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Vesper SJ. The development and application of the Environmental Relative Moldiness Index (ERMI). Crit Rev Microbiol 2024:1-11. [PMID: 38651788 DOI: 10.1080/1040841x.2024.2344112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 04/11/2024] [Indexed: 04/25/2024]
Abstract
The prevalence of asthma in the United States (U.S.) has doubled since 1970, coinciding with the increased use of gypsum-drywall in home construction. Mold growth is promoted when gypsum-drywall gets wet. Since asthma is linked to mold exposures, accurate quantification of mold contamination in homes is critical. Therefore, qPCR assays were created and then used to quantify 36 common molds in dust collected in representative U.S. homes during the first American Health Homes Survey (AHHS). The concentrations of the 36 molds, i.e. 26 water-damage molds (Group 1) and 10 outside molds (Group 2), were used in the formulation of a home's Environmental Relative Moldiness Index (ERMI) value. The ERMI values for each of the AHHS homes were assembled from lowest to highest to create the ERMI scale, which ranges from -10 to 20. Subsequent epidemiological studies consistently demonstrated that higher ERMI values were linked to asthma development, reduced lung capacity or occupant asthma. Reducing mold exposures by remediation or with HEPA filtration resulted in a reduced prevalence of asthma and improvements in respiratory health. The ERMI scale has also been successfully applied in evaluating mold concentrations in schools and large buildings and appears to have applications outside the U.S.
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Ortiz G, Rodriguez S, Pozar M, Moran A, Cheney A. Seeking care across the US-Mexico border: The experiences of Latinx and Indigenous Mexican caregivers of children with asthma or respiratory distress. Soc Sci Med 2024; 347:116736. [PMID: 38484457 DOI: 10.1016/j.socscimed.2024.116736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 02/12/2024] [Accepted: 02/26/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Many Latinx and Indigenous Mexican populations in the United States Southwest live in unincorporated communities in the US-Mexico borderlands called colonias. These environmental justice communities often lack basic infrastructure, including healthcare services, prompting many to seek services across the border. However, due to geopolitical factors more vulnerable caregivers are limited to utilize healthcare services in the US. This paper reports the experiences and healthcare decision-making of caregivers living in colonias in the US-Mexico border region who care for children with respiratory health conditions. METHODS This study was carried out from September to December 2020. Focus groups and interviews were conducted with Latinx and Indigenous Mexican caregivers of children with asthma or respiratory distress. Qualitative interviews elicited caregivers' perspectives on the environmental factors affecting children's chronic health conditions and use of healthcare services. The analysis employed the concept of structure vulnerability to theorize geography as a structural determinant of health for caregivers faced with making healthcare decisions for their suffering from respiratory health conditions. A survey was administered to collect basic sociodemographic information. RESULTS A total of 36 caregivers participated in the study. Structural factors including unincorporated community status and government inaction intersected with social determinants of health to prompt caregivers to cross the US-Mexico border to access healthcare services in Mexico for their children. Yet, more vulnerable caregivers (i.e., those without documentation status in the US) and their children, accessing healthcare services in the US was not an option limiting caregivers' ability to meet their children's healthcare needs. In such cases, geography acts as a structural determinant of health. CONCLUSION This study shows the importance of geography in health. Rural unincorporated colonias located in the borderlands are precariously located and lack basic critical infrastructure including healthcare access. Within such places, historically and socially marginalized populations become invisible, are subject to the health effects of environmental hazards, and are limited depending on their positionality and thus vulnerability to healthcare services.
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Affiliation(s)
- Gabriela Ortiz
- Department of Anthropology, University of California Riverside USA.
| | - Sophia Rodriguez
- Department of Anthropology, University of California Riverside USA.
| | | | - Ashley Moran
- University of California Riverside School of Medicine USA.
