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Finell E, Pyysiäinen J, Walden A. Frames of agency in a school with poor indoor-air quality: A longitudinal composite narrative study. Health Place 2024; 88:103256. [PMID: 38739984 DOI: 10.1016/j.healthplace.2024.103256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 04/19/2024] [Accepted: 04/23/2024] [Indexed: 05/16/2024]
Abstract
Problems with schools' indoor-air quality are common, and they can cause health problems to adolescents. However, no previous research has examined how adolescents make sense of such contaminated socio-material environments or what kinds of agency those environments afford. Taking an ecological psychology perspective informed by frame analysis, we analysed longitudinal focus group interviews with adolescents in a Finnish school with longstanding indoor-air problems. We constructed three composite first-person narratives that reflected different experiential frames, with corresponding forms and changes of agency. We found that our adolescents made sense of the same socio-material environment and its affordances in very different ways, and this process afforded them to develop many kinds of agency that changed over time.
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Affiliation(s)
- Eerika Finell
- Faculty of Social Sciences and Business Studies, Kuopio Campus, University of Eastern Finland, PO Box 1627, 70211, Finland.
| | - Jarkko Pyysiäinen
- Department of Economics and Management, University of Helsinki, Latokartanonkaari 5, 00790, Helsinki, Finland.
| | - Aino Walden
- Faculty of Social Sciences and Business Studies, Kuopio Campus, University of Eastern Finland, PO Box 1627, 70211, Finland.
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Xue H, Xue Q, Wang C, Chen Q, Wang D, Li Z, Xie B, Zheng W. Impact of diurnal temperature variations on sputum bacterial detection in hospitalized patients with acute COPD exacerbation: a retrospective study from Fuzhou, China. BMC Pulm Med 2024; 24:291. [PMID: 38909192 PMCID: PMC11193170 DOI: 10.1186/s12890-024-03102-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 06/14/2024] [Indexed: 06/24/2024] Open
Abstract
OBJECTIVE To investigate the association between meteorological data three days before admission and the status of sputum pathogens culture in hospitalized patients with Acute exacerbation of Chronic obstructive pulmonary disease (AECOPD) and respiratory infections. METHODS Data from 1,370 AECOPD patients (80.66% males, approximately 80% age > 70) with respiratory infections hospitalized in Fujian Provincial Hospital between December 2013 and December 2019 were collected. This cohort comprised, along with concurrent meteorological data from Fuzhou. Group differences were analyzed to compare the meteorological data three days prior to admission between patients with positive sputum pathogen cultures and those without. Logistic regression models were employed to investigate the association between meteorological parameters and the status of sputum pathogen cultures in patients with AECOPD and respiratory infections. Sensitivity analyses was conducted among the hospitalized patients from 2013 to 2016 and 2017-2019. Stratified analysis was performed to explore the factors affecting the effect of temperature differences and their interactions. RESULTS 578(42.19%) cases had a positive sputum culture report indicating pathogen growth. 323 cases were found with Gram-negative bacteria, 160 with Gram-positive bacteria, and 114 with fungi. Uni-variate analysis revealed statistical differences in DTD three days prior to admission (DTD-3d) between the positive and negative sputum culture groups (p = 0.019). Multivariate analysis indicated that an increase in the risk of positive sputum pathogen cultures was associated with greater DTD three days before admission (DTD-3d), with OR1.657 (95%CI [ 1.328-1.981]). The risk of positive sputum pathogen cultures was higher in groups with greater DTD-3d. The findings were consistent across different admission periods. Stratified analysis showed that patients without respiratory failure were more affected by DTD-3d, and an interaction effect was observed (p < 0.001). CONCLUSION In coastal areas, the diurnal temperature difference three days prior to admission affects the sputum pathogen status in AECOPD patients with respiratory infections.
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Affiliation(s)
- Hong Xue
- Department of Respiratory and Critical Care Medicine, Provincial School of Clinical Medicine, Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital, No. 134 East Street, Gulou District, Fuzhou City, 350001, Fujian Province, China
| | - Qing Xue
- The Third Clinical Medical College, Fujian Medical University, Ningde Municipal Hospital, Ningde, 350021, Fujian, China
| | - Chunhui Wang
- Fujian Meteorological Service Centre, Fujian Meteorological Bureau, Fuzhou City, 350001, Fujian Province, China
| | - Qianshun Chen
- Department of Thoracic Surgery, Provincial School of Clinical Medicine, Fujian Provincial Hospital, Fujian Medical University, Fuzhou City, 350001, Fujian Province, China
| | - Daxuan Wang
- The Third Clinical Medical College, Fujian Medical University, Ningde Municipal Hospital, Ningde, 350021, Fujian, China
| | - Zhen Li
- Microbiology Laboratory, Provincial School of Clinical Medicine, Fujian Provincial Hospital, Fujian Medical University, Fuzhou City, 350001, Fujian Province, China
| | - Baosong Xie
- Department of Respiratory and Critical Care Medicine, Provincial School of Clinical Medicine, Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital, No. 134 East Street, Gulou District, Fuzhou City, 350001, Fujian Province, China.
| | - Wei Zheng
- The Third Clinical Medical College, Fujian Medical University, Ningde Municipal Hospital, Ningde, 350021, Fujian, China.
- Fujian Meteorological Service Centre, Fujian Meteorological Bureau, Fuzhou City, 350001, Fujian Province, China.
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So M, Dziuban EJ, Pedati CS, Holbrook JR, Claussen AH, O'Masta B, Maher B, Cerles AA, Mahmooth Z, MacMillan L, Kaminski JW, Rush M. Childhood Physical Health and Attention Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis of Modifiable Factors. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:316-336. [PMID: 35947281 PMCID: PMC10032176 DOI: 10.1007/s11121-022-01398-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 10/15/2022]
Abstract
Although neurobiologic and genetic factors figure prominently in the development of attention deficit/hyperactivity disorder (ADHD), adverse physical health experiences and conditions encountered during childhood may also play a role. Poor health is known to impact the developing brain with potential lifelong implications for behavioral issues. In attempt to better understand the relationship between childhood physical health and the onset and presence of ADHD symptoms, we summarized international peer-reviewed articles documenting relationships between a select group of childhood diseases or health events (e.g., illnesses, injuries, syndromes) and subsequent ADHD outcomes among children ages 0-17 years. Drawing on a larger two-phase systematic review, 57 longitudinal or retrospective observational studies (1978-2021) of childhood allergies, asthma, eczema, head injury, infection, or sleep problems and later ADHD diagnosis or symptomatology were identified and subjected to meta-analysis. Significant associations were documented between childhood head injuries, infections, and sleep problems with both dichotomous and continuous measures of ADHD, and between allergies with dichotomous measures of ADHD. We did not observe significant associations between asthma or eczema with ADHD outcomes. Heterogeneity detected for multiple associations, primarily among continuously measured outcomes, underscores the potential value of future subgroup analyses and individual studies. Collectively, these findings shed light on the importance of physical health in understanding childhood ADHD. Possible etiologic links between physical health factors and ADHD are discussed, as are implications for prevention efforts by providers, systems, and communities.
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Affiliation(s)
- Marvin So
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS-E88, Atlanta, GA, 30341, USA.
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA.
| | - Eric J Dziuban
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Caitlin S Pedati
- Virginia Beach Department of Public Health, Virginia Beach, VA, USA
| | - Joseph R Holbrook
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS-E88, Atlanta, GA, 30341, USA
| | - Angelika H Claussen
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS-E88, Atlanta, GA, 30341, USA
| | | | - Brion Maher
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | | | - Jennifer W Kaminski
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS-E88, Atlanta, GA, 30341, USA
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Bender BG, Crooks J, Gerald JK, Hudson B, King DK, Kobernick A, Liu AH, Lowe AA, Morgan W, Nez P, Phan H, Wightman P, Gerald LB. Childhood asthma exacerbations on the Navajo Nation. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024:S2213-2198(24)00429-X. [PMID: 38697473 DOI: 10.1016/j.jaip.2024.04.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 04/09/2024] [Accepted: 04/22/2024] [Indexed: 05/05/2024]
Affiliation(s)
- Bruce G Bender
- Division of Biostatistics, Department of Pediatrics, Center for Health Promotion, National Jewish Health, Denver, Colo.
| | - James Crooks
- Division of Biostatistics, Department of Pediatrics, Center for Health Promotion, National Jewish Health, Denver, Colo
| | - Joe K Gerald
- Advanced Nursing and Science Division, College of Nursing, Department of Public Health Practice, Policy and Translational Research, Pulmonary and Sleep Medicine, The Zuckerman College of Public Health, Center for Population Science and Discovery, University of Arizona, Tucson, Ariz
| | - Bryan Hudson
- Division of Biostatistics, Department of Pediatrics, Center for Health Promotion, National Jewish Health, Denver, Colo
| | - Diane K King
- Center for Behavioral Health Research and Services, University of Alaska Anchorage, Anchorage, Alaska
| | - Aaron Kobernick
- Section of Allergy and Immunology, Department of Dermatology, University of Utah, Salt Lake City, Utah
| | - Andrew H Liu
- The Breathing Institute, Childrens Hospital Colorado, University of Colorado, Denver, Colo
| | - Ashley A Lowe
- Advanced Nursing and Science Division, College of Nursing, Department of Public Health Practice, Policy and Translational Research, Pulmonary and Sleep Medicine, The Zuckerman College of Public Health, Center for Population Science and Discovery, University of Arizona, Tucson, Ariz
| | - Wayne Morgan
- Advanced Nursing and Science Division, College of Nursing, Department of Public Health Practice, Policy and Translational Research, Pulmonary and Sleep Medicine, The Zuckerman College of Public Health, Center for Population Science and Discovery, University of Arizona, Tucson, Ariz
| | - Peter Nez
- Division of Biostatistics, Department of Pediatrics, Center for Health Promotion, National Jewish Health, Denver, Colo
| | - Hanna Phan
- Clinical Pharmacy, University of Michigan, Ann Arbor, Mich
| | - Patrick Wightman
- Advanced Nursing and Science Division, College of Nursing, Department of Public Health Practice, Policy and Translational Research, Pulmonary and Sleep Medicine, The Zuckerman College of Public Health, Center for Population Science and Discovery, University of Arizona, Tucson, Ariz
| | - Lynn B Gerald
- Office of Population Health Sciences, Office of the Vice Chancellor for Health Affairs, University of Illinois Chicago, Chicago, Ill
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Chudzik A, Jalkanen K, Täubel M, Szponar B, Paściak M. Identification of environmental Actinobacteria in buildings by means of chemotaxonomy, 16S rRNA sequencing, and MALDI-TOF MS. Microbiol Spectr 2024; 12:e0359623. [PMID: 38299830 PMCID: PMC10913483 DOI: 10.1128/spectrum.03596-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 01/05/2024] [Indexed: 02/02/2024] Open
Abstract
Actinobacteria are abundant in soil and other environmental ecosystems and are also an important part of the human microbiota. Hence, they can also be detected in indoor environments and on building materials, where actinobacterial proliferation on damp materials can indicate moisture damage. The aim of this study was to evaluate the matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) for the identification of 28 environmental strains of Actinobacteria isolated from building materials and indoor and outdoor air samples, mainly collected in the context of moisture damage investigations in buildings in Finland. The 16S rRNA gene sequencing and chemotaxonomic analyses were performed, and results were compared with the MALDI-TOF MS Biotyper identification. Using 16S rRNA gene sequencing, all isolates were identified on the species or genus level and were representatives of Streptomyces, Nocardia, and Pseudonocardia genera. Based on MALDI-TOF MS analysis, initially, 11 isolates were identified as Streptomyces spp. and 1 as Nocardia carnea with a high identification score. After an upgrade in the MALDI-TOF MS in-house database and re-evaluation of mass spectra, 13 additional isolates were identified as Nocardia, Pseudonocardia, and Streptomyces. MALDI-TOF MS has the potential in environmental strain identification; however, the standard database needs to be considerably enriched by environmental Actinobacteria representatives. IMPORTANCE The manuscript addresses the challenges in identifying environmental bacteria using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) Biotyper-based protein profiling. The matter of the studies-actinobacterial strains-has been isolated mostly from building materials that originated from a confirmed moisture-damaged situation. Polyphasic taxonomy, 16S RNA gene sequencing, and MALDI-TOF mass spectrometry were applied for identification purposes. In this experimental paper, a few important facts are highlighted. First, Actinobacteria are abundant in the natural as well as built environment, and their identification on the species and genus levels is difficult and time-consuming. Second, MALDI-TOF MS is an effective tool for identifying bacterial environmental strains, and in parallel, continuous enrichment of the proteomics mass spectral databases is necessary for proper identification. Third, the chemical approach aids in the taxonomical inquiry of Actinobacteria environmental strains.
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Affiliation(s)
- Anna Chudzik
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
| | - Kaisa Jalkanen
- Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Martin Täubel
- Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Bogumiła Szponar
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
| | - Mariola Paściak
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
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Lejeune S, Bouazza N, Nicaise PR, Jolaine V, Roditis L, Marguet C, Amat F, Berger P, Fayon M, Dubus JC, Valois S, Reix P, Pellan M, Brouard J, Chiron R, Giovannini-Chami L, de Blic J, Deschildre A, Lezmi G. COBRAPed cohort: Do sensitization patterns differentiate children with severe asthma from those with a milder disease? Pediatr Allergy Immunol 2024; 35:e14112. [PMID: 38520021 DOI: 10.1111/pai.14112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 03/05/2024] [Accepted: 03/06/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND It is unclear whether sensitization patterns differentiate children with severe recurrent wheeze (SRW)/severe asthma (SA) from those with non-severe recurrent wheeze (NSRW)/non-severe asthma (NSA). Our objective was to determine whether sensitization patterns can discriminate between children from the French COBRAPed cohort with NSRW/NSA and those with SRW/SA. METHODS IgE to 112 components (c-sIgE) (ImmunoCAP® ISAC) were analyzed in 125 preschools (3-6 years) and 170 school-age children (7-12 years). Supervised analyses and clustering methods were applied to identify patterns of sensitization among children with positive c-sIgE. RESULTS We observed c-sIgE sensitization in 51% of preschool and 75% of school-age children. Sensitization to house dust mite (HDM) components was more frequent among NSRW than SRW (53% vs. 24%, p < .01). Sensitization to non-specific lipid transfer protein (nsLTP) components was more frequent among SA than NSA (16% vs. 4%, p < .01) and associated with an FEV1/FVC < -1.64 z-score. Among sensitized children, seven clusters with varying patterns were identified. The two broader clusters identified in each age group were characterized by "few sensitizations, mainly to HDM." One cluster (n = 4) with "multiple sensitizations, mainly to grass pollen, HDM, PR-10, and nsLTP" was associated with SA in school-age children. CONCLUSIONS Although children with wheeze/asthma display frequent occurrences and high levels of sensitization, sensitization patterns did not provide strong signals to discriminate children with severe disease from those with milder disease. These results suggest that the severity of wheeze/asthma may depend on both IgE- and non-IgE-mediated mechanisms.
