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Thongjan N, Prapamontol T, Liwsrisakun C, Chairuangsri S, Hongsibsong S, Norbäck D. Organophosphate insecticide exposure and respiratory symptoms among school children in Northern Thailand: Interaction by biomass burning, dampness and season. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 949:175122. [PMID: 39084390 DOI: 10.1016/j.scitotenv.2024.175122] [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: 05/24/2024] [Revised: 07/15/2024] [Accepted: 07/27/2024] [Indexed: 08/02/2024]
Abstract
The aim was to study associations between dialkylphosphates (DAPs), organophosphate (OP) metabolites in urine, biomarkers of OP insecticide exposure, and respiratory symptoms among children in upper northern Thailand. We recruited junior high school children in randomly selected schools in four cities (N = 337), with repeated data collection in wet and dry seasons. Urine was collected and analyzed for six OP metabolites, with creatinine adjustment. Total DAP was expressed as sum of DAPs. Data on respiratory symptoms was collected by a standardized questionnaire. Associations were analyzed by multiple logistic regression. Totally 11.3 % lived in farm families. Total DAPs concentration was higher in dry season (p = 0.002) but did not differ between farm and non-farm children. Total DAPs in wet season was associated with current wheeze (p = 0.019), current asthma attacks (p = 0.012) and attacks of breathlessness in last 12 months (p = 0.021). Total DAPs in dry season was associated with current wheeze (p = 0.042), and associations between DAPs and respiratory symptoms were stronger for dimethylphosphate metabolites (DMPs) than for diethylphosphate metabolites (DEPs). DMPs are produced by certain OP pesticides. Biomass burning inside or outside the home, and dampness or mold at home, enhanced the association between total DAPs and attacks of breathlessness. In conclusion, OP pesticide exposure, measured as urinary DAPs, was higher in dry season and similar in farm and non-farm children. OPs exposure, especially to DMP related pesticides, can increase asthmatic symptoms, especially in wet season. Combined exposure to OP and smoke from biomass burning, or dampness and mold, can further increase the prevalence of attacks of breathlessness. There is a need to reduce OP insecticide and biomass smoke exposure among Thai children. Since different pesticides can be used in different seasons, studies on respiratory health effects of OPs pesticide exposure should be done in different seasons.
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Affiliation(s)
- Nathaporn Thongjan
- Research Institute for Health Sciences (RIHES), Chiang Mai University, Chiang Mai 50200, Thailand; Program in Environmental Science, Environmental Science Research Center, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Tippawan Prapamontol
- Research Institute for Health Sciences (RIHES), Chiang Mai University, Chiang Mai 50200, Thailand; Environmental and Occupational Health Sciences and Non-Communicable Diseases Center of Excellence, Chiang Mai University, Chiang Mai 50200, Thailand.
| | - Chalerm Liwsrisakun
- Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiangmai University, Chiang Mai 50200, Thailand
| | | | - Surat Hongsibsong
- Research Institute for Health Sciences (RIHES), Chiang Mai University, Chiang Mai 50200, Thailand
| | - Dan Norbäck
- Research Institute for Health Sciences (RIHES), Chiang Mai University, Chiang Mai 50200, Thailand; Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
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2
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Gatto MR, Mansour A, Li A, Bentley R. A State-of-the-Science Review of the Effect of Damp- and Mold-Affected Housing on Mental Health. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:86001. [PMID: 39162373 PMCID: PMC11334706 DOI: 10.1289/ehp14341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 07/14/2024] [Accepted: 07/31/2024] [Indexed: 08/21/2024]
Abstract
BACKGROUND While it is well-established that exposure to dampness or mold in homes negatively affects physical health, the association with mental health remains less well evidenced. As plausible psychosocial and biological pathways exist between dampness and mold exposure and poor mental health, a review of evidence is required. OBJECTIVE This State-of-the-Science review sought to assess what is known about the mental health effects of dampness or mold exposure and identify gaps in the literature and priorities for further research. METHODS A comprehensive search of electronic databases (MEDLINE, Embase, PsycInfo, Global Health, Web of Science, and Scopus) was conducted to identify relevant studies published from 2003 to 2023. Eligible studies included observational study designs such as cohort and cross-sectional studies. Target studies for review assessed the effect of dampness and/or mold on mental health outcomes. RESULTS Of the 1,169 records retrieved, 19 studies met the inclusion criteria. The available evidence described positive associations between residential dampness/mold exposure and poor mental health. In adults, associations were observed for outcomes such as depression, stress, and anxiety, while for children, associations were observed for emotional symptoms and emotional dysregulation. DISCUSSION Identified studies generally reported associations between exposure to dampness/mold in the home and poorer mental and emotional health. Given the methodological limitations present in the current evidence base, it is recommended that more research be conducted. https://doi.org/10.1289/EHP14341.
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Affiliation(s)
- Maria Rosa Gatto
- Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry, and Health Sciences, The University of Melbourne, Parkville, Australia
| | - Adelle Mansour
- Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry, and Health Sciences, The University of Melbourne, Parkville, Australia
| | - Ang Li
- Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry, and Health Sciences, The University of Melbourne, Parkville, Australia
| | - Rebecca Bentley
- Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry, and Health Sciences, The University of Melbourne, Parkville, Australia
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Bignier C, Havet L, Brisoux M, Omeiche C, Misra S, Gonsard A, Drummond D. Climate change and children's respiratory health. Paediatr Respir Rev 2024:S1526-0542(24)00056-3. [PMID: 39107182 DOI: 10.1016/j.prrv.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 07/19/2024] [Accepted: 07/22/2024] [Indexed: 08/09/2024]
Abstract
Climate change has significant consequences for children's respiratory health. Rising temperatures and extreme weather events increase children's exposure to allergens, mould, and air pollutants. Children are particularly vulnerable to these airborne particles due to their higher ventilation per unit of body weight, more frequent mouth breathing, and outdoor activities. Children with asthma and cystic fibrosis are at particularly high risk, with increased risks of exacerbation, but the effects of climate change could also be observed in the general population, with a risk of impaired lung development and growth. Mitigation measures, including reducing greenhouse gas emissions by healthcare professionals and healthcare systems, and adaptation measures, such as limiting outdoor activities during pollution peaks, are essential to preserve children's respiratory health. The mobilisation of society as a whole, including paediatricians, is crucial to limit the impact of climate change on children's respiratory health.
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Affiliation(s)
| | | | | | | | | | - Apolline Gonsard
- Service de pneumologie et d'allergologie pédiatrique, hôpital universitaire Necker-Enfants-Malades, AP-HP, Paris, France
| | - David Drummond
- Université Paris Cité, Paris, France; Service de pneumologie et d'allergologie pédiatrique, hôpital universitaire Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Inserm UMR 1138, équipe HeKA, Centre de Recherche des Cordeliers, France.
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Agache I, Canelo-Aybar C, Annesi-Maesano I, Cecchi L, Biagioni B, Chung F, D'Amato G, Damialis A, Del Giacco S, De Las Vecillas L, Dominguez-Ortega J, Galàn C, Gilles S, Giovannini M, Holgate S, Jeebhay M, Nadeau K, Papadopoulos N, Quirce S, Sastre J, Traidl-Hoffmann C, Walusiak-Skorupa J, Sousa-Pinto B, Salazar J, Rodríguez-Tanta LY, Cantero Y, Montesinos-Guevara C, Song Y, Alvarado-Gamarra G, Sola I, Alonso-Coello P, Nieto-Gutierrez W, Jutel M, Akdis CA. The impact of indoor pollution on asthma-related outcomes: A systematic review for the EAACI guidelines on environmental science for allergic diseases and asthma. Allergy 2024; 79:1761-1788. [PMID: 38366695 DOI: 10.1111/all.16051] [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: 12/18/2023] [Revised: 01/29/2024] [Accepted: 02/01/2024] [Indexed: 02/18/2024]
Abstract
Systematic review using GRADE of the impact of exposure to volatile organic compounds (VOCs), cleaning agents, mould/damp, pesticides on the risk of (i) new-onset asthma (incidence) and (ii) adverse asthma-related outcomes (impact). MEDLINE, EMBASE and Web of Science were searched for indoor pollutant exposure studies reporting on new-onset asthma and critical and important asthma-related outcomes. Ninety four studies were included: 11 for VOCs (7 for incidenceand 4 for impact), 25 for cleaning agents (7 for incidenceand 8 for impact), 48 for damp/mould (26 for incidence and 22 for impact) and 10 for pesticides (8 for incidence and 2 for impact). Exposure to damp/mould increases the risk of new-onset wheeze (moderate certainty evidence). Exposure to cleaning agents may be associated with a higher risk of new-onset asthma and with asthma severity (low level of certainty). Exposure to pesticides and VOCs may increase the risk of new-onset asthma (very low certainty evidence). The impact on asthma-related outcomes of all major indoor pollutants is uncertain. As the level of certainty is low or very low for most of the available evidence on the impact of indoor pollutants on asthma-related outcomes more rigorous research in the field is warranted.
