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Meng X, Cao S, Li S, Yan M, Guo Q, Gong J, Liu Q, Zhang JJ, Duan X. Household environmental factors and children's respiratory health: comparison of two cross-sectional studies over 25 years in Wuhan, China. J Thorac Dis 2021; 13:4589-4600. [PMID: 34422384 PMCID: PMC8339747 DOI: 10.21037/jtd-20-2170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 04/05/2021] [Indexed: 11/24/2022]
Abstract
Background Over the recent decades, residential lifestyle and household environment have changed substantially with rapid development of industrialization and urbanization in China. Whether the prevalence of respiratory diseases changed is still lack of evidence. The objective of this study is to assess potential changes in children’s respiratory disease prevalence and associated household environmental factors in Wuhan over a 25-year time interval. Methods Two cross-sectional studies in the Period 1 (1993 to 1996) and Period 2 (2017 to 2018) were compared in this research. Elementary school children in period 1 (N=2,517) and in period 2 (N=3,152) were recruited in Wuhan, China. The respiratory health condition, home environmental factors, and family socioeconomic status of each subject were acquired through questionnaire survey using the same protocols in both periods. We used the Chi-square test to analyze the difference of household environmental factors (focused on three indoor air quality determinants) and children’s respiratory health condition between two periods. Logistic regression models were used to assess the impacts of household environmental determinants on children’s respiratory diseases and symptoms between the two studies, by adjusting a set of covariates. Results The three indoor air quality determinants have reduced substantially in prevalence from period 1 to period 2: environment tobacco smoke (ETS) from 86.6% to 45.9%, household coal use from 47.6% to 4.9%, and kitchen smoke from 58.9% to 7.3%. The prevalence of certain respiratory symptoms in children significantly decreased, such as cough with colds (51.1% to 41.6%) and phlegm with colds (22.3% to 17.7%). The prevalence of asthma was 2.5% and 2.4% and that of bronchitis was 27.1% and 29.8% in both periods. Coal use was a risk factor for asthma in period 1 (OR =2.34, 95% CI: 1.30–4.23), while it was not significantly associated with prevalence of asthma in period 2 (OR =0.60, 95% CI: 0.08–4.51). Conclusions Household indoor air quality determinants and respiratory health condition of children in Wuhan has been improved over the last 25 years. At present, kitchen smoke is an important factor affecting the prevalence of wheeze whatever child has a cold or not and reducing exposure to ETS could be beneficial to protect children to be less likely to develop bronchitis.
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Affiliation(s)
- Xin Meng
- School of Energy and Environmental Engineering, Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, University of Science and Technology Beijing, Beijing, China.,Beijing Innovation Center for Engineering Science and Advanced Technology, State Key Joint Laboratory for Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, And Center for Environment and Health, Peking University, Beijing, China
| | - Suzhen Cao
- School of Energy and Environmental Engineering, Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, University of Science and Technology Beijing, Beijing, China
| | - Sai Li
- School of Energy and Environmental Engineering, Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, University of Science and Technology Beijing, Beijing, China
| | - Meilin Yan
- Beijing Innovation Center for Engineering Science and Advanced Technology, State Key Joint Laboratory for Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, And Center for Environment and Health, Peking University, Beijing, China
| | - Qian Guo
- School of Energy and Environmental Engineering, Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, University of Science and Technology Beijing, Beijing, China
| | - Jicheng Gong
- Beijing Innovation Center for Engineering Science and Advanced Technology, State Key Joint Laboratory for Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, And Center for Environment and Health, Peking University, Beijing, China
| | - Qin Liu
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Junfeng Jim Zhang
- Global Health Research Center, Duke Kunshan University, Kunshan, China.,Nicholas School of the Environment and Duke Global Health Institute, Duke University, Durham, USA.,Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaoli Duan
- School of Energy and Environmental Engineering, Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, University of Science and Technology Beijing, Beijing, China
