1
|
Baroni IF, Mehta GD, Sullivan AF, Camargo CA, Dumas O. Association between household cleaning product exposure in infancy and development of recurrent wheeze and asthma. Int Arch Occup Environ Health 2023; 96:1325-1332. [PMID: 37819536 DOI: 10.1007/s00420-023-02011-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/24/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVE Household chemicals may act as irritants in the lungs; however, their association with recurrent wheeze and asthma in children remains controversial. We aimed to investigate if household cleaning product exposure in infancy is associated with recurrent wheezing and asthma development in children. METHODS We analyzed data from two cohorts: MARC-35 consisting of 815 children with history of severe bronchiolitis in infancy, and MARC-43 consisting of 525 healthy children in infancy. Frequency of use of cleaning product at the child's home during infancy was collected via telephone interview with parents. Outcomes were recurrent wheezing by age 3 years and asthma diagnosis at age 6 years. RESULTS In MARC-35, there was no association between cleaning product exposure in infancy and recurrent wheeze (adjusted HR = 1.01 [95% CI 0.66-1.54] for 4-7 days/week exposure frequency), nor asthma (adjusted OR = 0.91 [95% CI 0.51-1.63]). In MARC-43, there was also no association between cleaning product exposure in infancy and recurrent wheeze (adjusted HR = 0.69 [95% CI 0.29-1.67] for 4-7 days/week exposure frequency). CONCLUSION We found no association between household cleaning product exposure in infancy and later development of recurrent wheeze or asthma, even among children who are at high risk for asthma due to history of severe bronchiolitis.
Collapse
Affiliation(s)
- Isis F Baroni
- Massachusetts General Hospital, Department of Emergency Medicine, Boston, MA, USA
| | - Geneva D Mehta
- Brigham and Women's Hospital, Department of Medicine, Division of Allergy and Immunology, Boston, MA, USA
| | - Ashley F Sullivan
- Massachusetts General Hospital, Department of Emergency Medicine, Boston, MA, USA
| | - Carlos A Camargo
- Massachusetts General Hospital, Department of Emergency Medicine, Boston, MA, USA
| | - Orianne Dumas
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, CESP, Équipe d'Épidémiologie Respiratoire Integrative, 16, Avenue Paul Vaillant Couturier, 94807, Villejuif Cedex, France.
| |
Collapse
|
2
|
Temkin AM, Geller SL, Swanson SA, Leiba NS, Naidenko OV, Andrews DQ. Volatile organic compounds emitted by conventional and "green" cleaning products in the U.S. market. CHEMOSPHERE 2023; 341:139570. [PMID: 37709066 DOI: 10.1016/j.chemosphere.2023.139570] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 09/16/2023]
Abstract
Exposure to cleaning products has been associated with harm to the respiratory system, neurotoxicity, harm to the reproductive system, and elevated risk of cancer, with greatest adverse impacts for workers exposed in an occupational setting. Social and consumer interest in cleaning products that are safer for health created a market category of "green" products defined here as products advertised as healthier, non-toxic, or free from harmful chemicals as well as products with a third-party certification for safety or environmental features. In the present study we examined the air quality impacts of cleaning products and air fresheners, measuring the number, concentrations, and emission factors of volatile organic compounds (VOCs) in an air chamber following product application. Across seven common product categories, 30 products were tested overall including 14 conventional, 9 identified as "green" with fragrance, and 7 identified as "green" and fragrance-free. A total of 530 unique VOCs were quantified with 205 additional VOCs detected below the limits of quantification. Of the quantifiable VOCs, 193 were considered hazardous according to either the California's Department of Toxic Substances Control Candidate Chemicals List or the European Chemical Agency's Classification and Labeling Inventory. The total concentration of VOCs and total emission factors across all products with detections ranged from below limits of detection to 18,708 μg/m3, 38,035 μg/g product and 3803 μg/application. Greater total concentration, total emission factors, and numbers of VOCs were generally observed in conventional cleaning products compared to products identified as "green", particularly compared to fragrance-free products. A hazard index approach was utilized to assess relative risk from measured VOC emissions. The five products with the highest hazard indices were conventional products with emissions of 2-butoxyethanol, isopropanol, toluene and chloroform. Overall, this analysis suggests that the use of "green" cleaning products, especially fragrance-free products, may reduce exposure to VOC emissions.
Collapse
Affiliation(s)
- Alexis M Temkin
- Environmental Working Group, 1250 I St NW Suite 1000, Washington DC, 20005, USA.
| | - Samara L Geller
- Environmental Working Group, 1250 I St NW Suite 1000, Washington DC, 20005, USA
| | - Sydney A Swanson
- Environmental Working Group, 1250 I St NW Suite 1000, Washington DC, 20005, USA
| | | | - Olga V Naidenko
- Environmental Working Group, 1250 I St NW Suite 1000, Washington DC, 20005, USA
| | - David Q Andrews
- Environmental Working Group, 1250 I St NW Suite 1000, Washington DC, 20005, USA
| |
Collapse
|
3
|
Le Moual N, Dumas O, Bonnet P, Eworo Nchama A, Le Bot B, Sévin E, Pin I, Siroux V, Mandin C. Exposure to Disinfectants and Cleaning Products and Respiratory Health of Workers and Children in Daycares: The CRESPI Cohort Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105903. [PMID: 37239629 DOI: 10.3390/ijerph20105903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023]
Abstract
Although cleaning tasks are frequently performed in daycare, no study has focused on exposures in daycares in relation to respiratory health. The CRESPI cohort is an epidemiological study among workers (n~320) and children (n~540) attending daycares. The purpose is to examine the impact of daycare exposures to disinfectants and cleaning products (DCP) on the respiratory health of workers and children. A sample of 108 randomly selected daycares in the region of Paris has been visited to collect settled dust to analyze semi-volatile organic compounds and microbiota, as well as sample indoor air to analyze aldehydes and volatile organic compounds. Innovative tools (smartphone applications) are used to scan DCP barcodes in daycare and inform their use; a database then matches the barcodes with the products' compositions. At baseline, workers/parents completed a standardized questionnaire, collecting information on DCP used at home, respiratory health, and potential confounders. Follow-up regarding children's respiratory health (monthly report through a smartphone application and biannual questionnaires) is ongoing until the end of 2023. Associations between DCP exposures and the respiratory health of workers/children will be evaluated. By identifying specific environments or DCP substances associated with the adverse respiratory health of workers and children, this longitudinal study will contribute to the improvement of preventive measures.
Collapse
Affiliation(s)
- Nicole Le Moual
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie Respiratoire Intégrative, CESP, 94807 Villejuif, France
| | - Orianne Dumas
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie Respiratoire Intégrative, CESP, 94807 Villejuif, France
| | - Pierre Bonnet
- Scientific and Technical Center for Building (CSTB), Indoor Environment Quality Unit, 77420 Champs-sur-Marne, France
| | - Anastasie Eworo Nchama
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie Respiratoire Intégrative, CESP, 94807 Villejuif, France
| | - Barbara Le Bot
- Irset (Institut de Recherche en Santé, Environnement et Travail)-UMR_S 1085, Inserm, École des Hautes Etudes en Santé Publique (EHESP), University of Rennes, 35000 Rennes, France
| | | | - Isabelle Pin
- Team of Environmental Epidemiology Applied to the Development and Respiratory Health, Institute for Advanced Biosciences, Inserm U 1209, CNRS UMR 5309, Université Grenoble Alpes, 38000 Grenoble, France
| | - Valérie Siroux
- Team of Environmental Epidemiology Applied to the Development and Respiratory Health, Institute for Advanced Biosciences, Inserm U 1209, CNRS UMR 5309, Université Grenoble Alpes, 38000 Grenoble, France
| | - Corinne Mandin
- Scientific and Technical Center for Building (CSTB), Indoor Environment Quality Unit, 77420 Champs-sur-Marne, France
| |
Collapse
|
4
|
Dai X, Dharmage SC, Lodge CJ. The relationship of early-life household air pollution with childhood asthma and lung function. Eur Respir Rev 2022; 31:220020. [PMID: 38743526 DOI: 10.1183/16000617.0020-2022] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 06/29/2022] [Indexed: 11/05/2022] Open
Abstract
The increase in childhood asthma over the past few decades has made it an important public health issue. Poor lung function growth associated with some phenotypes of asthma compounds its long-term impact on the individual. Exposure to early-life household risk factors is believed to be linked with respiratory health while infants' lungs are still developing. This review summarises epidemiological studies and mechanistic evidence focusing on the detrimental effects of early-life household air exposures on the respiratory health of children, in particular effects on asthma and lung function. Many early-life household air exposures, including tobacco smoke, gases from heating and cooking, mould/dampness and cleaning products are associated with childhood asthma development and lung function growth. These exposures may alter structural and mechanical characteristics of infants' lungs and contribute to deficits in later life. In addition, some risk factors, including tobacco smoke and cleaning products, can transmit effects across generations to increase the risk of asthma in subsequent generations. This review supports the hypothesis that risks of asthma and accelerated lung ageing are established in early life. The timing of exposure may be critical in the pathogenesis of respiratory diseases, in terms of future risk of asthma and reduced lung function in adults.