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Affiliation(s)
- Ioana Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - Carlos Canelo-Aybar
- Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
- Centro Cochrane Iberoamericano, Sant Antoni Maria Claret, Barcelona, Spain
| | - Isabella Annesi-Maesano
- Institute Desbrest of Epidemiology and Public Health, University of Montpellier and INSERM, Montpellier, France
| | - Lorenzo Cecchi
- Centre of Bioclimatology, University of Florence, Florence, Italy
| | - Benedetta Biagioni
- Allergy and Clinical Immunology Unit, San Giovanni di Dio Hospital, Florence, Italy
| | | | - Gennaro D'Amato
- Respiratory Disease Department, Hospital Cardarelli, Naples, Italy
- Medical School of Respiratory Allergy, University of Naples Federico II, Naples, Italy
| | - Athanasios Damialis
- Department of Ecology, School of Biology, Faculty of Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stefano Del Giacco
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato, Italy
| | - Leticia De Las Vecillas
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Javier Dominguez-Ortega
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Carmen Galàn
- Department of Botany, Ecology and Plant Physiology, International Campus of Excellence on Agrifood (ceiA3), University of Córdoba, Córdoba, Spain
| | - Stefanie Gilles
- Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Mattia Giovannini
- Allergy Unit, Meyer Children's Hospital IRCCS, Florence, Italy
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Stephen Holgate
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Mohamed Jeebhay
- Occupational Medicine Division and Centre for Environmental & Occupational Health Research, University of Cape Town, Cape Town, South Africa
| | - Kari Nadeau
- Department of Environmental Health, Center for Climate, Health, and the Global Environment, Climate and Population Studies, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Nikolaos Papadopoulos
- Allergy and Clinical Immunology Unit, Second Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
- University of Manchester, Manchester, UK
| | - Santiago Quirce
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Joaquin Sastre
- Allergy Service, Fundación Jiménez Díaz, Faculty of Medicine Universidad Autónoma de Madrid and CIBERES, Instituto Carlos III, Ministry of Science and Innovation, Madrid, Spain
| | - Claudia Traidl-Hoffmann
- Department of Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
- Institute of Environmental Medicine, Helmholtz Center Munich -German Research Center for Environmental Health, Augsburg, Germany
- Christine Kühne Center for Allergy Research and Education, Davos, Switzerland
| | - Jolanta Walusiak-Skorupa
- Department of Occupational Diseases and Environmental Health, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Bernardo Sousa-Pinto
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Josefina Salazar
- Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
- Centro Cochrane Iberoamericano, Sant Antoni Maria Claret, Barcelona, Spain
| | - L Yesenia Rodríguez-Tanta
- Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
- Centro Cochrane Iberoamericano, Sant Antoni Maria Claret, Barcelona, Spain
| | - Yahveth Cantero
- Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
- Centro Cochrane Iberoamericano, Sant Antoni Maria Claret, Barcelona, Spain
| | - Camila Montesinos-Guevara
- Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
- Centro Cochrane Iberoamericano, Sant Antoni Maria Claret, Barcelona, Spain
- Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Yang Song
- Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
- Centro Cochrane Iberoamericano, Sant Antoni Maria Claret, Barcelona, Spain
| | - Giancarlo Alvarado-Gamarra
- Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
- Centro Cochrane Iberoamericano, Sant Antoni Maria Claret, Barcelona, Spain
| | - Ivan Sola
- Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
- Centro Cochrane Iberoamericano, Sant Antoni Maria Claret, Barcelona, Spain
| | - Pablo Alonso-Coello
- Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
- Centro Cochrane Iberoamericano, Sant Antoni Maria Claret, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Wendy Nieto-Gutierrez
- Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
- Centro Cochrane Iberoamericano, Sant Antoni Maria Claret, Barcelona, Spain
| | - Marek Jutel
- Department of Clinical Immunology, Wrocław Medical University, and ALL-MED Medical Research Institute, Wroclaw, Poland
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University Zurich, Davos, Switzerland
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Sabouraud-Leclerc D. [The impact of today's environment on allergies: can we take action?]. SOINS. PEDIATRIE, PUERICULTURE 2024; 45:12-17. [PMID: 38553107 DOI: 10.1016/j.spp.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Allergic diseases have risen sharply in recent decades. After some epidemiological data, we take a look at the various hypotheses explaining this allergy "epidemic". Changes in our environment, such as pollution, are a source of climate change and an increase in allergic diseases through inflammation of epithelial barriers. Allergy prevention, a public health emergency, relies on environmental actions at both individual and collective levels.
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Norbäck D, Hashim JH, Hashim Z, Wieslander G. Fractional exhaled nitric oxide (FeNO) and respiratory symptoms in junior high school students in Penang, Malaysia: the role of household exposure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:213-224. [PMID: 36335594 DOI: 10.1080/09603123.2022.2143482] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
We studied associations between fractional exhaled nitric oxide (FeNO), health and household exposure among school children (N = 348) in Penang, Malaysia. Multiple logistic regression and linear mixed models were applied. Overall, 46.0% had elevated FeNO (>20 ppb) and 10.6% diagnosed asthma. Male gender (p = 0.002), parental asthma or allergy (p = 0.047), cat allergy (p = 0.009) and seafood allergy (p < 0.001), diagnosed asthma (p = 0.001), wheeze (p = 0.001), ocular symptoms (p = 0.001), rhinitis (p = 0.002) and respiratory infections (p = 0.004) were all associated with FeNO. Students exposed to ETS had lower FeNO (p = 0.05). Dampness and mould was associated with wheeze (p = 0.038), especially in wooden homes (interaction p = 0.042) and among students with elevated FeNO (interaction p = 0.024). Cat keeping increased rhinitis (p = 0.041) and respiratory infections (p = 0.008) and modified the dampness associations. In conclusion, FeNO can be associated with ocular and respiratory symptoms. Elevated FeNO, cat keeping and a wooden house can enhance the risk of wheeze when exposed to dampness and mould.
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Affiliation(s)
- Dan Norbäck
- Department of Medical Science, Occupational and Environmental Medicine, University Hospital, Uppsala, Sweden
| | - Jamal Hisham Hashim
- Department of Environmental Health and Occupational Safety, Universiti Selangor, Shah Alam, Malaysia
| | - Zailina Hashim
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Gunilla Wieslander
- Department of Medical Science, Occupational and Environmental Medicine, University Hospital, Uppsala, Sweden
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7
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Pham DL, Le KM, Truong DDK, Le HTT, Trinh THK. Environmental allergen reduction in asthma management: an overview. FRONTIERS IN ALLERGY 2023; 4:1229238. [PMID: 37868650 PMCID: PMC10587592 DOI: 10.3389/falgy.2023.1229238] [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: 05/26/2023] [Accepted: 09/12/2023] [Indexed: 10/24/2023] Open
Abstract
Asthma is a prevalent non-communicable disease that affects both children and adults. Many patients with severe, uncontrolled asthma could not achieve total control despite using anti-asthmatic drugs. There is increasing evidence that allergy to environmental allergens, including both indoor and outdoor allergens, is associated with asthma symptoms and severe asthma. Frequently reported sensitized allergens were dust mites, cockroaches, grass pollens, molds, pets, and rodents in allergic asthma patients, although the patterns of widespread allergens differed from each country. Allergen avoidance is the cornerstone of asthma management, especially in sensitized subjects. This review summarizes environmental allergen avoidance and clarifies their effects on asthma control. Despite contrasting results about the impact of allergen exposure reduction on asthma control, several studies supported the beneficial effects of reducing asthma-related symptoms or risk of exacerbations as a nondrug therapy. Identifying environmental allergens is helpful for asthma patients, and further studies on clinically effective avoidance methods are required.
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Affiliation(s)
- Duy Le Pham
- Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Kieu-Minh Le
- Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Diem D. K. Truong
- Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Huyen T. T. Le
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Tu H. K. Trinh
- Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
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Howard A, Mansour A, Warren-Myers G, Jensen C, Bentley R. Housing typologies and asthma: a scoping review. BMC Public Health 2023; 23:1766. [PMID: 37697282 PMCID: PMC10494403 DOI: 10.1186/s12889-023-16594-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/23/2023] [Indexed: 09/13/2023] Open
Abstract
Asthma is related to triggers within the home. Although it is recognised that triggers likely occur due to characteristics of housing, these characteristics have not been comprehensively reviewed, and there is a paucity of housing-focused interventions to reduce asthma and asthma symptoms. Following five steps identified by Arksey and O'Malley, we conducted a scoping review of published evidence on the associations between asthma and housing characteristics. We searched three electronic databases (PubMed, Scopus, Web of Science), identifying 33 studies that met our inclusion criteria. Through an iterative approach, we identified nine housing characteristics relevant to asthma onset or exacerbation, categorised as relating to the surrounding environment (location), the house itself (dwelling), or to conditions inside the home (occupancy). We conceptualise these three levels through a housing typologies framework. This facilitates the mapping of housing characteristics, and visualises how they can cluster and overlap to exacerbate asthma or asthma symptoms. Of the three levels in our framework, associations between asthma and locational features were evidenced most clearly in the literature reviewed. Within this category, environmental pollutants (and particularly air pollutants) were identified as a potentially important risk factor for asthma. Studies concerning associations between dwelling features and occupancy features and asthma reported inconsistent results, highlighting the need for greater research in these areas. Interpreting housing-related asthma triggers through this framework paves the way for the identification and targeting of typologies of housing that might adversely affect asthma, thus addressing multiple characteristics in tandem rather than as isolated elements.
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Affiliation(s)
- Amber Howard
- Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia.
| | - Adelle Mansour
- Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
| | | | - Christopher Jensen
- Melbourne School of Design, University of Melbourne, Victoria, Australia
| | - Rebecca Bentley
- Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
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Chen HK, Chang YH, Sun CW, Wu MT, Chen ML, Wang SL, Hsieh CJ. Associations of urinary phthalate metabolites with household environments among mothers and their preschool-age children. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 262:115162. [PMID: 37352583 DOI: 10.1016/j.ecoenv.2023.115162] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/16/2023] [Accepted: 06/17/2023] [Indexed: 06/25/2023]
Abstract
Phthalates have become a matter of public health concern due to their extensive use worldwide and negative health effects. The evaluation of potential sources of phthalate exposure is crucial to design prevention strategies, especially for vulnerable populations. This study included 528 mother-child pairs in the Taiwan Mother Infant Cohort Study who were followed up at ages 3-6 years between 2016 and 2020. Each mother was interviewed by using a structured questionnaire containing questions on demographic characteristics and household environment factors, such as the use of plastic food packaging, residential visible mold, insecticide sprays, and electric mosquito repellents. Eleven phthalate metabolites were analyzed in urine samples simultaneously collected from the mother-child pairs. The phthalate metabolite urinary concentrations were higher among the children than among their mothers, except those of mono-ethyl phthalate (MEP) and mono-2-ethylhexyl phthalate (MEHP). Multiple linear regression analyses showed that urine samples collected during the summer showed higher concentrations of phthalate metabolites than those collected during the winter. Family income levels had negative associations with the concentrations of MnBP and metabolites of di-2-ethylhexyl phthalate (DEHP) in children. The use of plastic food packaging was positively associated with mono-n-butyl phthalate (MnBP) and metabolites of DEHP in mothers. Residential visible mold or mold stains were significantly associated with higher MnBP and DEHP metabolite concentrations in children. The use of insecticide sprays was positively associated with MnBP concentrations in children. Significant associations between household environmental factors and phthalate exposure were mostly found in children, potentially indicating different exposure pathways between mothers and their children. Findings from this study provide additional information for the design of prevention strategies to protect the health of children and women.
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Affiliation(s)
- Hsing-Kang Chen
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan, ROC; Department of Psychiatry, Yuli Hospital, Ministry of Health and Welfare, Hualien, Taiwan, ROC
| | - Yu-Hsun Chang
- Department of Pediatrics, Hualien Tzu Chi General Hospital, Hualien, Taiwan, ROC; School of Medicine, Tzu Chi University, Hualien, Taiwan, ROC; Department of Pediatrics, National Taiwan University Hospital, Taiwan, ROC
| | - Chien-Wen Sun
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan, ROC
| | - Ming-Tsang Wu
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Graduate Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
| | - Mei-Lien Chen
- Institute of Environmental and Occupational Health Sciences, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Shu-Li Wang
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan, ROC; Department of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC; Department of Safety, Health, and Environmental Engineering, National United University, Miaoli, Taiwan, ROC.
| | - Chia-Jung Hsieh
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan, ROC; Department of Public Health, Tzu Chi University, Hualien, Taiwan, ROC.
