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Shi H, Wang T, Zhao Z, Norback D, Wang X, Li Y, Deng Q, Lu C, Zhang X, Zheng X, Qian H, Zhang L, Yu W, Shi Y, Chen T, Yu H, Qi H, Yang Y, Jiang L, Lin Y, Yao J, Lu J, Yan Q. Prevalence, risk factors, impact and management of pneumonia among preschool children in Chinese seven cities: a cross-sectional study with interrupted time series analysis. BMC Med 2023; 21:227. [PMID: 37365601 DOI: 10.1186/s12916-023-02951-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 06/19/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Pneumonia is a common disease worldwide in preschool children. Despite its large population size, China has had no comprehensive study of the national prevalence, risk factors, and management of pneumonia among preschool children. We therefore investigated the prevalence of pneumonia among preschool children in Chinese seven representative cities, and explore the possible risk factors of pneumonia on children, with a view to calling the world's attention to childhood pneumonia to reduce the prevalence of childhood pneumonia. METHODS Two group samples of 63,663 and 52,812 preschool children were recruited from 2011 and 2019 surveys, respectively. Which were derived from the cross-sectional China, Children, Homes, Health (CCHH) study using a multi-stage stratified sampling method. This survey was conducted in kindergartens in seven representative cities. Exclusion criteria were younger than 2 years old or older than 8 years old, non-permanent population, basic information such as gender, date of birth and breast feeding is incomplete. Pneumonia was determined on the basis of parents reported history of clearly diagnosed by the physician. All participants were assessed with a standard questionnaire. Risk factors for pneumonia, and association between pneumonia and other respiratory diseases were examined by multivariable-adjusted analyses done in all participants for whom data on the variables of interest were available. Disease management was evaluated by the parents' reported history of physician diagnosis, longitudinal comparison of risk factors in 2011 and 2019. RESULTS In 2011 and 2019, 31,277 (16,152 boys and 15,125 girls) and 32,016 (16,621 boys and 15,395 girls) preschool children aged at 2-8 of permanent population completed the questionnaire, respectively, and were thus included in the final analysis. The findings showed that the age-adjusted prevalence of pneumonia in children was 32.7% in 2011 and 26.4% in 2019. In 2011, girls (odds ratio [OR] 0.91, 95%CI [confidence interval]0.87-0.96; p = 0.0002), rural (0.85, 0.73-0.99; p = 0.0387), duration of breastfeeding ≥ 6 months(0.83, 0.79-0.88; p < 0.0001), birth weight (g) ≥ 4000 (0.88, 0.80-0.97; p = 0.0125), frequency of putting bedding to sunshine (Often) (0.82, 0.71-0.94; p = 0.0049), cooking fuel type (electricity) (0.87, 0.80-0.94; p = 0.0005), indoor use air-conditioning (0.85, 0.80-0.90; p < 0.0001) were associated with a reduced risk of childhood pneumonia. Age (4-6) (1.11, 1.03-1.20; p = 0.0052), parental smoking (one) (1.12, 1.07-1.18; p < 0.0001), used antibiotics (2.71, 2.52-2.90; p < 0.0001), history of parental allergy (one and two) (1.21, 1.12-1.32; p < 0.0001 and 1.33, 1.04-1.69; p = 0.0203), indoor dampness (1.24, 1.15-1.33; p < 0.0001), home interior decoration (1.11, 1.04-1.19; p = 0.0013), Wall painting materials (Paint) (1.16, 1.04-1.29; p = 0.0084), flooring materials (Laminate / Composite wood) (1.08, 1.02-1.16; p = 0.0126), indoor heating mode(Central heating)(1.18, 1.07-1.30, p = 0.0090), asthma (2.38, 2.17-2.61; p < 0.0001), allergic rhinitis (1.36, 1.25-1.47; p < 0.0001), wheezing (1.64, 1.55-1.74; p < 0.0001) were associated with an elevated risk of childhood pneumonia; pneumonia was associated with an elevated risk of childhood asthma (2.53, 2.31-2.78; p < 0.0001), allergic rhinitis (1.41, 1.29-1.53; p < 0.0001) and wheezing (1.64, 1.55-1.74; p < 0.0001). In 2019, girls (0.92, 0.87-0.97; p = 0.0019), duration of breastfeeding ≥ 6 months (0.92, 0.87-0.97; p = 0.0031), used antibiotics (0.22, 0.21-0.24; p < 0.0001), cooking fuel type (Other) (0.40, 0.23-0.63; p = 0.0003), indoor use air-conditioning (0.89, 0.83-0.95; p = 0.0009) were associated with a reduced risk of childhood pneumonia. Urbanisation (Suburb) (1.10, 1.02-1.18; p = 0.0093), premature birth (1.29, 1.08-1.55; p = 0.0051), birth weight (g) < 2500 (1.17, 1.02-1.35; p = 0.0284), parental smoking (1.30, 1.23-1.38; p < 0.0001), history of parental asthma (One) (1.23, 1.03-1.46; p = 0.0202), history of parental allergy (one and two) (1.20, 1.13-1.27; p < 0.0001 and 1.22, 1.08-1.37; p = 0.0014), cooking fuel type (Coal) (1.58, 1.02-2.52; p = 0.0356), indoor dampness (1.16, 1.08-1.24; p < 0.0001), asthma (1.88, 1.64-2.15; p < 0.0001), allergic rhinitis (1.57, 1.45-1.69; p < 0.0001), wheezing (2.43, 2.20-2.68; p < 0.0001) were associated with an elevated risk of childhood pneumonia; pneumonia was associated with an elevated risk of childhood asthma (1.96, 1.72-2.25; p < 0.0001), allergic rhinitis (1.60, 1.48-1.73; p < 0.0001) and wheezing (2.49, 2.25-2.75; p < 0.0001). CONCLUSIONS Pneumonia is prevalent among preschool children in China, and it affects other childhood respiratory diseases. Although the prevalence of pneumonia in Chinese children shows a decreasing trend in 2019 compared to 2011, a well-established management system is still needed to further reduce the prevalence of pneumonia and reduce the burden of disease in children.
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Affiliation(s)
- Haonan Shi
- School of Nursing & Health Management, Shanghai University of Medicine & Health Sciences, No.279, Zhouzhu Highway, Pudong New District, Shanghai, 201318, China
| | - Tingting Wang
- School of Nursing & Health Management, Shanghai University of Medicine & Health Sciences, No.279, Zhouzhu Highway, Pudong New District, Shanghai, 201318, China.