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Affiliation(s)
- Stéphanie Lejeune
- Pediatric Pulmonology and Allergy Department, U1019-UMR 9017-CIIL-Center for Infection and Immunity of Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, Hôpital Jeanne de Flandre, Univ. Lille, Lille, France
- Clinical Investigation Center, LIRIC UMR 995 Inserm, CIC-1403-Inserm-CHU, Univ. Lille, Lille, France
| | - Naïm Bouazza
- Unité de Recherche Clinique-Centre Investigation Clinique, APHP, Hôpital Necker-Enfants malades, Paris, France
| | - Pascale Roland Nicaise
- Immunology Department, Hôpital Bichat, APHP, Paris, France
- Inserm, PHERE, Université Paris Cité, Paris, France
| | - Valérie Jolaine
- Unité de Recherche Clinique-Centre Investigation Clinique, APHP, Hôpital Necker-Enfants malades, Paris, France
| | - Léa Roditis
- Pediatric Pulmonology and Allergology Unit CHU Toulouse, Children Hospital, Toulouse, France
| | - Christophe Marguet
- Pediatric Respiratory and Allergic Diseases, CF Reference Center, Rouen University Hospital-Charles Nicolle, EA3830-GHRV, Rouen University, Rouen, France
| | - Flore Amat
- Pediatric Pulmonology and Allergology, INSERM UMR 1018, Robert Debré Hospital, University of Paris Cité, Paris, France
| | - Patrick Berger
- Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM, U1045, Centre d'Investigation Clinique (CIC 1401), Univ. Bordeaux, Bordeaux, France
| | - Michael Fayon
- Unité de Pneumologie Pédiatrique, Centre d'Investigation Clinique (CIC 1401), CHU de Bordeaux, Bordeaux, France
| | - Jean-Christophe Dubus
- Unité de Pneumopédiatrie CHU Timone-Enfants, Aix-Marseille Université, IRD MEPHI, IHU Méditerranée-Infection, Marseille, France
| | - Sophie Valois
- Pédiatrie, CHU Grenoble Alpes, INSERM, Institute for Advanced Biosciences, Université Grenoble Alpes, Grenoble, France
| | - Philippe Reix
- Service de Pneumologie, Allergologie et Mucoviscidose Pédiatrique, CHU de Lyon, Lyon, France
- UMR 5558 (EMET), CNRS, LBBE, Université de Lyon, Villeurbanne, France
| | | | - Jacques Brouard
- Service de Pédiatrie Médicale, CHU Caen, Caen, France
- Groupe de Recherche sur l'Adaptation Microbienne (GRAM 2.0), Normandie Université, Caen, France
| | - Raphael Chiron
- Pediatric Department, Montpellier University Hospital, Montpellier, France
| | | | - Jacques de Blic
- Department of Pediatric Pulmonology and Allergy, AP-HP, Hôpital Necker-Enfants Malades, Université Paris Cité, Paris, France
| | - Antoine Deschildre
- Pediatric Pulmonology and Allergy Department, U1019-UMR 9017-CIIL-Center for Infection and Immunity of Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, Hôpital Jeanne de Flandre, Univ. Lille, Lille, France
- Clinical Investigation Center, LIRIC UMR 995 Inserm, CIC-1403-Inserm-CHU, Univ. Lille, Lille, France
| | - Guillaume Lezmi
- Department of Pediatric Pulmonology and Allergy, AP-HP, Hôpital Necker-Enfants Malades, Université Paris Cité, Paris, France
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Wei H, Yang F. Residual profiles and health risk of indoor allergens in China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 342:123151. [PMID: 38101531 DOI: 10.1016/j.envpol.2023.123151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 12/09/2023] [Accepted: 12/11/2023] [Indexed: 12/17/2023]
Abstract
Exposure to indoor allergens is a principal risk factor for allergic diseases. However, most of the previous studies on indoor allergens focused on very limited kinds of allergens in China. Knowledge of the simultaneous exposure to multiple allergens is still lacking. In this study, the residual profiles of 8 allergens were investigated in 166 dust samples from 11 cities in China. The house dust mite allergens including Der p 1, Der f 1, and Der 2 were detected in the range of <0.02-283.83 μg/g dust. The concentrations of dog allergen Can f 1 and cat allergen Fel d 1 varied widely, from <0.84-22,896.46 μg/g dust for Can f 1 and from <0.02-6298.96 μg/g dust for Fel d 1. Cockroach allergen Bla g 2 was detected in 68% of the samples but at a low level with a maximum of 9.44 μg/g dust. Comparatively low detection frequencies were found for mouse allergen Mus m 1 as 37% and for fungi allergen Asp f 2 as 24%. The frequency of cleaning sheets/bedding was negatively correlated to the levels of house dust mite allergens. The presence of pets indoors was associated with higher levels of pet allergens and lower levels of house dust mite allergens and cockroach allergen. Risk evaluation reveals that at least 4 allergens were found in more than 80% of the rooms and more than 2 allergens with median/high risk were detected in 42% of the rooms, indicating that simultaneous exposure to multiple allergens is prevalent in China.
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Affiliation(s)
- Huiying Wei
- Key Laboratory of Environment Remediation and Ecological Health, Ministry of Education, College of Environmental and Resource Sciences, Zhejiang University, 310058, Hangzhou, China
| | - Fangxing Yang
- Key Laboratory of Environment Remediation and Ecological Health, Ministry of Education, College of Environmental and Resource Sciences, Zhejiang University, 310058, Hangzhou, China; Innovation Center of Yangtze River Delta, Zhejiang University, 314100, Jiashan, China.
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Huang E, Albrecht L, O’Hearn K, Nicolas N, Armstrong J, Weinberg M, Menon K. Reporting of social determinants of health in randomized controlled trials conducted in the pediatric intensive care unit. Front Pediatr 2024; 12:1329648. [PMID: 38361997 PMCID: PMC10867174 DOI: 10.3389/fped.2024.1329648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 01/19/2024] [Indexed: 02/17/2024] Open
Abstract
Introduction The influence of social determinants of health (SDOH) on access to care and outcomes for critically ill children remains an understudied area with a paucity of high-quality data. Recent publications have highlighted the importance of incorporating SDOH considerations into research but the frequency with which this occurs in pediatric intensive care unit (PICU) research is unclear. Our objective was to determine the frequency and categories of SDOH variables reported and how these variables were defined in published PICU randomized controlled trials (RCTs). Methods We searched Medline, Embase, Lilacs, and Central from inception to Dec 2022. Inclusion criteria were randomized controlled trials of any intervention on children or their families in a PICU. Data related to study demographics and nine WHO SDOH categories were extracted, and descriptive statistics and qualitative data generated. Results 586 unique RCTs were included. Studies had a median sample size of 60 patients (IQR 40-106) with 73.0% of studies including ≤100 patients and 41.1% including ≤50 patients. A total of 181 (181/586, 30.9%) studies reported ≥1 SDOH variable of which 163 (163/586, 27.8%) reported them by randomization group. The most frequently reported categories were food insecurity (100/586, 17.1%) and social inclusion and non-discrimination (73/586, 12.5%). Twenty-five of 57 studies (43.9%) investigating feeding or nutrition and 11 of 82 (13.4%) assessing mechanical ventilation reported baseline nutritional assessments. Forty-one studies investigated interventions in children with asthma or bronchiolitis of which six reported on smoking in the home (6/41, 14.6%). Discussion Reporting of relevant SDOH variables occurs infrequently in PICU RCTs. In addition, when available, categorizations and definitions of SDOH vary considerably between studies. Standardization of SDOH variable collection along with consistent minimal reporting requirements for PICU RCT publications is needed.
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Affiliation(s)
- Emma Huang
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Lisa Albrecht
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Katie O’Hearn
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Naisha Nicolas
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Jennifer Armstrong
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Maya Weinberg
- Faculty of Science, University of Ottawa, Ottawa, ON, Canada
| | - Kusum Menon
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Department of Pediatrics, Children’s Hospital of Eastern Ontario and University of Ottawa, Ottawa, ON, Canada
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Carroll AR, Hall M, Noelke C, Ressler RW, Brown CM, Spencer KS, Bell DS, Williams DJ, Fritz CQ. Association of neighborhood opportunity and pediatric hospitalization rates in the United States. J Hosp Med 2024; 19:120-125. [PMID: 38073069 PMCID: PMC10872227 DOI: 10.1002/jhm.13252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/08/2023] [Accepted: 11/23/2023] [Indexed: 02/03/2024]
Abstract
We examined associations between a validated, multidimensional measure of social determinants of health and population-based hospitalization rates among children <18 years across 18 states from the 2017 Healthcare Cost and Utilization Project State Inpatient Databases and the US Census. The exposure was ZIP code-level Child Opportunity Index (COI), a composite measure of neighborhood resources and conditions that matter for children's health. The cohort included 614,823 hospitalizations among a population of 29,244,065 children (21.02 hospitalizations per 1000). Adjusted hospitalization rates decreased significantly and in a stepwise fashion as COI increased (p < .001 for each), from 26.56 per 1000 (95% confidence interval [CI] 26.41-26.71) in very low COI areas to 14.76 per 1000 (95% CI 14.66-14.87) in very high COI areas (incidence rate ratio 1.8; 95% CI 1.78-1.81). Decreasing neighborhood opportunity was associated with increasing hospitalization rates among children in 18 US states. These data underscore the importance of social context and community-engaged solutions for health systems aiming to eliminate care inequities.
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Affiliation(s)
- Alison R. Carroll
- Division of Pediatric Hospital Medicine, Department of Pediatrics, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN
| | - Matt Hall
- Children’s Hospital Association, Lenexa, KS
| | - Clemens Noelke
- Heller School for Social Policy and Management, Brandeis University, Waltham, MS
| | - Robert W. Ressler
- Heller School for Social Policy and Management, Brandeis University, Waltham, MS
| | - Charlotte M. Brown
- Division of Pediatric Hospital Medicine, Department of Pediatrics, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN
| | - Katherine S. Spencer
- Division of Pediatric Hospital Medicine, Department of Pediatrics, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN
| | - Deanna S. Bell
- Division of Pediatric Hospital Medicine, Department of Pediatrics, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN
| | - Derek J. Williams
- Division of Pediatric Hospital Medicine, Department of Pediatrics, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN
| | - Cristin Q. Fritz
- Division of Pediatric Hospital Medicine, Department of Pediatrics, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN
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Bole A, Bernstein A, White MJ. The Built Environment and Pediatric Health. Pediatrics 2024; 153:e2023064773. [PMID: 38105697 DOI: 10.1542/peds.2023-064773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/23/2023] [Indexed: 12/19/2023] Open
Abstract
Buildings, parks, and roads are all elements of the "built environment," which can be described as the human-made structures that comprise the neighborhoods and communities where people live, work, learn, and recreate (https://www.epa.gov/smm/basic-information-about-built-environment). The design of communities where children and adolescents live, learn, and play has a profound impact on their health. Moreover, the policies and practices that determine community design and the built environment are a root cause of disparities in the social determinants of health that contribute to health inequity. An understanding of the links between the built environment and pediatric health will help to inform pediatricians' and other pediatric health professionals' care for patients and advocacy on their behalf. This technical report describes the range of pediatric physical and mental health conditions influenced by the built environment, as well as historical and persistent effects of the built environment on health disparities. The accompanying policy statement outlines community design solutions that can improve pediatric health and health equity, including opportunities for pediatricians and the health care sector to incorporate this knowledge in patient care, as well as to play a role in advancing a health-promoting built environment for all children and families.
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Affiliation(s)
- Aparna Bole
- Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Aaron Bernstein
- Department of General Pediatrics, Boston Children's Hospital, and Center for Climate, Health and the Global Environment, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Michelle J White
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina
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Sarikloglou E, Fouzas S, Paraskakis E. Prediction of Asthma Exacerbations in Children. J Pers Med 2023; 14:20. [PMID: 38248721 PMCID: PMC10820562 DOI: 10.3390/jpm14010020] [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: 11/26/2023] [Revised: 12/17/2023] [Accepted: 12/20/2023] [Indexed: 01/23/2024] Open
Abstract
Asthma exacerbations are common in asthmatic children, even among those with good disease control. Asthma attacks result in the children and their parents missing school and work days; limit the patient's social and physical activities; and lead to emergency department visits, hospital admissions, or even fatal events. Thus, the prompt identification of asthmatic children at risk for exacerbation is crucial, as it may allow for proactive measures that could prevent these episodes. Children prone to asthma exacerbation are a heterogeneous group; various demographic factors such as younger age, ethnic group, low family income, clinical parameters (history of an exacerbation in the past 12 months, poor asthma control, poor adherence to treatment, comorbidities), Th2 inflammation, and environmental exposures (pollutants, stress, viral and bacterial pathogens) determine the risk of a future exacerbation and should be carefully considered. This paper aims to review the existing evidence regarding the predictors of asthma exacerbations in children and offer practical monitoring guidance for promptly recognizing patients at risk.
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Affiliation(s)
| | - Sotirios Fouzas
- Department of Pediatrics, University of Patras Medical School, 26504 Patras, Greece;
| | - Emmanouil Paraskakis
- Paediatric Respiratory Unit, Paediatric Department, University of Crete, 71500 Heraklion, Greece
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12
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Kwong K, Robinson M, Sullivan A, Letovsky S, Liu AH, Valcour A. Fungal allergen sensitization: Prevalence, risk factors, and geographic variation in the United States. J Allergy Clin Immunol 2023; 152:1658-1668. [PMID: 37741553 DOI: 10.1016/j.jaci.2023.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 08/30/2023] [Accepted: 09/08/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND Many fungal species are associated with the pathogenesis of allergic disease, yet most epidemiologic studies on IgE-mediated fungal sensitization have only included a few species. OBJECTIVE We investigated fungal allergen sensitization prevalence, risk factors, and geographic variation in the United States. METHODS From 2014 to 2019, a total of 7,912,504 serum-specific IgE (sIgE) test results for 17 fungal species were measured in 1,651,203 patients aged 0-85 years by a US-wide clinical laboratory. Fungal sensitization prevalence, patterns, and relationship with demographic characteristics, clinical diagnoses, and geographic regions were analyzed. RESULTS Twenty-two percent of patients were positive (sIgE > 0.10 kUA/L) to at least 1 fungal allergen; 13.7% were positive to >2 fungal allergens. Fungal species-specific positivity rates ranged 7.4-18.6% and were highest for Candida albicans (18.6%), Alternaria alternata (16.6%), Stemphylium herbarum (14.9%), and Aspergillus fumigatus (14.2%). Other fungi that were frequently tested had relatively low positivity rates (eg, Cladosporium herbarum 11.1%, Penicillium chrysogenum 10.7%). Independent risk factors for test positivity for all fungal species included male sex, teen age (highest in those aged 10-19 years), atopic dermatitis, and asthma. Fungal sensitization was generally higher in urban areas and ecoregions composed predominantly of grasslands and prairies compared to woodlands and forest, although there was greater variation in sensitization risk to different fungi in different ecoregions. CONCLUSION Independent risk factors for fungal sensitization include male sex, teen ages, atopic dermatitis, asthma, and ecoregion.
