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Ding Y, Zhu C, Li S, Liu N, Liu Q, Li W, Zhao C, Yuan B. Breastfeeding and risk of food allergy and allergic rhinitis in offspring: a systematic review and meta-analysis of cohort studies. Eur J Pediatr 2024; 183:3433-3443. [PMID: 38771371 PMCID: PMC11263247 DOI: 10.1007/s00431-024-05580-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 04/10/2024] [Accepted: 04/19/2024] [Indexed: 05/22/2024]
Abstract
The association between breastfeeding and the occurrence of allergic rhinitis (AR) and food allergy (FA) in offspring remains inconclusive. This review aims to comprehensively explore the potential relationships between various patterns and durations of breastfeeding and allergic diseases in offspring. We systematically searched PubMed, EMBASE, Cochrane, WOS databases, and Google Scholar for observational studies published up to March 30, 2023, that investigated the link between breastfeeding and allergies in offspring. The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS) and Joanna Briggs Institute (JBI). Pooled odds ratios (OR) and 95% confidence intervals (95% CI) were calculated employing an appropriate model based on the degree of heterogeneity. A total of 68 studies, encompassing 772,142 children, were ultimately included. The findings indicated that breastfeeding for more than 6 months was associated with a reduced risk of AR (OR = 0.88, 95% CI: 0.79 to 0.98) but posed a risk for FA (OR = 1.69, 95% CI: 1.27 to 2.25). Exclusive breastfeeding exhibited a protective effect against AR (OR = 0.94, 95% CI: 0.90 to 0.97), whereas non-breastfeeding was identified as a risk factor for AR (OR = 1.48; 95% CI: 1.03 to 2.12). No significant association was observed between breastfeeding patterns and FA. CONCLUSION Breastfeeding for more than 6 months proves to be an effective preventive measure against AR. However, large prospective high-quality studies are needed to investigate the potential risk of FA in children with prolonged breastfeeding. WHAT IS KNOWN • The impact of breastfeeding on allergic rhinitis and food allergy in offspring is controversial. • Previous meta-analyses fail to prove the effect of breastfeeding on food allergy in offspring of all ages. WHAT IS NEW • Breastfeeding for more than 6 months proves to be an effective preventive measure against AR. However, it potentially elevates the risk of FA in children. Non-breastfeeding is linked to an increased risk of AR in children, but there is no evidence of an association between breastfeeding patterns and FA in children. • The impact of breastfeeding on allergic rhinitis and food allergy in offspring may vary with the time and pattern of breastfeeding.
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Affiliation(s)
- Yali Ding
- Department of Pediatrics, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing Jiangsu, 210004, China
- Nanjing University of Chinese Medicine, Nanjing Jiangsu, 210023, China
- Nanjing Gaochun Traditional Chinese Medicine Hospital, Nanjing Jiangsu, 211300, China
| | - Chengbi Zhu
- Department of Pediatrics, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing Jiangsu, 210004, China
- Nanjing University of Chinese Medicine, Nanjing Jiangsu, 210023, China
| | - Shuo Li
- Department of Pediatrics, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing Jiangsu, 210004, China
- Nanjing University of Chinese Medicine, Nanjing Jiangsu, 210023, China
| | - Naixu Liu
- Department of Pediatrics, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing Jiangsu, 210004, China
- Nanjing University of Chinese Medicine, Nanjing Jiangsu, 210023, China
| | - Qian Liu
- Department of Pediatrics, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing Jiangsu, 210004, China
- Nanjing University of Chinese Medicine, Nanjing Jiangsu, 210023, China
| | - Weifeng Li
- Department of Pediatrics, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing Jiangsu, 210004, China
- Nanjing University of Chinese Medicine, Nanjing Jiangsu, 210023, China
| | - Changjiang Zhao
- Department of Pediatrics, Jiangyin Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangyin Jiangsu, 214400, China.
| | - Bin Yuan
- Department of Pediatrics, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing Jiangsu, 210004, China.
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Dong Y, Lau HX, Suaini NHA, Kee MZL, Ooi DSQ, Shek LPC, Lee BW, Godfrey KM, Tham EH, Ong MEH, Liu N, Wong L, Tan KH, Chan JKY, Yap FKP, Chong YS, Eriksson JG, Feng M, Loo EXL. A machine-learning exploration of the exposome from preconception in early childhood atopic eczema, rhinitis and wheeze development. ENVIRONMENTAL RESEARCH 2024; 250:118523. [PMID: 38382664 DOI: 10.1016/j.envres.2024.118523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/19/2024] [Accepted: 02/18/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Most previous research on the environmental epidemiology of childhood atopic eczema, rhinitis and wheeze is limited in the scope of risk factors studied. Our study adopted a machine learning approach to explore the role of the exposome starting already in the preconception phase. METHODS We performed a combined analysis of two multi-ethnic Asian birth cohorts, the Growing Up in Singapore Towards healthy Outcomes (GUSTO) and the Singapore PREconception Study of long Term maternal and child Outcomes (S-PRESTO) cohorts. Interviewer-administered questionnaires were used to collect information on demography, lifestyle and childhood atopic eczema, rhinitis and wheeze development. Data training was performed using XGBoost, genetic algorithm and logistic regression models, and the top variables with the highest importance were identified. Additive explanation values were identified and inputted into a final multiple logistic regression model. Generalised structural equation modelling with maternal and child blood micronutrients, metabolites and cytokines was performed to explain possible mechanisms. RESULTS The final study population included 1151 mother-child pairs. Our findings suggest that these childhood diseases are likely programmed in utero by the preconception and pregnancy exposomes through inflammatory pathways. We identified preconception alcohol consumption and maternal depressive symptoms during pregnancy as key modifiable maternal environmental exposures that increased eczema and rhinitis risk. Our mechanistic model suggested that higher maternal blood neopterin and child blood dimethylglycine protected against early childhood wheeze. After birth, early infection was a key driver of atopic eczema and rhinitis development. CONCLUSION Preconception and antenatal exposomes can programme atopic eczema, rhinitis and wheeze development in utero. Reducing maternal alcohol consumption during preconception and supporting maternal mental health during pregnancy may prevent atopic eczema and rhinitis by promoting an optimal antenatal environment. Our findings suggest a need to include preconception environmental exposures in future research to counter the earliest precursors of disease development in children.
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Affiliation(s)
- Yizhi Dong
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore.
| | - Hui Xing Lau
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, Singapore, 117609, Singapore.
| | - Noor Hidayatul Aini Suaini
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, Singapore, 117609, Singapore.
| | - Michelle Zhi Ling Kee
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, Singapore, 117609, Singapore.
| | - Delicia Shu Qin Ooi
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore.
| | - Lynette Pei-Chi Shek
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Bee Wah Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Keith M Godfrey
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, United Kingdom; MRC Lifecourse Epidemiology Centre, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.
| | - Elizabeth Huiwen Tham
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, Singapore, 117609, Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore; Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
| | - Marcus Eng Hock Ong
- Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore; Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore, Singapore.
| | - Nan Liu
- Duke-NUS Medical School, National University of Singapore, Singapore; Health Services Research Centre, Singapore Health Services, Singapore, Singapore; Institute of Data Science, National University of Singapore, Singapore.
| | - Limsoon Wong
- School of Computing, National University of Singapore, 13 Computing Drive, Singapore 117417, Singapore.
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital (KKH), Singapore.
| | - Jerry Kok Yen Chan
- Duke-NUS Medical School, National University of Singapore, Singapore; Department of Reproductive Medicine, KK Women's and Children's Hospital (KKH), Singapore.
| | - Fabian Kok Peng Yap
- Duke-NUS Medical School, National University of Singapore, Singapore; Department of Paediatrics, KK Women's and Children's Hospital (KKH), Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, Singapore, 117609, Singapore; Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.
| | - Johan Gunnar Eriksson
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, Singapore, 117609, Singapore; Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore; Folkhälsan Research Center, Helsinki, Finland; Department of General Practice and Primary Health Care, University of Helsinki, Finland.
| | - Mengling Feng
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore.