| | - Zhuohui Zhao
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, 200433, China
- Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment (Fudan University), Shanghai, 200433, China
| | - Dan Norback
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, SE-751, Uppsala, Sweden
| | - Xiaowei Wang
- Department of Operation and Security, Zhoupu Hospital Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai, 201318, China
| | - Yongsheng Li
- Department of Preventive Medicine, Medical College, Shihezi University, Shihezi, 832002, China
| | - Qihong Deng
- School of Public Health, Central South University, Changsha, 410083, China
| | - Chan Lu
- School of Public Health, Central South University, Changsha, 410083, China
| | - Xin Zhang
- Research Center for Environmental Science and Engineering, Shanxi University, Taiyuan, 237016, China
| | - Xiaohong Zheng
- School of Energy and Environment, Southeast University, Nanjing, 214135, China
| | - Hua Qian
- School of Energy and Environment, Southeast University, Nanjing, 214135, China
| | - Ling Zhang
- Wuhan University of Science and Technology, Wuhan, 430081, China
| | - Wei Yu
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, 400044, China
- National Centre for International Research of Low-Carbon and Green Buildings, Ministry of Science and Technology), Chongqing University, Chongqing, 400044, China
| | - Yuqing Shi
- Wuhan University of Science and Technology, Wuhan, 430081, China
| | - Tianyi Chen
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, 200433, China
| | - Huaijiang Yu
- People's Hospital of Bayingguoleng Mongolian Autonomous Prefecture, Kuerle, 841099, China
| | - Huizhen Qi
- Department of Neurology, The Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Ye Yang
- Department of No.1 Cadres, The Second Affiliated Hospital of Xinjiang Medical University, Urumqi, 830063, China
| | - Lan Jiang
- Department of Laboratory Medicine, Xinjiang Uyghur Autonomous Region Maternal and Child Health Hospital, Urumqi, 830001, China
| | - Yuting Lin
- Department of Laboratory Medicine, Xinjiang Uyghur Autonomous Region Maternal and Child Health Hospital, Urumqi, 830001, China
| | - Jian Yao
- School of Public Health, Xinjiang Medical University, Urumqi, 830054, China
- Xinjiang Key Laboratory of Special Environment and Health Research, Urumqi, 830054, China
| | - Junwen Lu
- School of Public Health, Xinjiang Medical University, Urumqi, 830054, China
- Xinjiang Key Laboratory of Special Environment and Health Research, Urumqi, 830054, China
| | - Qi Yan
- School of Public Health, Xinjiang Medical University, Urumqi, 830054, China
- Xinjiang Key Laboratory of Special Environment and Health Research, Urumqi, 830054, China
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Liu W, Cai J, Sun C, Zou Z, Zhang J, Huang C. Time-trends for eczema prevalences among children and adults from 1985 to 2015 in China: a systematic review. BMC Public Health 2022; 22:1294. [PMID: 35790959 PMCID: PMC9254617 DOI: 10.1186/s12889-022-13650-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/06/2022] [Indexed: 04/11/2023] Open
Abstract
Abstract
Background
Several studies have reported that childhood prevalence of eczema has been increasing worldwide. However, none study quantitatively evaluated prevalence trends of eczema among children and adults in the last 30 years in China.
Methods and Findings
Via a systematic review of literature databases in English and Chinese, we summarized all studies reporting eczema prevalences from 1985 to 2015 in China as well as diagramed prevalence and eczematous population trends against year for different age groups. A total of 93 studies and 17 studies (16 for children and one for adults) were selected for qualitative and quantitative synthesis, respectively. Childhood lifetime-ever eczema prevalences ranged from 10.0% to 30.0%. Prevalences among 3-12-year-olds children showed increasing trends in most specific cities, but national lifetime-ever eczema prevalences among 13-14-year-olds children decreased from 10.6% in 2001 to 8.6% in 2009 in mainland China. We estimated that about 1.5 million children aged 13-14-year-olds in 2009 and 15.5 million children aged 3-6-year-olds in 2012 had lifetime-ever eczema in mainland China. Similar studies were too few to ascertain time-trends of eczema prevalence among adults. About 39.4, 20.0, and 11.6 million adults aged 15-86-year-olds in 2010 had contact dermatitis, seborrheic dermatitis, and atopic dermatitis in the mainland China, respectively.
Conclusions
The burden of eczema became heavier in young children, whereas perhaps had been reduced in adolescent in China. More studies for eczema prevalence in adults are warranted.
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Sio YY, Chew FT. Risk factors of asthma in the Asian population: a systematic review and meta-analysis. J Physiol Anthropol 2021; 40:22. [PMID: 34886907 PMCID: PMC8662898 DOI: 10.1186/s40101-021-00273-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 11/12/2021] [Indexed: 12/15/2022] Open
Abstract
Background and objective An increasing trend of asthma prevalence was observed in Asia; however, contributions of environmental and host-related risk factors to the development of this disease remain uncertain. This study aimed to perform a systematic review and meta-analysis for asthma-associated risk factors reported in Asia. Methods We systematically searched three public databases (Web of Science, PubMed, and Scopus) in Feb 2021. We only included articles that reported environmental and host-related risk factors associated with asthma in the Asian population. Random-effect meta-analyses were conducted for frequently reported asthma-associated risk factors to provide an overall risk estimate of asthma development. Results Of 4030 records obtained from public databases, 289 articles were selected for review. The most frequently reported asthma-associated risk factor was the family history of allergy-related conditions. The random-effect asthma risk estimates (pooled odds ratio, OR) were 4.66 (95% confidence interval (CI): 3.73–5.82) for the family history of asthma, 3.50 (95% CI: 2.62–4.67) for the family history of atopy, 3.57 (95% CI: 3.03–4.22) for the family history of any allergic diseases, 1.96 (95% CI: 1.47–2.61) for the family history of allergic rhinitis, and 2.75 (95% CI: 1.12–6.76) for the family history of atopic dermatitis. For housing-related factors, including the presence of mold, mold spots, mold odor, cockroach, water damage, and incense burning, the random-effect pooled OR ranged from 1.43 to 1.73. Other risk factors with significant pooled OR for asthma development included male gender (1.30, 95% CI: 1.23–1.38), cigarette smoke exposure (1.44, 95% CI: 1.30–1.60), cigarette smoking (1.66, 95% CI: 1.44–1.90), body mass index (BMI)–related parameters (pooled OR ranged from 1.06 to 2.02), various types of air pollution (NO2, PM10, and O3; pooled OR ranged from 1.03 to 1.22), and pre- and perinatal factors (low birth weight, preterm birth, and cesarean section; pooled OR ranged from 1.14 to 1.32). Conclusions The family history of asthma was the most frequently reported risk factor for asthma development in Asia with the highest risk estimate for asthma development. This suggests a major role of the genetic component in asthma pathogenesis. Further study on asthma genetics is required to improve the current understanding of asthma etiology. Supplementary Information The online version contains supplementary material available at 10.1186/s40101-021-00273-x.
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Affiliation(s)
- Yang Yie Sio
- Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Department of Biological Sciences, National University of Singapore, Block S2, Level 5, 14 Science Drive 4, off Lower Kent Ridge Road, 117543, Singapore, Singapore
| | - Fook Tim Chew
- Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Department of Biological Sciences, National University of Singapore, Block S2, Level 5, 14 Science Drive 4, off Lower Kent Ridge Road, 117543, Singapore, Singapore.