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Affiliation(s)
- Kenny Kwong
- Department of Pediatrics, Division of Allergy-Immunology, Los Angeles County and University of Southern California Medical Center, Los Angeles, Calif.
| | | | | | | | - Andrew H Liu
- Pediatric Pulmonary & Sleep Medicine Section, and Breathing Institute, Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colo
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Aak A, Hage M, Rukke BA. Biological control of Cimex lectularius with Beauveria bassiana: Effects of substrate, dosage, application strategy, and bed bug physiology. PEST MANAGEMENT SCIENCE 2023; 79:4599-4606. [PMID: 37432134 DOI: 10.1002/ps.7659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 07/06/2023] [Accepted: 07/11/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Cimex lectularius L. (bed bug) (Hemiptera: Cimicidae) is a serious indoor pest worldwide, and this nuisance needs to be controlled using different methods in integrated pest management (IPM). Beauveria bassiana (Bals.-Criv.) Vuill. (Hypocreales: Cordycipitaceae) kills bed bugs, and insect pathogenic fungi may be utilized to control bed bugs in IPM. To increase knowledge of this methodology, forced exposure experiments were conducted with different formulations, doses, and substrates, using bed bugs in variable physiological states. RESULTS Both oil- and water-formulated fungal products showed significant improvement when conidial concentrations were raised in five steps from 0.02 to 2.0%. At low concentrations (0.02% in water) effects from substrate and application strategy were observed. Application on soft substrates (cotton and polyester) yielded significantly higher bed bug mortality rates than on harder substrates (paper, wood, and linoleum) with a final mortality of 35-63% against 8-10%. Multiple applications over time also improved B. bassiana's ability to kill bed bugs, and at low concentrations only a triple application on cotton showed 100% final mortality. Bed bug age and reproductive status significantly affected survival. Older and reproducing individuals showed higher mortality compared to newly emerged adults. Differences in feeding status also yielded differences in mortality timing, but only minor differences in final mortality rates. Egg production and hatching success were significantly reduced by some treatments. CONCLUSION B. bassiana appears to be an asset in the fight against bed bugs. Substrate, dosage, application strategy, and bed bug physiology are important factors to consider for optimal efficacy and safe indoor control with insect pathogenic fungi. © 2023 Society of Chemical Industry.
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Affiliation(s)
- Anders Aak
- Department of Pest Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Morten Hage
- Department of Pest Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Bjørn Arne Rukke
- Department of Pest Control, Norwegian Institute of Public Health, Oslo, Norway
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14
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Denning DW, Pfavayi LT. Poorly controlled asthma - Easy wins and future prospects for addressing fungal allergy. Allergol Int 2023; 72:493-506. [PMID: 37544851 DOI: 10.1016/j.alit.2023.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/25/2023] [Accepted: 06/28/2023] [Indexed: 08/08/2023] Open
Abstract
Poorly controlled asthma is especially common in low resource countries. Aside from lack of access to, or poor technique with, inhaled beta-2 agonists and corticosteroids, the most problematic forms of asthma are frequently associated with both fungal allergy and exposure, especially in adults leading to more asthma exacerbations and worse asthma. The umbrella term 'fungal asthma' describes many disorders linked to fungal exposure and/or allergy to fungi. One fungal asthma endotype, ABPA, is usually marked by a very high IgE and its differential diagnosis is reviewed. Both ABPA and fungal bronchitis in bronchiectasis are marked by thick excess airway mucus production. Dermatophyte skin infection can worsen asthma and eradication of the skin infection improves asthma. Exposure to fungi in the workplace, home and schools, often in damp or water-damaged buildings worsens asthma, and remediation improves symptom control and reduces exacerbations. Antifungal therapy is beneficial for fungal asthma as demonstrated in nine of 13 randomised controlled studies, reducing symptoms, corticosteroid need and exacerbations while improving lung function. Other useful therapies include azithromycin and some biologics approved for the treatment of severe asthma. If all individuals with poorly controlled and severe asthma could be 'relieved' of their fungal allergy and infection through antifungal therapy without systemic corticosteroids, the health benefits would be enormous and relatively inexpensive, improving the long term health of over 20 million adults and many children. Antifungal therapy carries some toxicity, drug interactions and triazole resistance risks, and data are incomplete. Here we summarise what is known and what remains uncertain about this complex topic.
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Affiliation(s)
- David W Denning
- Manchester Fungal Infection Group, The University of Manchester and Manchester Academic Health Science Centre, Manchester, UK.
| | - Lorraine T Pfavayi
- Institute of Immunology & Infection Research, Ashworth Laboratories, School of Biological Sciences, University of Edinburgh, Edinburgh, UK
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15
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Tran HM, Chuang TW, Chuang HC, Tsai FJ. Climate change and mortality rates of COPD and asthma: A global analysis from 2000 to 2018. ENVIRONMENTAL RESEARCH 2023; 233:116448. [PMID: 37352955 DOI: 10.1016/j.envres.2023.116448] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/02/2023] [Accepted: 06/16/2023] [Indexed: 06/25/2023]
Abstract
BACKGROUND Climate change plays a significant role in global health threats, particularly with respiratory diseases such as chronic obstructive pulmonary disease (COPD) and asthma, but the long-term global-scale impact of climate change on these diseases' mortality remains unclear. OBJECTIVE This study aims to investigate the impact of climate change on the age-standardized mortality rates (ASMR) of COPD and asthma at national levels. METHODS We used Global Burden of Disease (GBD) data of ASMR of COPD and asthma from 2000 to 2018. The climate change index was represented as the deviance percentage of temperature (DPT) and relative humidity (DPRH), calculated based on 19-year temperature and humidity averages. Annual temperature, RH, and fine particulate matter (PM2.5) levels in 185 countries/regions were obtained from ERA5 and the OECD's environmental statistics database. General linear mixed-effect regression models were used to examine the associations between climate change with the log of ASMR (LASMR) of COPD and asthma. RESULTS After adjusting for annual PM2.5, SDI level, smoking prevalence, and geographical regions, a 0.26% increase in DPT was associated with decreases of 0.016, 0.017, and 0.014 per 100,000 people in LASMR of COPD and 0.042, 0.046, and 0.040 per 100,000 people in LASMR of asthma for both genders, males, and females. A 2.68% increase in DPRH was associated with increases of 0.009 and 0.011 per 100,000 people in LASMR of COPD. We observed a negative association of DPT with LASMR for COPD in countries/regions with temperatures ranging from 3.8 to 29.9 °C and with LASMR for asthma ranging from -5.3-29.9 °C. However, we observed a positive association of DPRH with LASMR for both COPD and asthma in the RH range of 41.2-67.2%. CONCLUSION Climate change adaptation and mitigation could be crucial in reducing the associated COPD and asthma mortality rates, particularly in regions most vulnerable to temperature and humidity fluctuations.
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Affiliation(s)
- Huan Minh Tran
- Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan; Faculty of Public Health, Da Nang University of Medical Technology and Pharmacy, Da Nang, Viet Nam.
| | - Ting-Wu Chuang
- Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan; Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Hsiao-Chi Chuang
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; National Heart & Lung Institute, Imperial College London, UK.
| | - Feng-Jen Tsai
- Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan.
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16
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DeBoer EM, Morgan WJ, Quiros-Alcala L, Rosenfeld M, Stout JW, Davis SD, Gaffin JM. Defining and Promoting Pediatric Pulmonary Health: Assessing Lung Function and Structure. Pediatrics 2023; 152:e2023062292E. [PMID: 37656029 PMCID: PMC10484309 DOI: 10.1542/peds.2023-062292e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/16/2023] [Indexed: 09/02/2023] Open
Abstract
Lifelong respiratory health is rooted in the structural and functional development of the respiratory system in early life. Exposures and interventions antenatally through childhood can influence lung development into young adulthood, the life stage with the highest achievable lung function. Because early respiratory health sets the stage for adult lung function trajectories and risk of developing chronic obstructive pulmonary disease, understanding how to promote lung health in children will have far reaching personal and population benefits. To achieve this, it is critical to have accurate and precise measures of structural and functional lung development that track throughout life stages. From this foundation, evaluation of environmental, genetic, metabolic, and immune mechanisms involved in healthy lung development can be investigated. These goals require the involvement of general pediatricians, pediatric subspecialists, patients, and researchers to design and implement studies that are broadly generalizable and applicable to otherwise healthy and chronic disease populations. This National Institutes of Health workshop report details the key gaps and opportunities regarding lung function and structure.
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Affiliation(s)
- Emily M. DeBoer
- University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Wayne J. Morgan
- Department of Pediatrics, University of Arizona, Tucson, Arizona
| | - Lesliam Quiros-Alcala
- Johns Hopkins University, Bloomberg School of Public Health and Whiting School of Engineering, Environmental Health and Engineering, Baltimore, Maryland
| | - Margaret Rosenfeld
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - James W. Stout
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Stephanie D. Davis
- Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina
| | - Jonathan M. Gaffin
- Division of Pulmonary Medicine, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
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Fakunle AG, Jafta N, Bossers A, Wouters IM, Kersen WV, Naidoo RN, Smit LAM. Childhood lower respiratory tract infections linked to residential airborne bacterial and fungal microbiota. ENVIRONMENTAL RESEARCH 2023; 231:116063. [PMID: 37156352 DOI: 10.1016/j.envres.2023.116063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/19/2023] [Accepted: 05/04/2023] [Indexed: 05/10/2023]
Abstract
Residential microbial composition likely contributes to the development of lower respiratory tract infections (LRTI) among children, but the association is poorly understood. We aimed to study the relationship between the indoor airborne dust bacterial and fungal microbiota and childhood LRTI in Ibadan, Nigeria. Ninety-eight children under the age of five years hospitalized with LRTI were recruited and matched by age (±3 months), sex, and geographical location to 99 community-based controls without LRTI. Participants' homes were visited and sampled over a 14-day period for airborne house dust using electrostatic dustfall collectors (EDC). In airborne dust samples, the composition of bacterial and fungal communities was characterized by a meta-barcoding approach using amplicons targeting simultaneously the bacterial 16S rRNA gene and the internal-transcribed-spacer (ITS) region-1 of fungi in association with the SILVA and UNITE database respectively. A 100-unit change in house dust bacterial, but not fungal, richness (OR 1.06; 95%CI 1.03-1.10) and a 1-unit change in Shannon diversity (OR 1.92; 95%CI 1.28-3.01) were both independently associated with childhood LRTI after adjusting for other indoor environmental risk factors. Beta-diversity analysis showed that bacterial (PERMANOVA p < 0.001, R2 = 0.036) and fungal (PERMANOVA p < 0.001, R2 = 0.028) community composition differed significantly between homes of cases and controls. Pair-wise differential abundance analysis using both DESEq2 and MaAsLin2 consistently identified the bacterial phyla Deinococcota (Benjamini-Hochberg (BH) adjusted p-value <0.001) and Bacteriodota (BH-adjusted p-value = 0.004) to be negatively associated with LRTI. Within the fungal microbiota, phylum Ascomycota abundance (BH adjusted p-value <0.001) was observed to be directly associated with LRTI, while Basidiomycota abundance (BH adjusted p-value <0.001) was negatively associated with LRTI. Our study suggests that early-life exposure to certain airborne bacterial and fungal communities is associated with LRTI among children under the age of five years.
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Affiliation(s)
- Adekunle G Fakunle
- Discipline of Occupational and Environmental Health, University of KwaZulu-Natal, 321 George Campbell Building Howard College Campus, Durban, 4041, South Africa; Department of Public Health, Osun State University, Osogbo, Nigeria.
| | - Nkosana Jafta
- Discipline of Occupational and Environmental Health, University of KwaZulu-Natal, 321 George Campbell Building Howard College Campus, Durban, 4041, South Africa
| | - Alex Bossers
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Netherlands
| | - Inge M Wouters
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Netherlands
| | - Warner van Kersen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Netherlands
| | - Rajen N Naidoo
- Discipline of Occupational and Environmental Health, University of KwaZulu-Natal, 321 George Campbell Building Howard College Campus, Durban, 4041, South Africa
| | - Lidwien A M Smit
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Netherlands
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Abstract
PURPOSE OF REVIEW Social determinants of health play a major role in healthcare utilization and outcomes in patients with asthma. Continuing to understand how these complex and interwoven relationships interact to impact patient care will be crucial to creating innovative programmes that address these disparities. RECENT FINDINGS The current literature continues to support the association of substandard housing, urban and rural neighbourhoods, and race/ethnicity with poor asthma outcomes. Targeted interventions with community health workers (CHWs), telemedicine and local environmental rectifications can help improve outcomes. SUMMARY The link between social determinants and poor asthma outcomes continues to be supported by recent literature. These factors are both nonmodifiable and consequences of institutionalized racist policies that require innovative ideas, technologic equity and funding for groups most at risk for poorer outcomes.
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Affiliation(s)
- Andre E. Espaillat
- Divisions of Pediatric Pulmonology, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Michelle L. Hernandez
- Allergy & Immunology, Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC
- Children’s Research Institute, University of North Carolina, Chapel Hill, NC
| | - Allison J. Burbank
- Allergy & Immunology, Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC
- Children’s Research Institute, University of North Carolina, Chapel Hill, NC
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Mulec J, Skok S, Tomazin R, Letić J, Pliberšek T, Stopinšek S, Simčič S. Long-Term Monitoring of Bioaerosols in an Environment without UV and Desiccation Stress, an Example from the Cave Postojnska Jama, Slovenia. Microorganisms 2023; 11:microorganisms11030809. [PMID: 36985383 PMCID: PMC10053050 DOI: 10.3390/microorganisms11030809] [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: 02/24/2023] [Revised: 03/16/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
A natural cave environment subject to regular human visitation was selected for aerobiological study to minimize the effects of severe temperature fluctuations, UV radiation, and desiccation stress on the aerobiome. The longer sampling period of bioaerosols, up to 22 months, was generally not associated with a proportionally incremental and cumulative increase of microbial biomass. The culture-independent biomass indicator ATP enabled quick and reliable determination of the total microbial biomass. Total airborne microbial biomass was influenced by human visitation to the cave, as confirmed by significantly higher concentrations being observed along tourist footpaths (p < 0.05). Airborne beta-glucans (BG) and lipopolysaccharide (LPS) are present in cave air, but their impact on the cave remains to be evaluated. Staphylococcus spp., as an indicator of human presence, was detected at all sites studied. Their long-term survival decrease is likely due to high relative humidity, low temperature, the material to which they adhere, and potentially natural elevated radon concentration. The most commonly recorded species were: S. saprophyticus, which was identified in 52% of the studied sites, S. equorum in 29%, and S. warneri in 24% of the studied sites. Only a few isolates were assigned to Risk group 2: S. aureus, S. epidermidis, S. haemolyticus, S. pasteuri, and S. saprophyticus.
