城市之一，又有着极大的人口密度，开展相关的研究显得尤为重要。

儿童作为全社会高度关注，且极易受到异常情况或不利事件影响的特殊人群，对大气污染物的反应较为敏感。……