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Veivers D, Williams GM, Toelle BG, de Waterman AMC, Guo Y, Denison L, Yang BY, Dong GH, Jalaludin B, Marks GB, Knibbs LD. The Indoor Environment and Otitis Media among Australian Children: A National Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031551. [PMID: 35162576 PMCID: PMC8835613 DOI: 10.3390/ijerph19031551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 02/01/2023]
Abstract
The association between the indoor environment and lifetime prevalence of otitis media (OM) in Australian children was assessed. We analysed data from a cross-sectional study of children, aged 7–11 years, performed in twelve Australian cities during 2007–2008. The main outcome was a parental report of their child’s diagnosis with OM by a doctor. Information on the indoor environment (energy sources used for heating, cooling, and cooking, pets, and second-hand smoke exposure), in the first year of life and at present, was collected from parents by a questionnaire. Multi-level logistic regression models were used to adjust for individual- and area-level confounders. Our analysis comprised 2872 children (51% female, mean age: 10.0 (SD 1.2)). Of those, 1097 (39%) were reported to have OM. Exposure to gas heating in the first year of life was significantly associated with higher odds of OM in adjusted models (OR:1.22; 95% CI: 1.00,1.47), as was current exposure to reverse-cycle air conditioning (OR: 1.52, 95% CI: 1.27,1.82). Ownership of a cat or dog at any time was also associated with high odds of OM (OR: 1.50; 95% CI: 1.17,1.92). No other significant associations were observed. In this national study of Australian children, indoor environmental exposures associated with the lifetime prevalence of OM were gas heating, reverse-cycle air conditioning and pet ownership. Exposures in both early life and later childhood may both play a role in OM.
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Affiliation(s)
- David Veivers
- Faculty of Medicine, School of Public Health, The University of Queensland, Herston, QLD 4006, Australia;
- Northern Clinical School, The University of Sydney, St. Leonards, Sydney, NSW 2065, Australia
- Correspondence: ; Tel.: +61-2-94360012
| | - Gail M. Williams
- Faculty of Medicine, School of Public Health, The University of Queensland, Herston, QLD 4006, Australia;
| | - Brett G. Toelle
- Sydney Local Health District, Sydney, NSW 2050, Australia;
- Woolcock Institute of Medical Research, The University of Sydney, Sydney, NSW 2006, Australia; (A.M.C.d.W.); (B.J.); (G.B.M.)
| | - Adriana M. Cortés de Waterman
- Woolcock Institute of Medical Research, The University of Sydney, Sydney, NSW 2006, Australia; (A.M.C.d.W.); (B.J.); (G.B.M.)
| | - Yuming Guo
- Centre for Air Pollution, Energy and Health Research, Glebe, NSW 2037, Australia; (Y.G.); (L.D.K.)
- Department of Epidemiology and Biostatistics, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Lyn Denison
- ERM Services Australia, Melbourne, VIC 3000, Australia;
| | - Bo-Yi Yang
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China;
| | - Guang-Hui Dong
- Population Health, South Western Sydney Local Health District, Liverpool, NSW 2170, Australia;
| | - Bin Jalaludin
- Woolcock Institute of Medical Research, The University of Sydney, Sydney, NSW 2006, Australia; (A.M.C.d.W.); (B.J.); (G.B.M.)
- Centre for Air Pollution, Energy and Health Research, Glebe, NSW 2037, Australia; (Y.G.); (L.D.K.)
- Population Health, South Western Sydney Local Health District, Liverpool, NSW 2170, Australia;
- Ingham Institute, Liverpool, NSW 2170, Australia
| | - Guy B. Marks
- Woolcock Institute of Medical Research, The University of Sydney, Sydney, NSW 2006, Australia; (A.M.C.d.W.); (B.J.); (G.B.M.)
- Centre for Air Pollution, Energy and Health Research, Glebe, NSW 2037, Australia; (Y.G.); (L.D.K.)
- South Western Sydney Clinical School, The University of New South Wales, Liverpool, NSW 2170, Australia
| | - Luke D. Knibbs
- Centre for Air Pollution, Energy and Health Research, Glebe, NSW 2037, Australia; (Y.G.); (L.D.K.)