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Kasten-Arias C, Hodes T, Marino M, Kaufmann J, Lucas JA, Estela Vasquez Guzman C, Giebultowicz S, Chan B, Heintzman J. Healthcare utilization for asthma exacerbation among children of migrant and seasonal farmworkers. Prev Med Rep 2024; 38:102598. [PMID: 38283959 PMCID: PMC10821615 DOI: 10.1016/j.pmedr.2024.102598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 11/14/2023] [Accepted: 01/05/2024] [Indexed: 01/30/2024] Open
Abstract
Latino children of Migrant and Seasonal Farmworkers (MSFWs) with asthma are at risk for poor health outcomes due to medical access barriers. We compared differences in acute care utilization for asthma exacerbations among migrant and non-migrant Latino and non-Hispanic white (NHW) children at U.S. community health centers. A retrospective observational study utilizing electronic health record data from the ADVANCE Clinical Research Network of United States community health centers included 13,423 children ages 3-17 with a primary care visit between 2005 and 2017 from eight states. Emergency department (ED) and hospitalization data came from Oregon Medicaid claims. Outcomes included acute clinic visits, ED visits, and hospitalizations for asthma exacerbation. Regression analyses adjusted for patient-level covariates. Latino children had higher odds of acute clinic visits for asthma exacerbation compared to NHW children (MSFW odds ratio [OR] = 1.17, 95 % CI = 1.03-1.33; without migrant status OR = 1.13, 95 % CI = 1.03-1.23). MSFW children using Oregon Medicaid had fewer ED visits (rate ratio [RR] = 0.72, 95 % CI = 0.52-0.99) and hospitalizations (RR = 0.47, 95 % CI = 0.26-0.86) compared to NHW children. Increased community health center visits may help mitigate disparities in acute asthma care for MSFW children.
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Affiliation(s)
| | - Tahlia Hodes
- Oregon Health & Science University, Department of Family Medicine, Portland OR, USA
| | - Miguel Marino
- Oregon Health & Science University, Department of Family Medicine, Portland OR, USA
| | - Jorge Kaufmann
- Oregon Health & Science University, Department of Family Medicine, Portland OR, USA
| | - Jennifer A. Lucas
- Oregon Health & Science University, Department of Family Medicine, Portland OR, USA
| | | | | | - Brian Chan
- OCHIN, Inc. Portland, OR, USA
- Oregon Health & Science University, Department of Medicine, Division of General Internal Medicine & Geriatrics, Portland OR, USA
| | - John Heintzman
- Oregon Health & Science University, Department of Family Medicine, Portland OR, USA
- OCHIN, Inc. Portland, OR, USA
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Qi Y, Zhang J, Lin J, Yang J, Guan J, Li K, Weng J, Wang Z, Chen C, Xu H. Predicting the risk of acute respiratory failure among asthma patients-the A2-BEST2 risk score: a retrospective study. PeerJ 2023; 11:e16211. [PMID: 37901467 PMCID: PMC10607202 DOI: 10.7717/peerj.16211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 09/08/2023] [Indexed: 10/31/2023] Open
Abstract
Objectives Acute respiratory failure (ARF) is a common complication of bronchial asthma (BA). ARF onset increases the risk of patient death. This study aims to develop a predictive model for ARF in BA patients during hospitalization. Methods This was a retrospective cohort study carried out at two large tertiary hospitals. Three models were developed using three different ways: (1) the statistics-driven model, (2) the clinical knowledge-driven model, and (3) the decision tree model. The simplest and most efficient model was obtained by comparing their predictive power, stability, and practicability. Results This study included 398 patients, with 298 constituting the modeling group and 100 constituting the validation group. Models A, B, and C yielded seven, seven, and eleven predictors, respectively. Finally, we chose the clinical knowledge-driven model, whose C-statistics and Brier scores were 0.862 (0.820-0.904) and 0.1320, respectively. The Hosmer-Lemeshow test revealed that this model had good calibration. The clinical knowledge-driven model demonstrated satisfactory C-statistics during external and internal validation, with values of 0.890 (0.815-0.965) and 0.854 (0.820-0.900), respectively. A risk score for ARF incidence was created: The A2-BEST2 Risk Score (A2 (area of pulmonary infection, albumin), BMI, Economic condition, Smoking, and T2(hormone initiation Time and long-term regular medication Treatment)). ARF incidence increased gradually from 1.37% (The A2-BEST2 Risk Score ≤ 4) to 90.32% (A2-BEST2 Risk Score ≥ 11.5). Conclusion We constructed a predictive model of seven predictors to predict ARF in BA patients. This predictor's model is simple, practical, and supported by existing clinical knowledge.