| | - Evelyn Xiu Ling Loo
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, Singapore, 117609, Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Dean's Office, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Ren J, Wang C, Zhang P, Xu J, Bao Y. Epidemiological characterization and risk factors of rhinitis and rhinoconjunctivitis among preschool children in Shanghai, China. Int J Pediatr Otorhinolaryngol 2024; 179:111906. [PMID: 38492328 DOI: 10.1016/j.ijporl.2024.111906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/14/2023] [Accepted: 02/27/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Previous studies have reported an increasing prevalence of childhood allergic rhinitis in developing countries. There is still a lack of the recent epidemiology of allergic rhinitis among Chinese preschool children. Therefore, this study explored the prevalence of rhinitis symptoms and identified their associations with potential risk factors among children at the age of 3-6 in Shanghai, China. METHODS Validated International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was adopted to collect information about rhinitis symptoms and potential risk factors. Univariate and multivariate logistic regression analyses were used to assess associations between risk factors and allergic rhinitis and rhinoconjunctivitis. RESULTS A total of 6183 questionnaires were included in our study. The prevalence of rhinitis ever, current rhinitis, and physician-diagnosed rhinitis were 32.6%, 29.2%, and 14.3%, respectively, while the prevalence of current rhinoconjunctivitis was 11.3%. The higher prevalence was observed in boys than in girls in terms of rhinitis ever, current rhinitis, current rhinoconjunctivitis and doctor-diagnosed rhinitis. Autumn had the highest prevalence among four seasons. In our multivariate logistic regression analyses, history of allergic diseases and paracetamol use in the last year showed positive associations with the increased risk of both current rhinitis and rhinoconjunctivitis, and antibiotic use was an independent significant risk factor only for current rhinitis. Genetic factors, including maternal and paternal rhinitis, asthma, and eczema, were significantly associated with the prevalence of current rhinitis. Similar associations were seen between these factors and current rhinoconjunctivitis, except for paternal eczema. Among environmental factors, smoking exposure at home, heavy truck traffic in home's street, floor heating system were independent risk factors for both current rhinitis and rhinoconjunctivitis in the adjusted model, while cleaning the house less than once a week was only associated with current rhinitis. CONCLUSION The prevalence of current rhinitis was 29.2% among children aged 3-6 in Shanghai, China. Sex differences and seasonal variations were observed in the prevalence of rhinitis symptoms. The identified risk factors would provide a basis for policy makers and medical experts to take intervention measures to prevent allergic rhinitis and rhinoconjunctivitis.
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Affiliation(s)
- Jie Ren
- Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, China
| | - Chengdong Wang
- Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China
| | - Pingbo Zhang
- Shanghai Tonxin Clinic, Shanghai, 200082, China; Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Jing Xu
- Yangpu District Maternity and Child Healthcare Hospital, Shanghai, 200082, China
| | - Yixiao Bao
- Shanghai Tonxin Clinic, Shanghai, 200082, China.
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Brahim Errahmani M, Aichi M, Menaa M. Discriminant analysis and logistic regression on genetic history and environmental factors in children with asthma. Minerva Pediatr (Torino) 2024; 76:236-244. [PMID: 33845560 DOI: 10.23736/s2724-5276.21.06042-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Asthma is known to be related to genetic and environmental factors, we aimed to identify the predictors discriminating between children with asthma and a control group in order to build typical profiles of these children. METHODS A multidimensional analysis covered children (58 with asthma and 217 as control group), under 17 years of age, involving environmental variables and medical history of these children and their families. RESULTS Chi-square tests highlighted significant links between variables as rhinitis and conjunctivitis (P<0.001). The results showed, in group of asthmatic children, significant high frequencies of allergies, mainly seasonal (P<0.001), rhinitis, family history more present in mothers (P=0.002) and in maternal aunts and uncles (P<0.02). Allergies were mostly present in mothers of asthmatic children (P=0.03). Children whose father, mother or both had asthma were significantly more numerous in asthmatic group (P=0.0007). A multiple correspondence analysis (MCA) identified two typical profiles of children, a first group of asthmatic children with positive modalities of family history, medical and environmental factors, a second, the control group (nA, non-asthmatic children), with essentially negative modalities of the variables. Logistic regression (LR) resulted in a final model which retained four significant predictors, rhinitis (P=0.01), atopic dermatitis (P=0.04), mother antecedents (P=0.03) and paternal uncle antecedents (P=0.008) with a globally appreciable predictive value (82%) of the Hosmer-Lemeshow Test. CONCLUSIONS These results allowed the drafting of a typical profile quantifying through a function of a few predictors, the variation of the probability for a child to develop an asthma.
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Affiliation(s)
- Mohamed Brahim Errahmani
- Department of Chemistry, Faculty of Science, Blida1 University, Blida, Algeria -
- Department of Cellular Biology, Faculty of Biological Sciences, Blida1 University, Blida, Algeria -
| | - Mériem Aichi
- Department of Cellular Biology, Faculty of Biological Sciences, Blida1 University, Blida, Algeria
| | - Mahdia Menaa
- Department of Cellular Biology, Faculty of Biological Sciences, Blida1 University, Blida, Algeria
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Lin Y, Wang W, Zhu Z, Aodeng S, Wang L, Liu Y, Li J, Zha Y, Wang X, Lv W. Adverse Events for Monoclonal Antibodies in Patients with Allergic Rhinitis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. J Clin Med 2023; 12:2848. [PMID: 37109185 PMCID: PMC10144224 DOI: 10.3390/jcm12082848] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/02/2023] [Accepted: 03/06/2023] [Indexed: 04/29/2023] Open
Abstract
(1) Background: Allergic rhinitis (AR) is a common disease in otolaryngology and novel biological therapies are required for clinical needs. To assess the tolerability of monoclonal antibodies, justifying their clinical applications, we presented a comprehensive safety profile of biologics in AR; (2) Methods: A systematic literature search was conducted following PRISMA guidelines for randomized clinical trials comparing monoclonal antibodies and placebo in AR. PubMed, Web of Science, Medline, and Cochrane were searched up until 9 January 2023. Among 3590 records in total, 12 studies with more than 2600 patients were included. Quality was assessed for all studies using Cochrane risk-of-bias tool for randomized trials, and subgrouped meta-analysis was performed; (3) Results: We accomplished an up-to-date literature overview and analysis on adverse events of monoclonal antibodies in AR. Total, common, severe, discontinuation-causing, and serious adverse events failed to reach statistical significance. Country was an essential factor for heterogeneity, and urticaria was the adverse event at highest risk (RR 2.81, 95% CI 0.79-9.95); (4) Conclusions: Monoclonal antibodies are considered well tolerated and relatively safe in patients with AR. The regions of patients and hypersensitive adverse reactions such as urticaria require a special caution in biological treatments in AR.
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Affiliation(s)
- Yuxi Lin
- 4+4 Medical Doctor Program, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100006, China
| | - Weiqing Wang
- Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100006, China
| | - Zhenzhen Zhu
- Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100006, China
| | - Surita Aodeng
- Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100006, China
| | - Lei Wang
- Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100006, China
| | - Yuzhuo Liu
- Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100006, China
| | - Jingjing Li
- Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100006, China
| | - Yang Zha
- Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100006, China
| | - Xiaowei Wang
- Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100006, China
| | - Wei Lv
- Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100006, China
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Lu C, Liu Z, Yang W, Liao H, Liu Q, Li Q, Deng Q. Early life exposure to outdoor air pollution and indoor environmental factors on the development of childhood allergy from early symptoms to diseases. ENVIRONMENTAL RESEARCH 2023; 216:114538. [PMID: 36252839 DOI: 10.1016/j.envres.2022.114538] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/05/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The prevalence of childhood allergies has increased during past decades leading to serious hospitalization and heavy burden worldwide, yet the key factors responsible for the onset of early symptoms and development of diagnosed diseases are unclear. OBJECTIVE To explore the role of early life exposure to ambient air pollution and indoor environmental factors on early allergic symptoms and doctor diagnosed allergic diseases. METHODS A retrospective cohort study of 2598 preschool children was conducted at 36 kindergartens in Changsha, China from September of 2011 to February of 2012. A questionnaire was developed to survey each child's early onset of allergic symptoms (wheeze and rhinitis-like symptoms) and doctor diagnosis of allergic diseases (asthma and rhinitis) as well as home environments. Each mother's and child's exposures to ambient air pollutants (PM10, SO2, and NO2) and temperature were estimated for in utero and postnatal periods. The associations of early symptoms and diagnosed diseases with outdoor air pollution and indoor environmental variables were examined by logistic regression models. RESULTS Childhood early allergic symptoms (33.9%) including wheeze (14.7%) and rhinitis-like symptoms (25.4%) before 2 years old were not associated with outdoor air pollution exposure but was significantly associated with maternal exposure of window condensation at home in pregnancy with ORs (95% CI) of 1.33 (1.11-1.59), 1.30 (1.01-1.67) and 1.27 (1.04-1.55) respectively, and was associated with new furniture during first year after birth with OR (95% CI) of 1.43 (1.02-2.02) for early wheeze. Childhood diagnosed allergic diseases (28.4%) containing asthma (6.7%) and allergic rhinitis (AR) (7.2%) were significantly associated with both outdoor air pollutants (mainly for SO2 and NO2) during first 3 years and indoor new furniture, redecoration, and window condensation. We found that sex, age, parental atopy, maternal productive age, environmental tobacco smoke (ETS), antibiotics use, economic stress, early and late introduction of complementary foods, and outdoor air pollution modified the effects of home environmental exposure in early life on early allergic symptoms and diagnosed allergic diseases. CONCLUSION Our study indicates that early life exposure to indoor environmental factors plays a key role in early onset of allergic symptoms in children, and further exposure to ambient air pollution and indoor environmental factors contribute to the later development of asthma and allergic rhinitis.