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Wang J, Janson C, Gislason T, Gunnbjörnsdottir M, Jogi R, Orru H, Norbäck D. Volatile organic compounds (VOC) in homes associated with asthma and lung function among adults in Northern Europe. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 321:121103. [PMID: 36690293 DOI: 10.1016/j.envpol.2023.121103] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 06/17/2023]
Abstract
Associations between measured specific VOC reported to be associated with dampness and microbial growth in dwellings and asthma, lung function were investigated in 159 adults (one adult/home) from three North European cities (Reykjavik, Uppsala and Tartu). Spirometry was performed and forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and FEV1/FVC were measured. Among 159 participants, 58% were females, 24.5% atopics, 25.8% current smokers and 41% reported dampness or mold at home. Dimethyl disulphide (p = 0.004), ethyl isobutyrate (p = 0.021) and ethyl 2-methylbutyrate (p = 0.035) were associated with asthma. Isobutanol (p = 0.043), 3-methyl-1-butanol (p = 0.020), 2-hexanone (p = 0.033), 1-octen-3-ol (p = 0.027), 2-methyl-1-butanol (p = 0.022) and 2-ethyl-1-hexanol (p = 0.045) were associated with lower FEV1. Isobutanol (p = 0.004), 3-methyl-1-butanol (p = 0.001), 2-heptanone (p = 0.047) and 2-methyl-1-butanol (p = 0.002) were associated with lower FEV1/FVC. The association between dimethyl disulphide and asthma was more pronounced in females (p for interaction 0.099). The association between 1-butanol and lower FEV1 was more pronounced in males (p for interaction 0.046). The associations between 3-octanone (p for interaction 0.064), 2-ethyl-1-hexanol (p for interaction 0.049) and lower FEV1, and between 2-heptanone (p for interaction 0.021), 3-octanone (p for interaction 0.008) and lower FEV1/FVC were stronger in homes with dampness/mold. Factor analysis identified one VOC factor related to asthma and two VOC factors related to lower lung function. Increased air concentrations of 2-heptanone, ethyl 2-methylbutyrate and ethyl isobutyrate were related to prescence of certain mold species (Aspergillus sp., Cladosporum sp. and Penicillium sp.) or building dampness. Some VOC were associated with type of dwelling, building age and pet keeping. In conclusion, some VOC reported to be associated with dampness and microbial growth can be associated with asthma and lower lung function in adults. Associations between these VOC and respiratory illness can be stronger in homes with dampness/mold. There can be gender differences in respiratory health effects when exposed to indoor VOC.
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Affiliation(s)
- Juan Wang
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
| | - Christer Janson
- Department of Medical Sciences, Respiratory-, Allergy- and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Thorarinn Gislason
- Department of Sleep, Landspitali University Hospital, Reykjavik, Iceland; Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Maria Gunnbjörnsdottir
- Department of Sleep, Landspitali University Hospital, Reykjavik, Iceland; Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Rain Jogi
- Lung Clinic, Tartu University Hospital, Tartu, Estonia
| | - Hans Orru
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia; Occupational and Environmental Medicine, Dept of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Dan Norbäck
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
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11
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Vesper SJ, Wymer L, Coull BA, Koutrakis P, Cunningham A, Petty CR, Metwali N, Sheehan WJ, Gaffin JM, Permaul P, Lai PS, Bartnikas LM, Hauptman M, Gold DR, Baxi SN, Phipatanakul W. HEPA filtration intervention in classrooms may improve some students' asthma. J Asthma 2023; 60:479-486. [PMID: 35341426 PMCID: PMC9548522 DOI: 10.1080/02770903.2022.2059672] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 03/24/2022] [Accepted: 03/26/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The School Inner-City Asthma Intervention Study 2 (SICAS 2) tested interventions to reduce exposures in classrooms of students with asthma. The objective of this post-hoc analysis was limited to evaluating the effect of high-efficiency particulate (HEPA) filtration interventions on mold levels as quantified using the Environmental Relative Moldiness Index (ERMI) and the possible improvement in the students' asthma, as quantified by spirometry testing. METHODS Pre-intervention dust samples were collected at the beginning of the school year from classrooms and corresponding homes of students with asthma (n = 150). Follow-up dust samples were collected in the classrooms at the end of the HEPA or Sham intervention. For each dust sample, ERMI values and the Group 1 and Group 2 mold levels (components of the ERMI metric) were quantified. In addition, each student's lung function was evaluated by spirometry testing, specifically the percentage predicted forced expiratory volume at 1 sec (FEV1%), before and at the end of the intervention. RESULTS For those students with a higher Group 1 mold level in their pre-intervention classroom than home (n = 94), the FEV1% results for those students was significantly (p < 0.05) inversely correlated with the Group 1 level in their classrooms. After the HEPA intervention, the average Group 1 and ERMI values were significantly lowered, and the average FEV1% test results significantly increased by an average of 4.22% for students in HEPA compared to Sham classrooms. CONCLUSIONS HEPA intervention in classrooms reduced Group 1 and ERMI values, which corresponded to improvements in the students' FEV1% test results.
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Affiliation(s)
- Stephen J. Vesper
- US Environmental Protection Agency, Center for Environmental Measurement and Modeling, Cincinnati, OH, USA
| | - Larry Wymer
- US Environmental Protection Agency, Center for Environmental Measurement and Modeling, Cincinnati, OH, USA
| | - Brent A. Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Amparito Cunningham
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, MA, USA
| | - Carter R. Petty
- Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Boston, MA, USA
| | - Nervana Metwali
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - William J. Sheehan
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Jonathan M. Gaffin
- Harvard Medical School, Boston, MA, USA
- Division of Pulmonary Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Perdita Permaul
- Division of Pediatric Pulmonology, Allergy and Immunology, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, NY, USA
| | - Peggy S. Lai
- Harvard Medical School, Boston, MA, USA
- Division of Pulmonary and Critical Care, Massachusetts General Hospital, Boston, MA, USA
| | - Lisa M. Bartnikas
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Marissa Hauptman
- Harvard Medical School, Boston, MA, USA
- Division of General Pediatrics, Boston Children's Hospital, Boston, MA, USA
- Region 1 New England Pediatric Environmental Health Specialty Unit, Boston, MA, USA
| | - Diane R. Gold
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Sachin N. Baxi
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Wanda Phipatanakul
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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12
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Valdebenito R, Angelini F, Schmitt C, Baeza F, Cortinez-O'Ryan A, González F, Vives-Vergara A. [Developing tools to study the health impact of urban transformations in high vulnerability contexts: the RUCAS study]. CAD SAUDE PUBLICA 2023; 39:e00148322. [PMID: 37132718 DOI: 10.1590/0102-311xes148322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 03/02/2023] [Indexed: 05/04/2023] Open
Abstract
This article describes the design and characteristics of a questionnaire and an intradomiciliary observation tool developed to assess the housing-neighborhood-health relationship both cross-sectionally and longitudinally in the context of urban transformations carried out in populations of high socio-territorial vulnerability. The instruments were developed for the multi-method longitudinal study RUCAS (Urban Regeneration, Quality of Life and Health), a natural experiment aiming to assess the quality of life and health impact of a comprehensive Urban Regeneration Program in two social housing complexes in Chile. The design of the instruments followed four main stages: (1) narrative review of the literature to define the dimensions of the study, and of existing measurement instruments to identify appropriate items for measuring them; (2) content validation with experts; (3) pre-test; and (4) pilot study. The resulting questionnaire, composed of 262 items, considers the different stages of the life course and gender issues. The intradomiciliary observation tool (77 items) is applied by the interviewer. The instruments assess (i) characteristics of the current residential situation that are known to affect health and will be intervened by the program; (ii) dimensions of health potentially affected by the residential situation and/or by the intervention within the time frame of the study (4 years); (iii) other health and health-related conditions that are relevant, even if changes will not be modified within the time frame of the study; and (iv) relevant socioeconomic, occupational and demographic dimensions. The instruments have shown to be capable of addressing the multidimensionality of urban transformation processes in contexts of urban poverty in formal housing.
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Affiliation(s)
- Roxana Valdebenito
- Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Flavia Angelini
- Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Cristian Schmitt
- Escuela de Arquitectura, Pontificia Universidad Católica de Chile, Santiago, Chile
- Instituto de Geografía, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Fernando Baeza
- Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile
- Departamento de Educación Física, Deportes y Recreación, Universidad de la Frontera, Temuco, Chile
| | - Andrea Cortinez-O'Ryan
- Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile
- Facultad de Arquitectura, Artes y Diseño, Universidad Católica de Temuco, Temuco, Chile
| | - Francisca González
- Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alejandra Vives-Vergara
- Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile
- Centro de Desarrollo Urbano Sustentable, Pontificia Universidad Católica de Chile, Santiago, Chile
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13
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Goshua A, Sampath V, Efobi JA, Nadeau K. The Role of Climate Change in Asthma. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1426:25-41. [PMID: 37464115 DOI: 10.1007/978-3-031-32259-4_2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Human activity and increased use of fossil fuels have led to climate change. These changes are adversely affecting human health, including increasing the risk of developing asthma. Global temperatures are predicted to increase in the future. In 2019, asthma affected an estimated 262 million people and caused 455,000 deaths. These rates are expected to increase. Climate change by intensifying climate events such as drought, flooding, wildfires, sand storms, and thunderstorms has led to increases in air pollution, pollen season length, pollen and mold concentration, and allergenicity of pollen. These effects bear implications for the onset, exacerbation, and management of childhood asthma and are increasing health inequities. Global efforts to mitigate the effects of climate change are urgently needed with the goal of limiting global warming to between 1.5 and 2.0 °C of preindustrial times as per the 2015 Paris Agreement. Clinicians need to take an active role in these efforts in order to prevent further increases in asthma prevalence. There is a role for clinician advocacy in both the clinical setting as well as in local, regional, and national settings to install measures to control and curb the escalating disease burden of childhood asthma in the setting of climate change.
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Affiliation(s)
- Anna Goshua
- Stanford School of Medicine, Stanford, CA, USA
| | - Vanitha Sampath
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Palo Alto, CA, USA
| | - Jo Ann Efobi
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Palo Alto, CA, USA
| | - Kari Nadeau
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Palo Alto, CA, USA
- Division of Pulmonary, Allergy, and Critical Care Medicine, Stanford University, Stanford, CA, USA
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14
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Bolaños-Rosero B, Hernández-González X, Cavallín-Calanche HE, Godoy-Vitorino F, Vesper S. Impact of Hurricane Maria on mold levels in the homes of Piñones, Puerto Rico. AIR QUALITY, ATMOSPHERE, & HEALTH 2022; 16:661-668. [PMID: 37312968 PMCID: PMC10259649 DOI: 10.1007/s11869-022-01297-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 12/07/2022] [Indexed: 06/15/2023]
Abstract
Hurricane Maria struck Puerto Rico on September 20, 2017, severely impacting the island. In order to quantify the impact of the hurricane on the indoor air quality, we evaluated the fungal levels in households (n = 20) of the Piñones community for the period of 2018 and 2019. For each dust sample collected, the 36 Environmental Relative Moldiness Index (ERMI) molds were quantified using qPCR assays, and then Shannon Diversity Index (SDI) values for the fungal populations were calculated. Homes were in five separate regions, regarding their proximity in the studied area. We found that for regions with reported least water damage, the SDI values were similar for both sampled years, but for regions that reported mid-to-high level of damage region, the SDI values were significantly higher. Households that reported remediation actions between the two sampled years showed similar values for the second year as those that did not report any major impact. Our preliminary data provides insights into the significant impacts of hurricanes into indoor fungal environment.