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Cai T, Luo W, Ruan D, Wu YJ, Fox DA, Chen J. The History, Status, Gaps, and Future Directions of Neurotoxicology in China. ENVIRONMENTAL HEALTH PERSPECTIVES 2016; 124:722-732. [PMID: 26824332 PMCID: PMC4892912 DOI: 10.1289/ehp.1409566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 09/25/2015] [Accepted: 01/15/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Rapid economic development in China has produced serious ecological, environmental, and health problems. Neurotoxicity has been recognized as a major public health problem. The Chinese government, research institutes, and scientists conducted extensive studies concerning the source, characteristics, and mechanisms of neurotoxicants. OBJECTIVES This paper presents, for the first time, a comprehensive history and review of major sources of neurotoxicants, national bodies/legislation engaged, and major neurotoxicology research in China. METHODS Peer-reviewed research and pollution studies by Chinese scientists from 1991 to 2015 were examined. PubMed, Web of Science and Chinese National Knowledge Infrastructure (CNKI) were the major search tools. RESULTS The central problem is an increased exposure to neurotoxicants from air and water, food contamination, e-waste recycling, and manufacturing of household products. China formulated an institutional framework and standards system for management of major neurotoxicants. Basic and applied research was initiated, and international cooperation was achieved. The annual number of peer-reviewed neurotoxicology papers from Chinese authors increased almost 30-fold since 2001. CONCLUSIONS Despite extensive efforts, neurotoxicity remains a significant public health problem. This provides great challenges and opportunities. We identified 10 significant areas that require major educational, environmental, governmental, and research efforts, as well as attention to public awareness. For example, there is a need to increase efforts to utilize new in vivo and in vitro models, determine the potential neurotoxicity and mechanisms involved in newly emerging pollutants, and examine the effects and mechanisms of mixtures. In the future, we anticipate working with scientists worldwide to accomplish these goals and eliminate, prevent and treat neurotoxicity. CITATION Cai T, Luo W, Ruan D, Wu YJ, Fox DA, Chen J. 2016. The history, status, gaps, and future directions of neurotoxicology in China. Environ Health Perspect 124:722-732; http://dx.doi.org/10.1289/ehp.1409566.
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Affiliation(s)
- Tongjian Cai
- Department of Occupational and Environmental Health, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Fourth Military Medical University, Xi’an, Shaanxi, China
- Department of Epidemiology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Wenjing Luo
- Department of Occupational and Environmental Health, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Diyun Ruan
- Neurotoxicology Lab, School of Life Science, University of Science and Technology of China, Hefei, Anhui, China
| | - Yi-Jun Wu
- Laboratory of Molecular Toxicology, Institute of Zoology, Chinese Academy of Sciences, Beijing, China
| | - Donald A. Fox
- College of Optometry,
- Department of Biology and Biochemistry,
- Department of Pharmacological and Pharmaceutical Sciences, and
- Department of Health and Human Performance, University of Houston, Houston, Texas, USA
| | - Jingyuan Chen
- Department of Occupational and Environmental Health, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Fourth Military Medical University, Xi’an, Shaanxi, China
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Demoulin-Alexikova S, Plevkova J, Mazurova L, Zatko T, Alexik M, Hanacek J, Tatar M. Impact of Air Pollution on Age and Gender Related Increase in Cough Reflex Sensitivity of Healthy Children in Slovakia. Front Physiol 2016; 7:54. [PMID: 26941651 PMCID: PMC4763033 DOI: 10.3389/fphys.2016.00054] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 02/04/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Numerous studies show higher cough reflex sensitivity (CRS) and cough outcomes in children compared to adults and in females compared to males. Despite close link that exists between cough and environment the potential influence of environmental air pollution on age- and gender -related differences in cough has not been studied yet. PURPOSE The purpose of our study was to analyse whether the effects of exposure to environmental tobacco smoke (ETS) from parental smoking and PM10 from living in urban area are implied in age- and gender-related differences in cough outcomes of healthy, non-asthmatic children. Assessment of CRS using capsaicin and incidence of dry and wet cough was performed in 290 children (mean age 13.3 ± 2.6 years (138 females/152 males). RESULTS CRS was significantly higher in girls exposed to ETS [22.3 μmol/l (9.8-50.2 μmol/l)] compared to not exposed girls [79.9 μmol/l (56.4-112.2 μmol/l), p = 0.02] as well as compared to exposed boys [121.4 μmol/l (58.2-253.1 μmol/l), p = 0.01]. Incidence of dry cough lasting more than 3 weeks was significantly higher in exposed compared to not exposed girls. CRS was significantly higher in school-aged girls living in urban area [22.0 μmol/l (10.6-45.6 μmol/l)] compared to school-aged girls living in rural area [215.9 μmol/l (87.3-533.4 μmol/l); p = 0.003], as well as compared to teenage girls living in urban area [108.8 μmol/l (68.7-172.9 μmol/l); p = 0.007]. No CRS differences were found between urban and rural boys when controlled for age group. No CRS differences were found between school-aged and teenage boys when controlled for living area. CONCLUSIONS Our results have shown that the effect of ETS on CRS was gender specific, linked to female gender and the effect of PM10 on CRS was both gender and age specific, related to female gender and school-age. We suggest that age and gender related differences in incidence of cough and CRS might be, at least partially, ascribed to the effect of environmental pollutants. The role of age and gender in the effect of air pollution on cough strongly suggest some interplay of development with biological and behavioral factors.