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Liu W, Cai J, Sun C, Zou Z, Zhang J, Huang C. Associations between household airborne culturable fungi and allergies and airway illnesses in childhood in Shanghai, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:36570-36578. [PMID: 32564319 DOI: 10.1007/s11356-020-09717-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 06/11/2020] [Indexed: 06/11/2023]
Abstract
Associations of household airborne fungi with allergies in childhood were inconsistent in the epidemiologic studies. During 2013-2014, we conducted a case-control study (phase two), which was nested in a cross-sectional study (phase one) during 2011-2012 in Shanghai, China. We inspected indoor air quality of 454 residences for 5-10 years old children. We defined cases as those children who were reported illnesses in the questionnaire of phase one or phase two and defined controls as those children who were not reported illnesses in both phases. A total of 436 living rooms and 445 bedrooms had valid data of household airborne fungi, and their mean concentrations were 301 cfu/m3 and 310 cfu/m3, respectively. In the multiple logistic regression analyses with adjusting for potential confounders, most associations of 16 studied illnesses with airborne fungi concentration were not statistically significant. Taking children in the 1st quartile that was stratified according to airborne fungi concentration in the living room as reference, only children in the 3rd quartile were significantly associated with a higher odd of lifetime-ever ear infections (adjusted OR, 95% CI 3.05, 1.29-7.21), and children in the 4th quartile were significantly associated with a higher odd of lifetime-ever wheeze (2.72, 1.28-5.75); but children in the 3rd quartile (0.33, 0.17-0.68) and in the 4th quartile (0.47, 0.23-0.97) were significantly associated with a lower odd of rhinitis in the past 12 months prior to the home inspection. Our results indicate that exposures to indoor airborne fungi in low concentrations seemingly have no significant impacts on the risks of most allergic and airway illnesses in childhood. Since families with sick participants might pay more attention to improve indoor air quality, effects of "avoidance behavior" on associations between indoor pollutants and childhood health should be considered in the data analysis and design of the nested case-control study.
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Affiliation(s)
- Wei Liu
- Institute for Health and Environment, Chongqing University of Science and Technology, Chongqing, China
- School of Civil Engineering and Architecture, Chongqing University of Science and Technology, Chongqing, China
| | - Jiao Cai
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China
| | - Chanjuan Sun
- School of Environment and Architecture, University of Shanghai for Science and Technology, 516 Jungong Road, Yangpu District, Shanghai, People's Republic of China
| | - Zhijun Zou
- School of Environment and Architecture, University of Shanghai for Science and Technology, 516 Jungong Road, Yangpu District, Shanghai, People's Republic of China
| | - Jialing Zhang
- School of Environment and Architecture, University of Shanghai for Science and Technology, 516 Jungong Road, Yangpu District, Shanghai, People's Republic of China
| | - Chen Huang
- School of Environment and Architecture, University of Shanghai for Science and Technology, 516 Jungong Road, Yangpu District, Shanghai, People's Republic of China.
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Zhang HL, Wang BY, Luo Y, Li Y, Cai CS, Huang LL, He BH, Cai J, Li ZY, Mai AD, Guo Y. Association of pet-keeping in home with self-reported asthma and asthma-related symptoms in 11611 school children from China. J Asthma 2020; 58:1555-1564. [PMID: 32985283 DOI: 10.1080/02770903.2020.1818772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE We conducted a cross-sectional study to investigate the associations between domestic pets and respiratory health in children. METHODS We randomly recruited 11,611 school children from Zhongshan, a southern city in China. Information about the respiratory symptoms and disease history of the recruited children, the status of domestic pets, and other related risk factors were collected from March to July 2016. RESULTS We identified cat-keeping at home increases the risk of persistent cough (OR, 1.77; 95%CI, 1.03-3.05); poultry-keeping at home increases the risk of current asthma (OR, 3.87; 95%CI, 1.08-13.92) and allergic rhinitis (OR, 1.84; 95%CI, 1.01-3.37); sleeping with pets increases the risk of persistent phlegm (OR, 5.04; 95%CI, 1.05-24.28), doctor-diagnosed asthma (OR, 3.35; 95%CI, 1.31-8.57) and current asthma (OR, 4.94; 95%CI, 1.05-23.31) in children. CONCLUSIONS Cat-keeping and molds on the wall of the house had the multiplicative and additive interaction in doctor-diagnosed asthma. In conclusion, pet-keeping increased the risk of respiratory symptoms in children.
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Affiliation(s)
- Hao-Ling Zhang
- Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong Province, China
| | - Bo-Yuan Wang
- Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong Province, China
| | - Yun Luo
- Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong Province, China
| | - Yu Li
- Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong Province, China
| | - Chun-Sheng Cai
- Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong Province, China
| | - Li-Li Huang
- Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong Province, China
| | - Bin-Hong He
- Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong Province, China
| | - Jian Cai
- Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong Province, China
| | - Zi-Ying Li
- Guangdong Pharmaceutical University, Guangzhou, Guangdong Province, China
| | - Ai-Die Mai
- Guangdong Medical University, Dongguan, Guangdong Province, China
| | - Yan Guo
- Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong Province, China
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Ojwang V, Nwaru BI, Takkinen HM, Kaila M, Niemelä O, Haapala AM, Ilonen J, Toppari J, Hyöty H, Veijola R, Knip M, Virtanen SM. Early exposure to cats, dogs and farm animals and the risk of childhood asthma and allergy. Pediatr Allergy Immunol 2020; 31:265-272. [PMID: 31829464 DOI: 10.1111/pai.13186] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 12/02/2019] [Accepted: 12/03/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Synergistic role of exposure to cats, dogs, and farm animals during infancy on the risk of childhood asthma and allergy remains unknown. OBJECTIVES To investigate independent and synergistic associations between exposure to indoor pets and farm animals during infancy and the risk of asthma and allergy by age 5. METHODS We studied 3781 children participating in the Finnish Type 1 Diabetes Prediction and Prevention (DIPP) Nutrition Study. At age 5, a validated version of the International Study of Asthma and Allergies in Childhood questionnaire was administered to collect information on asthma and allergic disease, and exposure to indoor pets and farm animals during the first year of life. Allergen-specific IgE antibodies were analyzed from serum samples. Statistical analyses employed Cox proportional hazards and logistic regression. RESULTS Having a dog in the house was inversely associated with the risk of asthma (HR 0.60; 95% CI, 0.38-0.96), allergic rhinitis (OR 0.72; 95% CI, 0.53-0.97), and atopic sensitization (OR 0.77; 95% CI, 0.63-0.96). Having a cat was associated with a decreased risk of atopic eczema (OR 0.68; 95% CI, 0.51-0.92). Farm animals were neither independently nor in synergy with indoor pets associated with the outcomes. CONCLUSION Having a dog or cat in the house during the first year of life may protect against childhood asthma and allergy. We did not find a synergistic association between cat, dog, and farm animal exposure on the risk of childhood asthma and allergy. Future research should identify specific causative exposures conferred by indoor pets and whether they could be recommended for allergy prevention.