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Affiliation(s)
- B Bolaños-Rosero
- Department of Microbiology and Medical Zoology, University of Puerto Rico, San Juan, PR, USA
| | - X Hernández-González
- Department of Microbiology and Medical Zoology, University of Puerto Rico, San Juan, PR, USA
| | | | - F Godoy-Vitorino
- Department of Microbiology and Medical Zoology, University of Puerto Rico, San Juan, PR, USA
| | - S Vesper
- Center for Environmental Measurement and Modeling, United States Environmental Protection Agency, Cincinnati, OH, USA
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15
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Persistent Asthma at School Age: Associated Factors in Preschool Children with Asthma. CHILDREN (BASEL, SWITZERLAND) 2022; 10:children10010033. [PMID: 36670584 PMCID: PMC9856300 DOI: 10.3390/children10010033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/19/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022]
Abstract
Most patients with childhood asthma present their first symptoms at preschool age. Identifying modifiable risks and protective factors at an early age may help develop asthma prevention and control strategies. This study aimed to identify factors at preschool age that are associated with persistent asthma at school age. This retrospective observational study included preschool children with asthma from 2015 to 2020 at a university hospital in Southern Thailand. In total, 189 eligible participants (70.9% boys; median age, 7.6 [6.7, 8.5] years) were included. Wheeze characteristics included early transient wheeze, persistent wheeze, and late-onset wheeze that accounted for 55%, 27.5%, and 19.5% of the patients, respectively. Approximately 20% of the participants had persistent asthma. Breastfeeding was a protective factor (odds ratio [OR] 0.4 [0.2, 0.9], p = 0.04). The modifiable risk factors were siblings living in the same household (OR 2.6 [1.1, 6.2], p = 0.02) and residence in an industrial area (OR 3.8 [1.4, 10.5], p = 0.009). Additionally, presence of allergic rhinitis was associated with an increased risk of persistent asthma at school age (OR 3.6 [1.6, 8.2], p = 0.002). Early therapeutic interventions targeting modifiable factors provide a window of opportunity to prevent persistent asthma at school age.
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16
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Wang J, Janson C, Malinovschi A, Holm M, Franklin KA, Modig L, Johannessen A, Schlünssen V, Gislason T, Jogi NO, Norbäck D. Asthma, allergic rhinitis and atopic dermatitis in association with home environment - The RHINE study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 853:158609. [PMID: 36089044 DOI: 10.1016/j.scitotenv.2022.158609] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 09/02/2022] [Accepted: 09/04/2022] [Indexed: 06/15/2023]
Abstract
We studied home environment exposures in relation to asthma, allergic rhinitis and atopic dermatitis among offspring of participants (parents) in the Respiratory Health in Northern Europe (RHINE) study (age ≤ 30 y). Totally 17,881 offspring from Iceland, Norway, Sweden, Denmark and Estonia were included. Home environment exposures, including dampness and mold, type of dwelling, construction year and indoor painting were registered through a questionnaire answered by parents in the first follow up (RHINE II). The parents reported ten years later with in the frame of RHINE III offspring's birth year and offspring's asthma, allergic rhinitis, atopic dermatitis. They also reported dampness and mold at home from RHINE II to RHINE III. The prevalence of offspring's asthma before 10 y, asthma after 10 y, allergic rhinitis at any age and atopic dermatitis at any age were 9.7 %, 4.3 %, 15.6 % and 17.3 %, respectively. Asthma before 10 y was related to any indoor painting at RHINE II (OR = 1.14, 95%CI (1.02, 1.29)). Asthma after 10 y was associated with dampness/mold at home (OR = 1.33-1.62) and living in the newest buildings (constructed in 1986-2001) (OR = 1.30, 95%CI (1.02, 1.66)). Allergic rhinitis was associated with living in newer buildings (constructed in 1961-2001) (OR = 1.16-1.24). Atopic dermatitis was associated with visible mold (OR = 1.35, 95%CI(1.12, 1.62)), dampness/mold at home (OR = 1.18-1.38), living in apartments (OR = 1.22, 95%CI(1.10, 1.35)) and living in newer buildings (constructed in 1961-2001) (OR = 1.14-1.25). There were dose-response effects of dampness and mold on offspring's asthma after 10 y and atopic dermatitis (20 years exposure vs. 10 years exposure). Older offspring had increased risk of developing asthma after 10 y and atopic dermatitis. In conclusion, home dampness and mold, living in apartments, living in newer buildings and indoor painting were associated with offspring's asthma or allergic diseases. Stronger health effects were found among offspring with prolonged exposure of dampness/mold.
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Affiliation(s)
- Juan Wang
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
| | - Christer Janson
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Andrei Malinovschi
- Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Mathias Holm
- Occupational and Environmental Medicine, Gothenburg University, Gothenburg, Sweden
| | - Karl A Franklin
- Department of Surgical and Preoperative Sciences, Surgery, Umeå University, SE-901 85 Umeå, Sweden
| | - Lars Modig
- Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Umeå, Sweden
| | - Ane Johannessen
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Vivi Schlünssen
- Department of Public Health, Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Thorarinn Gislason
- Department of Sleep, Landspitali University Hospital, Reykjavik, Iceland; Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Nils Oskar Jogi
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Dan Norbäck
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
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17
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Burge S, Moore V, Burge C, Robertson A, Huntley C, Walters G. Occupational asthma in teachers. Occup Med (Lond) 2022; 72:541-549. [PMID: 36097688 DOI: 10.1093/occmed/kqac087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Work-related asthma symptoms are common in teachers and teaching assistants, there are few studies evaluating their causes. AIMS To identify causes of occupational asthma in teachers and teaching assistants referred to the Birmingham Occupational Lung Disease clinic 2000-20 using evaluation of serial Peak Expiratory Flow (PEF) records. METHODS Teachers and teaching assistants with possible occupational asthma were asked to record PEF 2-hourly at home and work for 4 weeks. Their records were evaluated with the Oasys programme. Those with a positive score for any of the three scores (area between curves (ABC), timepoint and Oasys score from discriminant analysis) were included. Repeat records were made as indicated to help identify the cause and the effects of remedial actions. RESULTS Thirty-eight teachers or teaching assistants met the inclusion criteria with all three Oasys scores positive in 24, 2/3 scores in nine and 1/3 in five. The building was the likely cause in 17 (in new builds particularly acrylates from carpet adhesives and in old buildings mould and construction dust), bystander exposure to agents in the schools in 12 (cleaning agents, acrylates from photocopiers and chloramines from indoor pools) and materials used in the classroom in 9 (most commonly MDF in design and technology classes). We illustrate how the PEF records helped identify the cause. CONCLUSIONS Oasys analysis of PEF records is a useful method of evaluating occupational asthma in teachers and identified difficult to confirm causes where successful remediation or redeployment was achieved.
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Affiliation(s)
- S Burge
- Occupational Lung Disease Unit, Birmingham Heartlands Hospital, Birmingham B9 5SS, UK
| | - V Moore
- Occupational Lung Disease Unit, Birmingham Heartlands Hospital, Birmingham B9 5SS, UK
| | - C Burge
- Occupational Lung Disease Unit, Birmingham Heartlands Hospital, Birmingham B9 5SS, UK
| | - A Robertson
- Occupational Lung Disease Unit, Birmingham Heartlands Hospital, Birmingham B9 5SS, UK
| | - C Huntley
- Occupational Lung Disease Unit, Birmingham Heartlands Hospital, Birmingham B9 5SS, UK
| | - G Walters
- Occupational Lung Disease Unit, Birmingham Heartlands Hospital, Birmingham B9 5SS, UK
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18
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Okada N, Shiraishi Y, Tomomatsu K, Oguma T, Asano K. Moldy odor from air conditioners in the residences of Japanese participants with and without asthma. INDOOR AIR 2022; 32:e13156. [PMID: 36437655 DOI: 10.1111/ina.13156] [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: 08/03/2022] [Revised: 10/08/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
Fungi, a major allergen associated with asthma onset and severity, can contaminate air conditioners if not properly maintained. We surveyed the prevalence and risk factors associated with fungal contamination of air conditioners and patient behavior to reduce this contamination. Japanese adults aged ≥30 years registered in the database of an Internet research company were asked to participate in an online survey. A moldy odor from the air conditioners in their residences was used as an indicator of fungal contamination. Among a total of 1006 adults, including 631 patients with asthma, 37.1% reported a moldy odor from air conditioners. The prevalence was higher in residences with indoor condensation and in air conditioners used for ≥6 years or frequently during the summer, but was lower in air conditioners with an auto-cleaning function. The risk of indoor condensation was higher in apartments, in the presence of an aquarium, and in the absence of a 24-h ventilation system. These risk factors did not differ between the residences or air conditioners of participants with and without asthma. Asthmatic patients were conscious of indoor air quality; however, do not necessarily take appropriate measures to reduce indoor mold contamination, possibly due to a lack of knowledge. In conclusion, appropriate patient education is required to reduce environmental fungal contamination and improve asthma control.
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Affiliation(s)
- Naoki Okada
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Japan
| | - Yoshiki Shiraishi
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Japan
| | - Katsuyoshi Tomomatsu
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Japan
| | - Tsuyoshi Oguma
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Japan
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Japan
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19
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Dai X, Dharmage SC, Lodge CJ. The relationship of early-life household air pollution with childhood asthma and lung function. Eur Respir Rev 2022; 31:220020. [PMID: 38743526 DOI: 10.1183/16000617.0020-2022] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 06/29/2022] [Indexed: 11/05/2022] Open
Abstract
The increase in childhood asthma over the past few decades has made it an important public health issue. Poor lung function growth associated with some phenotypes of asthma compounds its long-term impact on the individual. Exposure to early-life household risk factors is believed to be linked with respiratory health while infants' lungs are still developing. This review summarises epidemiological studies and mechanistic evidence focusing on the detrimental effects of early-life household air exposures on the respiratory health of children, in particular effects on asthma and lung function. Many early-life household air exposures, including tobacco smoke, gases from heating and cooking, mould/dampness and cleaning products are associated with childhood asthma development and lung function growth. These exposures may alter structural and mechanical characteristics of infants' lungs and contribute to deficits in later life. In addition, some risk factors, including tobacco smoke and cleaning products, can transmit effects across generations to increase the risk of asthma in subsequent generations. This review supports the hypothesis that risks of asthma and accelerated lung ageing are established in early life. The timing of exposure may be critical in the pathogenesis of respiratory diseases, in terms of future risk of asthma and reduced lung function in adults.