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Affiliation(s)
- Silvia Demoulin-Alexikova
- Department of Pathophysiology, Jessenius Faculty of Medicine in Martin, Comenius University in BratislavaBratislava, Slovakia; Service d'Explorations Fonctionnelles Pédiatriques, Hôpital d'Enfants, Centre Hospitalier Universitaire de NancyVandœuvre-lès-Nancy, France; EA 3450 DevAH - Laboratoire de Physiologie, Faculté de Médecine, Université de LorraineVandœuvre-lès-Nancy, France
| | - Jana Plevkova
- Department of Pathophysiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava Bratislava, Slovakia
| | - Lenka Mazurova
- Department of Pathophysiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava Bratislava, Slovakia
| | - Tomas Zatko
- Department of Pathophysiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava Bratislava, Slovakia
| | - Mikulas Alexik
- Department of Ophthalmology, Faculty Hospital of Žilina Žilina, Slovakia
| | - Jan Hanacek
- Department of Pathophysiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava Bratislava, Slovakia
| | - Milos Tatar
- Department of Pathophysiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava Bratislava, Slovakia
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Shibata T, Wilson JL, Watson LM, LeDuc A, Meng C, Ansariadi, La Ane R, Manyullei S, Maidin A. Childhood acute respiratory infections and household environment in an Eastern Indonesian urban setting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:12190-203. [PMID: 25429685 PMCID: PMC4276609 DOI: 10.3390/ijerph111212190] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 11/05/2014] [Accepted: 11/18/2014] [Indexed: 11/30/2022]
Abstract
This pilot study evaluated the potential effect of household environmental factors such as income, maternal characteristics, and indoor air pollution on children's respiratory status in an Eastern Indonesian community. Household data were collected from cross-sectional (n = 461 participants) and preliminary childhood case-control surveys (pneumonia cases = 31 diagnosed within three months at a local health clinic; controls = 30). Particulate matter (PM2.5 and PM10) was measured in living rooms, kitchens, children's bedrooms, and outside areas in close proximity once during the case-control household interviews (55 homes) and once per hour from 6 a.m. to midnight in 11 homes. The household survey showed that children were 1.98 times (p = 0.02) more likely to have coughing symptoms indicating respiratory infection, if mothers were not the primary caregivers. More children exhibited coughing if they were not exclusively breastfed (OR = 2.18; p = 0.06) or there was a possibility that their mothers were exposed to environmental tobacco smoke during pregnancy (OR = 2.05; p = 0.08). This study suggests that household incomes and mother's education have an indirect effect on childhood pneumonia and respiratory illness. The concentrations of PM2.5 and PM10 ranged from 0.5 to 35.7 µg/m3 and 7.7 to 575.7 µg/m3, respectively, based on grab samples. PM was significantly different between the case and control groups (p < 0.01). The study also suggests that ambient air may dilute indoor pollution, but also introduces pollution into the home from the community environment. Effective intervention programs need to be developed that consider multiple direct and indirect risk factors to protect children.