Collapse
Affiliation(s)
- Xin Dai
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Caroline J Lodge
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| |
Collapse
|
5
|
Kojima R, Shinohara R, Kushima M, Horiuchi S, Otawa S, Yokomichi H, Akiyama Y, Ooka T, Miyake K, Yamagata Z. Prenatal occupational disinfectant exposure and childhood allergies: the Japan Environment and Children's study. Occup Environ Med 2022; 79:521-526. [PMID: 35347078 DOI: 10.1136/oemed-2021-108034] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/20/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Disinfectants are widely used in the medical field, particularly recently because of the coronavirus pandemic, which has led to an increase in their use by both medical professionals and the general population. The objective of this study was to examine whether occupational disinfectant use during pregnancy was associated with the development of allergic disease in offspring at 3 years. METHODS We used data from 78 915 mother/child pairs who participated in the Japan Environment and Children's Study, which is a prospective birth cohort recruited between January 2011 and March 2014. We examined the associations between maternal disinfectant use during pregnancy and allergic diseases (asthma, eczema and food allergies) in children after adjustment for covariates including maternal postnatal return to work when the child was 1 year old by multivariate logistic regression. RESULTS Compared with those who never used disinfectants, participants who used disinfectant every day had a significantly higher risk of asthma in their offspring (adjusted OR 1.18, 95% CI 1.05 to 1.33 for 1-6 times a week; adjusted OR 1.26, 95% CI 1.05 to 1.52 for every day). The associations between disinfectant exposure and eczema were similar to those of asthma (adjusted OR 1.16, 95% CI 1.02 to 1.31 for 1-6 times a week; adjusted OR 1.29, 95% CI 1.06 to 1.57 for every day). We found a significant exposure-dependent relationship (p for trend <0.01). There were no significant associations between disinfectant use and food allergies. CONCLUSION Disinfectant use by pregnant women may be a risk factor for asthma and eczema in offspring. As disinfectants are an effective tool in the prevention of infectious diseases, replication of this study and further research into the mechanisms are warranted.
Collapse
Affiliation(s)
- Reiji Kojima
- Department of Health Sciences, School of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Ryoji Shinohara
- Center for Birth Cohort Studies, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Megumi Kushima
- Center for Birth Cohort Studies, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Sayaka Horiuchi
- Center for Birth Cohort Studies, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Sanae Otawa
- Center for Birth Cohort Studies, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Hiroshi Yokomichi
- Department of Health Sciences, School of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Yuka Akiyama
- Department of Health Sciences, School of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Tadao Ooka
- Department of Health Sciences, School of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Kunio Miyake
- Department of Health Sciences, School of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Zentaro Yamagata
- Department of Health Sciences, School of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan.,Center for Birth Cohort Studies, University of Yamanashi, Chuo, Yamanashi, Japan
| | | |
Collapse
|
6
|
Fujino T, Hasunuma H, Okuda M, Saito M, Utsunomiya T, Taniguchi Y, Taniguchi N, Shima M, Takeshima Y. Association between house renovation during pregnancy and wheezing in the first year of life: The Japan environment and children's study. Allergol Int 2021; 70:439-444. [PMID: 34074586 DOI: 10.1016/j.alit.2021.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 04/01/2021] [Accepted: 04/19/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Wheezing is a common symptom in infants, which may occasionally develop into asthma. There are many factors related to infant wheezing, including anatomical features, viral infections, and passive smoking. There are only a few reports on the association between renovation and pregnancy worldwide, and reports on this association are inadequate in Japan. This study aimed to examine the association between house renovation and new construction during pregnancy and wheezing in infants during the first year of life using data from the Japan Environment and Children's Study (JECS). METHODS Data of pregnant women registered in JECS were collected using self-administered questionnaires during the second/third trimester and 1 month after delivery. Childbirth records were completed by the doctors. Similarly, wheezing in infants was evaluated using self-administered questionnaires 1 year after birth. Logistic regression analysis was used to determine the primary outcome. RESULTS In total, 75,731 infants, excluding those with unknown gender, who were not singleton infants, and who relocated during pregnancy and the first month of life, were examined in this study. Renovation during pregnancy increased the prevalence of wheezing (odds ratio [OR]: 1.33, 95% confidence interval [CI]: 1.20-1.48) and recurrent wheezing (OR: 1.22, 95% CI: 1.00-1.48) in the first year of life. The relationship between new construction during pregnancy and wheezing in infants was insignificant (OR: 0.98, 95% CI: 0.90-1.06). CONCLUSIONS Renovation during pregnancy may be a risk factor for wheezing in infants, and should be avoided.
Collapse
Affiliation(s)
- Tetsuro Fujino
- Department of Pediatrics, Hyogo College of Medicine, Hyogo, Japan
| | - Hideki Hasunuma
- Department of Public Health, Hyogo College of Medicine, Hyogo, Japan; Hyogo Regional Center for the Japan Environment and Children's Study (JECS), Hyogo College of Medicine, Hyogo, Japan
| | - Masumi Okuda
- Department of Pediatrics, Hyogo College of Medicine, Hyogo, Japan.
| | - Midori Saito
- Department of Pediatrics, Hyogo College of Medicine, Hyogo, Japan
| | | | - Yohei Taniguchi
- Department of Pediatrics, Hyogo College of Medicine, Hyogo, Japan
| | - Naoko Taniguchi
- Department of Pediatrics, Hyogo College of Medicine, Hyogo, Japan; Hyogo Regional Center for the Japan Environment and Children's Study (JECS), Hyogo College of Medicine, Hyogo, Japan
| | - Masayuki Shima
- Department of Public Health, Hyogo College of Medicine, Hyogo, Japan; Hyogo Regional Center for the Japan Environment and Children's Study (JECS), Hyogo College of Medicine, Hyogo, Japan
| | - Yasuhiro Takeshima
- Department of Pediatrics, Hyogo College of Medicine, Hyogo, Japan; Hyogo Regional Center for the Japan Environment and Children's Study (JECS), Hyogo College of Medicine, Hyogo, Japan
| |
Collapse
|
7
|
Tsabouri S, Lavasidis G, Efstathiadou A, Papasavva M, Bellou V, Bergantini H, Priftis K, Ntzani EE. Association between childhood asthma and history of assisted reproduction techniques: a systematic review and meta-analysis. Eur J Pediatr 2021; 180:2007-2017. [PMID: 33598756 DOI: 10.1007/s00431-021-03975-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 01/04/2021] [Accepted: 02/02/2021] [Indexed: 11/29/2022]
Abstract
Genetic and environmental factors during early development may influence lung growth and impact lung function. We performed a meta-analysis of epidemiological studies examining the association between conception history of assisted reproduction techniques (ART) and childhood asthma. We searched PubMed and Embase up to November 2020 for relevant observational studies and synthesized data data under a fixed or random effects model as appropriate. Heterogeneity was assessed using the I2 metric. We identified 13 individual studies including 3,226,386 participants. We did not observe a statistically significant association between ART and physician-diagnosed asthma (n = 9, random OR 1.16; 95% CI 0.94-1.43; I2 61%). We observed a statistically significant association between ART and prescription of asthma medications (n = 6, fixed OR 1.27; 95% CI 1.23-1.32; I2 0%). Wheezing was also associated with ART (n = 4, fixed OR 1.71; 95% CI 1.08-2.72; I2 0%). When we combined studies using any asthma definition, a statistically significant association was observed (random OR 1.19; 95% CI 1.05-1.34; I2 80%).Conclusion: The available observational evidence suggests that the risk of asthma is higher among children born after ART. The mechanism and potential sources of bias behind this association are under scrutiny, and further work is needed to establish causality. What is Known: • "Positive" epidemiological signals for the association between assisted reproduction techniques and asthma stemming from large studies were not replicated by subsequent research. • Any available research synthesis effort so far bears no quantitative aspect. What is New: • The available observational evidence suggests that the risk of asthma is higher among children born after ART. • The mechanism and potential sources of bias behind this association are under scrutiny.
Collapse
Affiliation(s)
- Sofia Tsabouri
- Department of Pediatrics, University of Ioannina School of Medicine, Ioannina, Greece
| | - Georgios Lavasidis
- Evidence-Based Medicine Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
- Department of Pediatrics, Klinikum Stadt Soest, Soest, Germany
| | - Anthoula Efstathiadou
- Evidence-Based Medicine Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | | | - Vanessa Bellou
- Evidence-Based Medicine Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Helio Bergantini
- Evidence-Based Medicine Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Konstantinos Priftis
- Third Department of Paediatrics, University of Athens School of Medicine, Attikon University Hospital, Athens, Greece
| | - Evangelia E Ntzani
- Evidence-Based Medicine Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece.
- Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, RI, USA.
- Institute of Biosciences, University Research Center of loannina, University of Ioannina, Ioannina, Greece.
| |
Collapse
|
8
|
Dumas O, Le Moual N. Damaging effects of household cleaning products on the lungs. Expert Rev Respir Med 2019; 14:1-4. [PMID: 31682770 DOI: 10.1080/17476348.2020.1689123] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Orianne Dumas
- Inserm, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, F-94807, Villejuif, France.,Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180, Montigny le Bretonneux, France
| | - Nicole Le Moual
- Inserm, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, F-94807, Villejuif, France.,Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180, Montigny le Bretonneux, France
| |
Collapse
|
9
|
Tun MH, Tun HM, Mahoney JJ, Konya TB, Guttman DS, Becker AB, Mandhane PJ, Turvey SE, Subbarao P, Sears MR, Brook JR, Lou W, Takaro TK, Scott JA, Kozyrskyj AL. Postnatal exposure to household disinfectants, infant gut microbiota and subsequent risk of overweight in children. CMAJ 2019; 190:E1097-E1107. [PMID: 30224442 DOI: 10.1503/cmaj.170809] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Emerging links between household cleaning products and childhood overweight may involve the gut microbiome. We determined mediating effects of infant gut microbiota on associations between home use of cleaning products and future overweight. METHODS From the Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort, we tested associations between maternal report of cleaning product use and overweight at age 3, and whether associations were mediated by microbial profiles of fecal samples in 3- to 4-month-old infants. RESULTS Among 757 infants, the abundance of specific gut microbiota was associated with household cleaning with disinfectants and eco-friendly products in a dose-dependent manner. With more frequent use of disinfectants, Lachnospiraceae increasingly became more abundant (highest v. lowest quintile of use: adjusted odds ratio [AOR] 1.93, 95% confidence interval [CI] 1.08 to 3.45) while genus Haemophilus declined in abundance (highest v. lowest quintile of use: AOR 0.36, 95% CI 0.20 to 0.65). Enterobacteriaceae were successively depleted with greater use of eco-friendly products (AOR 0.45, 95% CI 0.27 to 0.74). Lachnospiraceae abundance significantly mediated associations of the top 30th centile of household disinfectant use with higher body mass index (BMI) z score (p = 0.02) and with increased odds of overweight or obesity (p = 0.04) at age 3. Use of eco-friendly products was associated with decreased odds of overweight or obesity independently of Enterobacteriaceae abundance (AOR 0.44, 95% CI 0.22 to 0.86), with no significant mediation (p = 0.2). INTERPRETATION Exposure to household disinfectants was associated with higher BMI at age 3, mediated by gut microbial composition at age 3-4 months. Although child overweight was less common in households that cleaned with eco-friendly products, the lack of mediation by infant gut microbiota suggests another pathway for this association.
