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Keller A, Groot J, Clippet-Jensen C, Pinot de Moira A, Pedersen M, Sigsgaard T, Loft S, Budtz-Jørgensen E, Nybo Andersen AM. Exposure to different residential indoor characteristics during childhood and asthma in adolescence: a latent class analysis of the Danish National Birth Cohort. Eur J Epidemiol 2024; 39:51-65. [PMID: 37865616 PMCID: PMC10811114 DOI: 10.1007/s10654-023-01051-y] [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: 12/09/2022] [Accepted: 09/11/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND Many residential indoor environments may have an impact on children's respiratory health. OBJECTIVES The aims of this study were to identify latent classes of children from the Danish National Birth Cohort (DNBC) who share similar patterns of exposure to indoor home characteristics, and to examine the association between membership in the latent classes and asthma in adolescence. METHODS We included data on residential indoor characteristics of offspring from the DNBC whose mothers had responded to the child's 11-year follow-up and who had data on asthma from the 18-year follow-up. Number of classes and associations were estimated using latent class analysis. To account for sample selection, we applied inverse probability weighting. RESULTS Our final model included five latent classes. The probability of current asthma at 18 years was highest among individuals in class one with higher clustering on household dampness (9, 95%CI 0.06-0.13). Individuals in class four (with higher clustering on pets ownership and living in a farm) had a lower risk of current asthma at age 18 compared to individuals in class one (with higher clustering on household dampness) (OR 0.53 (95%CI 0.32-0.88), p = .01). CONCLUSION Our findings suggest that, in a high-income country such as Denmark, groups of adolescents growing up in homes with mold and moisture during mid-childhood might be at increased risk of current asthma at age 18. Adolescents who grew-up in a farmhouse and who were exposed to pets seem less likely to suffer from asthma by age 18.
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Affiliation(s)
- Amélie Keller
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Jonathan Groot
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Clara Clippet-Jensen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Angela Pinot de Moira
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- National Heart and Lung Institute, Imperial College, London, United Kingdom
| | - Marie Pedersen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Torben Sigsgaard
- Environment, Work and Health, Department of Public Health, University of Aarhus, Aarhus, Denmark
| | - Steffen Loft
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Esben Budtz-Jørgensen
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anne-Marie Nybo Andersen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Cao C, Wang Y, Peng L, Wu W, Yang H, Li Z. Asthma and Other Respiratory Diseases of Children in Relation to Personal Behavior, Household, Parental and Environmental Factors in West China. TOXICS 2023; 11:964. [PMID: 38133365 PMCID: PMC10747494 DOI: 10.3390/toxics11120964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 11/23/2023] [Accepted: 11/24/2023] [Indexed: 12/23/2023]
Abstract
Asthma and other respiratory diseases, which are of great concern in public health, are paid less attention in areas that are less economically developed. This research aimed to study the prevalence of critical respiratory diseases of children living in West China and figure out the potential influencing factors. A total of 575 children under the age of 14 were recruited from Xinjiang, China, to participate in the study in 2022. Information on activity patterns, socioeconomic and parental factors, and household and surrounding environment situations was obtained using a questionnaire survey. Logistic regression models were applied to estimate the odds ratios of respiratory disease prevalence in relation to behavior patterns, household, parental and environmental factors, respectively. The prevalence of ever doctor-diagnosed asthma, doctor-diagnosed bronchitis and current bronchitis were 4.7%, 19.0% and 14.4%, respectively. The prevalence of doctor-diagnosed pneumonia was 8.2%, which was two times higher in urban than rural areas. Longer annual heating duration was significantly associated with higher risks in children's asthma and bronchitis, with an odds ratio (OR) and 95% confidence interval (95% CI) of 3.363 (95% CI: 1.215-9.298) and 1.267 (95% CI: 1.002-1.601), respectively. Opening the window longer in autumn would lead to higher risks of bronchitis, with ORs of 1.165 and 1.133, respectively, for doctor-diagnosed bronchitis and current bronchitis. Residential air pollution and having a residence close to waste incineration plant or garbage station were, respectively, significantly associated with higher risks of doctor-diagnosed bronchitis and asthma. Parental disease history was associated with a higher prevalence of children's asthma and respiratory diseases, whereas breastfeeding and doing physical exercise were, respectively, significantly associated with a lower risk of asthma. A high prevalence of respiratory diseases in children in West China may be partly attributed to longer annual heating time, opening windows longer in autumn, surrounding environmental pollution, as well as parental disease history, whereas promoting physical activity and breastfeeding could be an effective measure to reduce the risk of childhood asthma in West China.