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Affiliation(s)
- Xin Dai
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Caroline J Lodge
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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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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21
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Jaakkola MS, Hyrkäs-Palmu H, Jaakkola JJK. Residential Exposure to Dampness Is Related to Reduced Level of Asthma Control among Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11338. [PMID: 36141610 PMCID: PMC9517438 DOI: 10.3390/ijerph191811338] [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: 07/27/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
We assessed potential relations between indicators of indoor dampness and mold exposures at home and the level of asthma control among adults. The present population-based cross-sectional study, the Northern Finnish Asthma Study (NoFAS), included 1995 adult subjects with bronchial asthma who replied to study questionnaires (response rate: 40.4%). The Asthma Control Test (ACT) was used as the measure of asthma control. We calculated the mean difference in ACT score (ACTdifference) and the risk ratio (RR) of poor asthma control (ACT ≤ 19) for the exposure and reference groups and applied Poisson regression to adjust for potential confounding. Exposure to indoor dampness at home was related to a significantly reduced level of asthma control (ACTdifference: -0.83, 95% CI: -1.60 to -0.07), especially among men (ACTdifference: -2.68, 95% CI: -4.00 to -1.37). Water damage (aRR = 1.29, 95% CI: 1.01, 1.65) and indoor dampness, especially among men (aRR = 1.92, 95% CI: 1.15, 3.20), increased the risk of poor asthma control. We provide evidence that exposure to indoor dampness at home reduces asthma control among adults, especially in men. Indoor visible mold and mold odor were not significantly related to asthma control. Advice on how to prevent indoor dampness at home should be an important part of asthma management.
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Affiliation(s)
- Maritta S. Jaakkola
- Center for Environmental and Respiratory Health Research and Biocenter Oulu, Population Health, University of Oulu, FI-90014 Oulu, Finland
| | - Henna Hyrkäs-Palmu
- Center for Environmental and Respiratory Health Research and Biocenter Oulu, Population Health, University of Oulu, FI-90014 Oulu, Finland
| | - Jouni J. K. Jaakkola
- Center for Environmental and Respiratory Health Research and Biocenter Oulu, Population Health, University of Oulu, FI-90014 Oulu, Finland
- Finnish Meteorological Institute, FI-00101 Helsinki, Finland
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22
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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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23
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Mortimer K, Reddel HK, Pitrez PM, Bateman ED. Asthma management in low and middle income countries: case for change. Eur Respir J 2022; 60:2103179. [PMID: 35210321 PMCID: PMC9474897 DOI: 10.1183/13993003.03179-2021] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 02/07/2022] [Indexed: 11/05/2022]
Abstract
Asthma is the most common noncommunicable disease in children, and among the most common in adults. The great majority of people with asthma live in low and middle income countries (LMICs), which have disproportionately high asthma-related morbidity and mortality. Essential inhaled medications, particularly those containing inhaled corticosteroids (ICS), are often unavailable or unaffordable, and this explains much of the global burden of preventable asthma morbidity and mortality. Guidelines developed for LMICs are generally based on the outdated assumption that patients with asthma symptoms <1-3 times per week do not need (or benefit from) ICS. Even when ICS are prescribed, many patients manage their asthma with oral or inhaled short-acting β2-agonists (SABA) alone, owing to issues of availability and affordability. A single ICS-formoterol inhaler-based approach to asthma management for all severities of asthma, from mild to severe, starting at diagnosis, might overcome SABA overuse/over-reliance and reduce the burden of symptoms and severe exacerbations. However, ICS-formoterol inhalers are currently very poorly available or unaffordable in LMICs. There is a pressing need for pragmatic clinical trial evidence of the feasibility and cost-effectiveness of this and other strategies to improve asthma care in these countries. The global health inequality in asthma care that deprives so many children, adolescents and adults of healthy lives and puts them at increased risk of death, despite the availability of highly effective therapeutic approaches, is unacceptable. A World Health Assembly Resolution on universal access to affordable and effective asthma care is needed to focus attention and investment on addressing this need.
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Affiliation(s)
- Kevin Mortimer
- Dept of Respiratory Medicine, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
- Dept of Medicine, University of Cambridge, Cambridge, UK
| | - Helen K Reddel
- The Woolcock Institute of Medical Research and The University of Sydney, Sydney, Australia
| | - Paulo M Pitrez
- Pediatric Respiratory Division, Hospital Moinhos de Vento, Porto Alegre, Brazil
| | - Eric D Bateman
- Division of Pulmonology, Dept of Medicine, University of Cape Town, Cape Town, South Africa
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24
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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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25
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Banzon TM, Phipatanakul W. Environmental Interventions for Asthma. Semin Respir Crit Care Med 2022; 43:720-738. [PMID: 35803266 DOI: 10.1055/s-0042-1749453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Exposure and sensitization to environmental factors play a fundamental role in asthma development and is strongly associated with asthma morbidity. While hereditary factors are critical determinants of asthma, exposures to environmental factors are implicated in the phenotypic expression of asthma and have been strongly associated in the risk of its development. Significant interest has thus been geared toward potentially modifiable environmental exposures which may lead to the development of asthma. Allergen exposure, in particular indoor allergens, plays a significant role in the pathogenesis of asthma, and remediation is a primary component of asthma management. In the home, multifaceted and multitargeted environmental control strategies have been shown to reduce home exposures and improve asthma outcomes. In addition to the home environment, assessment of the school, daycare, and workplace environments of patients with asthma is necessary to ensure appropriate environmental control measures in conjunction with medical care. This article will discuss the role of the environment on asthma, review targeted environmental therapy, and examine environmental control measures to suppress environmental exposures in the home and school setting.
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Affiliation(s)
- Tina M Banzon
- Deparmtent of Allergy and Immunology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Wanda Phipatanakul
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.,Division of Immunology, Clinical Research Center, Boston Children's Hospital, Asthma, Allergy and Immunology, Boston, Massachusetts
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26
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Influence of Home Indoor Dampness Exposure on Volatile Organic Compounds in Exhaled Breath of Mothers and Their Infants: The NELA Birth Cohort. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12146864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Currently, the effect of exposure to indoor air contaminants and the presence of dampness at home on respiratory/atopic health is of particular concern to physicians. The measurement of volatile organic compounds (VOCs) in exhaled breath is a useful approach for monitoring environmental exposures. A great advantage of this strategy is that it allows the study of the impact of pollutants on the metabolism through a non-invasive method. In this paper, the levels of nine VOCs (acetone, isoprene, toluene, p/m-xylene, o-xylene, styrene, benzaldehyde, naphthalene, and 2-ethyl-1-hexanol) in the exhaled breath of subjects exposed and not exposed to home dampness were assessed. Exhaled breath samples were collected from 337 mother–child pairs of a birth cohort and analysed by gas-chromatography–mass-spectrometry. It was observed that the levels of 2-ethyl-1-hexanol in the exhaled breath of the mothers were significantly influenced by exposure to household humidity. In the case of the infants, differences in some of the VOC levels related to home dampness exposure; however, they did not reach statistical significance. In addition, it was also found that the eosinophil counts of the mothers exposed to home dampness were significantly elevated compared to those of the non-exposed mothers. To our knowledge, these findings show, for the first time, that exposure to home dampness may influence VOC patterns in exhaled breath.
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27
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Climate Change Related Catastrophic Rainfall Events and Non-Communicable Respiratory Disease: A Systematic Review of the Literature. CLIMATE 2022. [DOI: 10.3390/cli10070101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Climate change is increasing the frequency and intensity of extreme precipitation events, the impacts of which disproportionately impact urban populations. Pluvial flooding and flooding related sewer backups are thought to result in an increase in potentially hazardous human-pathogen encounters. However, the extent and nature of associations between flooding events and non-communicable respiratory diseases such as chronic bronchitis, asthma, and chronic obstructive pulmonary disease (COPD) are not well understood. This research seeks to characterize the state of research on flooding and NCRDs through a systematic review of the scientific literature. We conducted a systematic search of PubMed, Web of Science, and Scopus for published scholarly research papers using the terms flooding, monsoon, and tropical storm with terms for common NCRDs such as asthma, COPD, and chronic bronchitis. Papers were included if they covered research studies on individuals with defined outcomes of flooding events. We excluded review papers, case studies, and opinion pieces. We retrieved 200 articles from PubMed, 268 from Web of Science and 203 from Scopus which comprised 345 unique papers. An initial review of abstracts yielded 38 candidate papers. A full text review of each left 16 papers which were included for the review. All papers except for one found a significant association between a severe weather event and increased risk for at least one of the NCRDs included in this research. Our findings further suggest that extreme weather events may worsen pre-existing respiratory conditions and increase the risk of development of asthma. Future work should focus on more precisely defining measure of health outcomes using validated tools to describe asthma and COPD exacerbations. Research efforts should also work to collect granular data on patients’ health status and family history and assess possible confounding and mediating factors such as neighborhood water mitigation infrastructure, housing conditions, pollen counts, and other environmental variables.
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28
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Lemire E, Samuels EA, Wang W, Haber A. Unequal Housing Conditions And Code Enforcement Contribute To Asthma Disparities In Boston, Massachusetts. Health Aff (Millwood) 2022; 41:563-572. [PMID: 35377754 DOI: 10.1377/hlthaff.2021.01403] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Housing quality is a primary determinant of asthma disparities by race and social class in the US. We sought to assess how housing code enforcement systems in Boston, Massachusetts, address tenants' reports of asthma triggers. After adjustment for income and other neighborhood characteristics, racial demographics were significantly associated with asthma trigger incidence. For each 10 percent decrease in neighborhood proportion of White residents, trigger incidence increased by 3.14 reports per thousand residents. These disparities persisted during the study period (from 2011 through 2021), and for mold, which is an established asthma trigger, regressions showed that racial disparities are widening. The municipal response also demonstrated disparities: In neighborhoods with the fewest White residents compared to neighborhoods with the most White residents, adjusted models showed a 17 percent (3.51 days) slower median time until cases (tenant requests for inspections to the Inspectional Services Department) were closed, a 14 percent higher probability of being flagged as overdue, and a 54.4 percent lower probability of a repair. We found evidence that in Boston, despite several healthy housing initiatives, current regulatory systems are insufficient to address disparities in access to healthy housing. To reduce disparities in asthma burden, stronger inspectional standards and further enforcement policies to increase landlords' accountability and support tenants' rights to have repairs made are essential.