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Affiliation(s)
- Chan Lu
- XiangYa School of Public Health, Central South University, Changsha, 410078, Hunan, China.
| | - Zijing Liu
- XiangYa School of Public Health, Central South University, Changsha, 410078, Hunan, China.
| | - Wenhui Yang
- XiangYa School of Public Health, Central South University, Changsha, 410078, Hunan, China.
| | - Hongsen Liao
- XiangYa School of Public Health, Central South University, Changsha, 410078, Hunan, China.
| | - Qin Liu
- XiangYa School of Public Health, Central South University, Changsha, 410078, Hunan, China.
| | - Qin Li
- XiangYa School of Public Health, Central South University, Changsha, 410078, Hunan, China.
| | - Qihong Deng
- School of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China.
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Lu C, Liu Z, Liao H, Yang W, Li Q, Liu Q. Effects of early life exposure to home environmental factors on childhood allergic rhinitis: Modifications by outdoor air pollution and temperature. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 244:114076. [PMID: 36113271 DOI: 10.1016/j.ecoenv.2022.114076] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/08/2022] [Accepted: 09/09/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND There is growing evidence that allergic rhinitis (AR) is associated with indoor environmental factors, but their role in childhood AR during early life remains unclear. OBJECTIVE To investigate the association of preconceptional, prenatal, early postnatal, and current exposure to home environmental factors with childhood AR, and to further explore whether this association can be interacted by outdoor air pollution and temperature. METHODS A retrospective cohort study of 8689 preschool children was conducted during 2019-2020 in Changsha, China. A standard questionnaire was used to collect data on each family's health outcomes and home environments. We considered home environmental exposures during one year before conception, pregnancy, first year of life, and past year. Associations of indoor air pollution and allergens with AR were assessed by multiple logistic regression models. RESULTS Pre-birth exposure to indoor air pollution emitted by new furniture or redecoration and dampness related allergen derived from mold/damp stains and mold/damp clothes or bedding during 1 year before conception and pregnancy was significantly associated with increased AR, with adjusted ORs (95% CI) ranging from 1.35 (1.05-1.75) to 1.87 (1.55-2.27). Childhood AR was also significantly related with post-birth exposure to dampness related indoor allergen including mold/damp stains and mold/damp clothes or bedding in first year and past year and pollen allergen including total and nonflowing plants in past year, with a range of ORs (95% CI) from 1.20 (1.01-1.42) to 1.79 (1.42-2.27). We identified that pre-birth, particularly in utero exposure to both indoor air pollution from renovation and dampness related allergens, played a key role in AR development compared to post-birth exposures, and accumulative effect was observed with the highest risk of AR. High exposure to traffic-related air pollution (TRAP) including outdoor PM2.5, NO2, CO, and O3, as well as living near traffic road not only significantly increased adverse effect of home environmental factors but also decreased protective effect of household dogs on childhood AR. Early life exposure to low temperature in pregnancy and high temperature in first year significantly increased AR risk of home environmental exposure. Sensitivity analysis indicated that some sub-groups were more susceptible to AR risk of home environmental exposure. CONCLUSION Our study suggests that pre-birth exposure to home environmental factors played an important role in AR development and this effect can be interacted by TRAP and temperature, which supports a hypothesis of "(pre)fetal origin of childhood AR".
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Affiliation(s)
- Chan Lu
- XiangYa School of Public Health, Central South University, Changsha, China.
| | - Zijing Liu
- XiangYa School of Public Health, Central South University, Changsha, China.
| | - Hongsen Liao
- XiangYa School of Public Health, Central South University, Changsha, China.
| | - Wenhui Yang
- XiangYa School of Public Health, Central South University, Changsha, China.
| | - Qin Li
- XiangYa School of Public Health, Central South University, Changsha, China.
| | - Qin Liu
- XiangYa School of Public Health, Central South University, Changsha, China.
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Celebi Sozener Z, Ozdel Ozturk B, Cerci P, Turk M, Gorgulu Akin B, Akdis M, Altiner S, Ozbey U, Ogulur I, Mitamura Y, Yilmaz I, Nadeau K, Ozdemir C, Mungan D, Akdis CA. Epithelial barrier hypothesis: Effect of the external exposome on the microbiome and epithelial barriers in allergic disease. Allergy 2022; 77:1418-1449. [PMID: 35108405 PMCID: PMC9306534 DOI: 10.1111/all.15240] [Citation(s) in RCA: 139] [Impact Index Per Article: 69.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 01/25/2022] [Accepted: 01/29/2022] [Indexed: 12/11/2022]
Abstract
Environmental exposure plays a major role in the development of allergic diseases. The exposome can be classified into internal (e.g., aging, hormones, and metabolic processes), specific external (e.g., chemical pollutants or lifestyle factors), and general external (e.g., broader socioeconomic and psychological contexts) domains, all of which are interrelated. All the factors we are exposed to, from the moment of conception to death, are part of the external exposome. Several hundreds of thousands of new chemicals have been introduced in modern life without our having a full understanding of their toxic health effects and ways to mitigate these effects. Climate change, air pollution, microplastics, tobacco smoke, changes and loss of biodiversity, alterations in dietary habits, and the microbiome due to modernization, urbanization, and globalization constitute our surrounding environment and external exposome. Some of these factors disrupt the epithelial barriers of the skin and mucosal surfaces, and these disruptions have been linked in the last few decades to the increasing prevalence and severity of allergic and inflammatory diseases such as atopic dermatitis, food allergy, allergic rhinitis, chronic rhinosinusitis, eosinophilic esophagitis, and asthma. The epithelial barrier hypothesis provides a mechanistic explanation of how these factors can explain the rapid increase in allergic and autoimmune diseases. In this review, we discuss factors affecting the planet's health in the context of the 'epithelial barrier hypothesis,' including climate change, pollution, changes and loss of biodiversity, and emphasize the changes in the external exposome in the last few decades and their effects on allergic diseases. In addition, the roles of increased dietary fatty acid consumption and environmental substances (detergents, airborne pollen, ozone, microplastics, nanoparticles, and tobacco) affecting epithelial barriers are discussed. Considering the emerging data from recent studies, we suggest stringent governmental regulations, global policy adjustments, patient education, and the establishment of individualized control measures to mitigate environmental threats and decrease allergic disease.
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Affiliation(s)
| | - Betul Ozdel Ozturk
- School of MedicineDepartment of Chest DiseasesDivision of Immunology and Allergic DiseasesAnkara UniversityAnkaraTurkey
| | - Pamir Cerci
- Clinic of Immunology and Allergic DiseasesEskisehir City HospitalEskisehirTurkey
| | - Murat Turk
- Clinic of Immunology and Allergic DiseasesKayseri City HospitalKayseriTurkey
| | - Begum Gorgulu Akin
- Clinic of Immunology and Allergic DiseasesAnkara City HospitalAnkaraTurkey
| | - Mubeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF)University of ZurichDavosSwitzerland
| | - Seda Altiner
- Clinic of Internal Medicine Division of Immunology and Allergic DiseasesKahramanmaras Necip Fazil City HospitalKahramanmarasTurkey
| | - Umus Ozbey
- Department of Nutrition and DietAnkara UniversityAnkaraTurkey
| | - Ismail Ogulur
- Swiss Institute of Allergy and Asthma Research (SIAF)University of ZurichDavosSwitzerland
| | - Yasutaka Mitamura
- Swiss Institute of Allergy and Asthma Research (SIAF)University of ZurichDavosSwitzerland
| | - Insu Yilmaz
- Department of Chest DiseasesDivision of Immunology and Allergic DiseasesErciyes UniversityKayseriTurkey
| | - Kari Nadeau
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University School of MedicineDivision of Pulmonary and Critical Care MedicineDepartment of MedicineStanford UniversityStanfordCaliforniaUSA
| | - Cevdet Ozdemir
- Institute of Child HealthDepartment of Pediatric Basic SciencesIstanbul UniversityIstanbulTurkey
- Istanbul Faculty of MedicineDepartment of PediatricsDivision of Pediatric Allergy and ImmunologyIstanbul UniversityIstanbulTurkey
| | - Dilsad Mungan
- School of MedicineDepartment of Chest DiseasesDivision of Immunology and Allergic DiseasesAnkara UniversityAnkaraTurkey
| | - Cezmi A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF)University of ZurichDavosSwitzerland
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE)DavosSwitzerland
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9
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Duong QA, Pittet LF, Curtis N, Zimmermann P. Antibiotic exposure and adverse long-term health outcomes in children: a systematic review and meta-analysis. J Infect 2022; 85:213-300. [PMID: 35021114 DOI: 10.1016/j.jinf.2022.01.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 01/04/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Antibiotics are among the most commonly used drugs in children. In addition to inducing antibiotic resistance, antibiotic exposure has been associated with long-term adverse health outcomes. METHODS A systematic search using PRISMA Guidelines to identify original studies reporting associations between antibiotic exposure and long-term adverse health outcomes in children. Overall pooled estimates of the odds ratios (ORs) were obtained using fixed or random-effects models. RESULTS We identified 160 observational studies investigating 21 outcomes in 22,103,129 children. Antibiotic exposure was associated with an increased risk of atopic dermatitis (OR 1.40, 95% confidence interval (CI) 1.30-1.52, p<0.01), allergic symptoms (OR 1.93, 95%CI 1.66-2.26, p<0.01), food allergies (OR 1.35, 95%CI 1.20-1.52, p<0.01), allergic rhinoconjunctivitis (OR 1.66, 95%CI 1.51-1.83, p<0.01), wheezing (OR 1.81, 95%CI 1.65-1.97, p<0.01), asthma (OR 1.96, 95%CI 1.76-2.17, p<0.01), increased weight gain or overweight (OR 1.18, 95%CI 1.11-1.26, p<0.01), obesity (OR 1.21, 95%CI 1.05-1.40, p<0.01), juvenile idiopathic arthritis (OR 1.74, 95%CI 1.21-2.52, p<0.01), psoriasis (OR 1.75, 95%CI 1.44-2.11, p<0.01), autism spectrum disorders (OR 1.19, 95%CI 1.04-1.36, p=0.01) and neurodevelopment disorders (OR 1.29, 95%CI 1.09-1.53, p<0.01). Dose-response effects and stronger effects with broad-spectrum antibiotic were often reported. Antibiotic exposure was not associated with an altered risk of allergic sensitisation, infantile colic, abdominal pain, inflammatory bowel disease, celiac disease, type 1 diabetes, fluorosis, and attention deficit hyperactivity disorder. CONCLUSION Although a causal association cannot be determined from these studies, the results support the meticulous application of sound antibiotic stewardship to avoid potential adverse long-term health outcomes.
