幼児期の喘息等呼吸器疾患の有病率と家庭内における生活環境との関連

幼児期の喘息・喘鳴の有病率を明らかにし,生活環境との関連を検討することを目的に,1.6 歳児,3歳児健診を受診した母親を対象に自記式質問紙調査を行った.調査内容は,ATS-DLD 日本版・改訂版を修正した20項目,家族歴,栄養法,住環境などの12項目,属性5項目であった.有効回収数899名(92.8%).① A市の喘息の有病率は,1.6歳児8.4%(95%信頼区間confidence interval(CI),5.9～10.8%),3歳児13.7%(95% CI,10.4～17.1%)であった.② 3歳児では喘息など診断あり群が,診断なし群より家族歴があり(p<0.05),55.3%が他のアレルギー疾患を合併していた.③ 1.6歳児は,母親の喫煙(p<0.05),祖母の喫煙(p<0.01)と有病とに関連を認めたが,部屋の絨毯使用や,ペット飼育との関連は認めなかった.これらから,家族は,ダニ対策は認識していても,喫煙が乳幼児に及ぼす影響を理解していないと考えた.今後,受動喫煙の広報や禁煙指導などを強化することで,喘息や喘鳴の有病率を低下させる可能性があると考える.

This study aims at identifying the relationship between home environment and the prevalence of infantile wheezing symptoms. Mothers of young children aged 1.6 and 3 years were sampled. A questionnaire, prepared by the researcher, including 20 items based on the Japanese Revised Edition of the ATS-DLD, 12 items on family history, nutrition and dietary principles and home environment, and 5 items on demographic characteristics, was used for data gathering. Data from 899 (92.8%) samples were confirmed as appropriate for the analysis. ① The prevalence rate of infantile wheezing symptoms as revealed to be 8.4% (95% confidence interval (CI), 5.9～10.8%) in the 1.6 years cohort, and 13.7% (95% CI, 10.4～17.1%) in the 3 years cohort, respectively. ② A family history of wheezing symptoms on the paternal and / or maternal side, as well as a history of other allergic symptoms, were identified in the 3 years cohort with infantile wheezing symptoms. ③ A significant relationship was found between mother's and grandmother's smoking and infantile wheezing symptoms in the 1.6 year group (p<0.05), while carpet and pet revealed no significance. It was clearly identified that family members, including grandparents, were reluctant to recognize the relationship between their smoking and the prevalence of wheezing symptoms in their children. Thus, the development of appropriate strategies for family members to ‘stop smoking' in a household with infants and young children is inevitable.