- School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia
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Shahunja KM, Sly PD, Begum T, Biswas T, Mamun A. Family, neighborhood and psychosocial environmental factors and their associations with asthma in Australia: a systematic review and Meta-analysis. J Asthma 2021; 59:2539-2552. [PMID: 34905415 DOI: 10.1080/02770903.2021.2018707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Various associations between different environmental exposures and asthma have been reported in different countries and populations. We aimed to investigate the associations between family, neighborhood and psychosocial environmental factors and asthma-symptoms in Australia by conducting a systematic review and meta-analysis. DATA SOURCES We analyzed the primary research studies conducted in Australia across multiple databases, including PubMed, EMBASE and Scopus, published between 2000 and 2020. STUDY SELECTIONS The reviews and analyses focused on the overall association of different environmental exposures with the exacerbation of asthma-symptoms or asthma-related hospital visits. Quality-effect meta-analysis was done to estimate the pooled odds ratio for different environmental exposures for asthma-symptoms. RESULTS Among the 4799 unique published articles found, 46 were included here for systematic review and 28 for meta-analysis. Our review found that psychosocial factors, including low socioeconomic condition, maternal depression, mental stress, ethnicity, and discrimination, are associated with asthma-symptoms. Pooled analysis was conducted on family and neighborhood environmental factors and revealed that environmental tobacco smoking (ETS) (OR 1·69, 95% CI 1·19-2·38), synthetic bedding (OR 1·91, 95% CI 1·48-2·47) and gas heaters (OR 1·40, 95% CI 1·12-1·76) had significant overall associations with asthma-symptoms in Australia. CONCLUSION Although the studies were heterogeneous, both systematic review and meta-analysis found several psychosocial and family environmental exposures significantly associated with asthma-symptoms. Further study to identify their causal relationship and modification may reduce asthma-symptoms in the Australian population.
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Affiliation(s)
- K M Shahunja
- Institute for Social Science Research, The University of Queensland, Brisbane, Australia.,ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Australia.,The Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Brisbane, Australia
| | - Peter D Sly
- Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Tahmina Begum
- Institute for Social Science Research, The University of Queensland, Brisbane, Australia.,ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Australia
| | - Tuhin Biswas
- Institute for Social Science Research, The University of Queensland, Brisbane, Australia.,ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Australia
| | - Abdullah Mamun
- Institute for Social Science Research, The University of Queensland, Brisbane, Australia.,ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Australia.,The Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Brisbane, Australia
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Investigating the relationship between environmental factors and respiratory health outcomes in school children using the forced oscillation technique. Int J Hyg Environ Health 2017; 220:494-502. [DOI: 10.1016/j.ijheh.2017.01.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 12/28/2016] [Accepted: 01/03/2017] [Indexed: 11/21/2022]
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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.
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Affiliation(s)
- Shi Cong
- Hokkaido University Graduate School of Medicine, Department of Public Health Sciences
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Lin W, Brunekreef B, Gehring U. Meta-analysis of the effects of indoor nitrogen dioxide and gas cooking on asthma and wheeze in children. Int J Epidemiol 2013; 42:1724-37. [PMID: 23962958 DOI: 10.1093/ije/dyt150] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Since the meta-analysis on the association between indoor nitrogen dioxide (NO2) and childhood respiratory illness in 1992, many new studies have been published. The quantitative effects of indoor NO2 on respiratory illness have not been estimated in a formal meta-analysis since then. We aimed to quantify the association of indoor NO2 and its main source (gas cooking) with childhood asthma and wheeze. METHODS We extracted the association between indoor NO2 (and gas cooking) and childhood asthma and wheeze from population studies published up to 31 March 2013. Data were analysed by inverse-variance-weighted, random-effects meta-analysis. Sensitivity analyses were conducted for different strata. Publication bias and heterogeneity between studies were investigated. RESULTS A total of 41 studies met the inclusion criteria. The summary odds ratio from random effects meta-analysis for asthma and gas cooking exposure was 1.32 [95% confidential interval (CI) 1.18-1.48], and for a 15-ppb increase in NO2 it was 1.09 (95% CI 0.91-1.31). Indoor NO2 was associated with current wheeze (random effects OR 1.15; 95% CI 1.06-1.25). The estimates did not vary much with age or between regions. There was no evidence of publication bias. CONCLUSIONS This meta-analysis provides quantitative evidence that, in children, gas cooking increases the risk of asthma and indoor NO2 increases the risk of current wheeze.
