背景:近几十年来,所有年龄段的喘息和哮喘的患病率都在上升,尤其是儿童。这些疾病会导致生活质量下降,错过了学校,紧急护理和急诊科就诊,住院治疗,增加了医疗费用。环境暴露,包括农药暴露,可能是导致这种患病率增加的一个因素。
目的:评估农药暴露与儿童喘息和哮喘的关系。
方法:我们进行了一项关于农药暴露(客观测量)和儿童呼吸结果的系统评价。我们搜索了PubMed,Embase(Elsevier),CINAHL(EBSCO),Scopus(Elsevier),Cochrane系统评价数据库(Wiley),和临床试验。政府从1988年到2021年。主要搜索关键词包括\"杀虫剂\",\"杀虫剂\",\"除草剂\",“呼吸”,“哮喘”和“喘息”。
结果:在5767项研究中,25人符合纳入标准;8人评估了产前农药暴露(n=8407),12次评估的产后暴露(n=50,488),和五个评估的产前和产后暴露(n=20,919)。研究的主要农药是二氯二苯基二氯乙烯(DDE)(14项研究),其次是有机磷酸酯(7项研究)。结果评估的主要方法是问卷调查(84%),其次是肺活量测定(16%),注册表数据,血的措施。研究与研究设计和措施有关的证据强度各不相同。大多数研究(84%)报告了暴露与不良儿童呼吸道健康的正相关。
结论:研究表明农药暴露与儿童喘息和哮喘有关。不同的结果和方法加强了对这些研究的更多研究和标准化方法的需求,以确认农药暴露与儿童喘息和哮喘的建议关联。
BACKGROUND: The prevalence of wheeze and asthma has risen over recent decades for all age groups, especially children. These disorders can lead to decreased quality of life, missed school, urgent care and emergency department visits, hospitalizations, and increased health care costs. Environmental exposures, including pesticide exposure, are likely a contributing factor to this increased prevalence.
OBJECTIVE: To evaluate the association of pesticide exposure with childhood wheeze and asthma.
METHODS: We conducted a systematic
review evaluating studies of pesticide exposure (measured objectively) and child respiratory outcomes. We searched PubMed, Embase (Elsevier), CINAHL (EBSCO), Scopus (Elsevier), Cochrane Database of Systematic Reviews (Wiley), and ClinicalTrials. gov from 1988 - 2021. Main search keywords included \"pesticides\", \"insecticides\", \"herbicides\", \"respiratory\", \"asthma\" and \"wheeze\".
RESULTS: Out of 5767 studies, 25 met the inclusion criteria; eight evaluated prenatal pesticide exposure (n=8407), twelve evaluated postnatal exposures (n= 50,488), and five evaluated pre-and postnatal exposures (n=20,919). Main pesticides investigated were dichlorodiphenyldichloroethylene (DDE) (14 studies) followed by organophosphates (7 studies). Primary methods of outcome assessment were questionnaire-based (84%), followed by spirometry (16%), registry data, and blood measures. Studies varied in the strength of evidence relating to study design and measures. Most studies (84%) reported a positive association of exposure with adverse child respiratory health.
CONCLUSIONS: The studies suggest an association of pesticide exposure and childhood wheeze and asthma. The varying results and methods reinforce the need for more research and standardized approaches to these studies to confirm the suggested association of pesticide exposure and childhood wheeze and asthma.