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Affiliation(s)
- Changan Cao
- School of Medicine, Xiamen University, Xiamen 361104, China;
| | - Yuna Wang
- School of Chemical and Environmental Sciences, YiLi Normal University, Yining 835000, China; (Y.W.)
| | - Li Peng
- School of Energy and Environmental Engineering, University of Science of Technology Beijing, Beijing 10083, China;
| | - Weiqi Wu
- Department of Geography, University College London, London WC1E 6BT, UK;
| | - Huimin Yang
- School of Chemical and Environmental Sciences, YiLi Normal University, Yining 835000, China; (Y.W.)
| | - Zhigang Li
- Chinese Research Academy of Environmental Sciences, Beijing 100012, China
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Tischer C, Täubel M, Kirjavainen PV, Depner M, Hyvärinen A, Piippo-Savolainen E, Pekkanen J, Karvonen AM. Early-life residential exposure to moisture damage is associated with persistent wheezing in a Finnish birth cohort. Pediatr Allergy Immunol 2022; 33:e13864. [PMID: 36282133 PMCID: PMC9828426 DOI: 10.1111/pai.13864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 09/15/2022] [Accepted: 09/22/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND AIMS Moisture damage increases the risk for respiratory disorders in childhood. Our aim was to determine whether early age residential exposure to inspector-observed moisture damage or mold is associated with different wheezing phenotypes later in childhood. METHODS Building inspections were performed by civil engineers, in a standardized manner, in the children's homes-mostly single family and row houses (N = 344)-in the first year of life. The children were followed up with repeated questionnaires until the age of 6 years and wheezing phenotypes-never/infrequent, transient, intermediate, late onset, and persistent-were defined using latent class analyses. The multinomial logistic regression model was used for statistical analysis. RESULTS A total of 63% (n = 218) had infrequent or no wheeze, 23% (n = 80) had transient and 9.6% (n = 21) had a persistent wheeze. Due to the low prevalence, results for intermediate (3.8%, n = 13) and late-onset wheeze (3.5%, n = 12) were not further evaluated. Most consistent associations were observed with the persistent wheeze phenotype with an adjusted odds ratio (95% confidence intervals) 2.04 (0.67-6.18) for minor moisture damage with or without mold spots (present in 23.8% of homes) and 3.68 (1.04-13.05) for major damage or any moisture damage with visible mold in a child's main living areas (present in 13.4% of homes). Early-age moisture damage or mold in the kitchen was associated with transient wheezing. CONCLUSION At an early age, residential exposure to moisture damage or mold, can be dose-dependently associated especially with persistent wheezing phenotype later in childhood.