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Affiliation(s)
- Janez Mulec
- Karst Research Institute, Research Centre of the Slovenian Academy of Sciences and Arts, Titov Trg 2, SI-6230 Postojna, Slovenia
- UNESCO Chair on Karst Education, University of Nova Gorica, Glavni Trg 8, SI-5271 Vipava, Slovenia
| | - Sara Skok
- Karst Research Institute, Research Centre of the Slovenian Academy of Sciences and Arts, Titov Trg 2, SI-6230 Postojna, Slovenia
| | - Rok Tomazin
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška Cesta 4, SI-1000 Ljubljana, Slovenia
| | - Jasmina Letić
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška Cesta 4, SI-1000 Ljubljana, Slovenia
| | - Tadej Pliberšek
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška Cesta 4, SI-1000 Ljubljana, Slovenia
| | - Sanja Stopinšek
- Health Center Hrastnik, Novi Dom 11, SI-1430 Hrastnik, Slovenia
| | - Saša Simčič
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška Cesta 4, SI-1000 Ljubljana, Slovenia
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20
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Rocchi S, Valot B, Laboissière A, Guitton A, Scherer E, Millon L, Reboux G. Development of a cockroach (Blattella germanica) qPCR for the objective measurement of exposure at home. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 864:160965. [PMID: 36526200 DOI: 10.1016/j.scitotenv.2022.160965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/02/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
Cockroach allergens have a greater impact on asthma morbidity than those from dust mites, cats, and dogs. The American cockroach (Periplaneta americana) and the German cockroach (Blattella germanica) are most frequently responsible for sensitization. The worldwide prevalence of allergic sensitization has been estimated at 2 to 26 % and is influenced by unfavorable socioeconomic conditions. Exposure is generally measured by determining antigen levels in dust or through insect trapping. We developed a real-time quantitative PCR (qPCR) method to provide an objective measurement of B. germanica levels in dwellings. The specificity of the qPCR primers and TaqMan® hydrolysis probe was validated in silico with 18S rRNA sequences. No amplification was observed for other species of cockroaches, with the exception of Blattella nipponica, which is not common indoors. From 2018 to 2021, exposure to B. germanica was detected and quantified in 27 of 389 dwellings in Bourgogne-Franche-Comté (mean = 333.8; median = 9.1 and maximum = 5304 copy number equivalents) and in 236 of 3193 ELFE cohort dwellings in mainland France in 2011 (mean = 15.6; median < 1 and maximum = 1275 copy number equivalents). The distribution of dwellings testing positive for cockroaches (7 %) differed among the 12 regions of France: <1 % in two regions, between 1 and 5 % in eight regions, 16.5 % in two regions and 35 % around Paris. Exposure measurements by the EDC sampling and qPCR methods are effective ways to assess the exposure to cockroaches in dwellings. A knowledge of the level of exposure to cockroaches is particularly important for asthmatic patients, particularly those not allergic to other common antigens.
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Affiliation(s)
- Steffi Rocchi
- Department of Parasitology and Mycology, Centre Hospitalier Universitaire, Besançon, France; Chrono-Environnement Research Team UMR/CNRS-6249, Bourgogne-Franche-Comté University, Besançon, France.
| | - Benoit Valot
- Chrono-Environnement Research Team UMR/CNRS-6249, Bourgogne-Franche-Comté University, Besançon, France
| | - Audrey Laboissière
- Chrono-Environnement Research Team UMR/CNRS-6249, Bourgogne-Franche-Comté University, Besançon, France
| | - Audrey Guitton
- Chrono-Environnement Research Team UMR/CNRS-6249, Bourgogne-Franche-Comté University, Besançon, France
| | - Emeline Scherer
- Department of Parasitology and Mycology, Centre Hospitalier Universitaire, Besançon, France; Chrono-Environnement Research Team UMR/CNRS-6249, Bourgogne-Franche-Comté University, Besançon, France
| | - Laurence Millon
- Department of Parasitology and Mycology, Centre Hospitalier Universitaire, Besançon, France; Chrono-Environnement Research Team UMR/CNRS-6249, Bourgogne-Franche-Comté University, Besançon, France
| | - Gabriel Reboux
- Department of Parasitology and Mycology, Centre Hospitalier Universitaire, Besançon, France; Chrono-Environnement Research Team UMR/CNRS-6249, Bourgogne-Franche-Comté University, Besançon, France
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Burbank AJ, Hernandez ML, Jefferson A, Perry TT, Phipatanakul W, Poole J, Matsui EC. Environmental justice and allergic disease: A Work Group Report of the AAAAI Environmental Exposure and Respiratory Health Committee and the Diversity, Equity and Inclusion Committee. J Allergy Clin Immunol 2023; 151:656-670. [PMID: 36584926 PMCID: PMC9992350 DOI: 10.1016/j.jaci.2022.11.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/31/2022] [Accepted: 11/29/2022] [Indexed: 12/29/2022]
Abstract
Environmental justice is the concept that all people have the right to live in a healthy environment, to be protected against environmental hazards, and to participate in decisions affecting their communities. Communities of color and low-income populations live, work, and play in environments with disproportionate exposure to hazards associated with allergic disease. This unequal distribution of hazards has contributed to health disparities and is largely the result of systemic racism that promotes segregation of neighborhoods, disinvestment in predominantly racial/ethnic minority neighborhoods, and discriminatory housing, employment, and lending practices. The AAAAI Environmental Exposure and Respiratory Health Committee and Diversity, Equity and Inclusion Committee jointly developed this report to improve allergy/immunology specialists' awareness of environmental injustice, its roots in systemic racism, and its impact on health disparities in allergic disease. We present evidence supporting the relationship between exposure to environmental hazards, particularly at the neighborhood level, and the disproportionately high incidence and poor outcomes from allergic diseases in marginalized populations. Achieving environmental justice requires investment in at-risk communities to increase access to safe housing, clean air and water, employment opportunities, education, nutrition, and health care. Through policies that promote environmental justice, we can achieve greater health equity in allergic disease.
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Affiliation(s)
- Allison J Burbank
- Division of Pediatric Allergy and Immunology, University of North Carolina School of Medicine, Children's Research Institute, Chapel Hill, NC.
| | - Michelle L Hernandez
- Division of Pediatric Allergy and Immunology, University of North Carolina School of Medicine, Children's Research Institute, Chapel Hill, NC
| | - Akilah Jefferson
- University of Arkansas for Medical Sciences, Little Rock, Ark; Arkansas Children's Research Institute, Little Rock, Ark
| | - Tamara T Perry
- University of Arkansas for Medical Sciences, Little Rock, Ark; Arkansas Children's Research Institute, Little Rock, Ark
| | - Wanda Phipatanakul
- Division of Asthma, Allergy and Immunology, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Jill Poole
- Department of Internal Medicine, Division of Allergy and Immunology, University of Nebraska Medical Center, Omaha, Neb
| | - Elizabeth C Matsui
- Departments of Population Health and Pediatrics, Dell Medical School at University of Texas at Austin, Austin, Tex
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22
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Rojas-Sánchez OA. [Are pets, dog or cat, a risk or a protector factor for the development or exacerbation of asthma? Systematic review of systematic reviews]. Rev Salud Publica (Bogota) 2023; 22:104-112. [PMID: 36753134 DOI: 10.15446/rsap.v22n1.81323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 12/28/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Preliminary studies have shown conflicting results on the association between exposure to pets (cat or dog) and asthma. Previous scientific evidence has not been clear to determine if avoiding or allowing the exposure to pets could prevent, improve, or worsen the development of asthma and its symptoms. OBJECTIVE To try to explain the controversial relationship between exposure to pets (dog or cat) and its effect on the development of asthma or the exacerbation of symptoms in both children and adults. METHODS A standardized search in five electronic databases by an independent reviewer was carried out. The final sample of studies included in the overview of systematic reviews was screened and synthesized through a master table. A narrative description of the results was made. RESULTS This systematic review of systematic found determined principally that having a cat could be a risk factor and having a dog a protective factor in the development of asthma. However, early exposure to both cats and dogs (before the age of two) reduces the probability of asthma symptoms and wheezing in the school years. Additionally, having antecedents of sensibilization to pets allergen could be a risk factor to exacerbate asthma in both children and adults.
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Affiliation(s)
- Oscar Alberto Rojas-Sánchez
- OR: Enfermero. M. Sc. Epidemiología. Equipo Banco de Proyectos, Dirección de Investigación en Salud Pública, Instituto Nacional de Salud. Bogotá, Colombia.
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23
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Ruran HB, Tourigny L, Thorne PS, Metwali N. Innovative compounds to reduce β-D-glucans, endotoxin, and allergens newly discovered on smartphones. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2023; 2:79-83. [PMID: 36873732 PMCID: PMC9979623 DOI: 10.1016/j.jacig.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND Eight-four percent of people own smartphones and view them 14 billion times daily, making them potential vectors for environmental hazards such as allergens, β-D-glucans (BDGs), and endotoxin. Whether these toxins are prevalent and the effectiveness of cleaning solutions targeting these agents on smartphones have not been studied. OBJECTIVE We sought to determine (1) whether phones are reservoirs of allergen, endotoxin, and BDGs and (2) if present, whether their levels can be effectively reduced by using specific cleaning methods. METHODS Electrostatic wipes used to wipe the phones of 15 volunteers were tested to determine their allergen, BDG, and endotoxin levels. Cleaning interventions were done on simulated phone models; 70% isopropyl alcohol, 0.184% benzyl and ethyl benzyl ammonium chloride (Clorox nonbleach [The Chlorox Company, Oakland, Calif]), 0.12% chlorhexidine, 0.05% cetylpyridinium, 3% benzyl benzoate, and 3% tannic acid wipes were used and compared with wipes with no solution (the control). RESULTS The smartphones showed high and variable levels of BDG and endotoxin. Cat and dog allergens were found mostly on the smartphones of pet owners. The combination of chlorhexidine and cetylpyridinium significantly reduced BDG levels (mean 269 ng/wipe vs 1930 ng/wipe for the control [P < .05]) and endotoxin, (mean 349 vs 1320 endotoxin units/wipe for the control [P < .05]). The combination of benzyl benzoate and tannic acid significantly reduced the levels of cat and dog allergens (dog, mean level of 14 ng/wipe versus 407 ng/wipe for the control [P < .001]; cat, mean level of 55 ng/wipe versus 1550 ng/wipe for the control [P < .001]). The combination mixture solutions had the greatest reductions compared with the control. CONCLUSIONS There are elevated levels of BDG, allergens, and endotoxin on smartphones. The combination of chlorhexidine and cetylpyridinium was the most effective in reducing BDG and endotoxin levels, and the combination of benzyl benzoate and tannic acid was most effective in reducing cat and dog allergen levels on smartphones.
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Affiliation(s)
| | | | - Peter S. Thorne
- University of Iowa, Department of Occupational and Environmental Health, Iowa City
| | - Nervana Metwali
- University of Iowa, Department of Occupational and Environmental Health, Iowa City
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24
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Dockx Y, Täubel M, Hogervorst J, Luyten L, Peusens M, Rasking L, Sleurs H, Witters K, Plusquin M, Valkonen M, Nawrot TS, Casas L. Association of indoor dust microbiota with cognitive function and behavior in preschool-aged children. MICROBIOME 2023; 11:1. [PMID: 36593490 PMCID: PMC9806900 DOI: 10.1186/s40168-022-01406-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 10/21/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Childhood cognitive development depends on neuroimmune interactions. Immunomodulation by early-life microbial exposure may influence neuropsychological function. In this study, we investigate the association between residential indoor microbiota and cognition and behavior among preschoolers. RESULTS Indoor-settled dust bacterial and fungal characteristics were assessed using 16S and ITS amplicon sequencing (microbial diversity) and qPCR measurements (microbial loads). Child behavior was assessed using four scales: peer relationship, emotional, conduct, and hyperactivity was assessed by the Strengths and Difficulties Questionnaire (SDQ). Cognitive function was assessed using four tasks of the Cambridge Neuropsychological Test Automated Battery (CANTAB) software. The first two tasks were designed to assess attention and psychomotor speed (Motor Screening (MOT) and Big/Little Circle (BLC)) and the last two to evaluate the child's visual recognition/working memory (Spatial Span (SSP) and Delayed Matching to Sample (DMS)). Among the 172 included children (age 4-6 years), we observed a 51% (95%CI;75%;9%) lower odds of children scoring not normal for hyperactivity and a decrease of 3.20% (95%CI, -6.01%; -0.30%) in BLC response time, for every IQR increase in fungal Shannon diversity. Contrarily, microbial loads were directly associated with SDQ scales and response time. For example, a 2-fold increase in Gram-positive bacterial load was associated with 70% (95%CI 18%; 156%) higher odds of scoring not normal for hyperactivity and an increase of 5.17% (95%CI 0.87%; 9.65%) in DMS response time. CONCLUSIONS Our findings show that early-life exposure to diverse indoor fungal communities is associated with better behavioral and cognitive outcomes, whereas higher indoor microbial load was associated with worse outcomes. Video Abstract.
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Affiliation(s)
- Yinthe Dockx
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium
| | - Martin Täubel
- Environmental Health Unit, Department Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Janneke Hogervorst
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium
| | - Leen Luyten
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium
| | - Martien Peusens
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium
| | - Leen Rasking
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium
| | - Hanne Sleurs
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium
| | - Katrien Witters
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium
| | - Michelle Plusquin
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium
| | - Maria Valkonen
- Environmental Health Unit, Department Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Tim S. Nawrot
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium
- Center for Environment and Health, Department of Public Health, Leuven University (KU Leuven), Herestraat 49–706, BE-3000 Leuven, Belgium
| | - Lidia Casas
- Center for Environment and Health, Department of Public Health, Leuven University (KU Leuven), Herestraat 49–706, BE-3000 Leuven, Belgium
- Social Epidemiology and Health Policy, Department of Family Medicine and Population Health, University of Antwerp, Doornstraat 331, 2610 Wilrijk, Belgium
- Institute for Environment and Sustainable Development (IMDO), University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium
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25
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Seppälä T, Finell E, Kaikkonen S. Making sense of the delegitimation experiences of people suffering from indoor air problems in their homes. Int J Qual Stud Health Well-being 2022; 17:2075533. [PMID: 35545878 PMCID: PMC9116269 DOI: 10.1080/17482631.2022.2075533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Purpose Little is known about the delegitimation experiences of people who associate their health problems with the indoor air quality of their homes (i.e., indoor air sufferers). From other contexts, it is known that people suffering from contested illnesses frequently report delegitimation from authorities and laypersons. Therefore, we analysed delegitimation experiences among indoor air sufferers, focusing on how they explain why others delegitimize them. Method Two types of qualitative data—semi-structured interviews with eight people and essays written by 28 people—were subjected to a thematic analysis. Results Thematic analysis revealed three themes: 1) lack of understanding; 2) others’ lack of morality; and 3) social discrimination and inequality. Conclusion This study demonstrates that indoor air sufferers are vulnerable as individuals and as a group, and suggests that authorities working with people suffering from indoor air problems in homes must pay more attention to sufferers’ ability/willingness to trust people and the system responsible for their care.
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Affiliation(s)
- Tuija Seppälä
- Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
| | - Eerika Finell
- Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
| | - Suvi Kaikkonen
- Department of Finnish, University of Helsinki, Helsinki, Finland
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26
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Claeson AS, Sommar J, Liljelind I. Symptoms and oxylipins in plasma before and after exposure to rooms in which individuals have both experienced and not experienced building-related symptoms - an exploratory study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:2756-2766. [PMID: 34666571 DOI: 10.1080/09603123.2021.1988908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/30/2021] [Indexed: 06/13/2023]
Abstract
The aim of this study was to investigate if there are differences in symptom ratings and plasma concentrations of oxylipins as a measure of acute inflammation between individuals with building-related symptoms (BRS) and referents during exposure to rooms where people experienced BRS and rooms where they did not experience BRS. Medically examined individuals with BRS and healthy, age and sex matched referents working in the same building were exposed for 60 min. Ratings of symptoms and collection of blood to measure oxylipins in plasma were performed before and after each exposure. Individuals with BRS reported more symptoms (mostly mucosal) than the referents in the problem rooms and there was a tendency towards a difference between the groups in concentration of metabolites from the cyclooxygenase pathway (COX). The mean reported intensity of symptoms among all participants was also found to be positively correlated with both COX and lipoxygenase (LOX-15) oxylipins in problem rooms.