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Affiliation(s)
- Yanhong Qi
- General Practice, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jing Zhang
- Geriatric Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jiaying Lin
- General Practice, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
- General Practice, Taizhou Women and Children’s Hospital of Wenzhou Medical University, Taizhou, China
| | - Jingwen Yang
- General Practice, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
- General Practice, Taizhou Women and Children’s Hospital of Wenzhou Medical University, Taizhou, China
| | - Jiangan Guan
- Geriatric Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Keying Li
- General Practice, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jie Weng
- General Practice, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
- Wenzhou Medicial University, Sourthern Zhejiang Institute of Radiation Medicine and Nuclear Technology, Wenzhou, China
| | - Zhiyi Wang
- General Practice, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
- Wenzhou Medicial University, Sourthern Zhejiang Institute of Radiation Medicine and Nuclear Technology, Wenzhou, China
| | - Chan Chen
- Geriatric Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Wenzhou Medicial University, Sourthern Zhejiang Institute of Radiation Medicine and Nuclear Technology, Wenzhou, China
| | - Hui Xu
- General Practice, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
- Wenzhou Medicial University, Sourthern Zhejiang Institute of Radiation Medicine and Nuclear Technology, Wenzhou, China
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Raherison-Semjen C, Guilleminault L, Billiart I, Chenivesse C, De Oliveira A, Izadifar A, Lorenzo A, Nocent C, Oster JP, Padovani M, Perez T, Russier M, Steinecker M, Didier A. [Update of the 2021 recommendations for the management and follow-up of adult asthmatic patients under the guidance of the French Society of Pulmonology and the Paediatric Society of Pulmonology and Allergology. Long version]. Rev Mal Respir 2021; 38:1048-1083. [PMID: 34799211 DOI: 10.1016/j.rmr.2021.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 06/17/2021] [Indexed: 11/22/2022]
Affiliation(s)
- C Raherison-Semjen
- Université de Bordeaux, INSERM UMR 1219, Epicene Team, Bordeaux, France.
| | - L Guilleminault
- Pôle des voies respiratoires, CHU de Toulouse, Toulouse, France; Institut toulousain des maladies infectieuses et inflammatoires (Infinity), INSERM, UMR1291, CNRS UMR5051, université Toulouse III, CRISALIS F-CRIN, Toulouse, France
| | | | - C Chenivesse
- CHRU de Lille, service de pneumo-allergologie, 59000 Lille, France
| | - A De Oliveira
- Sorbonne université, département de médecine générale, Paris, France
| | - A Izadifar
- Département de pneumologie, centre cardiologique du Nord, Saint-Denis, France
| | - A Lorenzo
- Sorbonne université, département de médecine générale, Paris, France
| | - C Nocent
- CHG Côte Basque, Bayonne, France
| | - J P Oster
- Service de pneumologie, centre hospitalier Louis-Pasteur, Colmar, France
| | - M Padovani
- Espace Santé Ii, La Seyne-sur-Mer, France
| | - T Perez
- CHRU de Lille, service d'explorations fonctionnelles, 59000 Lille, France
| | - M Russier
- Service de pneumo-allergologie, CHR Orléans, Orléans, France
| | - M Steinecker
- Sorbonne université, département de médecine générale, Paris, France
| | - A Didier
- Université de Bordeaux, INSERM UMR 1219, Epicene Team, Bordeaux, France; Pôle des voies respiratoires, CHU de Toulouse, Toulouse, France