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Affiliation(s)
- Weiwei Lin
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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Demir AU, Celikel S, Karakaya G, Kalyoncu AF. Asthma and allergic diseases in school children from 1992 to 2007 with incidence data. J Asthma 2010; 47:1128-35. [PMID: 21039212 DOI: 10.3109/02770903.2010.517336] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Information about change in the prevalence of asthma and allergic diseases and factors related with these diseases would be beneficial in decreasing the burden of these diseases. OBJECTIVE To assess (i) change in prevalence of asthma and allergic diseases; (ii) factors associated with asthma and wheeze; and (iii) incidence of asthma and wheeze. METHODS A questionnaire was administered to children aged 7-12 years in first five grades in the same primary school in 1992 (n: 1036), 1997 (n: 738), 2002 (n: 621), and 2007 (n: 422) and filled by the parents. A second survey in 2007 (n: 474, in eight grades) was conducted in the same schoolchildren, 6 months apart, to assess the incidence of asthma and wheeze and the associated factors. RESULTS Comparison of 1992, 1997, 2002, and 2007 surveys revealed that prevalence of asthma (8.3%, 9.8%, 6.4%, 3.3%, respectively), wheeze (11.9%, 13.3%, 6.4%, 3.1%, respectively), hay fever (15.4%, 14.1%, 7.2%, 3.1%, respectively), and eczema (4.0%, 4.3%, 1.8%, 1.2%, respectively) were significantly lower in 2002 and 2007 compared with that in 1992. Percentage of passive smoking decreased after 1992 (74.0%, 64.0%, 64.1%, and 65.5%, respectively). Incidence of asthma and wheeze in 2007 surveys were 0.9/100 and 1.1/100, respectively. After the adjustment for age and gender, infection in the past, family atopy, and presence of atopic disease (eczema or hay fever) were associated with asthma and wheeze. Maternal smoking and lack of breast feeding were associated with asthma. Male gender, pet ownership in the past, lack of health insurance coverage, snoring, and wood or coal used as fuel were associated with wheeze. CONCLUSIONS Decreased prevalence of asthma and allergic diseases in the last 10 years could be related to decreased rate of passive smoking. Lower socioeconomic status and lack of breast feeding could increase the risk of asthma in children.
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Affiliation(s)
- Ahmet U Demir
- Department of Chest Diseases, Hacettepe University School of Medicine, Ankara, Turkey.
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Marks GB, Ezz W, Aust N, Toelle BG, Xuan W, Belousova E, Cosgrove C, Jalaludin B, Smith WT. Respiratory health effects of exposure to low-NOx unflued gas heaters in the classroom: a double-blind, cluster-randomized, crossover study. ENVIRONMENTAL HEALTH PERSPECTIVES 2010; 118:1476-82. [PMID: 20663737 PMCID: PMC2957932 DOI: 10.1289/ehp.1002186] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2010] [Accepted: 07/20/2010] [Indexed: 05/08/2023]
Abstract
BACKGROUND There are long-standing concerns about adverse effects of gas appliances on respiratory health. However, the potential adverse effect of low-NOx (nitrogen oxide) unflued gas heaters on children's health has not been assessed. OBJECTIVES Our goal was to compare the respiratory health effects and air quality consequences of exposure to low-NOx unflued gas heaters with exposure to non-indoor-air-emitting flued gas heaters in school classrooms. METHODS We conducted a double-blind, cluster-randomized, crossover study in 400 primary school students attending 22 schools in New South Wales, Australia. Children measured their lung function and recorded symptoms and medication use twice daily. Nitrogen dioxide (NO2) and formaldehyde concentrations were measured in classrooms using passive diffusion badges. RESULTS NO2 concentrations were, on average, 1.8 times higher [95% confidence interval (CI), 1.6-2.1] and formaldehyde concentrations were, on average, 9.4 ppb higher (95% CI, 5.7-13.1) during exposure to unflued gas versus flued gas heaters. Exposure to the unflued gas heaters was associated with increased cough reported in the evening [odds ratio (OR) = 1.16; 95% CI, 1.01-1.34] and wheeze reported in the morning (OR = 1.38; 95% CI, 1.04-1.83). The association with wheeze was greater in atopic subjects. There was no evidence of an adverse effect on lung function. CONCLUSIONS We conclude that classroom exposure to low-NOx unflued gas heaters causes increased respiratory symptoms, particularly in atopic children, but is not associated with significant decrements in lung function. It is important to seek alternative sources of heating that do not have adverse effects on health.