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Affiliation(s)
- Vincent Ojwang
- Faculty of Social Sciences/Health Sciences, Tampere University, Tampere, Finland.,Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Bright I Nwaru
- Faculty of Social Sciences/Health Sciences, Tampere University, Tampere, Finland.,Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.,Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Hanna-Mari Takkinen
- Faculty of Social Sciences/Health Sciences, Tampere University, Tampere, Finland.,Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Minna Kaila
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland.,Public Health Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Onni Niemelä
- Department of Laboratory Medicine, Medical Research Unit, Seinajoki Central Hospital, Tampere University, Tampere, Finland
| | | | - Jorma Ilonen
- Immunogenetics Laboratory, Institute of Biomedicine, University of Turku, Turku, Finland.,Department of Clinical Microbiology, Turku University Hospital, Turku, Finland
| | - Jorma Toppari
- Institute of Biomedicine, Research Centre of Integrative Physiology and Pharmacology, University of Turku, Turku, Finland.,Department of Pediatrics, Turku University Hospital, Turku, Finland
| | - Heikki Hyöty
- Fimlab Laboratories, Pirkanmaa Hospital District, Tampere, Finland.,Department of Virology, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Riitta Veijola
- Department of Pediatrics, PEDEGO Research Unit, Medical Research Centre, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Mikael Knip
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland.,Tampere Center for Child Health Research, Tampere University Hospital, Tampere University, Tampere, Finland.,Science Center of Pirkanmaa Hospital District, Tampere, Finland.,Folkhalsan Research Center, Helsinki, Finland.,Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Suvi M Virtanen
- Faculty of Social Sciences/Health Sciences, Tampere University, Tampere, Finland.,Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland.,Tampere Center for Child Health Research, Tampere University Hospital, Tampere University, Tampere, Finland.,Science Center of Pirkanmaa Hospital District, Tampere, Finland.,Science Centre, Tampere University Hospital, Tampere, Finland
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AlShatti KA, Ziyab AH. Pet-Keeping in Relation to Asthma, Rhinitis, and Eczema Symptoms Among Adolescents in Kuwait: A Cross-Sectional Study. Front Pediatr 2020; 8:331. [PMID: 32656169 PMCID: PMC7324793 DOI: 10.3389/fped.2020.00331] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 05/20/2020] [Indexed: 11/30/2022] Open
Abstract
Background: Findings on the associations between household pet-keeping and allergic diseases, including asthma, rhinitis, and eczema, have been contradictory, with investigations reporting positive, negative, and null associations. This study sought to estimate the prevalence of pet-keeping among families in Kuwait and to assess the associations between pet-keeping and symptoms of allergic diseases among adolescents. Methods: Schoolchildren aged 11-14 years (n = 3,864) were enrolled in this cross-sectional study. The children's parents completed questionnaires regarding their child's environmental exposures, including pet-keeping in the past 12 months, and clinical history and symptoms of allergic diseases. Associations were assessed using Poisson regression with robust variance estimation, and adjusted prevalence ratios (aPRs) and their 95% confidence intervals (CIs) were estimated. Results: Pet-keeping in the past 12 months was reported by 42.8% of the participating families. Birds, cats, rabbits, fish, and dogs were kept by 28.3, 13.2, 7.8, 3.9, and 3.1% of all households, respectively. Current cat ownership was significantly associated with current wheezing (aPR 1.29, 95% CI 1.05-1.58), current rhinitis symptoms (aPR 1.18, 95% CI 1.02-1.36), and ever doctor-diagnosed eczema (aPR 1.25, 95% CI 1.03-1.50). Current rabbit-keeping was positively associated with multiple symptoms of asthma (e.g., study-defined current asthma: aPR 1.38, 95% CI 1.04-1.82) and eczema (e.g., severe eczema: aPR 1.94, 95% CI 1.02-3.71). Similarly, current bird-keeping was associated with study-defined current rhinitis (aPR 1.19, 95% CI 1.05-1.41) and current itchy rash (aPR 1.27, 95% CI 1.10-1.46). Conclusions: Household pet-keeping is very common and diverse in Kuwait and was found to be positively associated with symptoms of allergic diseases among adolescents. The findings of associations between rabbit-keeping and symptoms of asthma and eczema add to the existing literature and further highlight the importance of considering the pet type when assessing such associations.
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Affiliation(s)
| | - Ali H Ziyab
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
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Morales-Romero J, Bedolla-Pulido TI, Bedolla-Pulido TR, Pulido-Guillén NA, Bedolla-Barajas M, Padilla-Padilla R, Pérez-Molina JJ, Orozco-Alatorre LG. Asthma prevalence, but not allergic rhinitis nor atopic dermatitis, is associated to exposure to dogs in adolescents. Allergol Immunopathol (Madr) 2020; 48:34-41. [PMID: 31477389 DOI: 10.1016/j.aller.2019.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 04/12/2019] [Accepted: 04/15/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Exposure to pets can be a predisposing factor in the development of certain diseases, including allergic diseases. OBJECTIVE We analyzed the role that exposure to indoor dogs and cats plays in the prevalence of allergic diseases. METHODS We examined the cross-sectional data of 1056 women and 936 men aged 15 to 18 years; these individuals were selected through stratified and cluster random sampling. We asked all participants about their exposure to indoor dogs and cats during the year that preceded our study. The prevalence of allergic diseases was determined through core questions taken from The International Study of Asthma and Allergies in Childhood questionnaire. RESULTS The prevalence was 12.7% (95% CI: 11.3%-14.2%) for asthma, 9.0% (95% CI: 7.8%-10.4%) for allergic rhinitis, and 5.2% (95% CI: 4.3%-6.2%) for atopic dermatitis. The multivariate analyses showed that exposure to indoor dogs, but not indoor cats, was associated with asthma prevalence (aOR 1.37; 95% CI: 1.03-1.83), as was male sex (aOR=1.42; 95% CI: 1.08-1.86), a personal history of allergic rhinitis (aOR=3.24; 95% CI: 2.25-4.66), and a maternal history of asthma (aOR=3.06; 95% CI: 1.89-4.98). The population attributable risk for exposure to indoor dogs was 18%. Notably, neither allergic rhinitis nor atopic dermatitis was found to be associated with dog or cat exposure (p> 0.05). CONCLUSION Exposure to dogs in late adolescence is a factor associated with asthma, although its contribution to the development of asthma should be investigated in new studies.
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Bedolla-Barajas M, Morales-Romero J, Bedolla-Pulido TI, Bedolla-Pulido TR, Meza-López C, Pulido-Guillén NA. Exposure to dogs but not cats is associated to a decrease in the prevalence in atopic dermatitis amongst school-children. Allergol Immunopathol (Madr) 2018; 46:431-437. [PMID: 29456039 DOI: 10.1016/j.aller.2017.09.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 09/14/2017] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The association regarding the exposure to pets, especially cats and dogs, and the prevalence of allergic diseases is inconsistent. OBJECTIVE We analyzed the role played by early exposure to dogs or cats in the prevalence of allergic diseases amongst school-aged children. METHOD Through a cross-sectional study, we examined 756 children, aged 6-7; these candidates were selected through cluster sampling. We inquired about the exposure that these children had had to dogs and cats, and whether these pets spent most of their time indoors or outdoors during the first year of the child's life. In order to identify the prevalence of allergic diseases and their symptoms, each child's parent completed the International Study of Asthma and Allergies in Childhood questionnaire. RESULTS Exposure to outdoor dogs was associated to nocturnal coughing, odds ratio (OR) 0.64, with a confidence interval of 95% (95% CI) 0.43-0.95 and with atopic dermatitis (OR: 0.39; 95% CI: 0.20-0.76). Interestingly, exposure to outdoor cats was associated to nocturnal coughing (OR: 0.51; 95% CI: 0.32-0.83) and current rhinitis symptoms (OR: 0.59; 95% CI 0.36-0.97). After carrying out the multivariate analyses, only exposure to dogs, both indoor and outdoor, was significantly associated to a decrease in the prevalence of atopic dermatitis OR 0.40 (95% CI: 0.20-0.79) and OR 0.38 (95% CI: 0.18-0.83), respectively. CONCLUSION Our findings suggest that exposure to dogs, whether they be indoor or outdoor pets, is associated to a decreased prevalence in atopic dermatitis.