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Biddle TA, Li Q, Maltz MR, Tandel PN, Chakraborty R, Yisrael K, Drover R, Cocker DR, Lo DD. Salton Sea aerosol exposure in mice induces a pulmonary response distinct from allergic inflammation. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 792:148450. [PMID: 34157526 DOI: 10.1016/j.scitotenv.2021.148450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/09/2021] [Accepted: 06/09/2021] [Indexed: 06/13/2023]
Abstract
In communities surrounding the Salton Sea, high rates of asthma are associated with high aerosol dust levels. However, the Salton Sea itself may play an additional role in pulmonary health. Therefore, to investigate a potential role of the Salton Sea on pulmonary health, we exposed mice to aerosolized Salton Sea water for 7 days and assessed tissue responses, including cellular infiltration and gene expression changes. For reference, mice were also exposed to aerosolized fungal allergen (Alternaria sp.) and Pacific Ocean aerosols. Exposure to aerosolized Alternaria sp. induced dramatic allergic inflammation, including neutrophil and eosinophil recruitment to the bronchoalveolar lavage fluid (BALF) and lung tissue. By contrast, Salton Sea "spray" induced only B cell recruitment to the lung tissue without increased inflammatory cell numbers in BALF. However, there were consistent gene expression changes suggestive of an inflammatory response. The response to the Salton Sea spray was notably distinct from the response to Pacific Ocean water, which induced some B cell recruitment but without an inflammatory gene expression profile. Our studies suggest that soluble components in Salton Sea water promote induction of a unique inflammation-associated response, though any relationship to asthma remains to be explored.
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Affiliation(s)
- Trevor A Biddle
- Division of Biomedical Sciences, University of California, Riverside School of Medicine, Riverside, CA, USA; BREATHE Center, University of California, Riverside, Riverside, CA, USA
| | - Qi Li
- Department of Chemical and Environmental Engineering, University of California, Riverside, Riverside, CA, USA; College of Engineering-Center for Environmental Research and Technology (CE-CERT), University of California, Riverside, Riverside, CA, USA
| | - Mia R Maltz
- Division of Biomedical Sciences, University of California, Riverside School of Medicine, Riverside, CA, USA; BREATHE Center, University of California, Riverside, Riverside, CA, USA; Center for Health Disparities Research, University of California, Riverside, Riverside, CA, USA
| | - Purvi N Tandel
- Division of Biomedical Sciences, University of California, Riverside School of Medicine, Riverside, CA, USA
| | - Rajrupa Chakraborty
- Division of Biomedical Sciences, University of California, Riverside School of Medicine, Riverside, CA, USA; BREATHE Center, University of California, Riverside, Riverside, CA, USA
| | - Keziyah Yisrael
- Division of Biomedical Sciences, University of California, Riverside School of Medicine, Riverside, CA, USA; BREATHE Center, University of California, Riverside, Riverside, CA, USA
| | - Ryan Drover
- Department of Chemical and Environmental Engineering, University of California, Riverside, Riverside, CA, USA; College of Engineering-Center for Environmental Research and Technology (CE-CERT), University of California, Riverside, Riverside, CA, USA
| | - David R Cocker
- Department of Chemical and Environmental Engineering, University of California, Riverside, Riverside, CA, USA; College of Engineering-Center for Environmental Research and Technology (CE-CERT), University of California, Riverside, Riverside, CA, USA
| | - David D Lo
- Division of Biomedical Sciences, University of California, Riverside School of Medicine, Riverside, CA, USA; BREATHE Center, University of California, Riverside, Riverside, CA, USA; Center for Health Disparities Research, University of California, Riverside, Riverside, CA, USA.