Collapse
Affiliation(s)
- Mon H Tun
- School of Public Health (M. Tun, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics (M. Tun, H. Tun, Mahoney, Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Dalla Lana School of Public Health (Konya, Brook, Lou, Scott), University of Toronto, Toronto, Ont.; Centre for the Analysis of Genome Evolution and Function (Guttman), University of Toronto, Toronto, Ont.; Department of Pediatrics and Child Health (Becker), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Turvey), Child and Family Research Institute, University of British Columbia, Vancouver, BC; Department of Pediatric Respiratory Medicine (Subbarao), University of Toronto. Toronto, Ont.; Department of Medicine (Sears), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Takarao), Simon Fraser University, Vancouver, BC; Canadian Healthy Infant Longitudinal Development Study (CHILD Study Investigators)
| | - Hein M Tun
- School of Public Health (M. Tun, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics (M. Tun, H. Tun, Mahoney, Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Dalla Lana School of Public Health (Konya, Brook, Lou, Scott), University of Toronto, Toronto, Ont.; Centre for the Analysis of Genome Evolution and Function (Guttman), University of Toronto, Toronto, Ont.; Department of Pediatrics and Child Health (Becker), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Turvey), Child and Family Research Institute, University of British Columbia, Vancouver, BC; Department of Pediatric Respiratory Medicine (Subbarao), University of Toronto. Toronto, Ont.; Department of Medicine (Sears), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Takarao), Simon Fraser University, Vancouver, BC; Canadian Healthy Infant Longitudinal Development Study (CHILD Study Investigators)
| | - Justin J Mahoney
- School of Public Health (M. Tun, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics (M. Tun, H. Tun, Mahoney, Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Dalla Lana School of Public Health (Konya, Brook, Lou, Scott), University of Toronto, Toronto, Ont.; Centre for the Analysis of Genome Evolution and Function (Guttman), University of Toronto, Toronto, Ont.; Department of Pediatrics and Child Health (Becker), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Turvey), Child and Family Research Institute, University of British Columbia, Vancouver, BC; Department of Pediatric Respiratory Medicine (Subbarao), University of Toronto. Toronto, Ont.; Department of Medicine (Sears), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Takarao), Simon Fraser University, Vancouver, BC; Canadian Healthy Infant Longitudinal Development Study (CHILD Study Investigators)
| | - Theodore B Konya
- School of Public Health (M. Tun, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics (M. Tun, H. Tun, Mahoney, Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Dalla Lana School of Public Health (Konya, Brook, Lou, Scott), University of Toronto, Toronto, Ont.; Centre for the Analysis of Genome Evolution and Function (Guttman), University of Toronto, Toronto, Ont.; Department of Pediatrics and Child Health (Becker), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Turvey), Child and Family Research Institute, University of British Columbia, Vancouver, BC; Department of Pediatric Respiratory Medicine (Subbarao), University of Toronto. Toronto, Ont.; Department of Medicine (Sears), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Takarao), Simon Fraser University, Vancouver, BC; Canadian Healthy Infant Longitudinal Development Study (CHILD Study Investigators)
| | - David S Guttman
- School of Public Health (M. Tun, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics (M. Tun, H. Tun, Mahoney, Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Dalla Lana School of Public Health (Konya, Brook, Lou, Scott), University of Toronto, Toronto, Ont.; Centre for the Analysis of Genome Evolution and Function (Guttman), University of Toronto, Toronto, Ont.; Department of Pediatrics and Child Health (Becker), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Turvey), Child and Family Research Institute, University of British Columbia, Vancouver, BC; Department of Pediatric Respiratory Medicine (Subbarao), University of Toronto. Toronto, Ont.; Department of Medicine (Sears), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Takarao), Simon Fraser University, Vancouver, BC; Canadian Healthy Infant Longitudinal Development Study (CHILD Study Investigators)
| | - Allan B Becker
- School of Public Health (M. Tun, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics (M. Tun, H. Tun, Mahoney, Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Dalla Lana School of Public Health (Konya, Brook, Lou, Scott), University of Toronto, Toronto, Ont.; Centre for the Analysis of Genome Evolution and Function (Guttman), University of Toronto, Toronto, Ont.; Department of Pediatrics and Child Health (Becker), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Turvey), Child and Family Research Institute, University of British Columbia, Vancouver, BC; Department of Pediatric Respiratory Medicine (Subbarao), University of Toronto. Toronto, Ont.; Department of Medicine (Sears), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Takarao), Simon Fraser University, Vancouver, BC; Canadian Healthy Infant Longitudinal Development Study (CHILD Study Investigators)
| | - Piush J Mandhane
- School of Public Health (M. Tun, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics (M. Tun, H. Tun, Mahoney, Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Dalla Lana School of Public Health (Konya, Brook, Lou, Scott), University of Toronto, Toronto, Ont.; Centre for the Analysis of Genome Evolution and Function (Guttman), University of Toronto, Toronto, Ont.; Department of Pediatrics and Child Health (Becker), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Turvey), Child and Family Research Institute, University of British Columbia, Vancouver, BC; Department of Pediatric Respiratory Medicine (Subbarao), University of Toronto. Toronto, Ont.; Department of Medicine (Sears), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Takarao), Simon Fraser University, Vancouver, BC; Canadian Healthy Infant Longitudinal Development Study (CHILD Study Investigators)
| | - Stuart E Turvey
- School of Public Health (M. Tun, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics (M. Tun, H. Tun, Mahoney, Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Dalla Lana School of Public Health (Konya, Brook, Lou, Scott), University of Toronto, Toronto, Ont.; Centre for the Analysis of Genome Evolution and Function (Guttman), University of Toronto, Toronto, Ont.; Department of Pediatrics and Child Health (Becker), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Turvey), Child and Family Research Institute, University of British Columbia, Vancouver, BC; Department of Pediatric Respiratory Medicine (Subbarao), University of Toronto. Toronto, Ont.; Department of Medicine (Sears), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Takarao), Simon Fraser University, Vancouver, BC; Canadian Healthy Infant Longitudinal Development Study (CHILD Study Investigators)
| | - Padmaja Subbarao
- School of Public Health (M. Tun, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics (M. Tun, H. Tun, Mahoney, Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Dalla Lana School of Public Health (Konya, Brook, Lou, Scott), University of Toronto, Toronto, Ont.; Centre for the Analysis of Genome Evolution and Function (Guttman), University of Toronto, Toronto, Ont.; Department of Pediatrics and Child Health (Becker), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Turvey), Child and Family Research Institute, University of British Columbia, Vancouver, BC; Department of Pediatric Respiratory Medicine (Subbarao), University of Toronto. Toronto, Ont.; Department of Medicine (Sears), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Takarao), Simon Fraser University, Vancouver, BC; Canadian Healthy Infant Longitudinal Development Study (CHILD Study Investigators)
| | - Malcolm R Sears
- School of Public Health (M. Tun, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics (M. Tun, H. Tun, Mahoney, Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Dalla Lana School of Public Health (Konya, Brook, Lou, Scott), University of Toronto, Toronto, Ont.; Centre for the Analysis of Genome Evolution and Function (Guttman), University of Toronto, Toronto, Ont.; Department of Pediatrics and Child Health (Becker), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Turvey), Child and Family Research Institute, University of British Columbia, Vancouver, BC; Department of Pediatric Respiratory Medicine (Subbarao), University of Toronto. Toronto, Ont.; Department of Medicine (Sears), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Takarao), Simon Fraser University, Vancouver, BC; Canadian Healthy Infant Longitudinal Development Study (CHILD Study Investigators)
| | - Jeffrey R Brook
- School of Public Health (M. Tun, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics (M. Tun, H. Tun, Mahoney, Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Dalla Lana School of Public Health (Konya, Brook, Lou, Scott), University of Toronto, Toronto, Ont.; Centre for the Analysis of Genome Evolution and Function (Guttman), University of Toronto, Toronto, Ont.; Department of Pediatrics and Child Health (Becker), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Turvey), Child and Family Research Institute, University of British Columbia, Vancouver, BC; Department of Pediatric Respiratory Medicine (Subbarao), University of Toronto. Toronto, Ont.; Department of Medicine (Sears), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Takarao), Simon Fraser University, Vancouver, BC; Canadian Healthy Infant Longitudinal Development Study (CHILD Study Investigators)
| | - Wendy Lou
- School of Public Health (M. Tun, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics (M. Tun, H. Tun, Mahoney, Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Dalla Lana School of Public Health (Konya, Brook, Lou, Scott), University of Toronto, Toronto, Ont.; Centre for the Analysis of Genome Evolution and Function (Guttman), University of Toronto, Toronto, Ont.; Department of Pediatrics and Child Health (Becker), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Turvey), Child and Family Research Institute, University of British Columbia, Vancouver, BC; Department of Pediatric Respiratory Medicine (Subbarao), University of Toronto. Toronto, Ont.; Department of Medicine (Sears), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Takarao), Simon Fraser University, Vancouver, BC; Canadian Healthy Infant Longitudinal Development Study (CHILD Study Investigators)
