Objective To investigate the relationship between the early exposure to multiple environmental factors and asthma prevalence at the age of 7 and 8 years in suburb and urban of Shanghai. Methods A total of 1 511 subjects aged 7 to 8 years from primary schools in the suburb areas and urban areas of Shanghai were included in the study. The cohort of the suburb children was divided into the early-migrated group who migrated with their family to Shanghai in their first year of life, and the late-migrated group who migrated after 3 years old. The aeroallergen sensitization and onset of asthma in these two groups of children and in the urban children were evaluated, and the results were further analyzed upon the correlation against their different early-life environmental exposures. Results The rate of asthma detection was significantly lower (5.7%) in the suburb children than that in the urban children (9.8%) (x2=8.63, P<0.01). Interestingly, in the suburb children, the rate of asthma detection in the early-migrated group (8.0%) was significantly much higher than that in the late-migrated group (3.8%) (x2=6.51, P=0.011). The analysis of early-life environmental exposures indicated that the atopic status of the children and their parents, and the passive smoking were predominantly the risk factors for asthma in the early-migrated group and the urban children. The exposure to poultry, domestic animals and/or pets was shown to be a protective factor in the suburb, but not in the urban. The only-child and a complete vaccination were not identified to be either risk or protective factors in both suburb and urban children. Conclusions The children lived in suburb in very early life and those in urban have the same morbidity. However, the asthma morbidity is lower in the late migrated group than in the early-migrated group. The early-life environmental exposure may be related to the incidence of asthma. Exposures to domestic poultry and pets are two of those factors.%目的 探讨上海城郊儿童哮喘发病率的差异,以及城郊儿童幼年生活环境等多因素差异与7~8岁时哮喘发病的相关性.方法对上海郊县4所小学784例7~8岁儿童和上海中心城区4所小学727例7~8岁儿童进行哮喘发病、过敏原致敏情况调查,以及幼年 (3岁内) 生活环境暴露因素调查.根据移居上海郊县的年龄将郊县小学儿童分为 1岁内移居组和 3岁后移居组,比较两组儿童哮喘发病率、调查生活环境情况.结果郊县小学7~8岁儿童哮喘检出率5.7%,低于中心城区同年龄儿童哮喘检出率(9.8%),差异有统计学意义 (χ2=8.63,P <0.01).1岁内移居上海郊县的儿童7~8岁时哮喘检出率为8.0%,与中心城区儿童相近而明显高于 3岁后移居上海郊县的儿童(3.8%),差异有统计学意义 (χ2=6.51,P =0.011).父母特应质、个人特应质、被动吸烟是城郊儿童哮喘发病的危险因素,郊县儿童资料显示幼年暴露于家禽、家畜或家养宠物是哮喘发病的保护因素;独生子女、完整的预防接种对城郊儿童均未显示危险因素或保护因素.结论出生早期生活于上海郊县或中心城区的儿童哮喘发病率相近;而学龄前移居上海郊县的儿童哮喘发病率低于早期移居组和中心城区组,提示生命早期环境暴露与哮喘的发病有关,家禽/家畜、家养宠物暴露是其中两个因素.
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