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Affiliation(s)
- Guy B Marks
- Respiratory and Environmental Epidemiology, Woolcock Institute of Medical Research, Sydney, New South Wales, Australia.
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Abstract
Indoor combustion produces both gases (eg, nitrogen dioxide, carbon monoxide) and particulate matter that may affect the development or exacerbation of asthma. Sources in the home include both heating devices (eg, fireplaces, woodstoves, kerosene heaters, flued [ie, vented] or nonflued gas heaters) and gas stoves for cooking. This article highlights the recent literature examining associations between exposure to indoor combustion and asthma development and severity. Since asthma is a chronic condition affecting both children and adults, both age groups are included in this article. Overall, there is some evidence of an association between exposure to indoor combustion and asthma, particularly asthma symptoms in children. Some sources of combustion such as coal stoves have been more consistently associated with these outcomes than other sources such as woodstoves.
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Affiliation(s)
- Kathleen Belanger
- Yale University School of Medicine, Department of Epidemiology and Public Health, New Haven, CT 06510, USA.
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Howden-Chapman P, Pierse N, Nicholls S, Gillespie-Bennett J, Viggers H, Cunningham M, Phipps R, Boulic M, Fjällström P, Free S, Chapman R, Lloyd B, Wickens K, Shields D, Baker M, Cunningham C, Woodward A, Bullen C, Crane J. Effects of improved home heating on asthma in community dwelling children: randomised controlled trial. BMJ 2008; 337:a1411. [PMID: 18812366 PMCID: PMC2658826 DOI: 10.1136/bmj.a1411] [Citation(s) in RCA: 120] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/15/2008] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To assess whether non-polluting, more effective home heating (heat pump, wood pellet burner, flued gas) has a positive effect on the health of children with asthma. DESIGN Randomised controlled trial. SETTING Households in five communities in New Zealand. PARTICIPANTS 409 children aged 6-12 years with doctor diagnosed asthma. INTERVENTIONS Installation of a non-polluting, more effective home heater before winter. The control group received a replacement heater at the end of the trial. MAIN OUTCOME MEASURES The primary outcome was change in lung function (peak expiratory flow rate and forced expiratory volume in one second, FEV(1)). Secondary outcomes were child reported respiratory tract symptoms and daily use of preventer and reliever drugs. At the end of winter 2005 (baseline) and winter 2006 (follow-up) parents reported their child's general health, use of health services, overall respiratory health, and housing conditions. Nitrogen dioxide levels were measured monthly for four months and temperatures in the living room and child's bedroom were recorded hourly. RESULTS Improvements in lung function were not significant (difference in mean FEV(1) 130.7 ml, 95% confidence interval -20.3 to 281.7). Compared with children in the control group, however, children in the intervention group had 1.80 fewer days off school (95% confidence interval 0.11 to 3.13), 0.40 fewer visits to a doctor for asthma (0.11 to 0.62), and 0.25 fewer visits to a pharmacist for asthma (0.09 to 0.32). Children in the intervention group also had fewer reports of poor health (adjusted odds ratio 0.48, 95% confidence interval 0.31 to 0.74), less sleep disturbed by wheezing (0.55, 0.35 to 0.85), less dry cough at night (0.52, 0.32 to 0.83), and reduced scores for lower respiratory tract symptoms (0.77, 0.73 to 0.81) than children in the control group. The intervention was associated with a mean temperature rise in the living room of 1.10 degrees C (95% confidence interval 0.54 degrees C to 1.64 degrees C) and in the child's bedroom of 0.57 degrees C (0.05 degrees C to 1.08 degrees C). Lower levels of nitrogen dioxide were measured in the living rooms of the intervention households than in those of the control households (geometric mean 8.5 microg/m(3) v 15.7 microg/m(3), P<0.001). A similar effect was found in the children's bedrooms (7.3 microg/m(3) v 10.9 microg/m(3), P<0.001). CONCLUSION Installing non-polluting, more effective heating in the homes of children with asthma did not significantly improve lung function but did significantly reduce symptoms of asthma, days off school, healthcare utilisation, and visits to a pharmacist. TRIAL REGISTRATION Clinical Trials NCT00489762.