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Affiliation(s)
- M Bedolla-Barajas
- Servicio de Alergia e Inmunología Clínica, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Salvador de Quevedo y Zubieta No. 750, Colonia La Perla, C.P. 44340, Guadalajara, Jalisco, Mexico.
| | - J Morales-Romero
- Instituto de Salud Pública, Universidad Veracruzana, Av. Luis Castelazo Ayala s/n., Colonia Industrial Ánimas, C.P. 91190, Xalapa, Veracruz, Mexico
| | - T I Bedolla-Pulido
- Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara. Sierra Mojada No. 950, Colonia Independencia Oriente, C.P. 44340, Guadalajara, Jalisco, Mexico
| | - T R Bedolla-Pulido
- Servicio de Alergia e Inmunología Clínica, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Salvador de Quevedo y Zubieta No. 750, Colonia La Perla, C.P. 44340, Guadalajara, Jalisco, Mexico
| | - C Meza-López
- División de Pediatría, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Salvador de Quevedo y Zubieta No. 750, Colonia La Perla, C.P. 44340, Guadalajara, Jalisco, Mexico
| | - N A Pulido-Guillén
- Psicología Clínica, Eulogio Parra No. 2330-301, Col. Las Américas, C.P. 44650, Guadalajara, Jalisco, Mexico
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Chu S, Zhang Y, Jiang Y, Sun W, Zhu Q, Wang B, Jiang F, Zhang J. Cesarean section without medical indication and risks of childhood allergic disorder, attenuated by breastfeeding. Sci Rep 2017; 7:9762. [PMID: 28852079 PMCID: PMC5575109 DOI: 10.1038/s41598-017-10206-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 08/04/2017] [Indexed: 12/13/2022] Open
Abstract
Caesarean section (CS) may increase the risk of asthma and allergic diseases in children, but previous studies could not preclude the potential confounding effect of underlying medical indications for CS. We aim to assess the association between CS itself (without indications) and risks of asthma and allergic rhinitis in children. The 2014 Shanghai Children's Health, Education and Lifestyle Evaluation was a large population-based survey with cluster random probability sampling in 26 primary schools in Shanghai, China, in 2014. The mode of delivery and child history of asthma and allergic rhinitis were reported by parents. We included 12639 children in our analysis. CS without medical indication was associated with an increased risk of childhood asthma. CS without medical indication and CS for fetal complications were associated with increased risks of childhood allergic rhinitis, respectively. In children fed by exclusive breastfeeding or mixed feeding in the first four months after birth, these risks were not significant. In contrast, in children fed by exclusive formula milk, CS was highly significantly associated with childhood asthma and allergic rhinitis. In conclusion, CS without medical indication was associated with increased risks of both childhood asthma and allergic rhinitis. Breastfeeding in early infancy may attenuate these risks.
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Affiliation(s)
- Shuyuan Chu
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China
- Laboratory of Respiratory Disease, Affiliated Hospital of Guilin Medical University, Guilin, 541001, China
| | - Yunting Zhang
- Child Health Advocacy Institute, Shanghai Children's Medical Center, School of medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Yanrui Jiang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Wanqi Sun
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Qi Zhu
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Bin Wang
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China
| | - Fan Jiang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of medicine, Shanghai Jiao Tong University, Shanghai, 200127, China.
| | - Jun Zhang
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China.
- School of Public Health, Guilin Medical University, Guilin, 541004, China.
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11
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Guo R, Zhou Y, Lu L, Cao L, Cao J. Atopy in children with juvenile systemic lupus erythematosus is associated with severe disease. PLoS One 2017; 12:e0177774. [PMID: 28545118 PMCID: PMC5435243 DOI: 10.1371/journal.pone.0177774] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 05/03/2017] [Indexed: 01/22/2023] Open
Abstract
The influence of co-existing atopy on the prognosis of juvenile systemic lupus erythematosus (JSLE) was assessed in this study. Patients diagnosed with JSLE between October 2005 and April 2016 were enrolled in a prospective study and followed up for 2 years. Management of patients was evaluated using the systemic lupus erythematosus disease activity index 2000 (SLEDAI-2K) score and laboratory variables. Eighty JSLE patients were enrolled at diagnosis and divided into those with (n = 35) and without (n = 45) atopy. When compared with the non-atopic group, atopic patients showed higher SLEDAI-2K score at disease onset (16.09 vs. 11.18), higher erythrocyte sedimentation rate (52.89 vs. 38.27 mm/h), higher percentage of total B-cells (25.85 vs. 19.51%), lower percentage (7.26 vs. 9.03%) and cytotoxicity (9.92 vs. 11.32%) of natural killer cells, and lower complement C3 (0.51 vs. 0.69 g/L) (all p<0.05). At 1, 3, 6, 12, 18, and 24 months, JSLE patients with atopy reached higher SLEDAI-2K score and lower ΔSLEDAI-2K improvement rate (at 1 month, 8.34 vs. 4.71 and 43.63 vs. 57.95%, respectively; at 3 months, 8.57 vs. 2.62 and 48.39 vs. 75.10%, respectively; at 6 months, 6.91 vs. 2.38 and 53.59 vs. 77.26%, respectively; at 12 months, 4.71 vs. 1.80 and 69.54 vs. 84.10%, respectively; at 18 months, 4.66 vs. 2.02 and 68.14 vs. 82.93%, respectively; at 24 months, 8.57 vs. 2.62 and 70.00 vs. 81.88%, respectively; all p<0.05). During the 24 months of follow-up, the total number of disease flares was higher in JSLE patients with co-existing atopy (3.77 vs. 1.51, p<0.05), and the atopic group needed much more time to reach the stable condition of the disease (6.88 vs. 4.65 months, p<0.05). JSLE patients combined with co-existing atopy had more severe disease at diagnosis and poorer outcomes than JSLE patients without atopy.