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Zhang Y, Hua L, Liu QH, Chu SY, Gan YX, Wu M, Bao YX, Chen Q, Zhang J. Household mold exposure interacts with inflammation-related genetic variants on childhood asthma: a case-control study. BMC Pulm Med 2021; 21:114. [PMID: 33810791 PMCID: PMC8019181 DOI: 10.1186/s12890-021-01484-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 03/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A number of studies have examined the association between mold exposure and childhood asthma. However, the conclusions were inconsistent, which might be partly attributable to the lack of consideration of gene function, especially the key genes affecting the pathogenesis of childhood asthma. Research on the interactions between genes and mold exposure on childhood asthma is still very limited. We therefore examined whether there is an interaction between inflammation-related genes and mold exposure on childhood asthma. METHODS A case-control study with 645 asthmatic children and 910 non-asthmatic children aged 3-12 years old was conducted. Eight single nucleotide polymorphisms (SNPs) in inflammation-related genes were genotyped using MassARRAY assay. Mold exposure was defined as self-reported visible mold on the walls. Associations between visible mold exposure, SNPs and childhood asthma were evaluated using logistic regression models. In addition, crossover analyses were used to estimate the gene-environment interactions on childhood asthma on an additive scale. RESULTS After excluding children without information on visible mold exposure or SNPs, 608 asthmatic and 839 non-asthmatic children were included in the analyses. Visible mold exposure was reported in 151 asthmatic (24.8%) and 119 non-asthmatic children (14.2%) (aOR 2.19, 95% CI 1.62-2.97). The rs7216389 SNP in gasdermin B gene (GSDMB) increased the risk of childhood asthma with each C to T substitution in a dose-dependent pattern (additive model, aOR 1.32, 95% CI 1.11-1.57). Children carrying the rs7216389 T allele and exposed to visible mold dramatically increased the risk of childhood asthma (aOR 3.21; 95% CI 1.77-5.99). The attributable proportion due to the interaction (AP: 0.47, 95% CI 0.03-0.90) and the relative excess risk due to the interaction (RERI: 1.49, 95% CI 0-2.99) were statistically significant. CONCLUSIONS In the present study, there was a significant additive interaction between visible mold exposure and rs7216389 SNP on childhood asthma. Future studies need to consider the gene-environment interactions when exploring the risk factors of childhood asthma.
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Affiliation(s)
- Yu Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Li Hua
- Department of Pediatric Pulmonology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Quan-Hua Liu
- Department of Pediatric Pulmonology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Shu-Yuan Chu
- Laboratory of Respiratory Disease, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China
| | - Yue-Xin Gan
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Min Wu
- Department of Chinese Traditional Medicine, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Yi-Xiao Bao
- Department of Pediatric Pulmonology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Qian Chen
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China.
| | - Jun Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China. .,Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China.
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Zhang HL, Wang BY, Luo Y, Li Y, Cai CS, Huang LL, He BH, Cai J, Li ZY, Mai AD, Guo Y. Association of pet-keeping in home with self-reported asthma and asthma-related symptoms in 11611 school children from China. J Asthma 2020; 58:1555-1564. [PMID: 32985283 DOI: 10.1080/02770903.2020.1818772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE We conducted a cross-sectional study to investigate the associations between domestic pets and respiratory health in children. METHODS We randomly recruited 11,611 school children from Zhongshan, a southern city in China. Information about the respiratory symptoms and disease history of the recruited children, the status of domestic pets, and other related risk factors were collected from March to July 2016. RESULTS We identified cat-keeping at home increases the risk of persistent cough (OR, 1.77; 95%CI, 1.03-3.05); poultry-keeping at home increases the risk of current asthma (OR, 3.87; 95%CI, 1.08-13.92) and allergic rhinitis (OR, 1.84; 95%CI, 1.01-3.37); sleeping with pets increases the risk of persistent phlegm (OR, 5.04; 95%CI, 1.05-24.28), doctor-diagnosed asthma (OR, 3.35; 95%CI, 1.31-8.57) and current asthma (OR, 4.94; 95%CI, 1.05-23.31) in children. CONCLUSIONS Cat-keeping and molds on the wall of the house had the multiplicative and additive interaction in doctor-diagnosed asthma. In conclusion, pet-keeping increased the risk of respiratory symptoms in children.