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Affiliation(s)
- Quynh Anh Duong
- Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Laure F Pittet
- Department of Paediatrics, The University of Melbourne, Parkville, Australia; Infectious Diseases Research Group, Murdoch Children's Research Institute, Parkville, Australia; Infectious Diseases Unit, The Royal Children's Hospital Melbourne, Parkville, Australia; Unit of Pediatric Infectious Diseases, Department of Pediatrics, Gynecology & Obstetrics, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland
| | - Nigel Curtis
- Department of Paediatrics, The University of Melbourne, Parkville, Australia; Infectious Diseases Research Group, Murdoch Children's Research Institute, Parkville, Australia; Infectious Diseases Unit, The Royal Children's Hospital Melbourne, Parkville, Australia
| | - Petra Zimmermann
- Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland; Infectious Diseases Research Group, Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, Fribourg Hospital HFR, Fribourg, Switzerland.
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10
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Risk factor analysis of allergic rhinitis in 6-8 year-old children in Taipei. PLoS One 2021; 16:e0249572. [PMID: 33798255 PMCID: PMC8018651 DOI: 10.1371/journal.pone.0249572] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 03/20/2021] [Indexed: 01/12/2023] Open
Abstract
The incidence of allergic rhinitis (AR) has increased rapidly in Taiwan during the past 30 years; however, potential risk factors of AR have yet to be examined. The purpose of this study is to explore the prevalence, personal and environmental risk factors of rhinitis. A cross-sectional survey was conducted in 26418 first graders (6–8 years old) in Taipei with a response rate of 94.6% (24999/26418). Modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaires were completed by their parents or main caregivers. Logistic regression was used to examine possible personal and environmental (in early life and current) factors related to rhinitis. The prevalence of rhinitis in the past 12 months was 42.8% in 6–8 years old children. Multivariate logistic regression analysis for both males and females revealed that male gender, antibiotic use in first year of life, bronchiolitis before the age of two years, diagnosed asthma, and diagnosed eczema, having a cat the first year of life were associated with an increased risk of rhinitis. Having older siblings, on the other hand, may reduce the risk of rhinitis. Based on the present study, we may recommend less use of antibiotics the first year of life and not having a cat in the home in the child’s first year of life as preventive measures to reduce the risk of rhinitis. From the subgroup analysis, we can take preventive measures for the different risk factors of rhinitis and the severity of rhinitis in each subgroup.
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11
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Du C, Li B, Yu W, Cai J, Wang L, Li X, Yao Y, Li B. Evaluating the effect of building construction periods on household dampness/mold and childhood diseases corresponding to different energy efficiency design requirements. INDOOR AIR 2021; 31:541-556. [PMID: 32731305 DOI: 10.1111/ina.12723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/31/2020] [Accepted: 07/19/2020] [Indexed: 06/11/2023]
Abstract
Despite concerns about building dampness and children' health, few studies have examined the effects of building energy efficiency standards. This study explored the connections between self-reported household dampness and children' adverse health outcomes across buildings corresponding to construction periods (pre-2001, 2001-2010, post-2010). Significant differences of dampness-related indicators were found between buildings; the prevalence was remarkable in pre-2001 buildings. The prevalence of lifetime-ever doctor-diagnosed diseases for children was significantly associated with building dampness (adjust odd ratios > 1), but was not affected by construction periods. The hygrothermal performance for a typical residence was simulated, varying in U-values of envelopes and air change rates. The simulated performance improvement increased indoor temperatures in 2001-2010 and post-2010 buildings. The frequency with higher indoor relative humidity was higher in pre-2001 buildings, leading to the highest values for maximum mold index (Mmax ) on wall surface, especially in winter. Compared to buildings in 2001-2010, increased insulation and lower air change rate led to a relatively higher relative humidity in post-2010 buildings, adversely increasing the Mmax values. The findings addressed the positive and negative role of building standard development, which help suggesting appropriate environmental and design solutions to trade-off energy savings and dampness/mold risk in residences.
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Affiliation(s)
- Chenqiu Du
- Joint International Research Laboratory of Green Buildings and Built Environments, Ministry of Education, Chongqing University, Chongqing, China
- National Centre for International Research of Low-carbon and Green Buildings, Ministry of Science and Technology, Chongqing University, Chongqing, China
| | - Baizhan Li
- Joint International Research Laboratory of Green Buildings and Built Environments, Ministry of Education, Chongqing University, Chongqing, China
- National Centre for International Research of Low-carbon and Green Buildings, Ministry of Science and Technology, Chongqing University, Chongqing, China
| | - Wei Yu
- Joint International Research Laboratory of Green Buildings and Built Environments, Ministry of Education, Chongqing University, Chongqing, China
- National Centre for International Research of Low-carbon and Green Buildings, Ministry of Science and Technology, Chongqing University, Chongqing, China
| | - Jiao Cai
- Joint International Research Laboratory of Green Buildings and Built Environments, Ministry of Education, Chongqing University, Chongqing, China
- National Centre for International Research of Low-carbon and Green Buildings, Ministry of Science and Technology, Chongqing University, Chongqing, China
| | - Lexiang Wang
- Joint International Research Laboratory of Green Buildings and Built Environments, Ministry of Education, Chongqing University, Chongqing, China
- National Centre for International Research of Low-carbon and Green Buildings, Ministry of Science and Technology, Chongqing University, Chongqing, China
| | - Xinyi Li
- Department of Civil and Structural Engineering, Sheffield University, Sheffield, UK
| | - Yinghui Yao
- Joint International Research Laboratory of Green Buildings and Built Environments, Ministry of Education, Chongqing University, Chongqing, China
- National Centre for International Research of Low-carbon and Green Buildings, Ministry of Science and Technology, Chongqing University, Chongqing, China
| | - Bicheng Li
- Joint International Research Laboratory of Green Buildings and Built Environments, Ministry of Education, Chongqing University, Chongqing, China
- National Centre for International Research of Low-carbon and Green Buildings, Ministry of Science and Technology, Chongqing University, Chongqing, China
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12
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Liu W, Cai J, Huang C, Chang J. Residence proximity to traffic-related facilities is associated with childhood asthma and rhinitis in Shandong, China. ENVIRONMENT INTERNATIONAL 2020; 143:105930. [PMID: 32634669 DOI: 10.1016/j.envint.2020.105930] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 05/28/2020] [Accepted: 06/24/2020] [Indexed: 06/11/2023]
Abstract
Associations of asthma and rhinitis with residential traffic proximity were investigated in several studies, but conclusions were inconsistent. From January to April in 2015, a cross-sectional study was conducted in two cities of Shandong, China. Parents-reported questionnaires were collected from 69 kindergartens for 3-6-year-olds preschoolers. Here we investigated associations of four traffic-related facilities (main traffic road, automobile 4S shop, filling station, and ground car park) close to residence with childhood asthma and rhinitis under considering individual and residential characteristics. In the two-level (kindergarten-child) mixed-effect logistic regression analyses among 5640 children who did not change residences since birth, filling station close to residence within 100 m (reference: >200 m) was significantly associated with lifetime-ever asthma (adjusted odds ratio, 95% confidence interval: 2.63, 1.28-5.40), wheeze (2.06, 1.35-3.15), rhinitis (1.69, 1.08-2.64) and current (past 12 months prior to the survey) wheeze (2.11, 1.34-3.34) and rhinitis (1.65, 1.05-2.59). Numbers of the facilities close to residence had dose-response relationships with odds of asthma, wheeze and rhinitis symptoms. These dose-response relationships were generally stronger in children whose bedrooms were in the 1st-3rd floors, and in children with low ventilation in bedroom and kitchen, and in children from families who did not using natural gas for cooking. The similar associations were found in the sensitive analyses among all surveyed 9597 children. Our results indicate that residence close to the traffic-related facilities likely is a risk factor for the occurrence of asthma and rhinitis among preschool children. The studied associations could be modified by household ventilation and air pollutants.