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Affiliation(s)
- Tomoyuki Shibata
- Public Health Program, Northern Illinois University, DeKalb, IL 60115, USA.
| | - James L Wilson
- Institute of the Study for Environment, Sustainability, and Energy, Northern Illinois University, DeKalb, IL 60115, USA.
| | - Lindsey M Watson
- Public Health Program, Northern Illinois University, DeKalb, IL 60115, USA.
| | - Alyse LeDuc
- Public Health Program, Northern Illinois University, DeKalb, IL 60115, USA.
| | - Can Meng
- Public Health Program, Northern Illinois University, DeKalb, IL 60115, USA.
| | - Ansariadi
- Faculty of Public Health, Universitas Hasanuddin, Makassar, South Sulawesi 90245, Indonesia.
| | - Ruslan La Ane
- Faculty of Public Health, Universitas Hasanuddin, Makassar, South Sulawesi 90245, Indonesia.
| | - Syamsuar Manyullei
- Faculty of Public Health, Universitas Hasanuddin, Makassar, South Sulawesi 90245, Indonesia.
| | - Alimin Maidin
- Faculty of Public Health, Universitas Hasanuddin, Makassar, South Sulawesi 90245, Indonesia.
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Kurmi OP, Semple S, Devereux GS, Gaihre S, Lam KBH, Sadhra S, Steiner MFC, Simkhada P, Smith WCS, Ayres JG. The effect of exposure to biomass smoke on respiratory symptoms in adult rural and urban Nepalese populations. Environ Health 2014; 13:92. [PMID: 25374400 PMCID: PMC4232609 DOI: 10.1186/1476-069x-13-92] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 10/28/2014] [Indexed: 05/22/2023]
Abstract
BACKGROUND Half of the world's population is exposed to household air pollution from biomass burning. This study aimed to assess the relationship between respiratory symptoms and biomass smoke exposure in rural and urban Nepal. METHODS A cross-sectional study of adults (16+ years) in a rural population (n = 846) exposed to biomass smoke and a non-exposed urban population (n = 802) in Nepal. A validated questionnaire was used along with measures of indoor air quality (PM2.5 and CO) and outdoor PM2.5. RESULTS Both men and women exposed to biomass smoke reported more respiratory symptoms compared to those exposed to clean fuel. Women exposed to biomass were more likely to complain of ever wheeze (32.0 % vs. 23.5%; p = 0.004) and breathlessness (17.8% vs. 12.0%, p = 0.017) compared to males with tobacco smoking being a major risk factor. Chronic cough was similar in both the biomass and non-biomass smoke exposed groups whereas chronic phlegm was reported less frequently by participants exposed to biomass smoke. Higher PM2.5 levels (≥2 SDs of the 24-hour mean) were associated with breathlessness (OR = 2.10, 95% CI 1.47, 2.99) and wheeze (1.76, 1.37, 2.26). CONCLUSIONS The study suggests that while those exposed to biomass smoke had higher prevalence of respiratory symptoms, urban dwellers (who were exposed to higher ambient air pollution) were more at risk of having productive cough.
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Affiliation(s)
- Om P Kurmi
- />Clinical Trials Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF UK
| | - Sean Semple
- />Scottish Centre for Indoor Air, Division of Applied Health Sciences, School of Medicine, University of Aberdeen, Aberdeen, AB24 3FX UK
| | - Graham S Devereux
- />Department of Child Health, Royal Aberdeen Children’s Hospital, University of Aberdeen, Aberdeen, AB25 2ZG UK
| | - Santosh Gaihre
- />Scottish Centre for Indoor Air, Division of Applied Health Sciences, School of Medicine, University of Aberdeen, Aberdeen, AB24 3FX UK
| | - Kin Bong Hubert Lam
- />Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, B15 2TT UK
| | - Steven Sadhra
- />Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, B15 2TT UK
| | - Markus FC Steiner
- />Scottish Centre for Indoor Air, Division of Applied Health Sciences, School of Medicine, University of Aberdeen, Aberdeen, AB24 3FX UK
| | - Padam Simkhada
- />School of Health and Related Research, University of Sheffield, Sheffield, S10 2TN UK
| | - William CS Smith
- />School of Medicine and Dentistry, University of Aberdeen, Aberdeen, AB24 3FX UK
| | - Jon G Ayres
- />Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, B15 2TT UK
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A Multiple Indicators Multiple Cause (MIMIC) model of respiratory health and household factors in Chinese children: the seven Northeastern cities (SNEC) study. Matern Child Health J 2014; 18:129-137. [PMID: 23440490 DOI: 10.1007/s10995-013-1245-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
In China, with the rapid economic development and improvement of living standards over the past few decades, the household living environment has shifted dramatically. The aim of the present study is to assess the impact of home environment factors on respiratory symptoms and asthma in Chinese children. Investigators analyzed data collected in the 25 districts from the seven Northeastern cities to examine health effects on respiratory symptoms and asthma in 31,049 children aged 2-14 years. Factor analysis was used to reduce 33 children's lifestyle and household variables to six new 'factor' variables. The multiple indicators multiple causes approach was used to examine the relationship between indoor air pollution and respiratory health status, controlling for covariates. Factor analyses generated six factor variables of potential household risk factors from an original list of 33 variables. The respiratory symptoms and asthma were significantly associated with the recent home renovation factor (estimate = 0.076, p < 0.001), pet ownership factor (estimate = 0.095, p < 0.001), environmental tobacco smoke (ETS) exposure factor (estimate = 0.181, p < 0.001) and PVC-flooring factor (estimate = 0.031, p = 0.007). Home ventilation factor was not related to any respiratory condition (estimate = 0.028, p = 0.074). Independent respiratory health effects existed for multiple household environmental factors recent home renovation, pet ownership, ETS, and PVC-flooring.