| | - Tim K Takaro
- School of Public Health (M. Tun, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics (M. Tun, H. Tun, Mahoney, Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Dalla Lana School of Public Health (Konya, Brook, Lou, Scott), University of Toronto, Toronto, Ont.; Centre for the Analysis of Genome Evolution and Function (Guttman), University of Toronto, Toronto, Ont.; Department of Pediatrics and Child Health (Becker), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Turvey), Child and Family Research Institute, University of British Columbia, Vancouver, BC; Department of Pediatric Respiratory Medicine (Subbarao), University of Toronto. Toronto, Ont.; Department of Medicine (Sears), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Takarao), Simon Fraser University, Vancouver, BC; Canadian Healthy Infant Longitudinal Development Study (CHILD Study Investigators)
| | - James A Scott
- School of Public Health (M. Tun, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics (M. Tun, H. Tun, Mahoney, Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Dalla Lana School of Public Health (Konya, Brook, Lou, Scott), University of Toronto, Toronto, Ont.; Centre for the Analysis of Genome Evolution and Function (Guttman), University of Toronto, Toronto, Ont.; Department of Pediatrics and Child Health (Becker), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Turvey), Child and Family Research Institute, University of British Columbia, Vancouver, BC; Department of Pediatric Respiratory Medicine (Subbarao), University of Toronto. Toronto, Ont.; Department of Medicine (Sears), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Takarao), Simon Fraser University, Vancouver, BC; Canadian Healthy Infant Longitudinal Development Study (CHILD Study Investigators)
| | - Anita L Kozyrskyj
- School of Public Health (M. Tun, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics (M. Tun, H. Tun, Mahoney, Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Dalla Lana School of Public Health (Konya, Brook, Lou, Scott), University of Toronto, Toronto, Ont.; Centre for the Analysis of Genome Evolution and Function (Guttman), University of Toronto, Toronto, Ont.; Department of Pediatrics and Child Health (Becker), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Turvey), Child and Family Research Institute, University of British Columbia, Vancouver, BC; Department of Pediatric Respiratory Medicine (Subbarao), University of Toronto. Toronto, Ont.; Department of Medicine (Sears), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Takarao), Simon Fraser University, Vancouver, BC; Canadian Healthy Infant Longitudinal Development Study (CHILD Study Investigators)
| | | |
Collapse
|
10
|
Bukalasa JS, Brunekreef B, Koppelman GH, Vonk JM, Gehring U. Use of cleaning agents at home and respiratory and allergic symptoms in adolescents: The PIAMA birth cohort study. ENVIRONMENT INTERNATIONAL 2019; 128:63-69. [PMID: 31029980 DOI: 10.1016/j.envint.2019.03.049] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 03/18/2019] [Accepted: 03/21/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND It has been suggested that adults who use cleaning agents in their homes have a higher risk of asthma and allergic symptoms. The associations of asthma and allergic symptoms with household use of cleaning agents in adolescents have not been investigated yet. OBJECTIVES To examine the associations of household cleaning agents use with the prevalence of asthma, rhinitis and eczema in adolescents. METHODS In this cross-sectional analysis, we included participants of the PIAMA birth cohort study with data on household use of 10 types of cleaning agents and information on asthma, rhinitis and/or eczema from parent-completed questionnaires at age 14 (N = 2333). For the cleaning agents, we developed a composite score ranging from 0 (no exposure) to 30 points (household use on 4-7 days per week for all 10 types of cleaning agents). Logistic regression was used to analyse associations between household cleaning agents use (composite score and specific cleaning agents) and outcomes, adjusting for potential confounders. RESULTS Seven, 13 and 11% of the participants had asthma, rhinitis and eczema, respectively, at age 14. The composite score for household use of cleaning agents was not associated with asthma, rhinitis and eczema. For instance, adjusted odds ratios (95% confidence interval) for the prevalence of asthma, rhinitis and eczema comparing those with the highest use of cleaning agents (≥10 points) to those with never/seldom use (0-4 points) were 0.95 (0.56, 1.63), 1.23 (0.82, 1.82) and 0.95 (0.56, 1.63), respectively. For individual cleaning agents, we only found the use of ammonia to be significantly associated with a lower risk of rhinitis [0.60, (0.44, 0.82)]. CONCLUSIONS There was no indication of an increased prevalence of asthma, rhinitis or eczema among adolescents living in households within the highest category of cleaning agents use.
Collapse
Affiliation(s)
- Joseph S Bukalasa
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Gerard H Koppelman
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Department of Pediatric Pulmonology and Pediatric Allergology, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands
| | - Judith M Vonk
- University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
| |
Collapse
|
11
|
Mikeš O, Vrbová M, Klánová J, Čupr P, Švancara J, Pikhart H. Early-life exposure to household chemicals and wheezing in children. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 663:418-425. [PMID: 30716632 DOI: 10.1016/j.scitotenv.2019.01.254] [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: 11/22/2018] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 06/09/2023]
Abstract
The prevalence of the asthmatic symptoms among children increases globally over the time. Reduced exposure to pathogens in early childhood and increased exposure to anthropogenic irritants result in increased risk of wheezing in children, and all of this may be related to the usage of household chemicals. Objective of this analysis thus was to study the potential effects of overall exposure to home chemicals in the early life on the phenotypes of wheezing from birth until five years of age. 3411 mother-infant pairs from the Czech part of the European Longitudinal Study of Pregnancy and Childhood (ELSPAC-CZ) participated in the study. The exposure was estimated by the composite household chemical score from 18 chemical-based products. Social, medical and environmental factors were taken into account as covariates in multivariable multinomial logistic regression using phenotypes of wheezing as a study outcome. We were able to determine the association between several wheezing childhood phenotypes and the frequent usage of household chemicals in the fully adjusted model. Statistically significant odds ratios (OR) for increasing exposures per 1 SD of exposure score were obtained for the intermediate onset transient (OR 1.27, 95% CI 1.10-1.47), intermediated onset persistent (OR 1.23, 95% CI 1.03-1.46), and early onset persistent phenotypes (OR 1.36, 95% CI 1.04-1.77) in comparison to never wheezing children. Moreover, the persistent phenotypes were significantly associated with school age asthma. Our study has shown the negative role of the increased household chemicals usage on the respiratory outcomes in children up to five years of age. Overall evaluation of the household chemical exposure may be useful tool for any large epidemiological studies.
Collapse
Affiliation(s)
- Ondřej Mikeš
- Research Centre for Toxic Compounds in the Environment, Faculty of Science, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic
| | - Markéta Vrbová
- Research Centre for Toxic Compounds in the Environment, Faculty of Science, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic; Department of Internal Gastroenterology, University Hospital Brno, Masaryk University, Faculty of Medicine, Jihlavska 20, 625 00 Brno, Czech Republic; Depertment of Clinical Immunology and Allergy, St. Anne's University Hospital, Masaryk University, Pekarska 53, Brno, Czech Republic
| | - Jana Klánová
- Research Centre for Toxic Compounds in the Environment, Faculty of Science, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic
| | - Pavel Čupr
- Research Centre for Toxic Compounds in the Environment, Faculty of Science, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic
| | - Jan Švancara
- Research Centre for Toxic Compounds in the Environment, Faculty of Science, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic; Institute of Biostatistics and Analyses, Faculty of Medicine and Faculty of Science, Masaryk University, Kamenice 3, 625 00 Brno, Czech Republic
| | - Hynek Pikhart
- Research Centre for Toxic Compounds in the Environment, Faculty of Science, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic; Department of Epidemiology & Public Health, University College London,1 - 19 Torrington Place, London WC1E 6BT, United Kingdom.
| |
Collapse
|
12
|
Abstract
OBJECTIVE The aim of this study was to determine if there is an association between bronchiolitis and future development of asthma in children younger than 2 years. METHODS We reviewed the medical records of 1991 patients younger than 2 years presenting to the emergency department from January 2000 to December 2010 who received a clinical diagnosis of acute bronchiolitis. Their demographic information, the number of bronchiolitis episodes, and family history of asthma were recorded. The primary care clinic records of these children were reviewed for a period of 1 year following their presentation to the emergency department to determine if they had received a diagnosis of asthma. A stepwise logistic regression was performed to determine what factors were associated with future asthma development. RESULTS We reviewed the medical record of 1991 children with the diagnosis of bronchiolitis for subsequent development of asthma. The following variables were identified as predictors of subsequent asthma: male sex (odds ratio [OR], 1.3; 95% confidence interval [CI], 1.05-1.55), family history of asthma (OR, 1.6; 95% CI, 1.33-1.95), atopy (OR, 1.4; 95% CI, 1.12-1.83), age older than 5 months (OR, 1.4 95% CI, 1.13-1.66), more than 2 episodes of bronchiolitis (OR, 2.4; 95% CI, 1.79-3.07), and allergies (OR1.6; 95% CI, 1.14-2.14). CONCLUSIONS In this limited sample, the predictor variables for asthma were male sex, age older than 5 months, more than 2 episodes of bronchiolitis, a history of atopy, and allergies.