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Affiliation(s)
- Wei Liu
- Institute for Health and Environment, 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
| | - Chen Huang
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Jing Chang
- Department of Thermal Energy and Power Engineering, Shandong Jiaotong University, Jinan, China.
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13
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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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14
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Liu W, Huang C, Cai J, Fu Q, Zou Z, Sun C, Zhang J. Prenatal and postnatal exposures to ambient air pollutants associated with allergies and airway diseases in childhood: A retrospective observational study. ENVIRONMENT INTERNATIONAL 2020; 142:105853. [PMID: 32585502 DOI: 10.1016/j.envint.2020.105853] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 05/24/2020] [Accepted: 06/01/2020] [Indexed: 06/11/2023]
Abstract
It's inconsistent about associations of early exposures to outdoor air pollutants with allergies and airway diseases in childhood. Here, we investigated associations of prenatal and postnatal exposures to outdoor nitrogen dioxide (NO2), sulphur dioxide (SO2), and PM10 (particulate matter with an aerodynamic diameter ≤ 10 μm) with asthma, wheeze, hay fever, rhinitis, pneumonia, and eczema in childhood. We surveyed 3,177 preschoolers who never change residences since birth in Shanghai, China. Parents reported information regarding children's health status. Daily-averaged concentrations of these pollutants in the children's gestation and in the first year of lifetime for district where children lived were collected by Shanghai Environmental Monitoring Center. After adjusting for covariates, exposures to higher level of NO2 during different trimesters of gestation and of the first year of lifetime had significant associations with the increased odds of asthma, hay fever, rhinitis, pneumonia, and eczema in childhood. Associations of NO2 exposures in the early trimesters of gestation and of the first year of lifetime with pneumonia were stronger than in the later trimesters, whereas associations of NO2 exposures in the early trimesters with hay fever and eczema were weaker than in the later trimesters. Our results indicated that prenatal and postnatal exposures to outdoor NO2 could be risk factors for allergies and airway diseases in childhood. Both dose and duration were related with the influence degree of early NO2 exposure on childhood allergies and airway diseases.
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Affiliation(s)
- Wei Liu
- Institute for Health and Environment, Chongqing University of Science and Technology, Chongqing, China
| | - Chen Huang
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China.
| | - Jiao Cai
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China
| | - Qingyan Fu
- Shanghai Environmental Monitoring Center, Shanghai, China
| | - Zhijun Zou
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Chanjuan Sun
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Jialing Zhang
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
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15
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Lu C, Norbäck D, Li Y, Deng Q. Early-life exposure to air pollution and childhood allergic diseases: an update on the link and its implications. Expert Rev Clin Immunol 2020; 16:813-827. [PMID: 32741235 DOI: 10.1080/1744666x.2020.1804868] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Although mounting evidence has linked environmental factors with childhood allergies, some specific key issues still remain unclear: what is the main environmental factor? what is the critical timing window? And whether these contribute to the development of disease? AREAS COVERED This selective review summarizes recent epidemiological studies on the association between early-life exposure to indoor/outdoor air pollution and childhood allergic diseases. A literature search was conducted in the PubMed and Web of Science for peer-reviewed articles published until April 2020. Exposure to the traffic-related air pollutant, NO2, exposure during pregnancy and early postnatal periods is found to be associated with childhood allergies, and exposure during different trimesters causes different allergic diseases. However, exposure to classical air pollutants (PM10 and SO2) also contributes to childhood allergy in developing countries. In addition, early-life exposure to indoor renovation and mold/dampness significantly increases the risk of allergy in children. A synergistic effect between indoor and outdoor air pollution is found in the development of allergic diseases. EXPERT OPINION Early-life exposure to outdoor air pollution and indoor environmental factors plays an important role in the development of childhood allergic diseases, and the synergy between indoor and outdoor exposures increases allergy risk. The available findings support the hypothesis of the 'fetal origins of childhood allergy,' with new implications for the effective control and early prevention of childhood allergies.
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Affiliation(s)
- Chan Lu
- XiangYa School of Public Health, Central South University , Changsha, China.,Hunan Engineering Research Center of Early Life Development and Disease Prevention, XiangYa Hospital, Central South University , Changsha, China
| | - Dan Norbäck
- Department of Medical Sciences, Uppsala University , Uppsala, Sweden
| | - Yuguo Li
- Department of Mechanical Engineering, The University of Hong Kong , Hong Kong, China
| | - Qihong Deng
- XiangYa School of Public Health, Central South University , Changsha, China.,Hunan Engineering Research Center of Early Life Development and Disease Prevention, XiangYa Hospital, Central South University , Changsha, China.,School of Energy Science and Engineering, Central South University , Changsha, China
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16
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Liu W, Cai J, Fu Q, Zou Z, Sun C, Zhang J, Huang C. Associations of ambient air pollutants with airway and allergic symptoms in 13,335 preschoolers in Shanghai, China. CHEMOSPHERE 2020; 252:126600. [PMID: 32234631 DOI: 10.1016/j.chemosphere.2020.126600] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 03/14/2020] [Accepted: 03/22/2020] [Indexed: 06/11/2023]
Abstract
Findings are inconsistent in studies for impacts of outdoor air pollutants on airway health in childhood. In this paper, we collected data regarding airway and allergic symptoms in the past year before a survey in 13,335 preschoolers from a cross-sectional study. Daily averaged concentrations of ambient sulphur dioxide (SO2), nitrogen dioxide (NO2), and particulate matter with an aerodynamic diameter ≤10 μm (PM10) in the past year before the survey were collected in the kindergarten-located district. We investigated associations of 12-month average concentrations of these pollutants with childhood airway and allergic symptoms. In the two-level (district-child) logistic regression analyses, exposure to higher level of NO2 and of PM10 increased odds of wheeze symptoms (adjusted OR, 95%CI: 1.03, 1.01-1.05 for per 3.0 μg/m3 increase in NO2; 1.22, 1.09-1.39 for per 7.6 μg/m3 increase in PM10), wheeze with a cold (1.03, 1.01-1.06; 1.22, 1.08-1.39), dry cough during night (1.05, 1.03-1.08; 1.23, 1.09-1.40), rhinitis symptoms (1.11, 1.08-1.13; 1.32, 1.07-1.63), rhinitis on pet (1.11, 1.05-1.18; 1.37, 0.95-1.98) and pollen (1.12, 1.03-1.21; 1.23, 0.84-1.82) exposure, eczema symptoms (1.09, 1.05-1.12; 1.22, 0.98-1.52), and lack of sleep due to eczema (1.12, 1.07-1.18; 1.58, 1.25-1.98). Exposures to NO2 and PM10 were also significantly and positively associated with the accumulative score of airway symptoms. Similar positive associations were found of NO2 and of PM10 with the individual symptoms and symptom scores among preschoolers from different kindergarten-located district. These results indicate that ambient NO2 and PM10 likely are risk factors for airway and allergic symptoms in childhood in Shanghai, China.
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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
| | - Qingyan Fu
- Shanghai Environmental Monitoring Center, Shanghai, China
| | - Zhijun Zou
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Chanjuan Sun
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Jialing Zhang
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Chen Huang
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China.