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Zhang J, Ou JX, Bai CX. Tobacco smoking in China: prevalence, disease burden, challenges and future strategies. Respirology 2012; 16:1165-72. [PMID: 21910781 DOI: 10.1111/j.1440-1843.2011.02062.x] [Citation(s) in RCA: 134] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
About one-third of the world's tobacco is produced and consumed in China. Despite existing tobacco control policies and activities, the prevalence of smoking in China remains high with 350 million smokers and 740 million passive smokers. Furthermore, smoking rates in the young population and in females are increasing. The number of deaths attributed to tobacco use has reached 1.2 million per year, whereas the death toll is expected to rise to 2 million annually by 2025. Sociocultural factors favouring smoking initiation, lack of awareness among the public about the hazards of smoking, weak support from the government and strong resistance from the tobacco industry are major reasons for the lack of effectiveness of current tobacco control measures. Effective intervention efforts are urgently required. Commitments from the government are crucial in tobacco control. Firm action should be taken on tobacco control issues at multiple levels including a reduction in tobacco supply, increased tobacco taxation, increased education, tobacco advertising limitations, decreased second-hand smoke exposure and smoking cessation support. The health-care community should also play a leading role in anti-tobacco campaigns and take a more active role in smoking cessation programmes.
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Affiliation(s)
- Jing Zhang
- Department of Pulmonary Medicine, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
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Pegas PN, Alves CA, Scotto MG, Evtyugina MG, Pio CA, Freitas MC. [Risk factors and prevalence of asthma and rhinitis among primary school children in Lisbon]. REVISTA PORTUGUESA DE PNEUMOLOGIA 2011; 17:109-16. [PMID: 21549669 DOI: 10.1016/j.rppneu.2011.01.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Accepted: 08/02/2010] [Indexed: 10/18/2022] Open
Abstract
AIMS A cross-sectional study was carried out with the objective of identifying nutrition habits and housing conditions as risk factors for respiratory problems in schoolchildren in Lisbon. MATERIAL AND METHODS Between October and December 2008, parents of 900 students of the basic schools of Lisbon were invited to answer a questionnaire of the International Study of Asthma and Allergies in Childhood Program (ISAAC). The response rate was 40%. Logistic regression was used in the analysis of results. RESULTS The prevalence of asthma, allergic rhinitis and wheeze was 5.6%, 43.0% and 43.3%, respectively. Risk factors independently associated with asthma were wheezing attacks, and dry cough at night not related to common cold in the last 12 months. Wheezing crises were found to affect children daily activities. Risk factors for wheeze were hay fever and the presence of a pet at home. A risk factor for rhinitis was cough at night. The frequent consumption of egg was also associated with increased risk of rhinitis. CONCLUSION Contrarily to asthma, the prevalence of allergic rhinitis and wheeze increased in comparison with previous ISAAC studies. Wheezing attacks were associated with asthma and hay fever was identified as a risk factor of manifesting wheezing symptoms. Having pets at home was pointed out as a significant risk factor for rhinitis, but not smoking exposure, mould, plush toys, diet (except egg consumption), breastfeeding or other conditions.
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Affiliation(s)
- P N Pegas
- Centro de Estudos do Ambiente e do Mar, Departamento de Ambiente e Ordenamento, Universidade de Aveiro, Aveiro, Portugal.