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Affiliation(s)
- Ruru Guo
- Department of Rheumatology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China
| | - Yanqing Zhou
- Department of Pediatrics, Central hospital of Jiading, Shanghai, P.R.China
| | - Liangjing Lu
- Department of Rheumatology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China
| | - Lanfang Cao
- Department of Pediatrics, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China
| | - Junjia Cao
- Department of Pediatrics, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China
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Cai J, Liu W, Hu Y, Zou Z, Shen L, Huang C. Household environment, lifestyle behaviors, and dietary habits in relation to childhood atopic eczema in Shanghai, China. Int Arch Occup Environ Health 2016; 90:141-159. [PMID: 27812754 DOI: 10.1007/s00420-016-1177-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 10/26/2016] [Indexed: 02/06/2023]
Abstract
PURPOSES We aim to investigate associations of the child's individual characteristics, building characteristics, home environmental exposures, family lifestyle behaviors, and dietary habits on childhood eczema during lifetime-ever and in the last year before the survey. METHODS During April 2011-April 2012, we conducted a cross-sectional study and collected 13,335 parents-reported questionnaires of 4-6-year-old children from 72 kindergartens in Shanghai, China. Logistic regression model was used to investigate associations. RESULTS After adjusted for sex, age, family history of atopy, and questionnaire reporter, the factors which were strongly associated (increased odds >30% and p value <0.05) with lifetime-ever eczema included mother employed during pregnancy (adjusted OR 1.33), residence renovated during pregnancy (1.49) and in the child's first year of life (1.31), using laminate (1.58) and solid (1.42) wood as material of floor covering (compared to using cement), residence located in urban district (1.38), and dampness-related exposures in the early residence (mold spots/stains: 1.41; mold odor: 1.41) and in the current residence (water damage: 1.33; damp stains: 1.34; mold spots: 1.32; and windows pane condensation: 1.31). Parental smoking, pet-keeping, and incense-burning had no significant associations with childhood eczema. Similar associations were found for eczema in the last year before the survey. Families with sick children likely changed lifestyle behaviors and dietary habits. CONCLUSIONS Childhood eczema could be influenced by many household environmental and non-environmental factors. Exposures during early lifetime likely have greater impact on childhood eczema than current exposures. Associations of lifestyle behaviors and dietary habits with childhood eczema could be modified by family avoidance behaviors.
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Affiliation(s)
- Jiao Cai
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, 516 Jungong Road, Yangpu District, Shanghai, People's Republic of China
| | - Wei Liu
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, 516 Jungong Road, Yangpu District, Shanghai, People's Republic of China
| | - Yu Hu
- Tongji Architectural Design (Group) Company Limited (TJAD), Shanghai, People's Republic of China
| | - Zhijun Zou
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, 516 Jungong Road, Yangpu District, Shanghai, People's Republic of China
| | - Li Shen
- R&B Technology (Shanghai) Company Limited, Shanghai, People's Republic of China
| | - Chen Huang
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, 516 Jungong Road, Yangpu District, Shanghai, People's Republic of China.
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Huang C, Wang X, Liu W, Cai J, Shen L, Zou Z, Lu R, Chang J, Wei X, Sun C, Zhao Z, Sun Y, Sundell J. Household indoor air quality and its associations with childhood asthma in Shanghai, China: On-site inspected methods and preliminary results. ENVIRONMENTAL RESEARCH 2016; 151:154-167. [PMID: 27479712 DOI: 10.1016/j.envres.2016.07.036] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 07/14/2016] [Accepted: 07/25/2016] [Indexed: 06/06/2023]
Abstract
Few studies were conducted for associations of home environment with childhood health by on-site inspection in China. During 2013-2014, we conducted a case-control study with home inspection among 454 children (186 asthma children and 268 non-asthma children) in Shanghai, China. In this paper, we detailedly described the inspected methods and analyzed the preliminarily collected data. Except in winter, most residences meet the national standard for indoor temperature and relative humidity. Most living rooms had ≤1000ppm CO2, whereas over half of the child's bedrooms had slightly >1000ppm CO2 during night. Most residences had notably lower than 2500cfu/m3 airborne culturable fungi and ≤100μg/m3 formaldehyde. More than 70% of the child's bedrooms had ≤75μg/m3 PM2.5 and ≤150μg/m3 PM10. Indoor and outdoor concentrations of particulate matters had strong linear correlations (r=0.891-0.922; p-value <0.001). Most differences between cases and controls were not significant with respect to CO2, culturable fungi, formaldehyde, and particulate matters. Before and after adjusted for potential confounders, indoor averaged concentration of CO2 and particulate matters generally had negative associations with childhood history of doctor-diagnosed asthma in spring, summer, and autumn. Only in winter, indoor CO2 concentration was significantly associated with the increased odds of childhood asthma. Our results indicated that air quality among most residences in Shanghai could meet the national standard for indoor air quality in warm seasons; but household air quality and ventilation status in winter should be greatly improved. We suspected that those "unexpected" negative associations could exist due to changes in lifestyle behaviors regarding indoor air quality after the child being diagnosed asthma by a doctor.
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Affiliation(s)
- Chen Huang
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Xueying Wang
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Wei Liu
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China.
| | - Jiao Cai
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Li Shen
- R&B Technology (Shanghai) Company Limited, Shanghai, China
| | - Zhijun Zou
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Rongchun Lu
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Jing Chang
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China; Department of Thermal Energy and Power Engineering, Shandong Jiaotong University, Jinan, China
| | - Xiaoyang Wei
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Chanjuan Sun
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Zhuohui Zhao
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Yuexia Sun
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Jan Sundell
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China; Department of Building Science, Tsinghua University, Beijing, China
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Huang C, Liu W, Cai J, Weschler LB, Wang X, Hu Y, Zou Z, Shen L, Sundell J. Breastfeeding and timing of first dietary introduction in relation to childhood asthma, allergies, and airway diseases: A cross-sectional study. J Asthma 2016; 54:488-497. [PMID: 27603296 DOI: 10.1080/02770903.2016.1231203] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES We investigated associations of breastfeeding (BF) durations and patterns and of timing of other dietary introductions with prevalence of asthma, wheeze, hay fever, rhinitis, pneumonia, and eczema among preschool children. METHODS During April 2011-April 2012, we conducted a cross-sectional study in 72 kindergartens from five districts of Shanghai, China and obtained 13,335 questionnaires of children 4-6-years-old. We used multiple logistic regression models to evaluate the target associations. RESULTS Compared to children who were never BF, children who were exclusively breastfed 3-6 months had the lowest risk of asthma (adjusted odds ratio and 95% confidence interval: 0.81, 0.72-0.91) and wheeze (0.93, 0.87-0.99); and exclusive BF >6 months was significantly associated with a reduced risk of hay fever (0.93, 0.89-0.97), rhinitis (0.97, 0.94-0.99), pneumonia (0.97, 0.94-0.99), and eczema (0.96, 0.93-0.99). No significant associations were found between time when fruits or vegetables were introduced and the studied diseases. Associations were independent of the child's sex and parent's ownership of the current residence. Longer duration BF was only significantly protective when there was no family history of atopy. CONCLUSIONS This study suggests that heredity, but not sex and socioeconomic status, may negatively impact the effect of BF on childhood airway and allergic diseases. Our findings support China's national recommendation that mothers provide exclusive BF for the first four months, and continue partial BF for more than 6 months.