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Affiliation(s)
- Christina Tischer
- Institute of Clinical Epidemiology and Biometry, University of Wuerzburg, Wuerzburg, Germany.,State Institute of Health, Bavarian Health and Food Safety Authority, Bad Kissingen, Germany.,Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland.,European Foundation for the Care of Newborn Infants (EFCNI), Munich, Germany
| | - Martin Täubel
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Pirkka V Kirjavainen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Martin Depner
- Institute for Asthma and Allergy Prevention (IAP), Helmholtz Zentrum München1, Neuherberg, Germany
| | - Anne Hyvärinen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Eija Piippo-Savolainen
- Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland.,Department of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Juha Pekkanen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Anne M Karvonen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
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Vilén L, Päivinen M, Atosuo J, Putus T. Transferring from moisture damaged school building to clean facilities - The avoidance of mold exposure induces a decline in symptoms and improvement in lung function among personnel. ENVIRONMENTAL RESEARCH 2022; 212:113598. [PMID: 35660408 DOI: 10.1016/j.envres.2022.113598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 05/25/2022] [Accepted: 05/30/2022] [Indexed: 06/15/2023]
Abstract
Working in a moisture-damaged building can cause different symptoms and effects on lung functions. Moving to a clean environment, it is believed to reduce symptoms and alleviate potential adverse health effects. This case study monitors the health effects of personnel in one school building before and after all school activities were transferred from a moisture-damaged school building to clean premises. The whole school staff was invited to attend this follow-up study. All participants (N = 45) were interviewed, and pulmonary functions were measured by spirometry and exhaled nitric oxide testing (FENO) before transferring the school activities to a new building and the control measurements were performed twice; three months and six months after the transfer. After transferring to temporary facilities, 82% of participants felt that their symptoms were improved or resolved and the pulmonary functions were improved; 50% of those who had decreased pulmonary functions at the beginning, their pulmonary function values returned to normal after three months. Over the next six months, the perceived symptoms continued to reduce so that 93% of the respondents felt fully asymptomatic with respect to indoor air, and the spirometry results improved further. Transferring workers from the damaged building to healthy environment provided beneficial health effects on pulmonary functions and to perceived symptoms even in a relatively short time period. Based on this study, and from the perspective of promoting and protecting the health and well-being of personnel, transferring school activities from a moisture damaged building to clean facilities brought considerable advantages, despite the possible cost and difficulties of finding replacement facilities.
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Affiliation(s)
- Liisa Vilén
- Department of Clinical Medicine, Environmental Medicine and Occupational Health, University of Turku, Turku, Finland; Clinical Research Unit TROSSI, University of Turku, Turku, Finland.
| | - Marja Päivinen
- Department of Clinical Medicine, Environmental Medicine and Occupational Health, University of Turku, Turku, Finland; Clinical Research Unit TROSSI, University of Turku, Turku, Finland
| | - Janne Atosuo
- Clinical Research Unit TROSSI, University of Turku, Turku, Finland; Department of Life Technologies, The Laboratory of Immunochemistry, University of Turku, Turku, Finland
| | - Tuula Putus
- Department of Clinical Medicine, Environmental Medicine and Occupational Health, University of Turku, Turku, Finland; Clinical Research Unit TROSSI, University of Turku, Turku, Finland
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Understanding the Cellular Sources of the Fractional Exhaled Nitric Oxide (FeNO) and Its Role as a Biomarker of Type 2 Inflammation in Asthma. BIOMED RESEARCH INTERNATIONAL 2022; 2022:5753524. [PMID: 35547356 PMCID: PMC9085317 DOI: 10.1155/2022/5753524] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/04/2022] [Accepted: 04/20/2022] [Indexed: 11/18/2022]
Abstract
Fractional exhaled nitric oxide (FeNO) has gained great clinical importance as a biomarker of type 2 inflammation in chronic airway diseases such as asthma. FeNO originates primarily in the bronchial epithelium and is produced in large quantities by the enzyme inducible nitric oxide synthase (iNOS). It should be noted that nitric oxide (NO) produced at femtomolar to picomolar levels is fundamental for respiratory physiology. This basal production is induced in the bronchial epithelium by interferon gamma (IFNγ) via Janus kinases (JAK)/STAT-1 signaling. However, when there is an increase in the expression of type 2 inflammatory cytokines such as IL-4 and IL-13, the STAT-6 pathway is activated, leading to overexpression of iNOS and consequently to an overproduction of airway NO. Increased NO levels contributes to bronchial hyperreactivity and mucus hypersecretion, increases vascular permeability, reduces ciliary heartbeat, and promotes free radical production, airway inflammation, and tissue damage. In asthmatic patients, FeNO levels usually rise above 25 parts per billion (ppb) and its follow-up helps to define asthma phenotype and to monitor the effectiveness of corticosteroid treatment and adherence to treatment. FeNO is also very useful to identify those severe asthma patients that might benefit of personalized therapies with monoclonal antibodies. In this review, we revised the cellular and molecular mechanisms of NO production in the airway and its relevance as a biomarker of type 2 inflammation in asthma.
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