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Affiliation(s)
| | - Johan Sommar
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Ingrid Liljelind
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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27
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Woo C, Bhuiyan MIU, Kim D, Kumari P, Lee SK, Park JY, Dong K, Lee K, Yamamoto N. DNA metabarcoding-based study on bacteria and fungi associated with house dust mites (Dermatophagoides spp.) in settled house dust. EXPERIMENTAL & APPLIED ACAROLOGY 2022; 88:329-347. [PMID: 36301451 DOI: 10.1007/s10493-022-00755-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
House dust mites (HDMs) including Dermatophagoides spp. are an important cause of respiratory allergies. However, their relationship with microorganisms in house dust has not been fully elucidated. Here, we characterized bacteria and fungi associated with HDMs in house dust samples collected in 107 homes in Korea by using DNA barcode sequencing of bacterial 16S rRNA gene, fungal internal transcribed spacer 2 (ITS2) region, and arthropod cytochrome c oxidase I (COI) gene. Our inter-kingdom co-occurrence network analysis and/or indicator species analysis identified that HDMs were positively related with a xerophilic fungus Wallemia, mycoparasitic fungi such as Cystobasidium, and some human skin-related bacterial and fungal genera, and they were negatively related with the hygrophilous fungus Cephalotrichum. Overall, our study has succeeded in adding novel insights into HDM-related bacteria and fungi in the house dust ecosystem, and in confirming the historically recognized fact that HDMs are associated with xerophilic fungi such as Wallemia. Understanding the microbial ecology in house dust is thought to be important for elucidating the etiology of human diseases including allergies, and our study revealed baseline information of house dust ecology in relation to HDMs. The findings could be useful from a perspective of human health.
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Affiliation(s)
- Cheolwoon Woo
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea
| | - Mohammad Imtiaj Uddin Bhuiyan
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea
| | - Donghyun Kim
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea
| | - Priyanka Kumari
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea
- Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea
| | - Seung-Kyung Lee
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea
- Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea
| | - Ji Young Park
- Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea
| | - Ke Dong
- Major of Life Science, College of Natural Sciences, Kyonggi University, Suwon, 16227, Republic of Korea
| | - Kiyoung Lee
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea
- Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea
| | - Naomichi Yamamoto
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea.
- Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea.
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28
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Wang K, Paszkiewicz O, Vincent M, Henkiel P, Kowalski D, Kowalska E, Markowska-Szczupak A. Evaluation of Antifungal Properties of Titania P25. MICROMACHINES 2022; 13:1851. [PMID: 36363871 PMCID: PMC9693362 DOI: 10.3390/mi13111851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/22/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
Commercial titania photocatalyst—P25 was chosen for an antifungal property examination due to it exhibiting one of the highest photocatalytic activities among titania photocatalysts. Titania P25 was homogenized first (HomoP25) and then annealed at different temperatures. Additionally, HomoP25 was modified with 0.5 wt% or 2.0 wt% of platinum by a photodeposition method. The obtained samples were characterized by diffuse-reflectance spectroscopy (DRS), X-ray photoabsorption spectroscopy (XPS), X-ray diffraction (XRD) and Raman spectroscopy. Moreover, photocatalytic activity was tested for methanol dehydrogenation under UV/vis irradiation. The spore-destroying effect of photocatalysts was investigated against two mold fungal species, i.e., Aspergillus fumigatus and Aspergillus niger. Both the mycelium growth and API ZYM (estimation of enzymatic activity) tests were applied for the assessment of antifungal effect. It was found that annealing caused a change of surface properties of the titania samples, i.e., an increase in the noncrystalline part, a growth of particles and enhanced oxygen adsorption on its surface, which resulted in an increase in both the hydrogen evolution rate and the antifungal effect. Titania samples annealed at 300−500 °C were highly active during 60-min UV/vis irradiation, inhibiting the germination of both fungal spores, whereas titania modification with platinum (0.5 and 2.0 wt%) had negligible effect, despite being highly active for hydrogen evolution. The control experiments revealed the lack of titania activity in the dark, as well as high resistance of fungi for applied UV/vis irradiation in the absence of photocatalysts. Moreover, the complete inhibition of 19 hydrolases, secreted by both tested fungi, was noted under UV/vis irradiation on the annealed P25 sample. It is proposed that titania photocatalysts of large particle sizes (>150 nm) and enriched surface with oxygen might efficiently destroy fungal structures under mild irradiation conditions and, thus, be highly promising as covering materials for daily products.
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Affiliation(s)
- Kunlei Wang
- Institute for Catalysis, Hokkaido University, N21, W10, Sapporo 001-0021, Japan
| | - Oliwia Paszkiewicz
- Department of Chemical and Process Engineering, West Pomeranian University of Technology in Szczecin, Piastow 42, 71-065 Szczecin, Poland
| | - Mewin Vincent
- Faculty of Chemistry & Biological and Chemical Research Centre, University of Warsaw, Zwirki i Wigury 101, 02-089 Warsaw, Poland
| | - Patrycja Henkiel
- Faculty of Chemistry & Biological and Chemical Research Centre, University of Warsaw, Zwirki i Wigury 101, 02-089 Warsaw, Poland
| | - Damian Kowalski
- Faculty of Chemistry & Biological and Chemical Research Centre, University of Warsaw, Zwirki i Wigury 101, 02-089 Warsaw, Poland
| | - Ewa Kowalska
- Institute for Catalysis, Hokkaido University, N21, W10, Sapporo 001-0021, Japan
| | - Agata Markowska-Szczupak
- Department of Chemical and Process Engineering, West Pomeranian University of Technology in Szczecin, Piastow 42, 71-065 Szczecin, Poland
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29
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Tischer C, Täubel M, Kirjavainen PV, Depner M, Hyvärinen A, Piippo-Savolainen E, Pekkanen J, Karvonen AM. Early-life residential exposure to moisture damage is associated with persistent wheezing in a Finnish birth cohort. Pediatr Allergy Immunol 2022; 33:e13864. [PMID: 36282133 PMCID: PMC9828426 DOI: 10.1111/pai.13864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 09/15/2022] [Accepted: 09/22/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND AIMS Moisture damage increases the risk for respiratory disorders in childhood. Our aim was to determine whether early age residential exposure to inspector-observed moisture damage or mold is associated with different wheezing phenotypes later in childhood. METHODS Building inspections were performed by civil engineers, in a standardized manner, in the children's homes-mostly single family and row houses (N = 344)-in the first year of life. The children were followed up with repeated questionnaires until the age of 6 years and wheezing phenotypes-never/infrequent, transient, intermediate, late onset, and persistent-were defined using latent class analyses. The multinomial logistic regression model was used for statistical analysis. RESULTS A total of 63% (n = 218) had infrequent or no wheeze, 23% (n = 80) had transient and 9.6% (n = 21) had a persistent wheeze. Due to the low prevalence, results for intermediate (3.8%, n = 13) and late-onset wheeze (3.5%, n = 12) were not further evaluated. Most consistent associations were observed with the persistent wheeze phenotype with an adjusted odds ratio (95% confidence intervals) 2.04 (0.67-6.18) for minor moisture damage with or without mold spots (present in 23.8% of homes) and 3.68 (1.04-13.05) for major damage or any moisture damage with visible mold in a child's main living areas (present in 13.4% of homes). Early-age moisture damage or mold in the kitchen was associated with transient wheezing. CONCLUSION At an early age, residential exposure to moisture damage or mold, can be dose-dependently associated especially with persistent wheezing phenotype later in childhood.
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Affiliation(s)
- Christina Tischer
- Institute of Clinical Epidemiology and Biometry, University of Wuerzburg, Wuerzburg, Germany.,State Institute of Health, Bavarian Health and Food Safety Authority, Bad Kissingen, Germany.,Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland.,European Foundation for the Care of Newborn Infants (EFCNI), Munich, Germany
| | - Martin Täubel
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Pirkka V Kirjavainen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Martin Depner
- Institute for Asthma and Allergy Prevention (IAP), Helmholtz Zentrum München1, Neuherberg, Germany
| | - Anne Hyvärinen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Eija Piippo-Savolainen
- Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland.,Department of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Juha Pekkanen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Anne M Karvonen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
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30
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Landaverde E, Généreux M, Maltais D, Gachon P. Respiratory and Otolaryngology Symptoms Following the 2019 Spring Floods in Quebec. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11738. [PMID: 36142009 PMCID: PMC9517661 DOI: 10.3390/ijerph191811738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Although floods may have important respiratory health impacts, few studies have examined this issue. This study aims to document the long-term impacts of the spring floods of 2019 in Quebec by (1) describing the population affected by the floods; (2) assessing the impacts on the respiratory system according to levels of exposure; and (3) determining the association between stressors and respiratory health. METHODS A population health survey was carried out across the six most affected regions 8-10 months post-floods. Data were collected on self-reported otolaryngology (ENT) and respiratory symptoms, along with primary and secondary stressors. Three levels of exposure were examined: flooded, disrupted and unaffected. RESULTS One in ten respondents declared being flooded and 31.4% being disrupted by the floods. Flooded and disrupted participants reported significantly more ENT symptoms (adjusted odds ratio (aOR): 3.18; 95% CI: 2.45-4.14; aOR: 1.76; 95% CI: 1.45-2.14) and respiratory symptoms (aOR: 3.41; 95% CI: 2.45-4.75; aOR: 1.45; 95% CI: 1.10-1.91) than the unaffected participants. All primary stressors and certain secondary stressors assessed were significantly associated with both ENT and respiratory symptoms, but no "dose-response" gradient could be observed. CONCLUSION This study highlights the long-term adverse effects of flood exposure on respiratory health.
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Affiliation(s)
- Elsa Landaverde
- Département des Sciences de la Santé Communautaire, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, QC J1H 5N4, Canada
| | - Mélissa Généreux
- Département des Sciences de la Santé Communautaire, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, QC J1H 5N4, Canada
| | - Danielle Maltais
- Département des Sciences Humaines et Sociales, Université du Québec à Chicoutimi, 555 Boulevard de l’Université, Ville de Saguenay, QC G7H21, Canada
| | - Philippe Gachon
- Département de Geographie et Centre ESCER (Étude et Simulation du Climat à l’Échelle Régionale), Université du Québec à Montréal, 201, Avenue du Président-Kennedy, Montréal, QC H2X 3Y7, Canada
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31
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Du C, Li B, Yu W, Yao R, Cai J, Li B, Yao Y, Wang Y, Chen M, Essah E. Characteristics of annual mold variations and association with childhood allergic symptoms/diseases via combining surveys and home visit measurements. INDOOR AIR 2022; 32:e13113. [PMID: 36168229 DOI: 10.1111/ina.13113] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/20/2022] [Accepted: 08/29/2022] [Indexed: 06/16/2023]
Abstract
The presence of dampness and visible molds leads to concerns of poor indoor air quality which has been consistently linked with increased exacerbation and development of allergy and respiratory diseases. Due to the limitations of epidemiological surveys, the actual fungal exposure characteristics in residences has not been sufficiently understood. This study aimed to characterize household fungal diversity and its annual temporal and spatial variations. We developed combined cross-sectional survey, repeated air sampling around a year, and DNA sequencing methods. The questionnaire survey was conducted in 2019, and 4943 valid cases were received from parents; a follow-up case-control study (11 cases and 12 controls) was designed, and onsite measurements of indoor environments were repeated in typical summer, transient season, and winter; dust from floor and beddings in children's room were collected and ITS based DNA sequencing of totally 68 samples was conducted. Results from 3361 children without changes to their residences since birth verified the significant associations of indoor dampness/mold indicators and prevalence of children-reported diseases, with increased adjusted odd ratios (aORs) >1 for studied asthma, wheeze, allergic rhinitis, and eczema. The airborne fungal concentrations from air sampling were higher than 1000 CFU/m3 in summer, regardless of indoors and outdoors, indicating an intermediate pollution level. The DNA sequencing for dust showed the Aspergillus was the predominant at genus level and the Aspergillus_penicillioides was the most common at species level; while the fungal community and composition varied significantly in different homes and seasons, according to α and β diversity analyses. The comprehensive research methods contribute to a holistic understanding of indoor fungal exposure, including the concentrations, seasonal variations, community, and diversity, and verifies the relations with children's adverse health outcomes. The study further elucidates the role of microbiome in human health, which helps setting health-protective thresholds and managing mold treatments in buildings, to promote indoor air quality and human well-beings.
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Affiliation(s)
- Chenqiu Du
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), School of Civil Engineering, Chongqing University, Chongqing, China
| | - Baizhan Li
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), School of Civil Engineering, Chongqing University, Chongqing, China
| | - Wei Yu
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), School of Civil Engineering, Chongqing University, Chongqing, China
| | - Runming Yao
- School of the Built Environment, University of Reading, Reading, UK
| | - Jiao Cai
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), School of Civil Engineering, Chongqing University, Chongqing, China
| | - Bicheng Li
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), School of Civil Engineering, Chongqing University, Chongqing, China
| | - Yinghui Yao
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), School of Civil Engineering, Chongqing University, Chongqing, China
| | - Yujue Wang
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), School of Civil Engineering, Chongqing University, Chongqing, China
| | - Min Chen
- Department of Radiation Oncology, Chongqing University Cancer Hospital, Chongqing, China
| | - Emmanuel Essah
- School of the Built Environment, University of Reading, Reading, UK
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Mortelliti CL, Banzon TM, Phipatanakul W, Vieira CZ. Environmental Exposures Impact Pediatric Asthma Within the School Environment. Immunol Allergy Clin North Am 2022; 42:743-760. [DOI: 10.1016/j.iac.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kim B, Mulready-Ward C, Thorpe LE, Titus AR. Housing environments and asthma outcomes within population-based samples of adults and children in NYC. Prev Med 2022; 161:107147. [PMID: 35803352 DOI: 10.1016/j.ypmed.2022.107147] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 06/02/2022] [Accepted: 07/03/2022] [Indexed: 01/14/2023]
Abstract
Exposure to indoor environmental risk factors is associated with patterns of asthma morbidity. In this study, we assessed the relationship between housing type (i.e., home ownership, public housing, rental assistance, rent-controlled housing and other rental housing) and asthma outcomes among New York City (NYC) adults and children (ages 1-13). We used the 2019 NYC Community Health Survey (CHS) and 2019 NYC KIDS survey to analyze associations between housing type and ever having been diagnosed with asthma ("ever asthma") and experiencing a past-year asthma attack. We further examined whether associations were modified by smoking status (among adults), smoking within the home (among children), and overweight/obesity. Among adults, living in public housing, compared to home ownership, was associated with higher odds of ever asthma (odds ratio [OR] = 1.95; 95% confidence interval [CI] = 1.35, 2.84), and past-year asthma attack (OR = 2.24; 95% CI 1.21,4.18). Living in rental assistance housing was also significantly associated with ever asthma (OR = 1.75; 95% CI 1.16, 2.66). Associations between public or rental assistance housing and ever asthma were marginally non-significant among children. Associations between living in public or rental assistance housing and ever asthma were more pronounced among ever smokers than among never smokers. Housing environments remain important predictors of both pediatric and adult asthma morbidity. Associations between living in subsidized housing and asthma outcomes among adults are most apparent among ever smokers.