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Affiliation(s)
- Chen Huang
- a Department of Building Environment and Energy Engineering , School of Environment and Architecture, University of Shanghai for Science and Technology , Shanghai , China
| | - Wei Liu
- a Department of Building Environment and Energy Engineering , School of Environment and Architecture, University of Shanghai for Science and Technology , Shanghai , China
| | - Jiao Cai
- a Department of Building Environment and Energy Engineering , School of Environment and Architecture, University of Shanghai for Science and Technology , Shanghai , China
| | | | - Xueying Wang
- a Department of Building Environment and Energy Engineering , School of Environment and Architecture, University of Shanghai for Science and Technology , Shanghai , China
| | - Yu Hu
- a Department of Building Environment and Energy Engineering , School of Environment and Architecture, University of Shanghai for Science and Technology , Shanghai , China
| | - Zhijun Zou
- a Department of Building Environment and Energy Engineering , School of Environment and Architecture, University of Shanghai for Science and Technology , Shanghai , China
| | - Li Shen
- a Department of Building Environment and Energy Engineering , School of Environment and Architecture, University of Shanghai for Science and Technology , Shanghai , China
| | - Jan Sundell
- a Department of Building Environment and Energy Engineering , School of Environment and Architecture, University of Shanghai for Science and Technology , Shanghai , China.,c Department of Building Science , Tsinghua University , Beijing , China
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Oluwole O, Arinola GO, Huo D, Olopade CO. Biomass fuel exposure and asthma symptoms among rural school children in Nigeria. J Asthma 2016; 54:347-356. [PMID: 27589676 DOI: 10.1080/02770903.2016.1227334] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Approximately 70% of rural Nigerian households rely on biomass fuels for cooking. The International Study of Asthma and Allergies in Childhood (ISAAC) estimates the prevalence of current wheeze among children in Nigeria to have risen from 10.7% in 1999 to approximately 20% in 2014. OBJECTIVE To examine the effects of biomass smoke exposure on asthma symptom prevalence in rural children in Nigeria. METHODS We conducted a cross-sectional survey in rural communities in Nigeria. Asthma symptoms were defined according to ISAAC definitions. Biomass smoke exposure was determined by the types of fuel used for cooking. Logistic regression was used to explore associations between biomass smoke and asthma symptoms. RESULTS The study population comprised 1,690 school children, of which 865 lived in households cooking with biomass and 825 lived in households not using biomass. Asthma symptoms were reported in 481 (28.5%) children. Biomass fuel was associated with increased odds of asthma symptoms. Adjusted odds ratios (aORs) were 1.38 (95% CI: 1.05-1.80) for nocturnal cough, 1.26 (95% CI: 1.00-1.61) for current wheeze, and 1.33 (95% CI: 1.05-1.69) for report of any asthma-related symptoms. Sex modified the associations between asthma symptoms with biomass fuel: aORs were stronger and significant for males (nocturnal cough = 1.85, 95% CI: 1.24-2.76; current wheeze = 1.48, 95% CI: 1.03-2.13; report of any asthma-related symptoms = 1.60, 95% CI: 1.12-2.28), but weaker and non-significant for females. CONCLUSION The risk of asthma symptoms related to biomass smoke exposure appears to differ by sex.
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Affiliation(s)
- Oluwafemi Oluwole
- a Community Health and Epidemiology and the Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan , Saskatoon , SK , Canada.,d Department of Medicine and The Center for Global Health , University of Chicago , IL , USA
| | - Ganiyu O Arinola
- b College of Medicine, University of Ibadan , Ibadan , Oyo State , Nigeria
| | - Dezheng Huo
- c Department of Public Health Science , University of Chicago , Chicago , IL , USA
| | - Christopher O Olopade
- d Department of Medicine and The Center for Global Health , University of Chicago , IL , USA
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Cai J, Liu W, Hu Y, Zou Z, Shen L, Huang C. Associations between home dampness-related exposures and childhood eczema among 13,335 preschool children in Shanghai, China: A cross-sectional study. ENVIRONMENTAL RESEARCH 2016; 146:18-26. [PMID: 26708528 DOI: 10.1016/j.envres.2015.12.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 12/04/2015] [Accepted: 12/07/2015] [Indexed: 06/05/2023]
Abstract
From April 2011 to April 2012, we conducted a cross-sectional study in Shanghai, China. A total of 13,335 modified ISAAC questionnaires (response rate: 85.3%) were returned by parents or guardians for 4-6 year-old children. Six dampness-related indicators (visible mold spots, visible damp stains, damp bed clothing, water damage, window pane condensation, and moldy odor) were used to evaluate home dampness-related exposures. In the present study, we applied logistic regression model to reveal associations, dose-response relationships, and statistical interaction effects of these dampness-related exposures, with childhood eczema, during lifetime since birth (ever) and in the last 12 months before the questionnaire. The dampness-related indicators were frequently reported in the perinatal and current residences. Prevalences of eczema ever and in the last 12 months were 22.9% and 13.2%, respectively. The dampness-related indicators were robustly associated and dose-response related with increased risk of eczema ever and in the last 12 months in the logistic regression analyses, with adjusted for potential confounders. Specifically, in the perinatal residence, visible mold spots or damp stains could increase 46% (OR, 95% CI: 1.46, 1.29-1.66) odds of childhood eczema (ever); in the current residence, visible mold spots and visible damp stains could increase 34% (1.34, 1.14-1.58) and 38% (1.38, 1.22-1.56) odds of childhood eczema (ever), respectively. Associations were not appreciably different between boys and girls, nor were they different between children with and without parental history of atopy. In conclusion, perinatal and current dampness-related exposures in the residence perhaps are risk factors for childhood eczema.
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Affiliation(s)
- Jiao Cai
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, 516 Jungong Road, Yangpu District, Shanghai, PR China
| | - Wei Liu
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, 516 Jungong Road, Yangpu District, Shanghai, PR China
| | - Yu Hu
- Tongji Architectural Design (Group) Company Limited (TJAD), Shanghai, PR China
| | - Zhijun Zou
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, 516 Jungong Road, Yangpu District, Shanghai, PR China
| | - Li Shen
- R&B Technology (Shanghai) Company Limited, Shanghai, PR China
| | - Chen Huang
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, 516 Jungong Road, Yangpu District, Shanghai, PR China.
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17
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Eldeirawi K, Kunzweiler C, Combs AMT, Persky VW. In utero exposure to pets is associated with asthma and wheezing in Mexican American children. J Asthma 2016; 53:374-81. [PMID: 26797097 DOI: 10.3109/02770903.2015.1104693] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To examine the associations of in utero and early life exposure to cats/dogs and birds with the risk of lifetime doctor-diagnosed asthma and other respiratory conditions in a sample of Mexican American (MA) children 4-18 years of age. METHODS This study is a population-based cross-sectional investigation of 1816 MA children. We conducted multiple logistic models examining the relationship of asthma and wheezing with exposures to cats/dogs and birds in utero, infancy and at the time of the survey adjusted for country of birth, family history of asthma/allergies, antibiotics use in infancy and other covariates. RESULTS In adjusted analyses, in utero exposure to cats/dogs and birds jointly was associated with increased odds of asthma (adjusted odds ratio (aOR): 2.89; 95% confidence interval (CI): 1.34-6.23), ever wheezing (aOR: 1.96; 95% CI: 1.11-3.46) and current exercise-induced wheezing (aOR: 3.16; 95% CI: 1.27-7.85) compared to children not exposed to these pets in utero. Children who were exposed to both cats/dogs and birds in utero had an elevated, albeit statistically non-significant, odds of current wheezing. Exposures in infancy and at the time of the survey to cats/dogs and birds were not associated with asthma or wheezing. CONCLUSIONS In utero exposure to pets might be associated with an increased risk of asthma and respiratory conditions in a sample of non-affluent MA children.