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Yang T, Wu Y, Abdullah ASM, Dai D, Li F, Wu J, Xiang H. Attitudes and behavioral response toward key tobacco control measures from the FCTC among Chinese urban residents. BMC Public Health 2007; 7:248. [PMID: 17877831 PMCID: PMC2194773 DOI: 10.1186/1471-2458-7-248] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2007] [Accepted: 09/18/2007] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Chinese National People's Congress ratified the WHO Framework Convention on Tobacco Control (FCTC) on 27 August 2005, signaling China's commitment to implement tobacco control policies and legislation consistent with the treaty. This study was designed to examine attitudes towards four WHO FCTC measures among Chinese urban residents. METHODS In a cross-sectional design study, survey data were collected from two Chinese urban cities involving a sample of 3,003 residents aged 15 years or older. Through a face-to-face interview, respondents were asked about attitudes toward four tobacco control measures developed by the WHO FCTC. Data on the four dependent measures were analyzed using multivariate logistic regression analyses. Using descriptive statistics, potential change in smoking behavior that smokers might make in response to increasing cigarette prices is also reported. RESULTS 81.8% of the respondents in the study sample supported banning smoking in public places, 68.8% favored increasing the cigarette tax, 85.1% supported health warnings on cigarette packages, and 85.7% favored banning tobacco advertising. The likelihood to support these measures was associated with gender, educational level, and personal income. Smokers were less likely to support these measures than non-smokers, with decreased support expressed by daily smokers compared to occasional smokers, and heavy smokers compared to light smokers. The proportion of switching to cheaper cigarette brands, decreasing smoking, and quitting smoking altogether with increased cigarette prices were 29.1%, 30.90% and 40.0% for occasional smokers, respectively; and 30.8%, 32.7% and 36.5% for daily smokers, respectively. CONCLUSION Results from this study indicate strong public support in key WHO FCTC measures and that increases in cigarette price may reduce tobacco consumption among Chinese urban residents. Findings from this study have implications with respect to policymaking and legislation for tobacco control in China.
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Affiliation(s)
- Tingzhong Yang
- Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Yanwei Wu
- Institute of Health Education, Chinese Center for Disease Control and Prevention
| | - Abu Saleh M Abdullah
- Department of International Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Di Dai
- Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | | | - Junqing Wu
- WHO collaborating Center for Research in Human Reproduction Unit of Epidemiology, China
| | - Haiqing Xiang
- Hangzhou Center for Disease Control and Prevention, China
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Joad JP, Sekizawa SI, Chen CY, Bonham AC. Air pollutants and cough. Pulm Pharmacol Ther 2007; 20:347-54. [PMID: 17174132 DOI: 10.1016/j.pupt.2006.10.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2006] [Accepted: 10/20/2006] [Indexed: 11/22/2022]
Abstract
Epidemiological studies have shown that exposure to air pollution is associated with respiratory symptoms and decreases in lung function. This paper reviews recent literature showing that exposure to particulate matter, irritant gases, environmental tobacco smoke (ETS), mixed pollutants, and molds is associated with an increase in cough and wheeze. Some pollutants, like particulate matter and mixed pollutants, appear to increase cough at least as much as wheeze. Others, like irritant gases, appear to increase wheeze more than cough. For ETS, exposure during childhood is associated with cough and wheeze in adulthood, suggesting that the pollutant permanently alters some important aspect of the lungs, immune system or nervous system. We have shown in animal studies that pollutants change the neural control of airways and cough. Second hand smoke (SHS) exposure lengthened stimulated apnoea, increased the number of stimulated coughs, and augmented the degree of stimulated bronchoconstriction. The mechanisms included enhanced reactivity of the peripheral sensory neurones and second-order neurones in the nucleus tractus solitarius (NTS). NTS effects were due to a substance P mechanism at least in part. Ozone and allergen increased the intrinsic excitability of second-order neurones in the NTS. The animal studies suggest that the cough and wheeze experienced by humans exposed to pollutants may involve plasticity in the nervous system.
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Affiliation(s)
- Jesse P Joad
- Department of Pediatrics, University of California, Davis, 2516 Stockton Blvd., Sacramento, CA 95817, USA.