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Affiliation(s)
- Byoungjun Kim
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States; Department of Population Health, New York University School of Medicine, New York, NY, United States
| | - Candace Mulready-Ward
- New York City Department of Health and Mental Hygiene, Long Island City, NY, United States
| | - Lorna E Thorpe
- Department of Population Health, New York University School of Medicine, New York, NY, United States
| | - Andrea R Titus
- Department of Population Health, New York University School of Medicine, New York, NY, United States.
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Hosseini B, Berthon BS, Jensen ME, McLoughlin RF, Wark PAB, Nichol K, Williams EJ, Baines KJ, Collison A, Starkey MR, Mattes J, Wood LG. The Effects of Increasing Fruit and Vegetable Intake in Children with Asthma on the Modulation of Innate Immune Responses. Nutrients 2022; 14:nu14153087. [PMID: 35956264 PMCID: PMC9370535 DOI: 10.3390/nu14153087] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/23/2022] [Accepted: 07/25/2022] [Indexed: 12/04/2022] Open
Abstract
Children with asthma are at risk of acute exacerbations triggered mainly by viral infections. A diet high in fruit and vegetables (F&V), a rich source of carotenoids, may improve innate immune responses in children with asthma. Children with asthma (3−11 years) with a history of exacerbations and low F&V intake (≤3 serves/d) were randomly assigned to a high F&V diet or control (usual diet) for 6 months. Outcomes included respiratory-related adverse events and in-vitro cytokine production in peripheral blood mononuclear cells (PBMCs), treated with rhinovirus-1B (RV1B), house dust mite (HDM) and lipopolysaccharide (LPS). During the trial, there were fewer subjects with ≥2 asthma exacerbations in the high F&V diet group (n = 22) compared to the control group (n = 25) (63.6% vs. 88.0%, p = 0.049). Duration and severity of exacerbations were similar between groups. LPS-induced interferon (IFN)-γ and IFN-λ production showed a small but significant increase in the high F&V group after 3 months compared to baseline (p < 0.05). Additionally, RV1B-induced IFN-λ production in PBMCs was positively associated with the change in plasma lycopene at 6 months (rs = 0.35, p = 0.015). A high F&V diet reduced asthma-related illness and modulated in vitro PBMC cytokine production in young children with asthma. Improving diet quality by increasing F&V intake could be an effective non-pharmacological strategy for preventing asthma-related illness by enhancing children’s innate immune responses.
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Affiliation(s)
- Banafsheh Hosseini
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW 2305, Australia; (B.H.); (B.S.B.); (R.F.M.); (P.A.B.W.); (K.N.); (E.J.W.); (K.J.B.); (A.C.); (M.R.S.)
| | - Bronwyn S. Berthon
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW 2305, Australia; (B.H.); (B.S.B.); (R.F.M.); (P.A.B.W.); (K.N.); (E.J.W.); (K.J.B.); (A.C.); (M.R.S.)
| | - Megan E. Jensen
- Priority Research Centre Grow Up Well, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW 2305, Australia; (M.E.J.); (J.M.)
| | - Rebecca F. McLoughlin
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW 2305, Australia; (B.H.); (B.S.B.); (R.F.M.); (P.A.B.W.); (K.N.); (E.J.W.); (K.J.B.); (A.C.); (M.R.S.)
| | - Peter A. B. Wark
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW 2305, Australia; (B.H.); (B.S.B.); (R.F.M.); (P.A.B.W.); (K.N.); (E.J.W.); (K.J.B.); (A.C.); (M.R.S.)
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW 2305, Australia
| | - Kristy Nichol
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW 2305, Australia; (B.H.); (B.S.B.); (R.F.M.); (P.A.B.W.); (K.N.); (E.J.W.); (K.J.B.); (A.C.); (M.R.S.)
| | - Evan J. Williams
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW 2305, Australia; (B.H.); (B.S.B.); (R.F.M.); (P.A.B.W.); (K.N.); (E.J.W.); (K.J.B.); (A.C.); (M.R.S.)
| | - Katherine J. Baines
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW 2305, Australia; (B.H.); (B.S.B.); (R.F.M.); (P.A.B.W.); (K.N.); (E.J.W.); (K.J.B.); (A.C.); (M.R.S.)
| | - Adam Collison
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW 2305, Australia; (B.H.); (B.S.B.); (R.F.M.); (P.A.B.W.); (K.N.); (E.J.W.); (K.J.B.); (A.C.); (M.R.S.)
- Priority Research Centre Grow Up Well, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW 2305, Australia; (M.E.J.); (J.M.)
| | - Malcolm R. Starkey
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW 2305, Australia; (B.H.); (B.S.B.); (R.F.M.); (P.A.B.W.); (K.N.); (E.J.W.); (K.J.B.); (A.C.); (M.R.S.)
- Priority Research Centre Grow Up Well, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW 2305, Australia; (M.E.J.); (J.M.)
- Department of Immunology and Pathology, Central Clinical School, Sub-Faculty of Translational Medicine and Public Health, Monash University, Melbourne, VIC 3004, Australia
| | - Joerg Mattes
- Priority Research Centre Grow Up Well, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW 2305, Australia; (M.E.J.); (J.M.)
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW 2305, Australia
| | - Lisa G. Wood
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW 2305, Australia; (B.H.); (B.S.B.); (R.F.M.); (P.A.B.W.); (K.N.); (E.J.W.); (K.J.B.); (A.C.); (M.R.S.)
- Priority Research Centre Grow Up Well, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW 2305, Australia; (M.E.J.); (J.M.)
- Correspondence:
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NIOSH Dampness and Mold Assessment Tool (DMAT): Documentation and Data Analysis of Dampness and Mold-Related Damage in Buildings and Its Application. BUILDINGS 2022; 12:1075-1092. [DOI: 10.3390/buildings12081075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Indoor dampness and mold are prevalent, and the exposure has been associated with various illnesses such as the exacerbation of existing asthma, asthma development, current asthma, ever-diagnosed asthma, bronchitis, respiratory infection, allergic rhinitis, dyspnea, wheezing, cough, upper respiratory symptoms, and eczema. However, assessing exposures or environments in damp and moldy buildings/rooms, especially by collecting and analyzing environmental samples for microbial agents, is complicated. Nonetheless, observational assessment (visual and olfactory inspection) has been demonstrated as an effective method for evaluating indoor dampness and mold. The National Institute for Occupational Safety and Health developed an observational assessment method called the Dampness and Mold Assessment Tool (DMAT). The DMAT uses a semi-quantitative approach to score the level of dampness and mold-related damage (mold odor, water damage/stains, visible mold, and wetness/dampness) by intensity or size for each of the room components (ceiling, walls, windows, floor, furnishings, ventilation system, pipes, and supplies and materials). Total or average room scores and factor-or component-specific scores can be calculated for data analysis. Because the DMAT uses a semi-quantitative scoring method, it better differentiates the level of damage compared to the binary (presence or absence of damage) approach. Thus, our DMAT provides useful information on identifying dampness and mold, tracking and comparing past and present damage by the scores, and prioritizing remediation to avoid potential adverse health effects in occupants. This protocol-type article describes the DMAT and demonstrates how to apply it to effectively manage indoor dampness and mold-related damage.
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Shahunja KM, Sly PD, Chisti MJ, Mamun A. Trajectories of asthma symptom presenting as wheezing and their associations with family environmental factors among children in Australia: evidence from a national birth cohort study. BMJ Open 2022; 12:e059830. [PMID: 35667731 PMCID: PMC9185592 DOI: 10.1136/bmjopen-2021-059830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Asthma is one of the greatest health burdens, yet contributors to asthma symptom trajectories are understudied in Australian children. We aimed to assess the trajectories of asthma symptom and their associations with several family environmental factors during the childhood period in Australia. DESIGN Secondary analysis from a cross-sequential cohort study. SETTING Nationwide representative data from the 'Longitudinal Study of Australian Children (LSAC)'. PARTICIPANTS Participants from the LSAC birth cohort. OUTCOME MEASURES Asthma symptom trajectory groups. METHODS Asthma symptom presenting as wheezing, family environmental factors and sociodemographic data (2004-2018) were obtained from the LSAC. Group-based trajectory modelling was applied to identify asthma symptom trajectories and multivariable logistic regression models were used to assess the associations between these and environmental factors. RESULTS Of 5107 children in the LSAC cohort, 3846 were included in our final analysis. We identified three distinct asthma symptom trajectories from age 0/1 year to 14/15 years: 'low/no' (69%), 'transient high' (17%) and 'persistent high' (14%). Compared with the 'low/no' group, children exposed to 'moderate and declining' (relative risk ratio (RRR): 2.22, 95% CI 1.94 to 2.54; RRR: 1.26, 95% CI 1.08 to 1.46) and 'high and persistent' prevalence of maternal smoking (RRR: 1.41, 95% CI 1.23 to 1.60; RRR: 1.26, 95% CI 1.10 to 1.44) were at increased risk of being classified into the 'transient high' and 'persistent high' trajectories of asthma symptom. Persistently bad external dwelling conditions (RRR: 1.27, 95% CI 1.07 to 1.51) were associated with 'transient high' trajectory while 'moderate and increasing' conditions of cluttered homes (RRR: 1.37, 95% CI 1.20 to 1.56) were associated with 'persistent high' trajectory of asthma symptom. Exposure to tobacco smoke inside the house also increased the risk of being in the 'persistent high' trajectory group (RRR: 1.30, 95% CI 1.12 to 1.50). CONCLUSION Poor home environment increased the risk of asthma symptom during childhood. Improving home environment and reducing exposure to tobacco smoke may facilitate a favourable asthma symptom trajectory during childhood.
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Affiliation(s)
- K M Shahunja
- Institute for Social Science Research, The University of Queensland, Saint Lucia, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Queensland, Australia
- The Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Brisbane, Queensland, Australia
| | - Peter D Sly
- Child Health Research Centre, Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Md Jobayer Chisti
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Abdullah Mamun
- Institute for Social Science Research, The University of Queensland, Saint Lucia, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Queensland, Australia
- The Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Brisbane, Queensland, Australia
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Maciag MC, Phipatanakul W. Update on indoor allergens and their impact on pediatric asthma. Ann Allergy Asthma Immunol 2022; 128:652-658. [PMID: 35227902 DOI: 10.1016/j.anai.2022.02.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/08/2022] [Accepted: 02/11/2022] [Indexed: 01/10/2023]
Abstract
OBJECTIVE In recent decades, many indoor allergens have been identified, including dust mite, cat, dog, mouse, cockroach, and indoor molds, which have important health effects particularly in sensitized individuals with asthma. This review aims to update our understanding regarding the extent of these exposures in the indoor environment, review strategies for reducing their levels in the environment, and highlight innovative recent trials targeting these exposures and their impact on pediatric asthma morbidity. DATA SOURCES Recent practice parameter updates on indoor allergen exposures, seminal studies, and recent peer-reviewed journal articles are referenced. STUDY SELECTIONS This review cites recent cohort studies of well-characterized pediatric patients with asthma and innovative randomized controlled trials evaluating exposure to environmental allergens, interventions to limit these exposures, and their outcomes. RESULTS Links between indoor aeroallergen exposures and health outcomes have been well established. However, only some allergen reduction interventions have been successful in improving health outcomes. CONCLUSION There are many complicating factors involved in allergic exposures and health outcomes. The interplay between patient genetic factors, indoor allergic triggers, airborne irritants and pollutants, and microbial exposures complicates the study of indoor allergen exposures and their impact on asthma morbidity.
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Affiliation(s)
- Michelle C Maciag
- Boston Children's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Asthma and Allergy Affiliates, Salem, Massachusetts
| | - Wanda Phipatanakul
- Boston Children's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
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De Roos AJ, Kenyon CC, Yen YT, Moore K, Melly S, Hubbard RA, Maltenfort M, Forrest CB, Diez Roux AV, Schinasi LH. Does Living near Trees and Other Vegetation Affect the Contemporaneous Odds of Asthma Exacerbation among Pediatric Asthma Patients? J Urban Health 2022; 99:533-548. [PMID: 35467328 PMCID: PMC9187838 DOI: 10.1007/s11524-022-00633-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/18/2022] [Indexed: 02/02/2023]
Abstract
Vegetation may influence asthma exacerbation through effects on aeroallergens, localized climates, air pollution, or children's behaviors and stress levels. We investigated the association between residential vegetation and asthma exacerbation by conducting a matched case-control study based on electronic health records of asthma patients, from the Children's Hospital of Philadelphia (CHOP). Our study included 17,639 exacerbation case events and 34,681 controls selected from non-exacerbation clinical visits for asthma, matched to cases by age, sex, race/ethnicity, public payment source, and residential proximity to the CHOP main campus ED and hospital. Overall greenness, tree canopy, grass/shrub cover, and impervious surface were assessed near children's homes (250 m) using satellite imagery and high-resolution landcover data. We used generalized estimating equations to estimate odds ratios (OR) and 95% confidence intervals (CI) for associations between each vegetation/landcover measure and asthma exacerbation, with adjustment for seasonal and sociodemographic factors-for all cases, and for cases defined by diagnosis setting and exacerbation frequency. Lower odds of asthma exacerbation were observed in association with greater levels of tree canopy near the home, but only for children who experienced multiple exacerbations in a year (OR = 0.94 per 10.2% greater tree canopy coverage, 95% CI = 0.90-0.99). Our findings suggest possible protection for asthma patients from tree canopy, but differing results by case frequency suggest that potential benefits may be specific to certain subpopulations of asthmatic children.
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Affiliation(s)
- Anneclaire J De Roos
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA. .,Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
| | - Chén C Kenyon
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Yun-Ting Yen
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Kari Moore
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Steven Melly
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Rebecca A Hubbard
- Department of Biostatistics, Epidemiology & Informatics, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Mitchell Maltenfort
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Christopher B Forrest
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ana V Diez Roux
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.,Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Leah H Schinasi
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.,Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
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Guilbert TW, Biagini JM, Ramsey RR, Keidel K, Curtsinger K, Kroner JW, Durrani SR, Stevens M, Pilipenko V, Martin LJ, Kercsmar CM, Hommel K, Hershey GKK. Treatment by biomarker-informed endotype vs guideline care in children with difficult-to-treat asthma. Ann Allergy Asthma Immunol 2022; 128:535-543.e6. [PMID: 35123074 PMCID: PMC9125694 DOI: 10.1016/j.anai.2022.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/21/2021] [Accepted: 01/19/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Asthma is heterogeneous, contributing to difficulty in disease management. OBJECTIVE To develop a biomarker-informed treatment model for difficult-to-treat (DTT) asthma and conduct a pilot feasibility study. METHODS School-aged children (n = 21) with DTT asthma were enrolled and completed 3 medical visits (V1-V3). V2 and V3 were completed approximately 3.5 months and 12 months after V1, respectively. At V1, guideline care and adherence interventions were initiated, and blood samples were collected for asthma biomarker assessment. A personalized treatment algorithm was developed based on biomarkers (treatment by endotype) and was implemented at V2. Asthma outcomes were compared from V1 to V2 (guideline-based care) to V2 to V3 (guideline + biomarker-informed care). RESULTS Overall retention was 86%. There was an even distribution of participants with allergy, without allergy, and with mixed allergies. The participants received an average of 5.9 interventions (range, 3-9). The allergic phenotype was characterized by increased CDHR3 risk genotype and high transepidermal water loss. High serum interleukin-6 level was most notable in the mixed allergic subgroup. The nonallergic phenotype was characterized by vitamin D deficiency and poor steroid treatment responsiveness. The personalized treatment plans were associated with decreased emergency department visits (median, 1 vs 0; P = .04) and increased asthma control test scores (median, 22.5 vs 23.0; P = .01). CONCLUSION The biomarker-based treatment algorithm triggered interventions on top of guideline care in all children with DTT asthma studied, supporting the need for this type of multipronged approach. Our findings identify the minimal biomarker set that is informative, reveal that this treatment-by-endotype intervention is feasible and may be superior to guideline care alone, and provide a strong foundation for a definitive trial. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT04179461.
