环境危害的分布及其影响的脆弱性因社会经济群体而异。我们的目标是分析出生时儿童社会经济地位(SEP)与学龄前(0-4岁)的外部暴露之间的关系。这项研究包括来自11个欧洲城市的8个队列的6万多名儿童(奥斯陆,哥本哈根,布里斯托尔,布拉德福德,鹿特丹,南希,普瓦捷,Gipuzkoa,Sabadell,瓦伦西亚和都灵)。SEP是通过孕产妇教育和家庭收入的标准化指标来衡量的。调查了三个儿童暴露组领域:行为,饮食和城市环境。我们为每个暴露组变量拟合了单独的逻辑回归模型-使用城市特定的中位数-在SEP(中/低与高)上调整了产妇年龄,出生和平价国家。在每个研究区域分别进行分析。SEP低的孩子,始终如一地跨研究领域,母乳喂养的低赔率(ORs),食用鸡蛋,鱼,水果,蔬菜和较高的OR电视屏幕时间,宠物所有权,接触二手烟,乳制品的消费,土豆,甜饮料,美味的饼干和薯片,脂肪和碳水化合物。例如,产妇教育-母乳喂养OR(95%置信区间(CI))在布里斯托尔为0.18(0.14-0.24),在奥斯陆为0.73(0.58-0.90).SEP也与城市环境密切相关,具有明显的城市间异质性。例如,收入PM2.5OR(95CI)在Sabadell的0.69(0.47-1.02)到奥斯陆的2.44(2.16-2.72)之间。已经到了学龄前,SEP较低的儿童饮食和行为一直较差,这可能会影响他们未来的健康和福祉。SEP-城市环境关系强烈依赖于环境。
Distribution of environmental hazards and vulnerability to their effects vary across socioeconomic groups. Our objective was to analyse the relationship between child socioeconomic position (SEP) at birth and the external
exposome at pre-school age (0-4 years). This study included more than 60,000 children from eight cohorts in eleven European cities (Oslo, Copenhagen, Bristol, Bradford, Rotterdam, Nancy, Poitiers, Gipuzkoa, Sabadell, Valencia and Turin). SEP was measured through maternal education and a standardised indicator of household income. Three child
exposome domains were investigated: behavioral, diet and urban environment. We fitted separate logistic regression model for each
exposome variable - dichotomised using the city-specific median - on SEP (medium/low vs high) adjusting for maternal age, country of birth and parity. Analyses were carried out separately in each study-area. Low-SEP children had, consistently across study-areas, lower Odds Ratios (ORs) of breastfeeding, consumption of eggs, fish, fruit, vegetables and higher ORs of TV screen time, pet ownership, exposure to second-hand smoke, consumption of dairy, potatoes, sweet beverages, savory biscuits and crisps, fats and carbohydrates. For example, maternal education-breastfeeding OR (95% Confidence Interval (CI)) ranged from 0.18 (0.14-0.24) in Bristol to 0.73 (0.58-0.90) in Oslo. SEP was also strongly associated with the urban environment with marked between-city heterogeneity. For example, income-PM2.5 OR (95%CI) ranged from 0.69 (0.47-1.02) in Sabadell to 2.44 (2.16-2.72) in Oslo. Already at pre-school age, children with lower SEP have consistently poorer diets and behaviours, which might influence their future health and wellbeing. SEP-urban environment relationships are strongly context-dependent.