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Potts JF, Rona RJ, Oyarzun MJ, Amigo H, Bustos P. Indoor risk factors for cough and their relation to wheeze and sensitization in Chilean young adults. Am J Public Health 2007; 98:680-6. [PMID: 17666696 PMCID: PMC2376996 DOI: 10.2105/ajph.2006.093302] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We assessed the effects of indoor risk factors, including smoking, on different types of cough and on cough and wheeze in combination. METHODS Our sample was composed of 1232 men and women residing in a semirural area of Chile. We used a standardized questionnaire, sensitization to 8 allergens, and bronchial hyperresponsiveness to methacholine to assess cough and wheeze characteristics. Information was gathered on dampness, mold, ventilation, heating, housing quality, smoking, and environmental tobacco smoke exposure. RESULTS Most exposures were associated with cough alone or cough in combination with wheeze. Smoking, past smoking, and environmental tobacco smoke exposure were strongly associated with dry cough and wheeze. The use of coal for heating was associated with dry cough. Leaks, mold, and lack of kitchen ventilation were associated with cough and wheeze. Nocturnal cough and productive cough were associated with specific types of sensitization, but dry cough was not. Productive cough was associated with hyperresponsiveness to methacholine. CONCLUSIONS Several different types of indoor exposures, including environmental tobacco smoke exposure, are important contributors to morbidity associated with cough and wheeze. A vigorous preventive strategy designed to lower exposures to indoor risk factors would lower rates of respiratory morbidity.
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Affiliation(s)
- James F Potts
- Respiratory Epidemiology and Public Health, Imperial College London, Emmanuel Kaye Building, Manresa Rd, London SW3 6LR, England.
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12
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Zhang JJ, Smith KR. Household air pollution from coal and biomass fuels in China: measurements, health impacts, and interventions. ENVIRONMENTAL HEALTH PERSPECTIVES 2007; 115:848-55. [PMID: 17589590 PMCID: PMC1892127 DOI: 10.1289/ehp.9479] [Citation(s) in RCA: 353] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2006] [Accepted: 02/27/2007] [Indexed: 05/14/2023]
Abstract
OBJECTIVE Nearly all China's rural residents and a shrinking fraction of urban residents use solid fuels (biomass and coal) for household cooking and/or heating. Consequently, global meta-analyses of epidemiologic studies indicate that indoor air pollution from solid fuel use in China is responsible for approximately 420,000 premature deaths annually, more than the approximately 300,000 attributed to urban outdoor air pollution in the country. Our objective in this review was to help elucidate the extent of this indoor air pollution health hazard. DATA SOURCES We reviewed approximately 200 publications in both Chinese- and English-language journals that reported health effects, exposure characteristics, and fuel/stove intervention options. CONCLUSIONS Observed health effects include respiratory illnesses, lung cancer, chronic obstructive pulmonary disease, weakening of the immune system, and reduction in lung function. Arsenic poisoning and fluorosis resulting from the use of "poisonous" coal have been observed in certain regions of China. Although attempts have been made in a few studies to identify specific coal smoke constituents responsible for specific adverse health effects, the majority of indoor air measurements include those of only particulate matter, carbon monoxide, sulfur dioxide, and/or nitrogen dioxide. These measurements indicate that pollution levels in households using solid fuel generally exceed China's indoor air quality standards. Intervention technologies ranging from simply adding a chimney to the more complex modernized bioenergy program are available, but they can be viable only with coordinated support from the government and the commercial sector.
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Affiliation(s)
- Junfeng Jim Zhang
- School of Public Health, University of Medicine and Dentistry of New Jersey, Piscataway, New Jersey 08854, USA.
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Ozge C, Toros F, Bayramkaya E, Camdeviren H, Sasmaz T. Which sociodemographic factors are important on smoking behaviour of high school students? The contribution of classification and regression tree methodology in a broad epidemiological survey. Postgrad Med J 2006; 82:532-41. [PMID: 16891446 PMCID: PMC2585710 DOI: 10.1136/pgmj.2005.040360] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The purpose of this study is to evaluate the most important sociodemographic factors on smoking status of high school students using a broad randomised epidemiological survey. METHODS Using in-class, self administered questionnaire about their sociodemographic variables and smoking behaviour, a representative sample of total 3304 students of preparatory, 9th, 10th, and 11th grades, from 22 randomly selected schools of Mersin, were evaluated and discriminative factors have been determined using appropriate statistics. In addition to binary logistic regression analysis, the study evaluated combined effects of these factors using classification and regression tree methodology, as a new statistical method. RESULTS The data showed that 38% of the students reported lifetime smoking and 16.9% of them reported current smoking with a male predominancy and increasing prevalence by age. Second hand smoking was reported at a 74.3% frequency with father predominance (56.6%). The significantly important factors that affect current smoking in these age groups were increased by household size, late birth rank, certain school types, low academic performance, increased second hand smoking, and stress (especially reported as separation from a close friend or because of violence at home). Classification and regression tree methodology showed the importance of some neglected sociodemographic factors with a good classification capacity. CONCLUSIONS It was concluded that, as closely related with sociocultural factors, smoking was a common problem in this young population, generating important academic and social burden in youth life and with increasing data about this behaviour and using new statistical methods, effective coping strategies could be composed.