Collapse
|
13
|
Holm SM, Leonard V, Durrani T, Miller MD. Do we know how best to disinfect child care sites in the United States? A review of available disinfectant efficacy data and health risks of the major disinfectant classes. Am J Infect Control 2019; 47:82-91. [PMID: 30172610 DOI: 10.1016/j.ajic.2018.06.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 06/24/2018] [Accepted: 06/25/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Children in child care settings have a high infectious burden. They are frequently exposed to sanitizing and disinfecting agents, whose toxicities have not been studied in these settings. Current guidance on the preferred disinfection agents for child care is vague. METHODS This article combines 2 different sources of information: the Environmental Protection Agency registration data on the efficacy of hospital-grade disinfectants and a review of the research on the toxicities of the most common of these disinfectants to summarize information that could be used for more evidence-based early care and education disinfection regulations and guidelines. RESULTS Coverage of these organisms varied both between disinfectant classes (defined by active ingredient), as well as within classes. The 3 most common active ingredients in the database-quaternary ammonias, bleaches, and hydrogen peroxides-had 251, 63, and 31 products, respectively. Quaternary ammonias and bleaches are both known asthmagens, with the potential for toxic gas release when mixed. Quaternary ammonias may also cause reproductive toxicity. Disinfectant-grade peroxides have relatively low inhalational toxicity. CONCLUSIONS A clear rationale is needed to establish policies for determining preferable disinfection products for use in child care settings, based on efficacy against relevant pathogens, toxicity, ease of use, and cost. When other factors are equal, the use of peroxide-based disinfectant products is recommended to minimize inhalational toxicity.
Collapse
|
14
|
Lodge CJ, Lowe AJ, Dharmage SC. EuroPrevall: insights into the allergic disease epidemic. Thorax 2018; 73:999-1000. [PMID: 30006450 DOI: 10.1136/thoraxjnl-2018-211660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2018] [Indexed: 11/03/2022]
Affiliation(s)
- Caroline J Lodge
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Adrian J Lowe
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| |
Collapse
|
15
|
Marbac M, Sedki M, Boutron-Ruault MC, Dumas O. Patterns of cleaning product exposures using a novel clustering approach for data with correlated variables. Ann Epidemiol 2018; 28:563-569.e6. [PMID: 29937403 DOI: 10.1016/j.annepidem.2018.05.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 05/14/2018] [Accepted: 05/15/2018] [Indexed: 01/03/2023]
Abstract
PURPOSE Clustering methods may be useful in epidemiology to better characterize exposures and account for their multidimensional aspects. In this context, application of clustering models allowing for highly dependent variables is of particular interest. We aimed to characterize patterns of domestic exposure to cleaning products using a novel clustering model allowing for highly dependent variables. METHODS To identify domestic cleaning patterns in a large population of French women, we used a mixture model of dependency blocks. This novel approach specifically models within-class dependencies, and is an alternative to the latent class model, which assumes conditional independence. Analyses were conducted in 19,398 participants of the E3N study (women aged 61-88 years) who completed a questionnaire regarding household cleaning habits. RESULTS Seven classes were identified, which differed with the frequency of cleaning tasks (e.g., dusting/sweeping/hoovering) and use of specific products (e.g., bleach, sprays). The model also grouped the variables into conditionally independent blocks, providing a summary of the main dependencies among the variables. CONCLUSIONS The mixture model of dependency blocks, a useful alternative to the latent class model, may have broader application in epidemiology, in particular, in the context of exposome research and growing need for data-reduction methods.
Collapse
Affiliation(s)
| | - Mohammed Sedki
- Université Paris-Sud and INSERM UMR 1181 B2PHI, Villejuif, France
| | - Marie-Christine Boutron-Ruault
- CESP, Inserm U1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, 948052, Villejuif, France; Gustave Roussy Institute, Villejuif, France
| | - Orianne Dumas
- INSERM, VIMA: Aging and chronic diseases, Epidemiological and public health approaches, U1168, F-94807, Villejuif, France; Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180, Montigny le Bretonneux, France.
| |
Collapse
|
16
|
Do Carpets Impair Indoor Air Quality and Cause Adverse Health Outcomes: A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020184. [PMID: 29360764 PMCID: PMC5858259 DOI: 10.3390/ijerph15020184] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 12/21/2017] [Accepted: 01/19/2018] [Indexed: 12/22/2022]
Abstract
Several earlier studies have shown the presence of more dust and allergens in carpets compared with non-carpeted floors. At the same time, adverse effects of carpeted floors on perceived indoor air quality as well as worsening of symptoms in individuals with asthma and allergies were reported. Avoiding extensive carpet use in offices, schools, kindergartens and bedrooms has therefore been recommended by several health authorities. More recently, carpet producers have argued that former assessments were obsolete and that modern rugs are unproblematic, even for those with asthma and allergies. To investigate whether the recommendation to be cautious with the use of carpets is still valid, or whether there are new data supporting that carpet flooring do not present a problem for indoor air quality and health, we have reviewed the literature on this matter. We have not found updated peer reviewed evidence that carpeted floor is unproblematic for the indoor environment. On the contrary, also more recent data support that carpets may act as a repository for pollutants which may become resuspended upon activity in the carpeted area. Also, the use of carpets is still linked to perception of reduced indoor air quality as well as adverse health effects as previously reported. To our knowledge, there are no publications that report on deposition of pollutants and adverse health outcomes associated with modern rugs. However, due to the three-dimensional structure of carpets, any carpet will to some extent act like a sink. Thus, continued caution should still be exercised when considering the use of wall-to-wall carpeted floors in schools, kindergartens and offices, as well as in children’s bedrooms unless special needs indicate that carpets are preferable.
Collapse
|
17
|
The First 1000 Days of Life Factors Associated with "Childhood Asthma Symptoms": Brisa Cohort, Brazil. Sci Rep 2017; 7:16028. [PMID: 29167579 PMCID: PMC5700095 DOI: 10.1038/s41598-017-16295-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 11/08/2017] [Indexed: 11/17/2022] Open
Abstract
This prospective study used data from the BRISA Cohort, São Luís, Brazil (n = 1140) and analyzed associations between environmental factors up to the first 1000 days of life and “Childhood Asthma Symptoms”. “Childhood Asthma Symptoms” was a latent variable based on the number of wheezing episodes, emergency care visit due to wheezing, diagnosis of asthma and diagnosis of rhinitis. A theoretical model that included prenatal factors (socioeconomic status, pregestational body mass index-BMI, soft drink and junk food consumption), birth factors (gestational age, smoking and diseases during pregnancy, birth weight and type of delivery), first year of life factors (breastfeeding, environmental aeroallergens and respiratory diseases) and BMI z-score in the second year of life, was analyzed by structural equation modeling. High pregestational BMI, high soft drink consumption, cesarean section without labor, chill in the first three months of life, carpeted floor and child’s exposure to tobacco were associated with higher values of “Childhood Asthma Symptoms”. In contrast, high birth weight, breastfeeding and infant’s age were associated with lower values of “Childhood Asthma Symptoms”. These findings support the hypothesis that environmental factors that are present before conception and up to the first 1000 days of life are associated with asthma.
Collapse
|
18
|
Liu X, Lao XQ, Wong CCY, Tan L, Zhang Z, Wong TW, Tse LA, Lau AP, Yu IT. Frequent use of household cleaning products is associated with rhinitis in Chinese children. J Allergy Clin Immunol 2016; 138:754-760.e6. [DOI: 10.1016/j.jaci.2016.03.038] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 02/26/2016] [Accepted: 03/03/2016] [Indexed: 12/11/2022]
|
19
|
Matulonga B, Rava M, Siroux V, Bernard A, Dumas O, Pin I, Zock JP, Nadif R, Leynaert B, Le Moual N. Women using bleach for home cleaning are at increased risk of non-allergic asthma. Respir Med 2016; 117:264-71. [PMID: 27492540 DOI: 10.1016/j.rmed.2016.06.019] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 06/10/2016] [Accepted: 06/24/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Bleach is widely used for household cleaning. Although it is recognized that occupational use of bleach may have adverse respiratory health effects, it is unknown whether common domestic use of bleach may be a risk factor for asthma. AIM To assess whether the domestic use of bleach for home cleaning is associated with asthma and other respiratory outcomes. METHODS Questionnaire-based information on respiratory symptoms and cleaning habits and data from skin prick-tests, bronchial responsiveness challenge and white blood cells were analyzed in 607 women participating in the follow-up of the Epidemiological Study on the Genetics and Environment of Asthma (EGEA). Bleach use was evaluated in 3 categories (<1 day/week; 1-3 days/week; 4-7 days/week "frequent"). RESULTS Overall, 37% of the women reported using bleach weekly. Women using bleach frequently (11%) were more likely to have current asthma as compared to non-users (adjusted Odds-Ratio (aOR) = 1.7; 95% Confidence Interval (95%CI) 1.0-3.0). Among women with asthma, frequent use of bleach was significantly associated with higher blood neutrophil cell counts. Bleach use was significantly associated with non-allergic asthma (aOR 3.3; 95%CI 1.5-7.1), and more particularly with non-allergic adult-onset asthma (aOR 4.9; 95%CI 2.0-11.6). Consistently, among women without allergic sensitization, significant positive associations were found between use of bleach and bronchial hyperresponsiveness, asthma like-symptoms and chronic cough. No association was observed for allergic asthma. CONCLUSIONS Frequent use of bleach for home-cleaning is associated with non-allergic adult-onset asthma, elevated neutrophil counts and lower-airway symptoms in women.
