论文总字数：46418字

摘 要

全球过敏性疾病患病率在近几十年时间内不断上涨。室内环境污染暴露被认为在儿童哮喘及过敏性疾病发生及加重过程中起显著作用，室内颗粒物可能是导致儿童哮喘等疾病的重要原因。但是，目前针对幼儿园的室内污染物测量还比较少，本研究选取南京幼儿园进行室内颗粒物PM2.5和PM10质量浓度现场测量，探究儿童哮喘及过敏性疾病与颗粒物浓度的相关性。

选取南京4家幼儿园进行颗粒物浓度现场测量，测量时间为2016年4月27日到5月22日，结果表明室内PM2.5质量浓度日均值变化范围为11.76～123.80，均值58.35，超过WHO标准值2倍,低于国内北京、深圳等城市，高于国外德国、意大利等地区;室内PM10质量浓度日均值变化范围为19.13～198.16，均值95.25，接近WHO标准值的2倍，低于国内外其他研究中颗粒物水平。室内PM2.5和PM10质量浓度比例范围为0.57～0.62，说明颗粒物PM10中PM 2.5的含量大于粗粒子PM2.5～10的含量。室内外PM2.5的I/O值范围0.82～1.22，均值0.97；检测点室内外PM10的I/O值范围0.74～0.95，均值0.84。说明颗粒物主要来自室外污染源。

单因素分析表明性别、年龄、母乳喂养持续时间、家庭成员过敏史和行政区对儿童哮喘及过敏性疾病有显著影响（P≤0.05）。加入混杂因子，多元逻辑回归分析表明PM2.5高浓度区间(gt;65µg/m3)与儿童夜间干咳具有显著相关性（P≤0.05），PM2.5高浓度区间患病率较高 （gt;65µg/m3 vs.≤65µg/m3：27.7% vs.14%）。

关键字： PM2.5 PM10 过敏性疾病 幼儿园 儿童

FIELD MEASUREMENTS OF

PARTICLE CONCENTRATION IN KINDERGARTENS OF NANJING AND ANALYSIS ON CHILDREN HEALTH

Abstract

The prevalence rates of asthma and other allergic diseases have increased apparently throughout the world in recent decades. Indoor environmental pollution exposure is considered to play a significant role in the development and exacerbation of asthma and allergic diseases among children, and particulate matter concentration may be an important cause. However, the current research on indoor pollution measurement is insufficient. The goal of this study is to measure concentrations of indoor particulate matter 2.5 and particulate matter 10 in several kindergartens of Nanjing and to study the association between children’s allergic diseases and indoor particulate matter concentrations.

Measurements of indoor particulate matter concentrations were undertaken in 4 selected kindergartens in Nanjing from April 27th to May 22th in 2016, the results have showed that data of different kindergartens were different and 3 kindergartens’ concentrations exceeded the standard. The daily mean value of indoor PM2.5 concentration ranged from 11.76 to 123.80, its average concentration 58.35was two times higher than the new guideline of WHO, and lower than the levels in domestic studies (Beijing, Shenzhen, etc),higher than the levels in foreign studies (Greece, Italy, etc). The daily mean value of indoor PM10 concentration ranged from 19.13 to 198.16, its average concentration 95.25was about two times higher than the new guideline of WHO, and lower than the levels in domestic and foreign studies. The proportion of indoor PM10 and indoor PM2.5 concentration ranged from 0.57 to 0.62, which meant the amount of PM2.5 was larger than that of PM2.5～10 in the PM10. Indoor and outdoor ratio of PM2.5 ranged 0.83～1.22, with its mean value 0.97, and indoor and outdoor ratio of PM10 ranged 0.74～0.95, with its mean value 0.84, which showed that indoor particulate matter were mainly affected by outdoor sources.

Through univariate analysis, sex, age, duration of breastfeeding, family allergic history and administrative region were found related to children allergies（P≤0.05）. Adding the confounding factors, multiple logistic regression analysis showed that high level concentration of PM2.5(gt;65µg/m3) was related to dry cough at night（P≤0.05）and the prevalence rate exposed to PM2.5 in high level was higher than in low level（gt;65µg/m3 vs. ≤65µg/m3：27.7% vs. 14%）.

KEY WORDS：PM2.5, PM10, Allergic diseases, Kindergartens, Children

目 录

摘 要 I

Abstract II

第1章 绪论 1

1.1 研究背景及意义 1

1.2 哮喘及过敏性疾病 1

1.3 儿童哮喘及过敏性病症的影响因素 2

1.4 颗粒物PM2.5和PM10对儿童健康的影响 2

1.5 研究目的 2

第2章 研究方法 4

2.1 幼儿园室内检测 4

2.1.1 检测对象 4

2.1.2 检测内容及仪器 4

2.1.3 检测过程 5

2.1.4 评价方法 5

2.2 数据处理方法 8

2.2.1 Logistic回归 8

2.2.2 OR值 8

2.2.3 室内外颗粒物关联性分析 8

第3章 幼儿园检测结果分析 9

3.1 幼儿园基本情况 9

3.2 气象对室外颗粒物的影响 9

3.3 幼儿园检测结果及分析 12

3.3.1 检测结果 12

3.3.2 学校PM2.5与PM10质量浓度日均值差异 17

3.3.3 幼儿园1号颗粒物浓度变化分析 18

3.3.4 室内外颗粒物浓度关系及I/O值 19

3.4 室内外PM2.5和PM10浓度随时间变化情况 24

3.5 工作日与双休日颗粒物浓度水平比较 27

3.6 室内PM2.5与PM10之间的相关性 28

3.7 小结 30

第4章 幼儿园儿童健康效果分析 32

4.1 南京儿童健康数据库 32

4.2 儿童基本信息 32

4.3 幼儿园儿童患病率 33

4.4 颗粒物质量浓度与患病率相关性分析 34

4.4.1 单因素分析 34

4.4.2 PM2.5及PM10对儿童哮喘及其他过敏性疾病的影响 38

4.4.3 多元逻辑回归分析 42

4.5 小结 43

第5章 结论与展望 44

5.1 结论 44

5.2 展望 46

致 谢 47

参考文献（References） 48

南京幼儿园颗粒物现场测量及健康效果分析

绪论

研究背景及意义

近几十年来，哮喘和过敏性疾病的患病率尤其是儿童患病率在世界范围内显著增长^[1-10]。国际儿童哮喘及过敏性疾病研究（International Study of Asthma and Allergies in Childhood，简称ISAAC）分别在1992-1998年和1999-2004年，开展了两次调查^[10]，调查表明：儿童过敏性鼻炎、哮喘和湿疹患病率呈上升趋势。1990年和2000年儿童哮喘协作组针对儿童哮喘在中国范围内开展调查^[2]，哮喘患病率分别是0.91%和1.50%；2010-2012年中国室内环境与儿童健康（China, Children, Homes, Health, 简称CCHH）在中国多个城市关于多种儿童过敏性疾病患病率开展调研^[11]，发现调查确诊哮喘患病率范围为1.7%～9.8%；哮喘患病率从1990年到2000年增长64.84%，从2000到2010年增长353.3%。

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