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Affiliation(s)
- Kamal Eldeirawi
- a Department of Health Systems Science , College of Nursing and
| | - Colin Kunzweiler
- b Division of Epidemiology and Biostatistics , School of Public Health, University of Illinois at Chicago , Chicago , IL , USA
| | | | - Victoria W Persky
- b Division of Epidemiology and Biostatistics , School of Public Health, University of Illinois at Chicago , Chicago , IL , USA
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Cross-sectional associations of dietary habits with asthma and wheeze in childhood: confounding for avoidance behaviors. Sci Bull (Beijing) 2015. [DOI: 10.1007/s11434-015-0957-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Wang X, Liu W, Hu Y, Zou Z, Shen L, Huang C. Home environment, lifestyles behaviors, and rhinitis in childhood. Int J Hyg Environ Health 2015; 219:220-31. [PMID: 26712524 DOI: 10.1016/j.ijheh.2015.11.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 11/05/2015] [Accepted: 11/25/2015] [Indexed: 11/24/2022]
Abstract
The prevalence of children allergic rhinitis has been increasing in China and associated factors still are not clear. In the present paper, we selected 13,335 parent-reported questionnaires of 4-6 years-old children, in a cross-sectional study from April 2011 to April 2012 in Shanghai city, and investigated associations of various factors with parent-reported allergic rhinitis (doctor-diagnosed) and rhinitis symptoms in childhood. After adjusted by age, sex, family history of atopy, and respondent of questionnaire, we find that no siblings, mother in older age during pregnancy, shorter breastfeeding, using antibiotics in the first year, and home dampness-related exposures, had significant associations with increased prevalence of the studied diseases. Location, type, building area, decoration materials and construction period of the residence, also had significant associations with these diseases. Current parental smoking and pet-keeping had no significant associations with the studied diseases. Incense-burning and using mosquito coils had significant associations with reduced risk of allergic rhinitis and with increased risk of rhinitis symptoms. Using air cleaner and cleaning the residence in high frequency had associations with increased risk, but eating fast food and ice cream often had associations with the reduced risk, of the studied diseases. Families with children being diagnosed allergic rhinitis likely change their lifestyle behaviors. In conclusion, childhood rhinitis could be influenced by heredity and many "environmental exposures". Avoidance behaviors and reverse causation in parental smoking, pet-keeping, and dietary habits for childhood rhinitis should be carefully considered.
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Affiliation(s)
- Xueying Wang
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, PR China
| | - Wei Liu
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, PR China
| | - Yu Hu
- Tongji Architectural Design (Group) Company Limited (TJAD), Shanghai, PR China
| | - Zhijun Zou
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, PR China
| | - Li Shen
- R&B Technology (Shanghai) Company Limited, Shanghai, PR China
| | - Chen Huang
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, PR China.
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Huang C, Liu W, Hu Y, Zou Z, Zhao Z, Shen L, Weschler LB, Sundell J. Updated prevalences of asthma, allergy, and airway symptoms, and a systematic review of trends over time for childhood asthma in Shanghai, China. PLoS One 2015; 10:e0121577. [PMID: 25875829 PMCID: PMC4395352 DOI: 10.1371/journal.pone.0121577] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 01/23/2015] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The prevalence of asthma among Shanghai children has increased over time. This increase might be associated with changes in environmental exposures. Investigation of the time-trend of asthma and current prevalences is essential to understanding the causes. OBJECTIVE To estimate the current prevalences of asthma, allergies and other respiratory symptoms among Shanghai preschool children, and to investigate the time-trend of childhood asthma prevalence of from 1990 to 2011. METHODS From April 2011 to April 2012, the CCHH (China, Children, Homes, Health) cross-sectional study was conducted in Shanghai. Questionnaires were distributed to 17,898 parents or guardians of preschool children from 72 kindergartens in 5 districts. Previous similar studies were also summarized by a systematic literature review. RESULTS From a total of 14,884 questionnaires for 3-7 year old children, prevalences of the following diseases and symptoms were calculated: asthma 10.2%, wheeze (ever) 28.1%, pneumonia (ever) 33.5%, otitis media 11.0%, rhinitis (ever) 54.1%, hay fever 12.2%, eczema (ever) 22.7%, and food allergy 15.7%. Urban children had higher prevalences of most symptoms than suburban children. The prevalence of asthma has increased significantly, almost five-fold, from 2.1% in 1990 to 10.2% in the present study. The prevalence of asthma in boys was higher than in girls in the present study and in all reviewed studies. CONCLUSIONS Asthma, allergy and airway symptoms are common among preschool children in Shanghai. The prevalence of childhood asthma in Shanghai has increased rapidly from 1990 to 2011.
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Affiliation(s)
- Chen Huang
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, PR China
| | - Wei Liu
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, PR China
| | - Yu Hu
- Tongji Architectural Design (Group) Co. Ltd. (TJAD), Shanghai, PR China
| | - Zhijun Zou
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, PR China
| | - Zhuohui Zhao
- Department of Environmental Health, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, PR China
| | - Li Shen
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, PR China
| | - Louise B. Weschler
- 161 Richdale Road, Colts Neck, New Jersey, 07722, United States of America
| | - Jan Sundell
- Department of Building Science, School of Architecture, Tsinghua University, Beijing, PR China
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Hu Y, Liu W, Huang C, Zou ZJ, Zhao ZH, Shen L, Sundell J. Home dampness, childhood asthma, hay fever, and airway symptoms in Shanghai, China: associations, dose-response relationships, and lifestyle's influences. INDOOR AIR 2014; 24:450-463. [PMID: 24571077 DOI: 10.1111/ina.12104] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 02/20/2013] [Indexed: 06/03/2023]
Abstract
Numerous studies of associations between dampness and respiratory diseases have been conducted, but their implications remain inconclusive. In this study of 13,335 parent-reported questionnaires (response rate: 85.3%), we analyzed associations between home dampness and asthma and related symptoms in 4- to 6-year-old children in a cross-sectional study of Shanghai. Indicators of home dampness were strongly and significantly associated with dry cough, wheeze, and rhinitis symptoms. In the current residence, children with visible mold spots (VMS) exposure had 32% higher risk of asthma (adjusted OR, 95% CI: 1.32, 1.07-1.64); damp clothing and/or bedding (frequently) was strongly associated with dry cough (1.78, 1.37-2.30); condensation on windows was strongly associated with hay fever (1.60, 1.27-2.01). In the early-life residence, VMS or damp stains (frequently) were strongly associated with dry cough (2.20, 1.55-3.11) and rhinitis ever (1.57, 1.11-2.21). Associations between dampness and diseases among children with or without family history of atopy were similar. The total number of dampness indicators had strong dose-response relationships with investigated health outcomes. Actions, including opening windows of the child's room at night and cleaning the child's room frequently, could potentially mitigate 25% of home VMS, thereby preventing more than 1.5% of attributable risk of the studied symptoms.
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Affiliation(s)
- Y Hu
- Department of Building Environment and Equipment Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
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Zhang Y, Li B, Huang C, Yang X, Qian H, Deng Q, Zhao Z, Li A, Zhao J, Zhang X, Qu F, Hu Y, Yang Q, Wang J, Zhang M, Wang F, Zheng X, Lu C, Liu Z, Sun Y, Mo J, Zhao Y, Liu W, Wang T, Norbäck D, Bornehag CG, Sundell J. Ten cities cross-sectional questionnaire survey of children asthma and other allergies in China. ACTA ACUST UNITED AC 2013. [DOI: 10.1007/s11434-013-5914-z] [Citation(s) in RCA: 173] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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