Collapse
Affiliation(s)
- Bobette Matulonga
- Inserm, UMR 1152, Pathophysiology and Epidemiology of Respiratory Diseases, Epidemiology Team, F-75890, Paris, France; Univ Paris-Saclay, Faculty of Medicine, Kremlin-Bicêtre, France
| | - Marta Rava
- Inserm, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, F-94807, Villejuif, France; Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180, Montigny le Bretonneux, France; Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid, Spain
| | - Valérie Siroux
- University Grenoble Alpes, IAB, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, F-38042, Grenoble, France; Inserm U823, IAB, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, F-38042, Grenoble, France
| | - Alfred Bernard
- Louvain Center for Toxicology and Applied Pharmacology (LTAP), Catholic University of Louvain, 1200, Brussels, Belgium
| | - Orianne Dumas
- Inserm, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, F-94807, Villejuif, France; Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180, Montigny le Bretonneux, France
| | - Isabelle Pin
- University Grenoble Alpes, IAB, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, F-38042, Grenoble, France; Inserm U823, IAB, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, F-38042, Grenoble, France; CHU de Grenoble, La Tronche, F-38043, Grenoble, France
| | - Jan-Paul Zock
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Rachel Nadif
- Inserm, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, F-94807, Villejuif, France; Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180, Montigny le Bretonneux, France
| | - Bénédicte Leynaert
- Inserm, UMR 1152, Pathophysiology and Epidemiology of Respiratory Diseases, Epidemiology Team, F-75890, Paris, France; University Paris Diderot Paris 7, UMR 1152, F-75890, Paris, France.
| | - Nicole Le Moual
- Inserm, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, F-94807, Villejuif, France; Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180, Montigny le Bretonneux, France
| |
Collapse
|
20
|
Apfelbacher C, Frew E, Xiang A, Apfel A, Smith H. Assessment of pet exposure by self-report in epidemiological studies of allergy and asthma: a systematic review. J Asthma 2016; 53:363-73. [PMID: 26539692 DOI: 10.3109/02770903.2015.1099161] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE In epidemiological studies that aim to investigate the relationship between pet exposure and allergy/asthma, pet exposure is often ascertained by means of a questionnaire, but it is unclear which questionnaire items are used. The objective of this study was to systematically review self-reported pet exposure assessment in questionnaires used in epidemiological studies which explore the associations between pets and allergy/asthma. METHODS A systematic literature search was conducted in PubMed and papers were selected according to pre-specified eligibility criteria. The pet exposure questions used were classified within a framework including direct pet contact, indirect pet contact (e.g. through carers or grandparents) and avoidance behaviour. Authors were contacted when the questions used were not reported in detail. RESULTS Ninety-six full text papers were systematically reviewed. All studies assessed direct pet contact, but less than half (45%) explicitly assessed whether pets were allowed indoors. The vast majority of studies assessed both pet exposures during the first year of life and after the first year of life. The minority (13%) assessed whether pet(s) were kept at places regularly visited by the child and pet exposure in utero (15%). Even fewer studies assessed indirect contact to pets (n = 8) and avoidance behaviour (n = 10). CONCLUSIONS In epidemiological studies, the ascertainment of pet exposure through questionnaires appears to vary greatly. This variation might partly explain the inconsistent and contradictory results of the effects of pet exposure on the development of allergy and asthma.
Collapse
Affiliation(s)
- Christian Apfelbacher
- a Division of Public Health and Primary Care , Brighton and Sussex Medical School , Brighton , UK and.,b Department of Medical Sociology , Institute of Epidemiology and Preventive Medicine, University of Regensburg , Regensburg , Germany
| | - Edward Frew
- a Division of Public Health and Primary Care , Brighton and Sussex Medical School , Brighton , UK and
| | - Ally Xiang
- a Division of Public Health and Primary Care , Brighton and Sussex Medical School , Brighton , UK and
| | - Alex Apfel
- a Division of Public Health and Primary Care , Brighton and Sussex Medical School , Brighton , UK and
| | - Helen Smith
- a Division of Public Health and Primary Care , Brighton and Sussex Medical School , Brighton , UK and
| |
Collapse
|
21
|
Tse SM, Coull BA, Sordillo JE, Datta S, Gold DR. Gender- and age-specific risk factors for wheeze from birth through adolescence. Pediatr Pulmonol 2015; 50:955-62. [PMID: 25348842 PMCID: PMC4800823 DOI: 10.1002/ppul.23113] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 07/29/2014] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND OBJECTIVE Cross-sectional gender differences in wheeze are well documented, but few studies have examined the gender-specific risk factors for wheeze longitudinally. This study aims to identify gender- and age-specific risk factors for wheeze from birth through adolescence. METHODS The incidence of wheeze was ascertained every 6 months through age 14 years in a birth cohort consisting of 499 children with a parental history of atopy. Gender- and age-specific risk factors were identified through generalized estimating equations. RESULTS A total of 454 (91.0%) and 351 (70.3%) children were followed past age 7 and 13 years, respectively. Maternal asthma was a risk factor for wheeze in girls (OR = 2.05, 95% CI 1.44-2.91, P < 0.0001) and boys (OR = 1.79, 1.29-2.48, P = 0.0004) and had a similar effect on wheeze throughout the ages. Paternal asthma (OR = 1.83, 1.38-2.57, P = 0.0005) and infant bronchiolitis (OR = 2.15, 1.47-3.14, P < 0.0001) were risk factors for boys only, with similar effects throughout the ages. CONCLUSION Using a prospective cohort, we identified gender- and age-specific risk factors for wheeze. The identification of gender-specific early life risk factors may allow for timely interventions and a more personalized approach to the treatment of asthma.
Collapse
Affiliation(s)
- Sze Man Tse
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.,Department of Pediatrics, Sainte-Justine University Hospital Center, Montreal, Quebec, Canada
| | - Brent A Coull
- Department of Biostatistics, Harvard School of Public Health, Boston, Massachusett
| | - Joanne E Sordillo
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Soma Datta
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Diane R Gold
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
22
|
Kim JH, Choi JY, Kim NY, Kim JW, Baek JH, Baek HS, Yoon JW, Jee HM, Choi SH, Kim HY, Kim KE, Shin YH, Han MY. Clinical risk factors associated with the development of wheezing in children less than 2 years of age who required hospitalization for viral lower respiratory tract infections. KOREAN JOURNAL OF PEDIATRICS 2015; 58:245-50. [PMID: 26300938 PMCID: PMC4543183 DOI: 10.3345/kjp.2015.58.7.245] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 09/11/2014] [Accepted: 10/07/2014] [Indexed: 11/27/2022]
Abstract
Purpose Wheezing following viral lower respiratory tract infections (LRTIs) in children <2 years of age is an important risk factor for the development of asthma later in life; however, not all children with viral LRTIs develop wheezing. This study investigated risk factors for the development of wheezing during viral LRTIs requiring hospitalization. Methods The study included 142 children <2 years of age hospitalized for LRTIs with at least one virus identified as the cause and classified them into children diagnosed with LRTIs with wheezing (n=70) and those diagnosed with LRTIs without wheezing (n=72). Results There were no significant differences in the viruses detected between the two groups. Multivariate logistic regression analysis showed that, after adjusting for potentially confounding variables including sex and age, the development of wheezing was strongly associated with parental history of allergic diseases (adjusted odds ratio [aOR], 20.19; 95% confidence interval [CI], 3.22-126.48), past history of allergic diseases (aOR, 13.95; 95% CI, 1.34-145.06), past history of hospitalization for respiratory illnesses (aOR, 21.36; 95% CI, 3.77-120.88), exposure to secondhand smoke at home (aOR, 14.45; 95% CI, 4.74-44.07), and total eosinophil count (aOR, 1.01; 95% CI, 1.01-1.02). Conclusion Past and parental history of allergic diseases, past history of hospitalization for respiratory illnesses, exposure to secondhand smoke at home, and total eosinophil count were closely associated with the development of wheezing in children <2 years of age who required hospitalization for viral LRTIs. Clinicians should take these factors into consideration when treating, counseling, and monitoring young children admitted for viral LRTIs.
Collapse
Affiliation(s)
- Joon Hwan Kim
- Department of Pediatrics, CHA Bundang Medical Center, Seongnam, Korea
| | - Ji-Yeon Choi
- Department of Pediatrics, CHA Bundang Medical Center, Seongnam, Korea
| | - Na Yeon Kim
- Department of Pediatrics, CHA Bundang Medical Center, Seongnam, Korea
| | - Jin Woo Kim
- Department of Pediatrics, CHA Bundang Medical Center, Seongnam, Korea
| | - Ji Hyeon Baek
- Department of Pediatrics, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Hye Sung Baek
- Department of Pediatrics, Hallym University Kandong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Jung Won Yoon
- Department of Pediatrics, Myongji Hospital, Goyang, Korea
| | - Hye Mi Jee
- Department of Pediatrics, CHA Bundang Medical Center, Seongnam, Korea. ; CHA University School of Medicine, Pocheon, Korea
| | - Sun Hee Choi
- Department of Pediatrics, Kyung Hee University School of Medicine, Seoul, Korea
| | - Hyeung Yoon Kim
- Department of Pediatrics, Bundang Jesaeng Hospital, Seongnam, Korea
| | - Ki Eun Kim
- CHA University School of Medicine, Pocheon, Korea. ; Department of Pediatrics, CHA Gangnam Medical Center, Seoul, Korea
| | - Youn Ho Shin
- CHA University School of Medicine, Pocheon, Korea. ; Department of Pediatrics, CHA Gangnam Medical Center, Seoul, Korea
| | - Man Yong Han
- Department of Pediatrics, CHA Bundang Medical Center, Seongnam, Korea. ; CHA University School of Medicine, Pocheon, Korea
| |
Collapse
|
23
|
Casas L, Espinosa A, Borràs-Santos A, Jacobs J, Krop E, Heederik D, Nemery B, Pekkanen J, Hyvärinen A, Täubel M, Zock JP. Domestic use of bleach and infections in children: a multicentre cross-sectional study. Occup Environ Med 2015; 72:602-4. [PMID: 25838260 DOI: 10.1136/oemed-2014-102701] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 02/03/2015] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To report the effects of bleach use at home on the frequency of infections in 9102 school-age children participating in the HITEA project. METHODS Parents of pupils aged 6-12 years from schools in Barcelona province (Spain), Utrecht province (the Netherlands) and Eastern and Central Finland were administered a questionnaire including questions on the frequency of infections (influenza, tonsillitis, sinusitis, otitis, bronchitis and pneumonia) in the past 12 months and bleach use at home. We developed multivariable mixed-effects multilogistic regression models to obtain relative risk ratios (RRR) and their 95% CI per country, and combined the RRR using random-effects meta-analyses. RESULTS Bleach use was common in Spain (72%, n=1945) and uncommon in Finland (7%, n=279). Overall, the prevalence of infections (recurrent or once) was higher among children of bleach users. Significant combined associations were shown for influenza only once (RRR=1.20, 95% CI 1.04 to 1.38), recurrent tonsillitis (RRR=1.35, 95% CI 1.07 to 1.71) and any infection (RRR=1.18, 95% CI 1.01 to 1.38). CONCLUSIONS Passive exposure to cleaning bleach in the home may have adverse effects on school-age children's health by increasing the risk of respiratory and other infections. The high frequency of use of disinfecting irritant cleaning products may be of public health concern, also when exposure occurs during childhood.