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Affiliation(s)
- Theresa W Guilbert
- Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Jocelyn M Biagini
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Rachelle R Ramsey
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Kristina Keidel
- Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Kristi Curtsinger
- Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - John W Kroner
- Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Sandy R Durrani
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Mariana Stevens
- Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Valentina Pilipenko
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Lisa J Martin
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Carolyn M Kercsmar
- Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Kevin Hommel
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Gurjit K Khurana Hershey
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
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Khalaf N, Al-Obaidi M, Mohammed S, Al-Malkey M, Nayyef H, Al-Hur F, Sameer F, Mesheal K, Taqi I, Ad’hiah A. Indoor house dust-borne fungi and risk of allergic respiratory diseases in Baghdad city. REVUE FRANÇAISE D'ALLERGOLOGIE 2022. [DOI: 10.1016/j.reval.2021.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Mendell MJ, Adams RI. Does evidence support measuring spore counts to identify dampness or mold in buildings? A literature review. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2022; 32:177-187. [PMID: 34475494 DOI: 10.1038/s41370-021-00377-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 07/28/2021] [Accepted: 08/02/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND To identify dampness or mold (D/M) in buildings, investigators generally inspect for observable D/M indicators, the presence of which justifies remediation. Investigators may also use microbiological measurement and interpretation strategies with uncertain scientific support. OBJECTIVE We assessed available evidence supporting uses of spore counts, the microbiological measurement most commonly used to assess D/M. METHODS We reviewed published studies assessing relationships between spore counts and observable D/M, across buildings with different observable D/M levels. RESULTS Penicillium/Aspergillus counts were consistently elevated in damp vs. reference (dry or outdoor) locations. Total spore counts provided a weaker, less consistent signal. The most detailed published analysis could distinguish groups of damp homes but not individual damp homes. SIGNIFICANCE Evidence did not validate current interpretations of spore count data for identifying single damp homes. Thus, such interpretations rest primarily on professional judgment. An additional series of informative but ineligible articles demonstrated an unconventional, more powerful "statistically based" comparison of multiple indoor vs. outdoor spore counts for identifying elevated indoor spores (and assumed D/M). Findings suggest that validation of enhanced spore trap approaches, including more samples indoors and outdoors plus statistically based comparisons of specific fungal groups, may allow evidence-based microbial identification of probable dampness in individual buildings.
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Affiliation(s)
- Mark J Mendell
- California Department of Public Health, Richmond, CA, USA.
| | - Rachel I Adams
- California Department of Public Health, Richmond, CA, USA
- Plant & Microbial Biology, University of California, Berkeley, CA, USA
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Chen Y, Kong D, Fu J, Zhang Y, Zhao Y, Liu Y, Chang Z, Liu Y, Liu X, Xu K, Jiang C, Fan Z. Associations between ambient temperature and adult asthma hospitalizations in Beijing, China: a time-stratified case-crossover study. Respir Res 2022; 23:38. [PMID: 35189885 PMCID: PMC8862352 DOI: 10.1186/s12931-022-01960-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 02/15/2022] [Indexed: 11/30/2022] Open
Abstract
Background Studies on the associations between ambient temperature and asthma hospitalizations are limited, and the results are controversial. We aimed to assess the short-term effects of ambient temperature on the risk of asthma hospitalizations and quantify the hospitalization burdens of asthma attributable to non-optimal temperature in adults in Beijing, China. Methods We collected daily asthma hospitalizations, meteorological factors and air quality data in Beijing from 2012 to 2015. We applied a time-stratified case-crossover design and fitted a distributed lag non-linear model with a conditional quasi-Poisson regression to explore the association between ambient temperature and adult asthma hospitalizations. The effect modifications of these associations by gender and age were assessed by stratified analyses. We also computed the attributable fractions and numbers with 95% empirical confidence intervals (eCI) of asthma hospitalizations due to extreme and moderate temperatures. Results From 2012 to 2015, we identified a total of 18,500 hospitalizations for asthma among adult residents in Beijing, China. Compared with the optimal temperature (22 °C), the cumulative relative risk (CRR) over lag 0–30 days was 2.32 with a 95% confidence interval (CI) of 1.57–3.42 for extreme cold corresponding to the 2.5th percentile (− 6.5 °C) of temperature distribution and 2.04 (95% CI 1.52–2.74) for extreme heat corresponding to the 97.5th percentile (29 °C) of temperature distribution. 29.1% (95% eCI 17.5–38.0%) of adult asthma hospitalizations was attributable to non-optimum temperatures. Moderate cold temperatures yielded most of the burdens, with an attributable fraction of 20.3% (95% eCI 9.1–28.7%). The temperature-related risks of asthma hospitalizations were more prominent in females and younger people (19–64 years old). Conclusions There was a U-shaped association between ambient temperature and the risk of adult asthma hospitalizations in Beijing, China. Females and younger patients were more vulnerable to the effects of non-optimum temperatures. Most of the burden was attributable to moderate cold. Our findings may uncover the potential impact of climate changes on asthma exacerbations. Supplementary Information The online version contains supplementary material available at 10.1186/s12931-022-01960-8.
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Affiliation(s)
- Yuxiong Chen
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Dehui Kong
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Jia Fu
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Yongqiao Zhang
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Yakun Zhao
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Yanbo Liu
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Zhen'ge Chang
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Yijie Liu
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Xiaole Liu
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Kaifeng Xu
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Chengyu Jiang
- Department of Biochemistry, State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Zhongjie Fan
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China.
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Prevalence, Risk Factors and Impacts Related to Mould-Affected Housing: An Australian Integrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031854. [PMID: 35162876 PMCID: PMC8835129 DOI: 10.3390/ijerph19031854] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 11/25/2022]
Abstract
In response to an Australian governmental inquiry into biotoxin-related illness, the purpose of this integrative review is to bring together the current state of evidence on the prevalence, risk factors and impacts related to mould-affected housing in an Australian context, in order to inform building, housing and health research, practice and policy. The robust integrative review methodology simultaneously sought quantitative and qualitative studies and grey literature from multiple disciplines, identifying only 45 studies directly relating to Australian housing and indoor mould. Twenty-one studies highlight negative health impacts relating to indoor residential mould, with asthma, respiratory, allergy conditions and emerging health concerns for chronic multiple-symptom presentation. The majority of studies reported risk factors for indoor mould including poor housing conditions, poor-quality rental accommodation, socioeconomic circumstance, age-related housing issues and concerns for surface/interstitial condensation and building defects in newer housing. Risks for indoor mould in both older and newer housing raise concerns for the extent of the problem of indoor mould in Australia. Understanding the national prevalence of housing risks and “root cause” associated with indoor mould is not conclusive from the limited existing evidence. Synthesis of this evidence reveals a lack of coverage on: (1) national and geographical representation, (2) climatical coverage, (3) housing typologies, (4) housing defects, (5) maintenance, (6) impact from urbanisation, and (7) occupant’s behaviour. This integrative review was key in identifying emerging housing and health concerns, highlighting gaps in data and implications to be addressed by researchers, practice and policy and acts as a comprehensive holistic review process that can be applied to other countries.
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Fishe J, Zheng Y, Lyu T, Bian J, Hu H. Environmental effects on acute exacerbations of respiratory diseases: A real-world big data study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 806:150352. [PMID: 34555607 PMCID: PMC8627495 DOI: 10.1016/j.scitotenv.2021.150352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 09/11/2021] [Accepted: 09/11/2021] [Indexed: 05/06/2023]
Abstract
BACKGROUND The effects of weather periods, race/ethnicity, and sex on environmental triggers for respiratory exacerbations are not well understood. This study linked the OneFlorida network (~15 million patients) with an external exposome database to analyze environmental triggers for asthma, bronchitis, and COPD exacerbations while accounting for seasonality, sex, and race/ethnicity. METHODS This is a case-crossover study of OneFlorida database from 2012 to 2017 examining associations of asthma, bronchitis, and COPD exacerbations with exposures to heat index, PM 2.5 and O 3. We spatiotemporally linked exposures using patients' residential addresses to generate average exposures during hazard and control periods, with each case serving as its own control. We considered age, sex, race/ethnicity, and neighborhood deprivation index as potential effect modifiers in conditional logistic regression models. RESULTS A total of 1,148,506 exacerbations among 533,446 patients were included. Across all three conditions, hotter heat indices conferred increasing exacerbation odds, except during November to March, where the opposite was seen. There were significant differences when stratified by race/ethnicity (e.g., for asthma in April, May, and October, heat index quartile 4, odds were 1.49 (95% confidence interval (CI) 1.42-1.57) for Non-Hispanic Blacks and 2.04 (95% CI 1.92-2.17) for Hispanics compared to 1.27 (95% CI 1.19-1.36) for Non-Hispanic Whites). Pediatric patients' odds of asthma and bronchitis exacerbations were significantly lower than adults in certain circumstances (e.g., for asthma during June - September, pediatric odds 0.71 (95% CI 0.68-0.74) and adult odds 0.82 (95% CI 0.79-0.85) for the highest quartile of PM 2.5). CONCLUSION This study of acute exacerbations of asthma, bronchitis, and COPD found exacerbation risk after exposure to heat index, PM 2.5 and O 3 varies by weather period, age, and race/ethnicity. Future work can build upon these results to alert vulnerable populations to exacerbation triggers.
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Affiliation(s)
- Jennifer Fishe
- Department of Emergency Medicine, University of Florida College of Medicine - Jacksonville, United States of America; Center for Data Solutions, University of Florida College of Medicine - Jacksonville, United States of America.
| | - Yi Zheng
- Department of Epidemiology, University of Florida College of Medicine & College of Public Health and Health Professions, United States of America
| | - Tianchen Lyu
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, United States of America
| | - Jiang Bian
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, United States of America
| | - Hui Hu
- Department of Epidemiology, University of Florida College of Medicine & College of Public Health and Health Professions, United States of America
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Deschildre A, Abou-Taam R, Drummond D, Giovannini-Chami L, Labouret G, Lejeune S, Lezmi G, Lecam MT, Marguet C, Petat H, Taillé C, Wanin S, Corvol H, Epaud R. [Update of the 2021 Recommendations for the management of and follow-up of adolescent asthmatic patients (over 12 years) under the guidance of the French Society of Pulmonology and the Paediatric Society of Pulmonology and Allergology. Long version]. Rev Mal Respir 2022; 39:e1-e31. [PMID: 35148929 DOI: 10.1016/j.rmr.2021.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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)
- A Deschildre
- Université Lille, CHU Lille, service de pneumologie et allergologie pédiatriques, hôpital Jeanne de Flandre, 59000 Lille, France; Centre d'infection et d'immunité de Lille, Inserm U1019, CNRS UMR9017, équipe OpinFIELD: Infections opportunistes, Immunité, Environnement et Maladies Pulmonaires, Institut Pasteur de Lille, 59019 Lille cedex, France.
| | - R Abou-Taam
- Service de pneumologie et allergologie pédiatriques, hôpital Necker-enfants malades, APHP, université de Paris, Paris, France
| | - D Drummond
- Service de pneumologie et allergologie pédiatriques, hôpital Necker-enfants malades, APHP, université de Paris, Paris, France
| | - L Giovannini-Chami
- Service de Pneumo-Allergologie pédiatrique, Hôpitaux pédiatriques de Nice CHU-Lenval, 57, avenue de la Californie, 06200 Nice, France
| | - G Labouret
- Service de Pneumo-allergologie pédiatrique, Hôpital des Enfants, CHU Toulouse, 31000 Toulouse, France
| | - S Lejeune
- Université Lille, CHU Lille, service de pneumologie et allergologie pédiatriques, hôpital Jeanne de Flandre, 59000 Lille, France; Centre d'infection et d'immunité de Lille, Inserm U1019, CNRS UMR9017, équipe OpinFIELD: Infections opportunistes, Immunité, Environnement et Maladies Pulmonaires, Institut Pasteur de Lille, 59019 Lille cedex, France
| | - G Lezmi
- Service de pneumologie et allergologie pédiatriques, hôpital Necker-enfants malades, APHP, université de Paris, Paris, France
| | - M T Lecam
- Service de pathologies professionnelles et de l'environnement. Centre Hospitalier Inter Communal de Créteil, 94000 Créteil, France
| | - C Marguet
- Université de Normandie, UNIROUEN, EA 2456, CHU Rouen, maladies respiratoires et allergiques, CRCM, département de Pédiatrie, et de Médecine de l'adolescent, 76000 Rouen, France; Groupe de Recherche sur l'Adaptation Microbienne (GRAM 2.0), Normandie Université, UNICAEN,UNIROUEN, EA2656, 14033 Caen, France
| | - H Petat
- Université de Normandie, UNIROUEN, EA 2456, CHU Rouen, maladies respiratoires et allergiques, CRCM, département de Pédiatrie, et de Médecine de l'adolescent, 76000 Rouen, France; Groupe de Recherche sur l'Adaptation Microbienne (GRAM 2.0), Normandie Université, UNICAEN,UNIROUEN, EA2656, 14033 Caen, France
| | - C Taillé
- Groupe Hospitalier Universitaire AP-HP Nord-Université de Paris, hôpital Bichat, Service de Pneumologie et Centre de Référence constitutif des maladies pulmonaires rares ; Inserm UMR1152, Paris, France
| | - S Wanin
- Service d'allergologie pédiatrique, hôpital universitaire Armand Trousseau, 75012 Paris, France; Unité Transversale d'éducation thérapeutique Sorbonne Université, Paris, France
| | - H Corvol
- Service de pneumologie pédiatrique, Sorbonne Université, Centre de Recherche Saint-Antoine, Inserm UMRS938, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Trousseau, Paris, France
| | - R Epaud
- Centre hospitalier intercommunal de Créteil, service de pédiatrie générale, 94000 Créteil, France; Université Paris Est Créteil, Inserm, IMRB, 94010 Créteil, France; FHU SENEC, Créteil, France
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Karlina R, Flexeder C, Musiol S, Bhattacharyya M, Schneider E, Altun I, Gschwendtner S, Neumann AU, Nano J, Schloter M, Peters A, Schulz H, Schmidt‐Weber CB, Standl M, Traidl‐Hoffmann C, Alessandrini F, Ussar S. Differential effects of lung inflammation on insulin resistance in humans and mice. Allergy 2022; 77:2482-2497. [PMID: 35060125 DOI: 10.1111/all.15226] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 12/07/2021] [Accepted: 12/24/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND The rates of obesity, its associated diseases, and allergies are raising at alarming rates in most countries. House dust mites (HDM) are highly allergenic and exposure often associates with an urban sedentary indoor lifestyle, also resulting in obesity. The aim of this study was to investigate the epidemiological association and physiological impact of lung inflammation on obesity and glucose homeostasis. METHODS Epidemiological data from 2207 adults of the population-based KORA FF4 cohort were used to test associations between asthma and rhinitis with metrics of body weight and insulin sensitivity. To obtain functional insights, C57BL/6J mice were intranasally sensitized and challenged with HDM and simultaneously fed with either low-fat or high-fat diet for 12 weeks followed by a detailed metabolic and biochemical phenotyping of the lung, liver, and adipose tissues. RESULTS We found a direct association of asthma with insulin resistance but not body weight in humans. In mice, co-development of obesity and HDM-induced lung inflammation attenuated inflammation in lung and perigonadal fat, with little impact on body weight, but small shifts in the composition of gut microbiota. Exposure to HDM improved glucose tolerance, reduced hepatosteatosis, and increased energy expenditure and basal metabolic rate. These effects associate with increased activity of thermogenic adipose tissues independent of uncoupling protein 1. CONCLUSIONS Asthma associates with insulin resistance in humans, but HDM challenge results in opposing effects on glucose homeostasis in mice due to increased energy expenditure, reduced adipose inflammation, and hepatosteatosis.