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17
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The relationship of prenatal antibiotic exposure and infant antibiotic administration with childhood allergies: a systematic review. BMC Pediatr 2020; 20:312. [PMID: 32593308 PMCID: PMC7320596 DOI: 10.1186/s12887-020-02042-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 03/23/2020] [Indexed: 12/14/2022] Open
Abstract
Background Early antibiotic exposure may be contributing to the onset of childhood allergies. The main objective of this study was to conduct a systematic review on the relationship between early life antibiotic exposure and childhood asthma, eczema and hay fever. Methods Pubmed and Embase were searched for studies published between 01-01-2008 and 01-08-2018, examining the effects of (1) prenatal antibiotic exposure and (2) infant antibiotic administration (during the first 2 years of life) on childhood asthma, eczema and hay fever from 0 to 18 years of age. These publications were assessed using the Newcastle Ottawa Scale (NOS) and analysed narratively. Results (1) Prenatal antibiotics: Asthma (12 studies): The majority of studies (9/12) reported significant relationships (range OR 1.13 (1.02–1.24) to OR 3.19 (1.52–6.67)). Three studies reported inconsistent findings. Eczema (3 studies): An overall significant effect was reported in one study and in two other studies only when prenatal antibiotic exposure was prolonged. (2) Infant antibiotics: Asthma (27 studies): 17/27 studies reported overall significant findings (range HR 1.12 (1.08–1.16) to OR 3.21 (1.89–5.45)). Dose-response effects and stronger effects with broad-spectrum antibiotic were often reported. 10/27 studies reported inconsistent findings depending on certain conditions and types of analyses. Of 19 studies addressing reverse causation or confounding by indication at least somewhat, 11 reported overall significant effects. Eczema (15 studies): 6/15 studies reported overall significant effects; 9 studies had either insignificant or inconsistent findings. Hay fever (9 studies): 6/9 reported significant effects, and the other three insignificant or inconsistent findings. General: Multiple and broad-spectrum antibiotics were more strongly associated with allergies. The majority of studies scored a 6 or 7 out of 9 based on the NOS, indicating they generally had a medium risk of bias. Although most studies showed significant findings between early antibiotic exposure and asthma, the actual effects are still unclear as intrapartum antibiotic administration, familial factors and confounding by maternal and child infections were often not addressed. Conclusions This review points to a moderate amount of evidence for a relationship between early life antibiotics (especially prenatal) and childhood asthma, some evidence for a relationship with hay fever and less convincing evidence for a relationship with eczema. More studies are still needed addressing intra-partum antibiotics, familial factors, and possible confounding by maternal and childhood infections. Children exposed to multiple, broad-spectrum antibiotics early in life appear to have a greater risk of allergies, especially asthma; these effects should be investigated further.
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Lu HY, Chiu CW, Kao PH, Tsai ZT, Gau CC, Lee WF, Wu CY, Lan YT, Hung CC, Chang FY, Huang YW, Huang HY, Chang-Chien J, Tsai HJ, Yao TC. Association between maternal age at delivery and allergic rhinitis in schoolchildren: A population-based study. World Allergy Organ J 2020; 13:100127. [PMID: 32612736 PMCID: PMC7322179 DOI: 10.1016/j.waojou.2020.100127] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 04/23/2020] [Accepted: 04/28/2020] [Indexed: 12/01/2022] Open
Abstract
Background Some studies have shown associations of maternal age at delivery with asthma and food allergy in offspring. However, the relationship between maternal age at delivery and allergic rhinitis is largely unclear. This study aimed to investigate the association between maternal age at delivery and allergic rhinitis in a population sample of Asian children, and to explore potential effect modifiers. Methods A total of 1344 singleton-birth children (763 boys, 56.8%; mean age, 6.4 years) participating in the Longitudinal Investigation of Global Health in Taiwanese Schoolchildren (LIGHTS) cohort were evaluated by a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire and interviewed by pediatricians. Allergic sensitization was determined by using Phadiatop Infant. Multiple logistic regression models with covariates adjustment were performed to investigate the association of maternal age at delivery with allergic rhinitis and allergic sensitization in offspring. Results Among 1344 study children, 793 (59%) had physician-diagnosed allergic rhinitis. Advanced maternal age at delivery (≥40 years) was significantly associated with increased odds of allergic rhinitis (adjusted odds ratio [AOR] = 4.58, 95% confidence interval [CI]: 1.90–11.03) and allergic sensitization (AOR = 2.86, 95% CI: 1.13–7.22) in offspring. A sex-stratified analysis revealed that the association of advanced maternal age with allergic rhinitis was statistically significant only in female offspring (AOR = 7.02, 95% CI: 1.89–26.14). Stratified analyses by birth order or environmental tobacco smoke exposure during pregnancy did not reveal any significant differences. Conclusion Advanced maternal age at delivery was associated with increased risk of allergic rhinitis in Asian children, probably more pronounced among girls.
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Key Words
- ANOVA, analysis of variance
- AOR, adjusted odds ratio
- ARIA, allergic rhinitis and its impact on asthma
- Allergic rhinitis
- Allergic sensitization
- CI, confidence interval
- Children
- EMR, electronic medical records
- ETS, environmental tobacco smoke
- ISAAC, International Study of Asthma and Allergies in Childhood
- IgE, immunoglobulin E
- LIGHTS, Longitudinal Investigation of Global Health in Taiwanese Schoolchildren
- Maternal age at delivery
- NTD, New Taiwan Dollar
- SD, standard deviation
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Affiliation(s)
- Hung-Yi Lu
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chi-Wei Chiu
- School of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Po-Hsiang Kao
- School of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Zhao-Ting Tsai
- School of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chun-Chun Gau
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Division of Pediatric General Medicine, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Wan-Fang Lee
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chao-Yi Wu
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yu-Tung Lan
- School of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chung-Chieh Hung
- School of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Fang-Yu Chang
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yu-Wen Huang
- School of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Hsin-Yi Huang
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ju Chang-Chien
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Hui-Ju Tsai
- Institutes of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Tsung-Chieh Yao
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,School of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan
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19
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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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20
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Jones PJ, Koolhof IS, Wheeler AJ, Williamson GJ, Lucani C, Campbell SL, Bowman DMJS, Johnston FH. Can smartphone data identify the local environmental drivers of respiratory disease? ENVIRONMENTAL RESEARCH 2020; 182:109118. [PMID: 32069747 DOI: 10.1016/j.envres.2020.109118] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 12/09/2019] [Accepted: 01/03/2020] [Indexed: 06/10/2023]
Abstract
Asthma and allergic rhinitis (or hay fever) are ubiquitous, chronic health conditions that seasonally affect a sizeable proportion of the population. Both are commonly triggered or exacerbated by environmental conditions including aeroallergens, air quality and weather. Smartphone technology offers new opportunities to identify environmental drivers by allowing large-scale, real-time collection of day-to-day symptoms. As yet, however, few studies have explored the potential of this technology to provide useful epidemiological data on environment-symptom relationships. Here, we use data from the smartphone app 'AirRater' to examine relationships between asthma and allergic rhinitis symptoms and weather, air quality and pollen loads in Hobart, Tasmania, Australia. We draw on symptom data logged by app users over a three-year period and use time-series analysis to assess the relationship between symptoms and environmental co-variates. Symptoms are associated with particulate matter (IRR 1.06, 95% CI: 1.04-1.08), maximum temperature (IRR 1.28, 95% CI: 1.13-1.44) and pollen taxa including Betula (IRR 1.04, 95% CI: 1.02-1.07), Cupressaceae (IRR 1.02, 95% CI: 1.01-1.04), Myrtaceae (IRR 1.06, 95% CI: 1.02-1.10) and Poaceae (IRR 1.05, 95% CI: 1.01-1.09). The importance of these pollen taxa varies seasonally and more taxa are associated with allergic rhinitis (eye/nose) than asthma (lung) symptoms. Our results are congruent with established epidemiological evidence, while providing important local insights including the association between symptoms and Myrtaceae pollen. We conclude that smartphone-sourced data can be a useful tool in environmental epidemiology.
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Affiliation(s)
- Penelope J Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia.
| | - Iain S Koolhof
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia; School of Natural Sciences, University of Tasmania, Hobart, TAS, 7001, Australia.
| | - Amanda J Wheeler
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia; Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, 3000, Australia.
| | - Grant J Williamson
- School of Natural Sciences, University of Tasmania, Hobart, TAS, 7001, Australia.
| | - Christopher Lucani
- School of Natural Sciences, University of Tasmania, Hobart, TAS, 7001, Australia.
| | - Sharon L Campbell
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia; Public Health Services, Department of Health, Hobart, TAS, 7000, Australia.
| | - David M J S Bowman
- School of Natural Sciences, University of Tasmania, Hobart, TAS, 7001, Australia.
| | - Fay H Johnston
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia; Public Health Services, Department of Health, Hobart, TAS, 7000, Australia.
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21
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Huang S, Garshick E, Weschler LB, Hong C, Li J, Li L, Qu F, Gao D, Zhou Y, Sundell J, Zhang Y, Koutrakis P. Home environmental and lifestyle factors associated with asthma, rhinitis and wheeze in children in Beijing, China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 256:113426. [PMID: 31672368 PMCID: PMC7050389 DOI: 10.1016/j.envpol.2019.113426] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 10/15/2019] [Accepted: 10/15/2019] [Indexed: 05/04/2023]
Abstract
BACKGROUND The prevalence of asthma and allergic diseases has increased rapidly in urban China since 2000. There has been limited study of associations between home environmental and lifestyle factors with asthma and symptoms of allergic disease in China. METHODS In a cross-sectional analysis of 2214 children in Beijing, we applied a two-step hybrid Least Absolute Shrinkage and Selection Operator (LASSO) algorithm to identify environmental and lifestyle-related factors associated with asthma, rhinitis and wheeze from a wide range of candidates. We used group LASSO to select variables, using cross-validation as the criterion. Effect estimates were then calculated using adaptive LASSO. Model performance was assessed using Area Under the Curve (AUC) values. RESULTS We found a number of environmental and lifestyle-related factors significantly associated with asthma, rhinitis or wheeze, which changed the probability of asthma, rhinitis or wheeze from -5.76% (95%CI: -7.74%, -3.79%) to 27.4% (95%CI: 16.6%, 38.3%). The three factors associated with the largest change in probability of asthma were short birth length, carpeted floor and paternal allergy; for rhinitis they were maternal smoking during pregnancy, paternal allergy and living close to industrial area; and for wheeze they were carpeted floor, short birth length and maternal allergy. Other home environmental risk factors identified were living close to a highway, industrial area or river, sharing bedroom, cooking with gas, furry pets, cockroaches, incense, printer/photocopier, TV, damp, and window condensation in winter. Lifestyle-related risk factors were child caretakers other than parents, and age<3 for the day-care. Other risk factors included use of antibiotics, and mother's occupation. Major protective factors for wheeze were living in a rural/suburban region, air conditioner use, and mother's occupation in healthcare. CONCLUSIONS Our findings suggest that changes in lifestyle and indoor environments associated with the urbanization and industrialization of China are associated with asthma, rhinitis, and wheeze in children.