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Affiliation(s)
- Philippa Howden-Chapman
- He Kainga Oranga/Housing and Health Research Programme, University of Otago, Wellington, PO 7343, Wellington South, New Zealand.
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Tanaka K, Miyake Y, Kiyohara C. Environmental factors and allergic disorders. Allergol Int 2007; 56:363-96. [PMID: 17965579 DOI: 10.2332/allergolint.r-07-143] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2007] [Indexed: 12/19/2022] Open
Abstract
Despite numerous studies on possible associations between environmental exposure and allergic disorders, any conclusions made remain a matter of controversy. We conducted a review of evidence in relation to environmental and nutritional determinants and wheeze, asthma, atopic dermatitis, and allergic rhinitis. Identified were 263 articles for analysis after consideration of 1093 papers that were published since 2000 and selected by electronic search of the PubMed database using keywords relevant to epidemiological studies. Most were cross-sectional and case-control studies. Several prospective cohort studies revealed inconsistent associations between various environmental factors and the risk of any allergic disorder. Therefore, the evidence was inadequate to infer the presence or absence of a causal relationship between various environmental exposures and allergic diseases. However, evidence is suggestive of positive associations of allergies with heredity. Because almost all the studies were performed in Western countries, the application of these findings to people in other countries, including Japan, may not be appropriate. Further epidemiological information gained from population-based prospective cohort studies, in particular among Japanese together with other Asians, is needed to assess causal relationships between various environmental factors and allergic diseases.
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Affiliation(s)
- Keiko Tanaka
- Department of Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
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Abstract
Indoor air pollution (IAP) is an important environmental health issue in developing countries and is a major contributor to mortality and morbidity from acute lower respiratory illness in children. In developed countries, IAP in homes is not nearly as severe as it can be in developing countries; however, evidence suggests that it does contribute significantly to the risk of adverse respiratory health in children. Children spend the majority of their time indoors, mostly at home. Homes are built so that air exchange between the indoor and outdoor environments is minimised and there is a large range of pollution emission sources inside. For many pollutants, indoor concentrations regularly exceed those outdoors. Although there has been considerable interest in the health effects of IAP, questions still remain regarding the role of IAP in the exacerbation and/or development of respiratory disease. Prospective, longitudinal studies are required to better clarify the contribution of IAP to the respiratory health of children.
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Qian Z, He Q, Kong L, Xu F, Wei F, Chapman RS, Chen W, Edwards RD, Bascom R. Respiratory responses to diverse indoor combustion air pollution sources. INDOOR AIR 2007; 17:135-42. [PMID: 17391236 DOI: 10.1111/j.1600-0668.2006.00463.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
UNLABELLED Diverse indoor combustion sources contribute to the indoor air environment. To evaluate the effect of these sources on human respiratory health, we examined associations between respiratory conditions and household factors in the 2360 children's fathers (mean = 38.4 years old) and associations between lung function and household factors in 463 primary school children (mean = 8.3 years old) from Wuhan, China. Factor analysis developed new uncorrelated 'factor' variables. Unconditional logistic regression models or linear regression models, controlling for important covariates, estimated the respiratory health effects. Coal smoke derived from home heating ('heating coal smoke') was associated with high adult reporting of persistent cough, persistent phlegm, and wheeze. Cooking coal smoke was associated with physician-diagnosed adult asthma and decreased forced vital capacity (FVC), and forced expiratory volume at 1 s (FEV(1)) in children. The presence of any home cigarette smoker was associated with more reports of persistent cough, persistent phlegm, cough with phlegm, and bronchitis. Our study suggests that in Wuhan, there may be independent respiratory health effects of different indoor combustion sources and their exposure factors for these study populations. PRACTICAL IMPLICATIONS We conclude that multiple indoor air pollution sources could have adverse respiratory health effects on both children and middle-aged men in the city of Wuhan, China. These results may have implications for the Wuhan local government, the Chinese government, or other related organizations in efforts on protecting public health through regulation of indoor air pollution from indoor combustion sources.
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Affiliation(s)
- Z Qian
- Department of Health Evaluation Sciences, Pennsylvania State University, Hershey, PA 17033-0855, USA.
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