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Affiliation(s)
- Ruth Karlina
- RG Adipocytes & Metabolism, Institute for Diabetes & Obesity Helmholtz Zentrum München Munich Germany
- German Center for Diabetes Research (DZD) Munich Germany
| | - Claudia Flexeder
- Institute of Epidemiology Helmholtz Zentrum München, German Research Center for Environmental Health Munich Germany
- Institute and Clinic for Occupational, Social and Environmental Medicine University Hospital, LMU Munich Munich Germany
- German Center for Lung Research (DZL) Munich Germany
| | - Stephanie Musiol
- German Center for Lung Research (DZL) Munich Germany
- Center of Allergy & Environment (ZAUM) Technical University of Munich and Helmholtz Zentrum München, German Research Center for Environmental Health Munich Germany
| | - Madhumita Bhattacharyya
- Department of Environmental Medicine, Faculty of Medicine University of Augsburg Augsburg Germany
| | - Evelyn Schneider
- German Center for Lung Research (DZL) Munich Germany
- Center of Allergy & Environment (ZAUM) Technical University of Munich and Helmholtz Zentrum München, German Research Center for Environmental Health Munich Germany
| | - Irem Altun
- RG Adipocytes & Metabolism, Institute for Diabetes & Obesity Helmholtz Zentrum München Munich Germany
- German Center for Diabetes Research (DZD) Munich Germany
| | - Silvia Gschwendtner
- Research Unit for Comparative Microbiome Analysis Helmholtz Zentrum München, German Research Center for Environmental Health Neuherberg Germany
| | - Avidan U. Neumann
- Department of Environmental Medicine, Faculty of Medicine University of Augsburg Augsburg Germany
- Institute of Environmental Medicine Helmholtz Zentrum München, German Research Center for Environmental Health Augsburg Germany
| | - Jana Nano
- German Center for Diabetes Research (DZD) Munich Germany
- Institute of Epidemiology Helmholtz Zentrum München, German Research Center for Environmental Health Munich Germany
| | - Michael Schloter
- Research Unit for Comparative Microbiome Analysis Helmholtz Zentrum München, German Research Center for Environmental Health Neuherberg Germany
| | - Annette Peters
- German Center for Diabetes Research (DZD) Munich Germany
- Institute of Epidemiology Helmholtz Zentrum München, German Research Center for Environmental Health Munich Germany
| | - Holger Schulz
- Institute of Epidemiology Helmholtz Zentrum München, German Research Center for Environmental Health Munich Germany
- German Center for Lung Research (DZL) Munich Germany
| | - Carsten B. Schmidt‐Weber
- German Center for Lung Research (DZL) Munich Germany
- Center of Allergy & Environment (ZAUM) Technical University of Munich and Helmholtz Zentrum München, German Research Center for Environmental Health Munich Germany
| | - Marie Standl
- Institute of Epidemiology Helmholtz Zentrum München, German Research Center for Environmental Health Munich Germany
- German Center for Lung Research (DZL) Munich Germany
| | - Claudia Traidl‐Hoffmann
- Department of Environmental Medicine, Faculty of Medicine University of Augsburg Augsburg Germany
- Institute of Environmental Medicine Helmholtz Zentrum München, German Research Center for Environmental Health Augsburg Germany
- Environmental Medicine Technical University Munich Munich Germany
| | - Francesca Alessandrini
- German Center for Lung Research (DZL) Munich Germany
- Center of Allergy & Environment (ZAUM) Technical University of Munich and Helmholtz Zentrum München, German Research Center for Environmental Health Munich Germany
| | - Siegfried Ussar
- RG Adipocytes & Metabolism, Institute for Diabetes & Obesity Helmholtz Zentrum München Munich Germany
- German Center for Diabetes Research (DZD) Munich Germany
- Department of Medicine Technical University of Munich Munich Germany
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Effect of vitamin D supplementation on total and allergen-specific IgE in children with asthma and low vitamin D levels. J Allergy Clin Immunol 2022; 149:440-444.e2. [PMID: 34118248 PMCID: PMC8655021 DOI: 10.1016/j.jaci.2021.05.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/27/2021] [Accepted: 05/25/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Observational studies have yielded inconsistent findings for the relation between vitamin D level and total IgE or allergic sensitization. OBJECTIVE To determine whether vitamin D supplementation reduces levels of total IgE and IgE to each of 2 common indoor allergens in children with asthma and low vitamin D levels. METHODS Total IgE, IgE to Dermatophagoides pteronyssinus, and IgE to Blattella germanica were measured at the randomization and exit visits for 174 participants in the Vitamin D Kids Asthma Study, a multicenter, double-blind, randomized placebo-controlled trial of vitamin D3 supplementation (4000 IU/d) to prevent severe exacerbations in children with persistent asthma and vitamin D levels less than 30 ng/mL. Multivariable linear regression was used for the analysis of the effect of vitamin D supplementation on change in each IgE measure. RESULTS Participants were followed for an average of 316 days. At the exit visit, more subjects in the vitamin D arm achieved a vitamin D level equal to or more than 30 ng/mL compared with those in the placebo arm (87% vs 30%; P < .001). In a multivariable analysis, vitamin D3 supplementation had no significant effect on change in total IgE, IgE to Dermatophagoides pteronyssinus, or IgE to Blattella germanica between the exit and randomization visits (eg, for log10 total IgE, β = 0.007; 95% CI, -0.061 to 0.074; P = .85). CONCLUSIONS Vitamin D supplementation, compared with placebo, has no significant effect on serum levels of total IgE, IgE to dust mite, or IgE to cockroach in children with asthma and low vitamin D levels.
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Homaira N, Dickins E, Hodgson S, Chan M, Wales S, Gray M, Donnelly S, Burns C, Owens L, Plaister M, Flynn A, Andresen J, Keane K, Wheeler K, Gould B, Shaw N, Jaffe A, Breen C, Altman L, Woolfenden S. Impact of integrated care coordination on pediatric asthma hospital presentations. Front Pediatr 2022; 10:929819. [PMID: 36210953 PMCID: PMC9537948 DOI: 10.3389/fped.2022.929819] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 08/22/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Frequent asthma attacks in children result in unscheduled hospital presentations. Patient centered care coordination can reduce asthma hospital presentations. In 2016, The Sydney Children's Hospitals Network launched the Asthma Follow up Integrated Care Initiative with the aim to reduce pediatric asthma emergency department (ED) presentations by 50% through developing and testing an integrated model of care led by care coordinators (CCs). METHODS The integrated model of care was developed by a multidisciplinary team at Sydney Children's Hospital Randwick (SCH,R) and implemented in two phases: Phase I and Phase II. Children aged 2-16 years who presented ≥4 times to the ED of the SCH,R in the preceding 12 months were enrolled in Phase I and those who had ≥4 ED presentations and ≥1 hospital admissions with asthma attack were enrolled in Phase II. Phase I included a suite of interventions delivered by CCs including encouraging parents/carers to schedule follow-up visits with GP post-discharge, ensuring parents/carers are provided with standard asthma resource pack, offering referrals to asthma education sessions, sending a letter to the child's GP advising of the child's recent hospital presentation and coordinating asthma education webinar for GPs. In addition, in Phase II CCs sent text messages to parents/carers reminding them to follow-up with the child's GP. We compared the change in ED visits and hospital admissions at baseline (6 months pre-enrolment) and at 6-and 12-months post-enrolment in the program. RESULTS During December 2016-January 2021, 160 children (99 in Phase I and 61 in Phase II) were enrolled. Compared to baseline at 6- and 12-months post-enrolment, the proportion of children requiring ≥1 asthma ED presentations reduced by 43 and 61% in Phase I and 41 and 66% in Phase II. Similarly, the proportion of children requiring ≥1 asthma hospital admissions at 6- and 12-months post-enrolment reduced by 40 and 47% in Phase I and 62 and 69% in Phase II. CONCLUSION Our results support that care coordinator led integrated model of asthma care which enables integration of acute and primary care services and provides families with asthma resources and education can reduce asthma hospital presentations in children.
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Affiliation(s)
- Nusrat Homaira
- Discipline of Paediatrics and Child Health, Faculty of Medicine and Health, UNSW Sydney, Kensington, NSW, Australia.,Sydney Children's Hospital, Sydney, NSW, Australia
| | - Emma Dickins
- Integrated Care, Sydney Children's Hospital Network, Sydney, NSW, Australia
| | - Stephanie Hodgson
- Integrated Care, Sydney Children's Hospital Network, Sydney, NSW, Australia
| | - Mei Chan
- Discipline of Paediatrics and Child Health, Faculty of Medicine and Health, UNSW Sydney, Kensington, NSW, Australia
| | - Sandra Wales
- Sydney Children's Hospital, Sydney, NSW, Australia
| | - Melinda Gray
- Sydney Children's Hospital, Sydney, NSW, Australia
| | | | | | - Louisa Owens
- Sydney Children's Hospital, Sydney, NSW, Australia
| | | | | | - Jennifer Andresen
- Integrated Care, Sydney Children's Hospital Network, Sydney, NSW, Australia
| | | | - Karen Wheeler
- Central and Eastern Sydney Public Health Network, Sydney, NSW, Australia
| | | | - Nadine Shaw
- Sydney Children's Hospital, Sydney, NSW, Australia
| | - Adam Jaffe
- Discipline of Paediatrics and Child Health, Faculty of Medicine and Health, UNSW Sydney, Kensington, NSW, Australia.,Sydney Children's Hospital, Sydney, NSW, Australia
| | - Christie Breen
- Integrated Care, Sydney Children's Hospital Network, Sydney, NSW, Australia
| | - Lisa Altman
- Integrated Care, Sydney Children's Hospital Network, Sydney, NSW, Australia
| | - Susan Woolfenden
- Discipline of Paediatrics and Child Health, Faculty of Medicine and Health, UNSW Sydney, Kensington, NSW, Australia.,Integrated Care, Sydney Children's Hospital Network, Sydney, NSW, Australia
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Kirychuk S, Russell E, Rennie D, Karunanayake C, Roberts C, Seeseequasis J, Thompson B, McMullin K, Ramsden VR, Fenton M, Abonyi S, Pahwa P, Dosman JA. Housing inadequacy in rural Saskatchewan First Nation communities. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000470. [PMID: 36962499 PMCID: PMC10021235 DOI: 10.1371/journal.pgph.0000470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/21/2022] [Indexed: 11/19/2022]
Abstract
Housing and house conditions on First Nation communities in Canada are important determinants of health for community members. Little is known about rural First Nation housing in the Canadian Prairies. The aim was to survey houses in two rural First Nation communities in Saskatchewan, Canada to understand housing conditions, prevalence of mold/mildew and dampness, and sources, locations and frequency of mold and dampness. Surveys were conducted with an adult member of each household in 144 houses. Surveys assessed: size, age, and number of rooms in the house; number of individuals residing in the house; presence of mold/mildew and dampness, and sources, locations and frequency of mold and dampness. Houses were mostly two-bedrooms (25.7%) or more (67.4%). Thirty-one percent of houses had six or more people living in the house with crowding present in 68.8% of houses. Almost half of the houses (44.5%) were in need of major repairs. More than half of the houses had water or dampness in the past 12 months in which dripping/puddles and standing water were most commonly identified and were from surface water and plumbing. More than half of the houses indicated that this dampness caused damage. A smell of mold or mildew was present in over half of the houses (52.1%) and 73.3% of these houses indicated that this smell was always present. Housing adequacy including crowding, dampness, and mold are significant issues for houses in these two rural Saskatchewan First Nation communities. Housing inadequacy is more common in these rural communities as compared to Canadian statistics. Housing inadequacy is modifiable and is important to address for multiple reasons, but notably, as a social determinant of health. Federal government strategy to address and redress housing in First Nation communities in Canada is a fiduciary responsibility and critical to reconciliation.
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Affiliation(s)
- Shelley Kirychuk
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatchewan, Canada
- Department of Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Eric Russell
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatchewan, Canada
| | - Donna Rennie
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatchewan, Canada
| | - Chandima Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatchewan, Canada
| | - Clarice Roberts
- Community Member, Montreal Lake Cree Nation, Saskatchewan, Canada
| | | | - Brooke Thompson
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatchewan, Canada
| | - Kathleen McMullin
- Community Health and Epidemiology, University of Saskatchewan, Saskatchewan, Canada
| | - Vivian R Ramsden
- Department of Academic Family Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Mark Fenton
- Division of Respirology, Critical Care and Sleep Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Sylvia Abonyi
- Community Health and Epidemiology, University of Saskatchewan, Saskatchewan, Canada
| | - Punam Pahwa
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatchewan, Canada
- Community Health and Epidemiology, University of Saskatchewan, Saskatchewan, Canada
| | - James A Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatchewan, Canada
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Single-cell RNA transcriptomic analysis identifies Creb5 and CD11b-DCs as regulator of asthma exacerbations. Mucosal Immunol 2022; 15:1363-1374. [PMID: 36038770 PMCID: PMC9705253 DOI: 10.1038/s41385-022-00556-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 07/20/2022] [Accepted: 08/08/2022] [Indexed: 02/04/2023]
Abstract
Immune responses that result in asthma exacerbation are associated with allergen or viral exposure. Identification of common immune factors will be beneficial for the development of uniformed targeted therapy. We employed a House Dust Mite (HDM) mouse model of asthma and challenged allergic HDM mice with allergens (HDM, cockroach extract (CRE)) or respiratory syncytial virus (RSV). Purified lung immune cells underwent high-dimensional single-cell RNA deep sequencing (scRNA-seq) to generate an RNA transcriptome. Gene silencing with siRNA was employed to confirm the efficacy of scRNA-seq analysis. scRNA-seq UMAP analysis portrayed an array of cell markers within individual immune clusters. SCENIC R analysis showed an increase in regulon number and activity in CD11b- DC cells. Analysis of conserved regulon factors further identified Creb5 as a shared regulon between the exacerbation groups. Creb5 siRNAs attenuated HDM, CRE or RSV-induced asthma exacerbation. scRNA-seq multidimensional analysis of immune clusters identified gene pathways that were conserved between the exacerbation groups. We propose that these analyses provide a strong framework that could be used to identify specific therapeutic targets in multifaceted pathologies.
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