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Affiliation(s)
- Shaodan Huang
- Department of Building Science, Tsitnghua University, Beijing, 100084, China; Beijing Key Lab of Indoor Air Quality Evaluation and Control, Beijing, 100084, China; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, 02115, USA
| | - Eric Garshick
- Pulmonary, Allergy, Sleep, and Critical Care Medicine Section, Medical Service, VA Boston Healthcare System, Boston, MA, 02132, USA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Louise B Weschler
- Department of Building Science, Tsitnghua University, Beijing, 100084, China; 161 Richdale Road, Colts Neck, NJ, 07722, USA
| | - Chuan Hong
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, 02115, USA
| | - Jing Li
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, 02115, USA.
| | - Linyan Li
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, 02115, USA
| | - Fang Qu
- Department of Building Science, Tsitnghua University, Beijing, 100084, China; China Meteorological Administration Training Centre, China Meteorological Administration, Beijing, 100081, China
| | - Dewen Gao
- Beijing Key Lab of Indoor Air Quality Evaluation and Control, Beijing, 100084, China
| | - Yanmin Zhou
- School of Architecture, Tsinghua University, Beijing, 100084, China; Beijing Key Lab of Indoor Air Quality Evaluation and Control, Beijing, 100084, China
| | - Jan Sundell
- School of Environmental Science and Engineering, Tianjin University, Tianjing, 300072, China
| | - Yinping Zhang
- Department of Building Science, Tsitnghua University, Beijing, 100084, China; Beijing Key Lab of Indoor Air Quality Evaluation and Control, Beijing, 100084, China.
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, 02115, USA
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22
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Sbihi H, Boutin RCT, Cutler C, Suen M, Finlay BB, Turvey SE. Thinking bigger: How early-life environmental exposures shape the gut microbiome and influence the development of asthma and allergic disease. Allergy 2019; 74:2103-2115. [PMID: 30964945 DOI: 10.1111/all.13812] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 02/27/2019] [Accepted: 03/22/2019] [Indexed: 02/06/2023]
Abstract
Imbalance, or dysbiosis, of the gut microbiome of infants has been linked to an increased risk of asthma and allergic diseases. Most studies to date have provided a wealth of data showing correlations between early-life risk factors for disease and changes in the structure of the gut microbiome that disrupt normal immunoregulation. These studies have typically focused on one specific risk factor, such as mode of delivery or early-life antibiotic use. Such "micro-level" exposures have a considerable impact on affected individuals but not necessarily the whole population. In this review, we place these mechanisms under a larger lens that takes into account the influence of upstream "macro-level" environmental factors such as air pollution and the built environment. While these exposures likely have a smaller impact on the microbiome at an individual level, their ubiquitous nature confers them with a large influence at the population level. We focus on features of the indoor and outdoor human-made environment, their microbiomes and the research challenges inherent in integrating the built environment microbiomes with the early-life gut microbiome. We argue that an exposome perspective integrating internal and external microbiomes with macro-level environmental factors can provide a more comprehensive framework to define how environmental exposures can shape the gut microbiome and influence the development of allergic disease.
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Affiliation(s)
- Hind Sbihi
- Department of Pediatrics, British Columbia Children’s Hospital The University of British Columbia Vancouver British Columbia Canada
| | - Rozlyn CT. Boutin
- Department of Microbiology and Immunology, Michael Smith Laboratories The University of British Columbia Vancouver British Columbia Canada
| | - Chelsea Cutler
- Department of Pediatrics, British Columbia Children’s Hospital The University of British Columbia Vancouver British Columbia Canada
| | - Mandy Suen
- Department of Pediatrics, British Columbia Children’s Hospital The University of British Columbia Vancouver British Columbia Canada
| | - B. Brett Finlay
- Department of Microbiology and Immunology, Michael Smith Laboratories The University of British Columbia Vancouver British Columbia Canada
| | - Stuart E. Turvey
- Department of Pediatrics, British Columbia Children’s Hospital The University of British Columbia Vancouver British Columbia Canada
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23
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Cheng Q, Wang X, Wei Q, Bai L, Zhang Y, Gao J, Duan J, Xu Z, Yi W, Pan R, Su H. The short-term effects of cold spells on pediatric outpatient admission for allergic rhinitis in Hefei, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 664:374-380. [PMID: 30743130 DOI: 10.1016/j.scitotenv.2019.01.237] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 12/25/2018] [Accepted: 01/19/2019] [Indexed: 05/27/2023]
Abstract
BACKGROUND Some studies have reported that cold weather is associated with the development of allergic rhinitis (AR), but the study of extreme cold temperatures and AR is scarced. This study was conducted to find out the optimal definition of the cold spells in Hefei and to explore the relationship between cold spells and childhood AR, further to identify potential susceptible populations. METHODS Data of daily AR, meteorological variables and air pollutants from January 1, 2014 to December 31, 2016 were collected in Hefei. Poisson generalized linear regression with a distributed-lag nonlinear model (DLNM) was used to explore the relationship between cold spells and daily pediatric outpatient with allergic rhinitis, by comparing the number of the admission during the cold spells with those during non-cold spells in cold seasons (December to April), after adjusting for relative humidity, air pollutants, seasonality, long-term trends, calendar month, holiday and day of the week (DOW). RESULTS All definitions of cold spells both had a certain impact on children with allergic rhinitis, and the trend of their effects was similar. The optimal cold spells was defined as the daily average temperature for below 10th with two consecutive days during the study period, and the greatest impact of cold spells was at lag0, with a 12.5% (95%CI: 6.3%-19.1%) increase of AR than non-cold spell days, and its impact could last for 2 days. Male children, children aged 5-18 years and non-scattered children were considered to be more vulnerable to AR in cold spell days. CONCLUSIONS There was evidence showed that the cold spells may significantly increase the pediatric outpatient admission for allergic rhinitis, especially for male children, children aged 5-18 years and non-scattered children. For the serious threat posed by cold spells, caregivers and health practitioners should strengthen their awareness of the prevention of vulnerable people.
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Affiliation(s)
- Qiang Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Xu Wang
- Anhui Province Children's Hospital, Hefei, Anhui, China
| | - Qiannan Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Lijun Bai
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Yanwu Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Jiaojiao Gao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Jun Duan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Zihan Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China.
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24
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Cai J, Li B, Yu W, Wang H, Du C, Zhang Y, Huang C, Zhao Z, Deng Q, Yang X, Zhang X, Qian H, Sun Y, Liu W, Wang J, Yang Q, Zeng F, Norbäck D, Sundell J. Household dampness-related exposures in relation to childhood asthma and rhinitis in China: A multicentre observational study. ENVIRONMENT INTERNATIONAL 2019; 126:735-746. [PMID: 30878869 DOI: 10.1016/j.envint.2019.03.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 03/05/2019] [Accepted: 03/06/2019] [Indexed: 06/09/2023]
Abstract
During 2010-2012, we conducted an observational study on household environment and health outcomes among 40,010 preschool children from seven cities of China. Here we examined associations of six dampness-related indicators (visible mold spots, visible damp stains, damp clothing and/or bedding, water damage, condensation on windowpane, moldy odor) in the current residence and three dampness-related indicators (visible mold spots, condensation on windowpane, moldy odor) in the early residence with childhood asthma and rhinitis. In the multi-level logistic regression analyses, visible mold spots and visible damp stains in the current residence were significantly associated with the increased odds of doctor-diagnosed asthma and allergic rhinitis during lifetime-ever (adjusted odd ratios (AORs) range: 1.18-1.35). All dampness-related indicators were significantly associated with increased odds of wheeze and rhinitis during lifetime-ever and in the past 12 months (AORs range: 1.16-2.64). The cumulative numbers of damp indicators had positively dose-response relationships with the increased odds of the studied diseases. These associations for wheeze and rhinitis were similar between northern children and southern children. Similar results were found in the sensitive analyses among children without a family history of allergies and among children without asthma and allergic rhinitis. For 3-6 years-old children in mainland of China in 2011, we speculated that about 90,000 (2.02%) children with asthma and about 59,000 (1.09%) children with allergic rhinitis could be attributable to exposing to visible mold spots in the current residence. Our results suggested that early and lifetime exposures to household dampness indicators are risk factors for childhood asthma and rhinitis.