Collapse
Affiliation(s)
- Lidia Casas
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain University Pompeu Fabra (UPF), Barcelona, Spain
| | - Ana Espinosa
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain University Pompeu Fabra (UPF), Barcelona, Spain Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Alícia Borràs-Santos
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain University Pompeu Fabra (UPF), Barcelona, Spain
| | - José Jacobs
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Esmeralda Krop
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Dick Heederik
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Benoit Nemery
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Juha Pekkanen
- Department of Health Protection, National Institute for Health and Welfare (THL), Kuopio, Finland Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Anne Hyvärinen
- Department of Health Protection, National Institute for Health and Welfare (THL), Kuopio, Finland
| | - Martin Täubel
- Department of Health Protection, National Institute for Health and Welfare (THL), Kuopio, Finland
| | - Jan-Paul Zock
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| |
Collapse
|
24
|
Dick S, Friend A, Dynes K, AlKandari F, Doust E, Cowie H, Ayres JG, Turner SW. A systematic review of associations between environmental exposures and development of asthma in children aged up to 9 years. BMJ Open 2014; 4:e006554. [PMID: 25421340 PMCID: PMC4244417 DOI: 10.1136/bmjopen-2014-006554] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Childhood asthma is a complex condition where many environmental factors are implicated in causation. The aim of this study was to complete a systematic review of the literature describing associations between environmental exposures and the development of asthma in young children. SETTING A systematic review of the literature up to November 2013 was conducted using key words agreed by the research team. Abstracts were screened and potentially eligible papers reviewed. Papers describing associations between exposures and exacerbation of pre-existing asthma were not included. Papers were placed into the following predefined categories: secondhand smoke (SHS), inhaled chemicals, damp housing/mould, inhaled allergens, air pollution, domestic combustion, dietary exposures, respiratory virus infection and medications. PARTICIPANTS Children aged up to 9 years. PRIMARY OUTCOMES Diagnosed asthma and wheeze. RESULTS 14,691 abstracts were identified, 207 papers reviewed and 135 included in the present review of which 15 were systematic reviews, 6 were meta-analyses and 14 were intervention studies. There was consistent evidence linking exposures to SHS, inhaled chemicals, mould, ambient air pollutants, some deficiencies in maternal diet and respiratory viruses to an increased risk for asthma (OR typically increased by 1.5-2.0). There was less consistent evidence linking exposures to pets, breast feeding and infant dietary exposures to asthma risk, and although there were consistent associations between exposures to antibiotics and paracetamol in early life, these associations might reflect reverse causation. There was good evidence that exposures to house dust mites (in isolation) was not associated with asthma risk. Evidence from observational and intervention studies suggest that interactions between exposures were important to asthma causation, where the effect size was typically 1.5-3.0. CONCLUSIONS There are many publications reporting associations between environmental exposures and modest changes in risk for asthma in young children, and this review highlights the complex interactions between exposures that further increase risk.
Collapse
Affiliation(s)
- S Dick
- Occupational and Environmental Medicine, University of Aberdeen, Aberdeen, UK
| | - A Friend
- Department of Child Health, University of Aberdeen, Aberdeen, UK
| | - K Dynes
- Department of Child Health, University of Aberdeen, Aberdeen, UK
| | - F AlKandari
- Department of Child Health, University of Aberdeen, Aberdeen, UK
| | - E Doust
- Institute of Occupational Medicine, Edinburgh, UK
| | - H Cowie
- Institute of Occupational Medicine, Edinburgh, UK
| | - J G Ayres
- Occupational and Environmental Medicine, University of Aberdeen, Aberdeen, UK
- Environmental and Respiratory Medicine, University of Birmingham, Birmingham, UK
| | - S W Turner
- Department of Child Health, University of Aberdeen, Aberdeen, UK
| |
Collapse
|
25
|
Camacho-Rivera M, Kawachi I, Bennett GG, Subramanian SV. Associations of neighborhood concentrated poverty, neighborhood racial/ethnic composition, and indoor allergen exposures: a cross-sectional analysis of los angeles households, 2006-2008. J Urban Health 2014; 91:661-76. [PMID: 24771244 PMCID: PMC4134442 DOI: 10.1007/s11524-014-9872-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Although racial/ethnic, socioeconomic, and neighborhood factors have been linked to asthma, and the association between indoor allergens and asthma is well documented, few studies have examined the relationship between these factors and indoor allergens. We examined the frequency of reported indoor allergens and differences by racial/ethnic, socioeconomic, and neighborhood characteristics among a diverse sample of Los Angeles households. Multilevel logistic regression models were used to analyze the data from 723 households from wave 2 of the Los Angeles Family and Neighborhood Survey. The reported presence of rats, mice, cockroaches, mold, pets, and tobacco smoke were the primary outcomes of interest. Hispanic and Asian households had a nearly threefold increase in the odds of reporting cockroaches compared to non-Hispanic Whites (OR, 2.85; 95 % CI 1.38-5.88 and OR, 2.62; 95 % CI 1.02-6.73, respectively) even after adjusting for socioeconomic factors. Primary caregivers who had obtained a high school degree were significantly less likely to report the presence of mice and cockroaches compared to primary caregivers with less than a high school degree (OR, 0.19; 95 % CI 0.08-0.46 and OR, 0.39; 95 % CI 0.23-0.68, respectively). Primary caregivers with more than a high school degree were also less likely to report the presence of rats, mice, and cockroaches within their households, compared to those with less than a high school degree. Compared to renters, home owners were less likely to report the presence of mice, cockroaches, and mold within their households. At the neighborhood level, households located within neighborhoods of high concentrated poverty (where the average poverty rate is at least 50 %) were more likely to report the presence of mice and cockroaches compared to households in low concentrated poverty neighborhoods (average poverty rate is 10 % or less), after adjusting for individual race/ethnicity and socioeconomic characteristics. Our study found evidence in support of neighborhood-level racial/ethnic and socioeconomic influences on indoor allergen exposure, above and beyond individual factors. Future studies should continue to explore individual and neighborhood-level racial/ethnic and socioeconomic differences in household allergen exposures across diverse contexts.
Collapse
Affiliation(s)
- Marlene Camacho-Rivera
- Department of Population Health, North Shore-Long Island Jewish Health System, Great Neck, NY, USA
| | | | | | | |
Collapse
|
26
|
Mari A, Antonietta Ciardiello M, Passalacqua G, Vliagoftis H, Wardlaw AJ, Wickman M. Developments in the field of allergy in 2012 through the eyes of Clinical & Experimental Allergy. Clin Exp Allergy 2014; 43:1309-32. [PMID: 24118214 DOI: 10.1111/cea.12212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In 2012, we received 683 submissions and published 20 editorials, 38 reviews, 11 letters and 128 original articles. This represents an acceptance rate for original papers in the range of 20%. About 30% of original papers were triaged not to go out to review, either because the editors did not feel they had sufficient priority for publication or because the topic did not feel right for the readers of the journal. We place great emphasis on obtaining sufficient high-quality reviews to make our decisions on publication fair and consistent. Inevitably, however, there is a degree of luck about what gets published and which papers miss out, and we are always happy to receive an appeal on our decisions either at the triage stage or after review. This gives us the opportunity to revisit the decision and revise it or explain in more detail to the authors the basis for the decision. Once again in 2012, we were delighted by the quality of the papers submitted and the breadth and depth of research into allergic disease that it revealed. The pattern of papers submitted was similar in previous years with considerable emphasis on all aspects of asthma and rhinitis. We were particularly pleased with our special issue on severe asthma. Elucidating mechanisms using either animal models or patients has always been a major theme of the journal, and the excellent work in these areas has been summarized by Harissios Vliagoftis with a particularly interesting section on early-life events guiding the development of allergic disease, which understandably continue to be a major theme of research. Magnus Wickman summarized the papers looking at the epidemiology of allergic disease including work from birth cohorts, which are an increasingly rich source of data on risk factors for allergic disease, and two papers on the epidemiology of anaphylaxis. Giovanni Passalacqua discussed the papers in the clinical allergy section of the journal, and Adriano Mari who runs the excellent Allergome website discussed the papers looking at allergens including characterization and the relative usefulness of allergen arrays versus single extracts in diagnosis and management.