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Affiliation(s)
- Hao-Ling Zhang
- Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong Province, China
| | - Bo-Yuan Wang
- Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong Province, China
| | - Yun Luo
- Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong Province, China
| | - Yu Li
- Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong Province, China
| | - Chun-Sheng Cai
- Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong Province, China
| | - Li-Li Huang
- Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong Province, China
| | - Bin-Hong He
- Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong Province, China
| | - Jian Cai
- Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong Province, China
| | - Zi-Ying Li
- Guangdong Pharmaceutical University, Guangzhou, Guangdong Province, China
| | - Ai-Die Mai
- Guangdong Medical University, Dongguan, Guangdong Province, China
| | - Yan Guo
- Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong Province, China
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Microbial Agents in the Indoor Environment: Associations with Health. CURRENT TOPICS IN ENVIRONMENTAL HEALTH AND PREVENTIVE MEDICINE 2020. [PMCID: PMC7122805 DOI: 10.1007/978-981-32-9182-9_9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
There is international consensus that damp buildings and indoor mould can increase the risk of asthma, rhinitis, bronchitis and respiratory tract infections but we do not know which types of microbial agents that are causing the observed adverse health effects. Microbial indoor exposure is a broader concept than microbial growth in buildings. Other sources of indoor microbial exposure include the outdoor environment, humans (crowdedness) and furry pet keeping. Microbial exposure can have different health effects depending on the dose, different exposure route, genetic disposition and the timing of exposure. Microbial stimulation linked to large microbial diversity in early life can protect against disease development, especially for allergic asthma and atopy. Protective effects are more often reported for bacterial exposure and adverse health effects are more often linked to mould exposure. There are many studies on health associations for indoor exposure to endotoxin, mainly from homes. The risk of getting atopic asthma may be less if you are exposed to endotoxin in childhood but the risk of non-atopic asthma may increase if exposed to endotoxin especially in adulthood. Moreover, genetic disposition modifies health effects of endotoxin. Epidemiological studies on muramic acid (from gram-positive bacteria) or ergosterol (from mould) are few. Studies on health effects of indoor exposure to beta-1-3-glucan (from mould) have conflicting results (positive as well as negative associations). Epidemiological studies on health effects of indoor exposure to mycotoxins are very few. Some studies have reported health associations for MVOC, but it is unclear to what extent MVOC has microbial sources in indoor environments. Many studies have reported health associations for fungal DNA, especially as a risk factor for childhood asthma at home. Since most studies on health effects of indoor exposure to mould, bacteria and microbial agents are cross-sectional, it is difficult to draw conclusions on causality. More prospective studies on indoor microbial exposure are needed and studies should include other indoor environments than homes, such as day care centers, schools, hospitals and offices.
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Assessment of Respiratory Health Symptoms and Asthma in Children near a Drying Saline Lake. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203828. [PMID: 31614424 PMCID: PMC6843482 DOI: 10.3390/ijerph16203828] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 10/08/2019] [Accepted: 10/09/2019] [Indexed: 11/17/2022]
Abstract
Residents of the Imperial Valley, a rural, agricultural border region in California, have raised concerns over high rates of pediatric asthma symptoms. There is an urgent need to understand the influences and predictors of children's respiratory health in Imperial Valley. We assessed the impacts of sociodemographic, lifestyle, and household factors on children's respiratory health and asthma prevalence by administering a survey to parents of elementary school children (n = 357) in northern Imperial Valley. We observed an overall asthma prevalence of 22.4% and respiratory symptoms and allergies were widely reported, including wheezing (35.3%), allergies (36.1%), bronchitic symptoms (28.6%), and dry cough (33.3%). Asthmatics were significantly more likely to report respiratory symptoms, but high rates of wheezing, allergies, and dry cough were observed among nonasthmatics, suggesting the possibility for underdiagnosis of respiratory impairment in our school-age population. Having an asthmatic mother and exposure to environmental tobacco smoke were also associated with greater odds of asthma. Our findings provide evidence to support community concerns about children's respiratory health, while also suggesting that household and demographic characteristics have limited explanatory power for assessing asthma in this population. This work provides critical baseline data with which to evaluate local environmental factors and their influence on asthma and respiratory symptoms.
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