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Affiliation(s)
- Evan Lemire
- Evan Lemire, Harvard University, Boston, Massachusetts
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29
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Vesper S, Wymer L, Kroner J, Pongracic JA, Zoratti EM, Little FF, Wood RA, Kercsmar CM, Gruchalla RS, Gill MA, Kattan M, Teach SJ, Patel S, Johnson CC, Bacharier LB, Gern JE, Jackson DJ, Sigelman SM, Togias A, Liu AH, Busse WW, Khurana Hershey GK. Association of mold levels in urban children's homes with difficult-to-control asthma. J Allergy Clin Immunol 2022; 149:1481-1485. [PMID: 34606833 PMCID: PMC8975947 DOI: 10.1016/j.jaci.2021.07.047] [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: 04/20/2021] [Revised: 06/17/2021] [Accepted: 07/14/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Mold sensitization and exposure are associated with asthma severity, but the specific species that contribute to difficult-to-control (DTC) asthma are unknown. OBJECTIVE We sought to determine the association between overall and specific mold levels in the homes of urban children and DTC asthma. METHODS The Asthma Phenotypes in the Inner-City study recruited participants, aged 6 to 17 years, from 8 US cities and classified each participant as having either DTC asthma or easy-to-control (ETC) asthma on the basis of treatment step level. Dust samples had been collected in each participant's home (n = 485), and any dust remaining (n = 265 samples), after other analyses, was frozen at -20oC. The dust samples (n = 265) were analyzed using quantitative PCR to determine the concentrations of the 36 molds in the Environmental Relative Moldiness Index. Logistic regression was performed to discriminate specific mold content of dust from homes of children with DTC versus ETC asthma. RESULTS Frozen-dust samples were available from 54% of homes of children with DTC (139 of 253) and ETC asthma (126 of 232). Only the average concentration of the mold Mucor was significantly (P < .001) greater in homes of children with DTC asthma. In homes with window air-conditioning units, the Mucor concentration contributed about a 22% increase (1.6 odds ratio; 95% CI, 1.2-2.2) in the ability to discriminate between cases of DTC and ETC asthma. CONCLUSIONS Mucor levels in the homes of urban youth were a predictor of DTC asthma, and these higher Mucor levels were more likely in homes with a window air-conditioner.
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Affiliation(s)
- Stephen Vesper
- United States Environmental Protection Agency, Center for Environmental Measurement and Modeling, Cincinnati, OH
| | - Larry Wymer
- United States Environmental Protection Agency, Center for Environmental Measurement and Modeling, Cincinnati, OH
| | - John Kroner
- Cincinnati Children’s Hospital, Cincinnati, OH
| | | | | | | | - Robert A. Wood
- Johns Hopkins University School of Medicine, Baltimore, MD
| | | | | | | | - Meyer Kattan
- College of Physicians and Surgeons, Columbia University, New York, NY
| | | | | | | | | | - James E. Gern
- University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Daniel J. Jackson
- University of Wisconsin School of Medicine and Public Health, Madison, WI
| | | | - Alkis Togias
- National Institute of Allergy and Infectious Diseases, Rockville, MD
| | - Andrew H. Liu
- National Jewish Health, Denver, CO, and Children’s Hospital Colorado and University of Colorado School of Medicine, Aurora, CO
| | - William W. Busse
- University of Wisconsin School of Medicine and Public Health, Madison, WI
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30
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Antonogeorgos G, Liakou E, Koutsokera A, Drakontaeidis P, Thanasia M, Mandrapylia M, Fouzas S, Ellwood P, García-Marcos L, Panagiotakos DB, Priftis KN, Douros K. Parental education moderates the association between indoor moisture environment and asthma in adolescents: the Greek Global Asthma Network (GAN) cross-sectional study. BMC Public Health 2022; 22:597. [PMID: 35346139 PMCID: PMC8962010 DOI: 10.1186/s12889-022-13065-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 03/14/2022] [Indexed: 11/11/2022] Open
Abstract
Objective Asthma is a major contributor to childhood morbidity. Several environmental and socioeconomic status (SES) factors have been implicated in its etiopathogeneses such as indoor moisture and parental education level. Our study examined the association between exposure to indoor dampness and/or mould (IDM) with adolescent asthma and how parental education could modify or mediate this relationship. Method A total of 1934 adolescents (boys: 47.5%, mean age (standard variation): 12.7(0.6) years) and their parents were voluntarily enrolled and completed a validated questionnaire on adolescents’ asthma status, parental educational level, and adolescents’ indoor exposure to IDM during three different lifetime periods, i.e., pregnancy, the first year of life and the current time. Results There was a significant modification effect of parental education only for the current exposure; higher parental education lowered almost 50% the odds of IDM and asthma (adjusted odds ratio (aOR): 1.96, 95% Confidence Intervals (CI): (1.05–3.68) and aOR:1.55, 95% CI (1.04–2.32), for primary/secondary and tertiary parental education, respectively). Conclusion Adolescents whose parents had a higher education level had lesser odds to have asthma, even if they were exposed to a moisture home environment. This could be attributed to the increased knowledge about asthma risk factors and the improved measures for the amelioration of moisture-home environment that highly educated parents are more likely to take. Further research is needed in order to elucidate the interweaved role of family SES in the aforementioned relation.
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Affiliation(s)
- George Antonogeorgos
- Allergology and Pulmonology Unit, 3Rd Paediatric Department, National and Kapodistrian University of Athens, 12462, Athens, Greece.,Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17676, Athens, Greece
| | - Evangelia Liakou
- Allergology and Pulmonology Unit, 3Rd Paediatric Department, National and Kapodistrian University of Athens, 12462, Athens, Greece
| | - Alexandra Koutsokera
- Allergology and Pulmonology Unit, 3Rd Paediatric Department, National and Kapodistrian University of Athens, 12462, Athens, Greece
| | - Pavlos Drakontaeidis
- Allergology and Pulmonology Unit, 3Rd Paediatric Department, National and Kapodistrian University of Athens, 12462, Athens, Greece
| | - Marina Thanasia
- Allergology and Pulmonology Unit, 3Rd Paediatric Department, National and Kapodistrian University of Athens, 12462, Athens, Greece
| | - Maria Mandrapylia
- Allergology and Pulmonology Unit, 3Rd Paediatric Department, National and Kapodistrian University of Athens, 12462, Athens, Greece
| | - Sotirios Fouzas
- Division of Paediatrics & Obstetrics - Gynaecology, School of Medicine, University of Patras, Patras, Greece
| | - Philippa Ellwood
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, 1023, Auckland, New Zealand
| | - Luis García-Marcos
- Paediatric Allergy and Pulmonology Units, 'Virgen de La Arrixaca' University Children's Hospital, University of Murcia, ARADyAL Network and Biomedical Research Institute of Murcia (IMIB-Arrixaca), 30394, Murcia, Spain
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17676, Athens, Greece
| | - Kostas N Priftis
- Allergology and Pulmonology Unit, 3Rd Paediatric Department, National and Kapodistrian University of Athens, 12462, Athens, Greece
| | - Konstantinos Douros
- Allergology and Pulmonology Unit, 3Rd Paediatric Department, National and Kapodistrian University of Athens, 12462, Athens, Greece.
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Prapamontol T, Norbäck D, Thongjan N, Suwannarin N, Somsunun K, Ponsawansong P, Radarit K, Kawichai S, Naksen W. Asthma and rhinitis in wet and dry season among students in upper Northern Thailand: the role of building dampness and household air pollution. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022:1-13. [PMID: 35253533 DOI: 10.1080/09603123.2022.2047902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/24/2022] [Indexed: 06/14/2023]
Abstract
We investigated associations between domestic exposure and respiratory health in students inNorthern Thailand in wet and dry season (1159 participants), calculating odds ratios (OR) with 95% confidence intervals (CI) by multilevel logistic regression. Totally 6.0% had wheeze, 23.0% dyspnoea, 4.0% current asthma, 54.6% rhinitis and 31.5% rhinoconjunctivitis. Girls had less wheeze (OR 0.66; 95% CI 0.43-1.00) and current asthma (OR 0.32; 95% CI 0.19-0.54). Water leakage was associated with wheeze (OR 2.35; 95% CI 1.09-5.06), dyspnea (OR 2.00; 95% CI 1.24-3.23) and rhinoconjunctivitis (OR 1.62; 95% CI 1.11-2.38). Mould was associated with rhinitis (OR 1.89; 95% CI 1.06-3.38). Window pane condensation was associated with wheeze (OR 2.60; 95% CI 1.13-5.98) and rhinoconjunctivitis (OR 1.70; 95% CI 1.08-2.67). Biomass burning was associated with wheeze, dyspnoea, rhinitis and rhinoconjunctivitis. In conclusion, household dampness and pollution from domestic biomass burning can increase asthma symptoms and rhinitis symptoms in students in northern Thailand.
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Affiliation(s)
- Tippawan Prapamontol
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Dan Norbäck
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Nathaporn Thongjan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Neeranuch Suwannarin
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Kawinwut Somsunun
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | | | - Kesseya Radarit
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Sawaeng Kawichai
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Warangkana Naksen
- Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand
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OUP accepted manuscript. Occup Med (Lond) 2022; 72:411-414. [DOI: 10.1093/occmed/kqac023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Elangovan D, Rahman HBH, Dhandapani R, Palanivel V, Thangavelu S, Paramasivam R, Muthupandian S. Coating of wallpaper with green synthesized silver nanoparticles from Passiflora foetida fruit and its illustrated antifungal mechanism. Process Biochem 2022. [DOI: 10.1016/j.procbio.2021.11.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Sun L, Miller JD, Van Ryswyk K, Wheeler AJ, Héroux M, Goldberg MS, Mallach G. Household determinants of biocontaminant exposures in Canadian homes. INDOOR AIR 2022; 32:e12933. [PMID: 34561903 PMCID: PMC9293439 DOI: 10.1111/ina.12933] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/12/2021] [Accepted: 09/11/2021] [Indexed: 06/13/2023]
Abstract
Exposure to biocontaminants, such as dust mites, animal dander, bacteria, and mold, is associated with a range of health effects. This study identified household characteristics associated with indoor biocontaminant loadings in four Canadian cities. Floor dust was collected in 290 Canadian homes in Edmonton, Halifax, Montreal, and Windsor. The dust samples were analyzed for house dust mite allergens (Der f 1 and Der p 1), cat allergen (Fel d 1), cockroach allergen (Bla g 1), beta-(1,3)-D-glucan, and endotoxin. Household information was obtained through questionnaires and home inspections. We performed univariate and multivariate analyses to identify household determinants of biocontaminant loadings and mold odor presence. We observed large regional variations for all biocontaminants, except for cockroach allergen. The ranges of the contaminants measured in loadings and concentrations were similar to that of previous Canadian studies. Household characteristics including presence of carpeting, low floor cleaning frequency, older home age, presence of pets, and indoor relative humidity above 45% were positively associated with the presence of multiple indoor biocontaminants. High floor cleaning frequency and use of dehumidifiers were negatively associated with the presence of multiple indoor biocontaminants. Mold odor was positively associated with older home age, past water damage, and visible mold growth.