Collapse
Affiliation(s)
- A Mari
- Allergome, Allergy Data Laboratories s.c., Latina, Italy
| | | | | | | | | | | |
Collapse
|
27
|
Cong S, Araki A, Ukawa S, Ait Bamai Y, Tajima S, Kanazawa A, Yuasa M, Tamakoshi A, Kishi R. Association of mechanical ventilation and flue use in heaters with asthma symptoms in Japanese schoolchildren: a cross-sectional study in Sapporo, Japan. J Epidemiol 2014; 24:230-8. [PMID: 24747197 PMCID: PMC4000771 DOI: 10.2188/jea.je20130135] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background Use of fuel heaters is associated with childhood asthma. However, no studies have evaluated the associations of flue use and mechanical ventilation (ventilation) with asthma symptoms in schoolchildren. Methods This cross-sectional study investigated schoolchildren in grades 1 through 6 (age 6–12 years) in Sapporo, Japan. From November 2008 through January 2009, parents completed questionnaires regarding their home environment and their children’s asthma symptoms. Results In total, 4445 (69.5%) parents of 6393 children returned the questionnaire. After excluding incomplete responses, data on 3874 children (60.6%) were analyzed. The prevalence of current asthma symptoms and ever asthma symptoms were 12.8% and 30.9%, respectively. As compared with electric heaters, current asthma symptoms was associated with use of flued heaters without ventilation (OR = 1.62; 95% CI, 1.03–2.64) and unflued heaters with ventilation (OR = 1.77; 95% CI, 1.09–2.95) or without ventilation (OR = 2.23; 95% CI, 1.31–3.85). Regardless of dampness, unflued heaters were significantly associated with current asthma symptoms in the presence and absence of ventilation. Conclusions Use of unflued heaters was associated with current asthma symptoms, regardless of dampness. In particular, the prevalence of current asthma symptoms was higher in the absence of ventilation than in the presence of ventilation. Ever asthma symptoms was only associated with use of unflued heaters without ventilation. Consequently, use of fuel heaters, especially those that have no flue or ventilation, deserves attention, as their use might be associated with childhood asthma symptoms.
Collapse
Affiliation(s)
- Shi Cong
- Hokkaido University Graduate School of Medicine, Department of Public Health Sciences
| | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Bédard A, Varraso R, Sanchez M, Clavel-Chapelon F, Zock JP, Kauffmann F, Le Moual N. Cleaning sprays, household help and asthma among elderly women. Respir Med 2013; 108:171-80. [PMID: 24238771 DOI: 10.1016/j.rmed.2013.10.018] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 10/21/2013] [Accepted: 10/23/2013] [Indexed: 01/09/2023]
Abstract
OBJECTIVE There is increasing evidence on the deleterious role in asthma of the use of household cleaning products in spray forms in adults. Household help might induce misclassification errors. The aim of the present analysis was to study associations between household exposure to cleaning sprays and current asthma in elderly women, taking into account household help. METHODS A nested case-control survey on respiratory health was undertaken among a random sample of French women from the E3N study. Data were available for 570 women (235 with current asthma and 335 without asthma history; 68 years old on average, 59% never smokers). Three estimates of domestic exposure were used: 1) self-reported, 2) using principal component analysis, 3) a composite score for sprays. Associations between domestic exposures and asthma were assessed by logistic regression, adjusted for age, educational level, BMI and smoking status. Analyses were further stratified on household help in order to evaluate a potential misclassification bias. RESULTS Among women without household help (n = 325), a significant association was observed between weekly use of at least one spray and current asthma (OR [95% CI]: 1.86[1.04-3.33]). No association was observed among women with household help. CONCLUSIONS Weekly household use of cleaning sprays may have a deleterious effect on asthma. It is important to take into account household help to limit misclassification bias.
Collapse
Affiliation(s)
- Annabelle Bédard
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Respiratory and Environmental Epidemiology Team, F-94807 Villejuif, France; Univ Paris Sud, UMRS 1018, F-94807 Villejuif, France.
| | - Raphaëlle Varraso
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Respiratory and Environmental Epidemiology Team, F-94807 Villejuif, France; Univ Paris Sud, UMRS 1018, F-94807 Villejuif, France
| | - Margaux Sanchez
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Respiratory and Environmental Epidemiology Team, F-94807 Villejuif, France; Univ Paris Sud, UMRS 1018, F-94807 Villejuif, France
| | - Françoise Clavel-Chapelon
- Univ Paris Sud, UMRS 1018, F-94807 Villejuif, France; Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, hormones et santé de la femme Team, Gustave Roussy Institute, F-94805 Villejuif, France
| | - Jan-Paul Zock
- Centre for Research in Environmental Epidemiology (CREAL), 08003 Barcelona, Spain; IMIM, Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), 08003 Spain
| | - Francine Kauffmann
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Respiratory and Environmental Epidemiology Team, F-94807 Villejuif, France; Univ Paris Sud, UMRS 1018, F-94807 Villejuif, France
| | - Nicole Le Moual
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Respiratory and Environmental Epidemiology Team, F-94807 Villejuif, France; Univ Paris Sud, UMRS 1018, F-94807 Villejuif, France
| |
Collapse
|
29
|
Baumann S, Lorentz A. Obesity - a promoter of allergy? Int Arch Allergy Immunol 2013; 162:205-13. [PMID: 24021931 DOI: 10.1159/000353972] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The prevalence of both obesity and allergy has been increasing throughout the world, leading to the hypothesis that the two are linked to one another. This overview summarizes the results of 34 studies from 2002 to 2012 that investigated a possible contributing effect of increasing body mass on the development and prevalence of various atopic diseases. Obesity was found to clearly affect bronchial asthma. However, the correlation was stronger in the nonatopic asthma phenotype. Obesity was found to be associated with the development of atopic dermatitis in children only. No clear association was found between obesity and the prevalence of allergic rhinitis or allergic conjunctivitis or increased sensitization to food allergens. This review sums up our study results and discusses a possible role of obesity in the promotion of allergy and asthma.
Collapse
Affiliation(s)
- Susanne Baumann
- Department of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | | |
Collapse
|
30
|
Abstract
The present review addresses recent advances and especially challenging aspects regarding the role of environmental risk factors in adult-onset asthma, for which the causes are poorly established. In the first part of the review, we discuss aspects regarding some environmental risk factors for adult-onset asthma: air pollution, occupational exposures with a focus on an emerging risk represented by exposure to cleaning agents (both at home and in the workplace), and lifestyle and nutrition. The second part is focused on perspectives and challenges, regarding relevant topics on which research is needed to improve the understanding of the role of environmental factors in asthma. Aspects of exposure assessment, the complexity of multiple exposures, the interrelationships of the environment with behavioral characteristics and the importance of studying biological markers and gene-environment interactions to identify the role of the environment in asthma are discussed. We conclude that environmental and lifestyle exposures play an important role in asthma or related phenotypes. The changes in lifestyle and the environment in recent decades have modified the specific risk factors in asthma even for well-recognized risks such as occupational exposures. To better understand the role of the environment in asthma, the use of objective (quantitative measurement of exposures) or modern tools (bar code, GPS) and the development of multidisciplinary collaboration would be very promising. A better understanding of the complex interrelationships between socio-economic, nutritional, lifestyle and environmental conditions might help to study their joint and independent roles in asthma.
Collapse
|
31
|
Exposure to cats: update on risks for sensitization and allergic diseases. Curr Allergy Asthma Rep 2013; 12:413-23. [PMID: 22878928 DOI: 10.1007/s11882-012-0288-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Cats are the pets most commonly implicated in the etiology of asthma and allergic disease. However, systematic reviews have concluded that there is a lack of evidence to support the idea that cat exposure in early life increases the risk of allergic disease. Indeed, it appears most likely that cat exposure is protective against allergic diseases. Recent large prospective studies have shown that living with a cat during childhood, especially during the first year of a child's life, could be protective. However, any advice given to the parents should also incorporate how new acquisition of cats can affect other family members, especially those who are already sensitized. Research is urgently needed to determine whether the suggested impact of acquisition of cats in adult life is modified by the person's childhood pet ownership, to help parents who seek advice on whether or not to get a cat.
Collapse
|
32
|
Risk factors and characteristics of respiratory and allergic phenotypes in early childhood. J Allergy Clin Immunol 2012; 130:389-96.e4. [PMID: 22846748 DOI: 10.1016/j.jaci.2012.05.054] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2011] [Revised: 05/21/2012] [Accepted: 05/22/2012] [Indexed: 11/23/2022]
Abstract
BACKGROUND Unsupervised approaches can be used to analyze complex respiratory and allergic disorders. OBJECTIVE We investigated the respiratory and allergic phenotypes of children followed in the Pollution and Asthma Risk: An Infant Study (PARIS) birth cohort. METHODS Information on respiratory and allergic disorders, medical visits, and medications was collected during medical examinations of children at 18 months of age; biomarker data were also collected (total and allergen-specific IgE levels and eosinophilia). Phenotypes were determined by using latent class analysis. Associated risk factors were determined based on answers to questionnaires about environmental exposures. RESULTS Apart from a reference group, which had a low prevalence of respiratory symptoms or allergies (n=1271 [69.4%]), 3 phenotypes were identified. On the basis of clinical signs of severity and use of health care resources, we identified a mild phenotype (n=306 [16.7%]) characterized by occasional mild wheeze and 2 severe phenotypes separated by atopic status. The atopic severe phenotype (n=59 [3.2%]) included 49 (83%) children with wheezing and was characterized by a high prevalence of atopy (61% with allergenic sensitization) and atopic dermatitis (78%). In contrast, atopy was rare among children with the nonatopic severe phenotype (n=195 [11%]); this group included 88% of the children with recurrent wheezing. Risk factors for respiratory disease included parental history of asthma, male sex, siblings, day care attendance, exposure to tobacco smoke or molds, indoor renovations, and being overweight, although these factors did not have similar affects on risk for all phenotypes. CONCLUSION Atopy should be taken into account when assessing the risk of severe exacerbations (that require hospital-based care) in wheezing infants; precautions should be taken against respiratory irritants and molds and to prevent children from becoming overweight.
Collapse
|
33
|
Casas L, Zock JP, Carsin AE, Fernandez-Somoano A, Esplugues A, Santa-Marina L, Tardón A, Ballester F, Basterrechea M, Sunyer J. The use of household cleaning products during pregnancy and lower respiratory tract infections and wheezing during early life. Int J Public Health 2012; 58:757-64. [DOI: 10.1007/s00038-012-0417-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Revised: 09/17/2012] [Accepted: 09/26/2012] [Indexed: 10/27/2022] Open
|