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Affiliation(s)
- Jiao Cai
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Baizhan Li
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China.
| | - Wei Yu
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Han Wang
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Chenqiu Du
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Yinping Zhang
- School of Architecture, Tsinghua University, Beijing, China
| | - Chen Huang
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Zhuohui Zhao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Key Lab of Health Technology Assessment, National Health and Family Planning Commission of the People's Republic of China, Fudan University, Shanghai, China
| | - Qihong Deng
- School of Public Health, Central South University, Changsha, Hunan, China
| | - Xu Yang
- College of Life Sciences, Central China Normal University, Wuhan, China
| | - Xin Zhang
- Research Center for Environmental Science and Engineering, Shanxi University, Taiyuan, China
| | - Hua Qian
- School of Energy and Environment, Southeast University, Nanjing, China
| | - Yuexia Sun
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Wei Liu
- School of Architecture, Tsinghua University, Beijing, China
| | - Juan Wang
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala SE-751, Sweden
| | - Qin Yang
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Fanbin Zeng
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Dan Norbäck
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala SE-751, Sweden
| | - Jan Sundell
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
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25
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Zhang Y, Zhang L. Increasing Prevalence of Allergic Rhinitis in China. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2019; 11:156-169. [PMID: 30661309 PMCID: PMC6340797 DOI: 10.4168/aair.2019.11.2.156] [Citation(s) in RCA: 143] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 08/16/2018] [Accepted: 08/28/2018] [Indexed: 12/21/2022]
Abstract
Allergic rhinitis (AR) is a critical public health, medical and economic problem in China. AR is also an important risk factor which will cause many diseases or disorders, especially in children. The trend of AR incidence is still on the rise in recent years and has had a significant effect on the general public. This significant increase is alarming, which highlights an urgent need for better understanding of the prevalence status and characteristics, sensitization patterns, and the associated risk factors of AR in order to improve treatment and develop effective prevention strategies.
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Affiliation(s)
- Yuan Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China.,Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Luo Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China.,Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China.
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26
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Chong SN, Chew FT. Epidemiology of allergic rhinitis and associated risk factors in Asia. World Allergy Organ J 2018; 11:17. [PMID: 30128063 PMCID: PMC6091170 DOI: 10.1186/s40413-018-0198-z] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 07/11/2018] [Indexed: 12/22/2022] Open
Abstract
This review article aims to present the epidemiology and associated risk factors of allergic rhinitis (AR) in Asia. AR-related literature published on Asia was systematically reviewed and the associated risk factors were investigated. The prevalence of AR in Asia varied considerably depending on the geographical location, study design and population involved. Several risk factors were observed to have strong association with disease presentation across multiple studies. Among these, family income, family size, daily personal computer usage time, personal and parental education attainment, and stress level have shown some level of biological gradient influence when multiple risk levels were analyzed. This suggests that AR manifestation and presentation possibly might be strongly affected by various personal and family factors. These findings are beneficial as they may provide insights into modifiable factors that may influence AR presentation. In addition, these results indicate that strategies to reduce personal and family-related risk factors have to be developed in order to alleviate the odds of AR expression.
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Affiliation(s)
- Sher Ney Chong
- Department of Biological Sciences, Faculty of Science, Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, National University of Singapore, Block S2, Level 5, Science Drive 4, Lower Kent Ridge Rd, Singapore, 117543 Singapore
| | - Fook Tim Chew
- Department of Biological Sciences, Faculty of Science, Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, National University of Singapore, Block S2, Level 5, Science Drive 4, Lower Kent Ridge Rd, Singapore, 117543 Singapore
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27
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Residential Ambient Traffic in Relation to Childhood Pneumonia among Urban Children in Shandong, China: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061076. [PMID: 29799501 PMCID: PMC6025011 DOI: 10.3390/ijerph15061076] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 05/21/2018] [Accepted: 05/22/2018] [Indexed: 12/21/2022]
Abstract
Pneumonia is a leading cause of childhood death. Few studies have investigated associations between residential ambient environmental exposures and pneumonia. In January⁻April 2015, we conducted a cross-sectional study in Shandong Province (China) and collected 9597 (response rate: 78.7%) parent-reported questionnaires for 3⁻6-year-old children from 69 urban kindergartens. We then selected 5640 children who had never changed residence since birth and examined associations between residential ambient traffic-related facilities and childhood pneumonia considering residential characteristics. Prevalence of doctor-diagnosed pneumonia during lifetime-ever was 25.9%. In the multivariate logistic regression analyses, residence close to a main traffic road (adjusted odds ratio, 95% confidence interval: 1.23, 1.08⁻1.40) and automobile 4S shop (1.76, 1.16⁻2.67) within 200 m, residence close to a filling station within 100 m (1.71, 1.10⁻2.65; reference: >200 m), as well as having a ground car park in the residential community (1.24, 1.08⁻1.42) were significantly associated with childhood pneumonia. The cumulative numbers of these traffic-related facilities had a positive dose-response relationship with the increased odds of childhood pneumonia. These associations and dose-response relationships were stronger among boys and among children with worse bedroom ventilation status during the night. Associations of residence close to the main traffic road and ground car parks in the residential community with childhood pneumonia were stronger among children living in the 1st⁻3rd floors than those living on higher floors. Similar results were found in the two-level (kindergarten-child) logistic regression analyses. Our findings indicate that living near traffic-related facilities is likely a risk factor for childhood pneumonia among urban children. The child's sex, bedroom floor level, and bedroom ventilation could modify associations of ambient traffic-related facilities with childhood pneumonia.
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28
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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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29
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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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30
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Liu W, Huang C, Hu Y, Fu Q, Zou Z, Sun C, Shen L, Wang X, Cai J, Pan J, Huang Y, Chang J, Sun Y, Sundell J. Associations of gestational and early life exposures to ambient air pollution with childhood respiratory diseases in Shanghai, China: A retrospective cohort study. ENVIRONMENT INTERNATIONAL 2016; 92-93:284-293. [PMID: 27128713 DOI: 10.1016/j.envint.2016.04.019] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 04/12/2016] [Accepted: 04/13/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Associations of ambient air pollutants with respiratory health are inconsistent. OBJECTIVES We analyzed the associations of gestational and early life exposures to air pollutants with doctor-diagnosed asthma, allergic rhinitis, and pneumonia in children. METHODS We selected 3358 preschool children who did not alter residences after birth from a cross-sectional study in 2011-2012 in Shanghai, China. Parents reported children's respiratory health history, home environment, and family lifestyle behaviors. We collected daily concentrations of sulphur dioxide (SO2), nitrogen dioxide (NO2), and particulate matter with an aerodynamic diameter ≤10μm (PM10) during the child's total lifetime (2006-2012) for each district where the children lived. We analyzed the associations using logistic regression models. RESULTS After adjusting for covariates and the other studied pollutants, we found that exposure to NO2 (increment of 20μg/m(3)) during the first year of life was significantly associated with asthma [odds ratio (OR)=1.77; 95% confidence interval (CI): 1.29-2.43] and allergic rhinitis (OR=1.67; 95% CI: 1.07-2.61). Exposure to NO2 during gestation, the first two and three years, and over total lifetimewas all consistently associated with increased odds of allergic rhinitis. Quartiles of NO2 concentration during different exposure periods showed a slight dose-response relationship with the studied diseases. These diseases had significant associations with pollutant mixtures that included NO2, but had no significant association with exposures to SO2 and PM10 individually or in mixtures. CONCLUSIONS Gestational and early life exposures to ambient NO2 are risk factors for childhood respiratory diseases.
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Affiliation(s)
- Wei Liu
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China
| | - Chen Huang
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China.
| | - Yu Hu
- Tongji Architectural Design (Group) Company Limited (TJAD), Shanghai, China
| | - Qingyan Fu
- Shanghai Environmental Monitoring Center (SEMC), Shanghai, China
| | - Zhijun Zou
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China
| | - Chanjuan Sun
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China
| | - Li Shen
- R&B Technology (Shanghai) Company Limited, Shanghai, China
| | - Xueying Wang
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China
| | - Jiao Cai
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China
| | - Jun Pan
- Shanghai Environmental Monitoring Center (SEMC), Shanghai, China
| | - Yanmin Huang
- Shanghai Environmental Monitoring Center (SEMC), Shanghai, China
| | - Jing Chang
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China; Department of Thermal Energy and Power Engineering, Shandong Jiaotong University, Jinan, China
| | - Yuexia Sun
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Jan Sundell
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China; Department of Building Science, Tsinghua University, Beijing, China
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