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Affiliation(s)
- Liu Sun
- Air Health Effects Assessment Division, Water and Air Quality BureauHealth CanadaOttawaOntarioCanada
| | - J. David Miller
- Department of ChemistryCarleton UniversityOttawaOntarioCanada
| | - Keith Van Ryswyk
- Air Health Effects Assessment Division, Water and Air Quality BureauHealth CanadaOttawaOntarioCanada
| | - Amanda J. Wheeler
- Behaviour, Environment, and Cognition Research Program, Mary MacKillop Institute for Health ResearchAustralian Catholic UniversityMelbourneVictoriaAustralia
| | - Marie‐Eve Héroux
- Air Health Effects Assessment Division, Water and Air Quality BureauHealth CanadaOttawaOntarioCanada
| | - Mark S. Goldberg
- Department of MedicineMcGill UniversityMontrealQuébecCanada
- Department of Epidemiology, Biostatistics and Occupational HealthMcGill UniversityMontrealQuébecCanada
- Centre for Outcomes Research and EvaluationResearch Institute of the McGill University Hospital CentreMontrealQuébecCanada
| | - Gary Mallach
- Air Health Effects Assessment Division, Water and Air Quality BureauHealth CanadaOttawaOntarioCanada
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Sio YY, Chew FT. Risk factors of asthma in the Asian population: a systematic review and meta-analysis. J Physiol Anthropol 2021; 40:22. [PMID: 34886907 PMCID: PMC8662898 DOI: 10.1186/s40101-021-00273-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 11/12/2021] [Indexed: 12/15/2022] Open
Abstract
Background and objective An increasing trend of asthma prevalence was observed in Asia; however, contributions of environmental and host-related risk factors to the development of this disease remain uncertain. This study aimed to perform a systematic review and meta-analysis for asthma-associated risk factors reported in Asia. Methods We systematically searched three public databases (Web of Science, PubMed, and Scopus) in Feb 2021. We only included articles that reported environmental and host-related risk factors associated with asthma in the Asian population. Random-effect meta-analyses were conducted for frequently reported asthma-associated risk factors to provide an overall risk estimate of asthma development. Results Of 4030 records obtained from public databases, 289 articles were selected for review. The most frequently reported asthma-associated risk factor was the family history of allergy-related conditions. The random-effect asthma risk estimates (pooled odds ratio, OR) were 4.66 (95% confidence interval (CI): 3.73–5.82) for the family history of asthma, 3.50 (95% CI: 2.62–4.67) for the family history of atopy, 3.57 (95% CI: 3.03–4.22) for the family history of any allergic diseases, 1.96 (95% CI: 1.47–2.61) for the family history of allergic rhinitis, and 2.75 (95% CI: 1.12–6.76) for the family history of atopic dermatitis. For housing-related factors, including the presence of mold, mold spots, mold odor, cockroach, water damage, and incense burning, the random-effect pooled OR ranged from 1.43 to 1.73. Other risk factors with significant pooled OR for asthma development included male gender (1.30, 95% CI: 1.23–1.38), cigarette smoke exposure (1.44, 95% CI: 1.30–1.60), cigarette smoking (1.66, 95% CI: 1.44–1.90), body mass index (BMI)–related parameters (pooled OR ranged from 1.06 to 2.02), various types of air pollution (NO2, PM10, and O3; pooled OR ranged from 1.03 to 1.22), and pre- and perinatal factors (low birth weight, preterm birth, and cesarean section; pooled OR ranged from 1.14 to 1.32). Conclusions The family history of asthma was the most frequently reported risk factor for asthma development in Asia with the highest risk estimate for asthma development. This suggests a major role of the genetic component in asthma pathogenesis. Further study on asthma genetics is required to improve the current understanding of asthma etiology. Supplementary Information The online version contains supplementary material available at 10.1186/s40101-021-00273-x.
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Affiliation(s)
- Yang Yie Sio
- Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Department of Biological Sciences, National University of Singapore, Block S2, Level 5, 14 Science Drive 4, off Lower Kent Ridge Road, 117543, Singapore, Singapore
| | - Fook Tim Chew
- Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Department of Biological Sciences, National University of Singapore, Block S2, Level 5, 14 Science Drive 4, off Lower Kent Ridge Road, 117543, Singapore, Singapore.
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Prapamontol T, Norbäck D, Thongjan N, Suwannarin N, Somsunun K, Ponsawansong P, Khuanpan T, Kawichai S, Naksen W. Associations between indoor environment in residential buildings in wet and dry seasons and health of students in upper northern Thailand. INDOOR AIR 2021; 31:2252-2265. [PMID: 34121228 DOI: 10.1111/ina.12873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/30/2021] [Accepted: 05/27/2021] [Indexed: 06/12/2023]
Abstract
We performed a repeated questionnaire study on home environment and health (six medical symptoms) in 1159 junior high school students (age 12.8 ± 0.7 years) in upper northern Thailand in wet and dry seasons. Data on outdoor temperature, relative humidity (RH), and air pollution were collected from nearest monitoring station. Odds ratios (OR) were calculated by multi-level logistic regression. Most common symptoms were rhinitis (62.5%), headache (49.8%), throat (42.8%), and ocular symptoms (42.5%). Ocular symptoms were more common at lower RH and rhinitis more common in dry season. Water leakage (28.2%), indoor mold (7.1%), mold odor (4.1%), and windowpane condensation (13.6%) were associated with all six symptoms (ORs: 1.3-3.5). Other risk factors included cat keeping, environmental tobacco smoke (ETS), other odor than mold odor, gas cooking, and cooking with biomass fire. Biomass burning inside and outside the home for other reasons than cooking was associated with all six symptoms (ORs: 1.5-2.6). Associations between home environment exposure and rhinitis were stronger in wet season. In conclusion, dampness-related exposure, windowpane condensation, cat keeping, ETS, gas cooking, and biomass burning can impair adolescent health in upper northern Thailand. In subtropical areas, environmental health effects should be investigated in wet and dry seasons.
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Affiliation(s)
- Tippawan Prapamontol
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Dan Norbäck
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Nathaporn Thongjan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Neeranuch Suwannarin
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Kawinwut Somsunun
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | | | - Tosabhorn Khuanpan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Sawaeng Kawichai
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Warangkana Naksen
- Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand
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The Toxicity of Wiped Dust and Airborne Microbes in Individual Classrooms Increase the Risk of Teachers' Work-Related Symptoms: A Cross-Sectional Study. Pathogens 2021; 10:pathogens10111360. [PMID: 34832514 PMCID: PMC8624243 DOI: 10.3390/pathogens10111360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/06/2021] [Accepted: 10/12/2021] [Indexed: 12/23/2022] Open
Abstract
Background: The causes and pathophysiological mechanisms of building-related symptoms (BRS) remain open. Objective: We aimed to investigate the association between teachers’ individual work-related symptoms and intrinsic in vitro toxicity in classrooms. This is a further analysis of a previously published dataset. Methods: Teachers from 15 Finnish schools in Helsinki responded to the symptom survey. The boar sperm motility inhibition assay, a sensitive indicator of mitochondrial dysfunction, was used to measure the toxicity of wiped dust and cultured microbial fallout samples collected from the teachers’ classrooms. Results: 231 teachers whose classroom toxicity data had been collected responded to the questionnaire. Logistic regression analysis adjusted for age, gender, smoking, and atopy showed that classroom dust intrinsic toxicity was statistically significantly associated with the following 12 symptoms reported by teachers (adjusted ORs in parentheses): nose stuffiness (4.1), runny nose (6.9), hoarseness (6.4), globus sensation (9.0), throat mucus (7.6), throat itching (4.4), shortness of breath (12.2), dry cough (4.7), wet eyes (12.7), hypersensitivity to sound (7.9), difficulty falling asleep (7.6), and increased need for sleep (7.7). Toxicity of cultured microbes was found to be associated with nine symptoms (adjusted ORs in parentheses): headache (2.3), nose stuffiness (2.2), nose dryness (2.2), mouth dryness (2.8), hoarseness (2.2), sore throat (2.8), throat mucus (2.3), eye discharge (10.2), and increased need for sleep (3.5). Conclusions: The toxicity of classroom dust and airborne microbes in boar sperm motility inhibition assay significantly increased teachers’ risk of work-related respiratory and ocular symptoms. Potential pathophysiological mechanisms of BRS are discussed.
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Zeng Y, Zhang Y, Huang X, Song L, Polsky K, Wu Y, Kheradmand F, Guo Y, Green LK, Corry DB, Knight JM. Novel acute hypersensitivity pneumonitis model induced by airway mycosis and high dose lipopolysaccharide. Respir Res 2021; 22:263. [PMID: 34629055 PMCID: PMC8503997 DOI: 10.1186/s12931-021-01850-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 09/20/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Inhalation of fungal spores is a strong risk factor for severe asthma and experimentally leads to development of airway mycosis and asthma-like disease in mice. However, in addition to fungal spores, humans are simultaneously exposed to other inflammatory agents such as lipopolysaccharide (LPS), with uncertain relevance to disease expression. To determine how high dose inhalation of LPS influences the expression of allergic airway disease induced by the allergenic mold Aspergillus niger (A. niger). METHODS C57BL/6J mice were intranasally challenged with the viable spores of A. niger with and without 1 μg of LPS over two weeks. Changes in airway hyperreactivity, airway and lung inflammatory cell recruitment, antigen-specific immunoglobulins, and histopathology were determined. RESULTS In comparison to mice challenged only with A. niger, addition of LPS (1 μg) to A. niger abrogated airway hyperresponsiveness and strongly attenuated airway eosinophilia, PAS+ goblet cells and TH2 responses while enhancing TH1 and TH17 cell recruitment to lung. Addition of LPS resulted in more severe, diffuse lung inflammation with scattered, loosely-formed parenchymal granulomas, but failed to alter fungus-induced IgE and IgG antibodies. CONCLUSIONS In contrast to the strongly allergic lung phenotype induced by fungal spores alone, addition of a relatively high dose of LPS abrogates asthma-like features, replacing them with a phenotype more consistent with acute hypersensitivity pneumonitis (HP). These findings extend the already established link between airway mycosis and asthma to HP and describe a robust model for further dissecting the pathophysiology of HP.
