接触农药是一个全球性的公共卫生问题,尤其是对儿童。它与儿童慢性呼吸系统疾病的关系引起了相当大的关注,但是现有的证据仍然没有定论,不能确定。因此,本系统综述和荟萃分析旨在确定与农药暴露和哮喘相关的全球综合效应大小,喘息,儿童呼吸道感染。
■从电子数据库中对相关文献进行了全面搜索,包括PubMed,谷歌学者,Hinari,语义学者,科学直接。研究提供了对农药暴露与儿童哮喘之间关联的影响大小,喘息,包括儿童的呼吸道感染。文章经过筛选,数据被提取,每个研究的质量由4名独立评审员进行评估.使用综合荟萃分析版本3.3.070和MetaXL版本2,进行了显著异质性的随机效应模型和同质研究的固定效应模型,以95%置信区间估计合并效应大小。漏斗图和HigginsI2统计量用于确定纳入研究的异质性。亚组分析是根据农药暴露的类型计算的,研究设计,样本大小类别,和结果评估技术。
■本荟萃分析共纳入了38篇文章,其中118,303名18岁以下儿童。儿童中的农药暴露使哮喘的风险增加了24%;(OR=1.24,95%CI:1.14-1.35)具有极端异质性(I2=81%,p<0.001)。暴露于农药会使儿童发生喘息的几率增加34%(OR=1.34,95%CI:1.14-1.57),具有高异质性(I2=79%,p<0.001),并且还增加了发生下呼吸道感染的风险79%(OR=1.79,95%CI:1.45-2.21),且异质性低(I2=30%,p值=0.18)。
■这项荟萃分析提供了有价值的证据支持儿童哮喘之间的关联,喘息,和下呼吸道感染与农药接触。这些发现将有助于更好地了解农药暴露对儿童呼吸道健康影响的估计,并为循证预防策略和公共卫生干预措施提供信息。
UNASSIGNED: Exposure to pesticides is a global public health problem, especially for children. Its association with chronic respiratory disease among children has attracted considerable attention, but the existing evidence remains inconclusive and cannot be certain. Therefore, this systematic review and meta-analysis aim to determine the global pooled effect size of association with pesticide exposure and asthma, wheezing, and respiratory tract infections among children.
UNASSIGNED: A comprehensive search was conducted for relevant literature from electronic databases, including PubMed, Google Scholar, Hinari, Semantic Scholar, and Science Direct. Studies that provided effect size on the association between pesticide exposure and childhood asthma, wheezing, and respiratory tract infections in children were included. The articles were screened, data was extracted, and the quality of each study was assessed with four independent reviewers. Random effects models for significant heterogeneity and fixed effect models for homogeneous studies were conducted to estimate pooled effect sizes with 95% confidence intervals using Comprehensive Meta-Analysis version 3.3.070 and MetaXL version 2. Funnel plot and Higgins I 2 statistics were used to determine the heterogeneity of the included studies. Subgroup analyses were computed based on the types of pesticide exposure, study design, sample size category, and outcome assessment technique.
UNASSIGNED: A total of 38 articles with 118,303 children less than 18 years of age were included in this meta-analysis. Pesticide exposure among children increased the risk of asthma by 24%; (OR = 1.24, 95% CI: 1.14-1.35) with extreme heterogeneity (I 2 = 81%, p < 0.001). Exposure to pesticides increased the odds of developing wheezing among children by 34% (OR = 1.34, 95% CI: 1.14-1.57), with high heterogeneity (I 2 = 79%, p < 0.001) and also increased the risk of developing lower respiratory tract infection by 79% (OR = 1.79, 95% CI: 1.45-2.21) with nonsignificant low heterogeneity (I 2 = 30%, p-value = 0.18).
UNASSIGNED: This meta-analysis provided valuable evidence supporting the association between childhood asthma, wheezing, and lower respiratory tract infection with pesticide exposure. The findings would contribute to a better understanding of the estimate of the effect of pesticide exposure on respiratory health in children and inform evidence-based preventive strategies and public health interventions.