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Affiliation(s)
- C Ozge
- Department of Chest Disease, Mersin University School of Medicine, Mersin, Turkey.
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Chubak J, McTiernan A, Sorensen B, Wener MH, Yasui Y, Velasquez M, Wood B, Rajan KB, Wetmore CM, Potter JD, Ulrich CM. Moderate-intensity exercise reduces the incidence of colds among postmenopausal women. Am J Med 2006; 119:937-42. [PMID: 17071161 DOI: 10.1016/j.amjmed.2006.06.033] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2005] [Revised: 06/10/2006] [Accepted: 06/12/2006] [Indexed: 10/24/2022]
Abstract
PURPOSE Our aim was to assess the effect of a moderate-intensity, year-long exercise program on the risk of colds and other upper respiratory tract infections in postmenopausal women. SUBJECTS A total of 115 overweight and obese, sedentary, postmenopausal women in the Seattle area participated. METHODS Participants were randomly assigned to the moderate-intensity exercise group or the control group. The intervention consisted of 45 minutes of moderate-intensity exercise 5 days per week for 12 months. Control participants attended once-weekly, 45-minute stretching sessions. Questionnaires asking about upper respiratory tract infections in the previous 3 months were administered quarterly during the course of the year-long trial. Poisson regression was used to estimate the effect of exercise on colds and other upper respiratory tract infections. RESULTS Over 12 months, the risk of colds decreased in exercisers relative to stretchers (P = .02): In the final 3 months of the study, the risk of colds in stretchers was more than threefold that of exercisers (P = .03). Risk of upper respiratory tract infections overall did not differ (P = .16), yet may have been biased by differential proportions of influenza vaccinations in the intervention and control groups. CONCLUSIONS This study suggests that 1 year of moderate-intensity exercise training can reduce the incidence of colds among postmenopausal women. These findings are of public health relevance and add a new facet to the growing literature on the health benefits of moderate exercise.
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Affiliation(s)
- Jessica Chubak
- Fred Hutchinson Cancer Research Center, Cancer Prevention Program, Seattle, Wash 98109-1024, USA
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Yang T, Fisher KJ, Li F, Danaher BG. Attitudes to smoking cessation and triggers to relapse among Chinese male smokers. BMC Public Health 2006; 6:65. [PMID: 16533411 PMCID: PMC1431522 DOI: 10.1186/1471-2458-6-65] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2005] [Accepted: 03/14/2006] [Indexed: 11/10/2022] Open
Abstract
Background Smoking is related to many diseases, and the relapse to smoking after cessation in China is noticeable. We examined the attitudes of Chinese male smokers regarding smoking cessation and reasons for relapse. Methods We interviewed 201 male smokers in Hangzhou City, Zhejiang province, China who had tried to quit smoking at least once in order to identify reasons for quitting and situations triggering relapse. Results The most significant reported reasons for quitting included personal health (77.1%), the cost of cigarettes (53.7%), and family pressures to quit (29.9%). The most common factors triggering relapse were social situations (34.3%), feeling negative or down (13.4%) and times of being alone (8.4%). Conclusion Health and family concerns, personal factors, the influence of others and a lack of cessation resources were cited as salient factors concerning smoking cessation among male smokers in this study. Effective smoking control efforts in China will require attention to these influences if China is to curb its current smoking epidemic.
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Affiliation(s)
- Tingzhong Yang
- Department of Social Medicine, School of Medicine, University of Zhejiang, 353 Yan'an Road, Hangzhou, Zhejiang 310031, China
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