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Affiliation(s)
- Yuying Zeng
- Division of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China
| | - Yun Zhang
- Department of Medicine, Biology of Inflammation Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA
- Department of Pathology & Immunology, Biology of Inflammation Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA
| | - Xinyan Huang
- Division of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China
| | - Lizhen Song
- Department of Medicine, Biology of Inflammation Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA
| | - Katherine Polsky
- Department of Medicine, Biology of Inflammation Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA
| | - Yifan Wu
- Department of Medicine, Biology of Inflammation Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA
| | - Farrah Kheradmand
- Department of Medicine, Biology of Inflammation Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA
- Department of Pathology & Immunology, Biology of Inflammation Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA
- Biology of Inflammation Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA
- Michael E. DeBakey VA Center for Translational Research on Inflammatory Diseases, Houston, TX, 77030, USA
| | - Yubiao Guo
- Division of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China.
| | - Linda K Green
- Department of Pathology and Immunology, Michael E. DeBakey VA Center, 2002 Holcombe Boulevard, Houston, TX, 77030, USA
| | - David B Corry
- Department of Medicine, Biology of Inflammation Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
- Department of Pathology & Immunology, Biology of Inflammation Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
- Biology of Inflammation Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
- Michael E. DeBakey VA Center for Translational Research on Inflammatory Diseases, Houston, TX, 77030, USA.
| | - John M Knight
- Department of Pathology & Immunology, Biology of Inflammation Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
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Yang Q, Wang J, Norbäck D. The home environment in a nationwide sample of multi-family buildings in Sweden: associations with ocular, nasal, throat and dermal symptoms, headache, and fatigue among adults. INDOOR AIR 2021; 31:1402-1416. [PMID: 33682978 DOI: 10.1111/ina.12787] [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: 12/08/2020] [Accepted: 12/17/2020] [Indexed: 06/12/2023]
Abstract
Risk factors at home for ocular, nasal, throat and dermal symptoms, headache, and fatigue were studied in a nationwide questionnaire survey in Sweden, the BETSI study in 2006. Totally, 5775 adults from a stratified random sample of multi-family buildings participated. Associations between home environment factors and weekly symptoms were analyzed by multi-level logistic regression. In total, 8.3% had ocular symptoms; 11.9% nasal symptoms; 7.1% throat symptoms; 11.9% dermal symptoms; 8.5% headache and 23.1% fatigue. Subjects in colder climate zones had more mucosal and throat symptoms but less fatigue and ocular symptoms. Rented apartments had poorer indoor environment than self-owned apartments. Those living in buildings constructed from 1961 to 1985 had most symptoms. Building dampness, mold and mold odor were risk factors, especially headache and ocular symptoms. Lack of mechanical ventilation system was another risk factor, especially for headache. Environmental tobacco smoke (ETS), electric radiators, and crowdedness were other risk factors. Oiled wooden floors, recent indoor painting, and new floor materials were negatively associated with symptoms. In conclusion, building dampness, mold, poor ventilation conditions, crowdedness, ETS, and emissions from electric radiators in apartments in Sweden can increase the risk of ocular, nasal, throat and dermal symptoms, headache, and fatigue.
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Affiliation(s)
- Qin Yang
- College of Civil Engineering, Guizhou University, Guiyang, China
- Department of Medical Sciences, Uppsala University and University Hospital, Uppsala, Sweden
| | - Juan Wang
- Department of Medical Sciences, Uppsala University and University Hospital, Uppsala, Sweden
| | - Dan Norbäck
- Department of Medical Sciences, Uppsala University and University Hospital, Uppsala, Sweden
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Li H, Dai T, Liu C, Liu Q, Tan C. Phenotypes of atopic dermatitis and the risk for subsequent asthma: a systematic review and meta-analysis. J Am Acad Dermatol 2021; 86:365-372. [PMID: 34384834 DOI: 10.1016/j.jaad.2021.07.064] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/22/2021] [Accepted: 07/28/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Various atopic dermatitis (AD) phenotypes showed an enormously heterogenic risk for subsequent asthma development. OBJECTIVE We aimed to investigate the association between AD phenotypes and the risk for progression to asthma. METHODS We searched PubMed, Embase, and Web of Science databases for relevant publications. Pooled relative risks (RR) with 95% confidence intervals (CI) were calculated using the CMA-3.0 software. This study has been registered with PROSPERO (CRD42019129273). RESULTS We analyzed 39 publications with 458,810 participants. The RR for asthma in AD was 2.16 (95% CI, 1.88-2.48). The risk in persistent AD (RR, 3.36; 95% CI, 2.83-3.99) was higher than in transient AD (RR, 1.52; 95% CI, 1.34-1.73), and in severe AD (RR, 2.40; 95% CI, 1.96-2.94) was higher than mild (RR, 1.82; 95% CI, 1.03-3.23) or moderate (RR, 1.51; 95% CI, 1.30-1.75) AD. The risk for asthma in early-onset AD was slightly higher than in late-onset AD and in boys higher than girls. LIMITATIONS The AD and asthma definitions differed across the included studies. CONCLUSION Patients with persistent or severe AD were at a higher risk for developing asthma. These findings further elucidate the atopic march and identify target populations for asthma prevention.
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Affiliation(s)
- Hongmin Li
- Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese, Medicine, 155 Hanzhong Road, Nanjing, 210029, China.
| | - Ting Dai
- Children's Hospital of Fudan University, National Children's Medical Center, 399 Wanyuan Road, Shanghai, 200032, China
| | - Cong Liu
- Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese, Medicine, 155 Hanzhong Road, Nanjing, 210029, China
| | - Qing Liu
- Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese, Medicine, 155 Hanzhong Road, Nanjing, 210029, China
| | - Cheng Tan
- Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese, Medicine, 155 Hanzhong Road, Nanjing, 210029, China.
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Cherrie MPC, Sarran C, Osborne NJ. Climatic factors are associated with asthma prevalence: An ecological study using English quality outcomes framework general practitioner practice data. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 779:146478. [PMID: 34030283 DOI: 10.1016/j.scitotenv.2021.146478] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 03/10/2021] [Accepted: 03/10/2021] [Indexed: 06/12/2023]
Abstract
Asthma is a complex disease with multiple environmental factors proposed to contribute to aetiology. Geographical analyses can shed light on the determinants of asthma. Ultraviolet radiation has been associated with asthma prevalence in past ecological studies. We have increased the detail of examining the association between asthma and ultraviolet radiation with addition of the variables of temperature, relative humidity and precipitation. An ecological study was designed to investigate meteorological factors associated with asthma prevalence in England. Data from the 2005 quality outcomes framework were used to determine the prevalence of asthma in primary care in England. This information was supplemented with indicators of obesity and smoking of the General Practitioner practice and population (by age and sex), deprivation and ethnicity at lower super output level from the 2001 and 2011 census. Annual mean meteorological data was attained from the Met Office and Joint Research Centre. We used a multiple linear regression to examine individual and multiple climatic factors through a principal components analysis. We tested for an association with asthma prevalence, after taking into account the spatial autocorrelation of the data. Asthma prevalence from general practice surgeries in England was 5.88% (95% CI 5.83 to 5.92). In the highest ultraviolet radiation weighted by the pre-vitamin D action spectrum (UVvitd) quartile (2.12 to 2.50 kJ/m2/day), asthma had a 5% reduction in prevalence; compared to the lowest quartile here (0.95 (95% CI 0.92 to 0.98)). Similar reductions were found in the higher temperature 0.93 (95% CI 0.90 to 96). The opposite was found with relative humidity 1.09 (95% CI 1.05 to 1.12). A combination of high temperature and UVvitd highlighted postcode districts in the South East of England with a climate beneficial to low asthma prevalence. The South West of England represented a climate which had both beneficial and detrimental associations with asthma development. Climate is associated with asthma prevalence in England. Understanding the contribution of multiple climatic factors and the relationship with the indoor environment could help to explain the population distribution of asthma.
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Affiliation(s)
- Mark P C Cherrie
- Institute of Occupational Medicine, Edinburgh, EH14 4AP, UK; Centre for Research on Environment Society and Health, University of Edinburgh, Scotland, UK; European Centre for Environment and Human Health (ECEHH), University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, UK
| | | | - Nicholas J Osborne
- European Centre for Environment and Human Health (ECEHH), University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, UK; School of Public Health, University of Queensland, Australia.
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Toxicity studies of Aspergillus fumigatus administered by inhalation to B6C3F1/N mice (revised). TOXICITY REPORT SERIES 2021:NTP-TOX-100. [PMID: 34283822 PMCID: PMC8436148 DOI: 10.22427/ntp-tox-100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Aspergillus fumigatus is a thermotolerant, soil-borne fungal species that is ubiquitous in the environment. Mold was nominated to the National Toxicology Program (NTP) by a private individual due to suspected adverse health effects associated with personal exposure in indoor and occupational settings. A. fumigatus is of particular concern in the biowaste industry as the species can contaminate self-heating compost piles. Because of this potential for personal and occupational exposure and the lack of available toxicity data, toxicity studies were conducted in which male and female B6C3F1/N mice were exposed to A. fumigatus conidia (spores) two times a week for 3 months. All in-life procedures, including inhalation exposure, test article preparation, and hematology analysis, were completed by the National Institute for Occupational Safety and Health (NIOSH, Morgantown, WV). Battelle (Columbus, OH) conducted terminal necropsies, measured terminal body and organ weights, and evaluated gross lesions on-site at NIOSH. Tissue processing and histopathology were completed at Battelle. Grocott's methenamine silver (GMS) staining was performed at NIOSH. Genetic toxicology studies on mouse peripheral blood erythrocytes were conducted by Integrated Laboratory Systems, LLC (Research Triangle Park, NC). (Abstract Abridged).
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Norbäck D, Zhang X, Tian L, Zhang Y, Zhang Z, Yang L, Chen X, Zeng Z, Lu C, Zhao Z. Prenatal and perinatal home environment and reported onset of wheeze, rhinitis and eczema symptoms in preschool children in Northern China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 774:145700. [PMID: 33609817 DOI: 10.1016/j.scitotenv.2021.145700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 02/03/2021] [Accepted: 02/03/2021] [Indexed: 06/12/2023]
Abstract
Early life environment can affect asthma and allergies but few cohort studies on this issue are available from China. Our aim was to investigate reported onset of childhood wheeze, rhinitis and eczema symptoms in relation to prenatal, perinatal and postnatal home environment. Data on home environment and symptoms (ISAAC based questions) in first two years of life and in the past 12 months were reported by parents of the children (3-6 y) in a cross-sectional questionnaire survey in ten day care centers in Taiyuan, northern China (N = 3606). Changes of symptoms from the first 2 years of life to the past 12 months (recall period) were calculated retrospectively. Multilevel logistic regression analysis was applied. Reported onset of wheeze, rhinitis and eczema were 11.8%, 22.2% and 3.3%, respectively. Redecorating during pregnancy increased reported onset of rhinitis (OR = 2.29) and eczema (OR = 4.91). New furniture during pregnancy increased reported onset of rhinitis (OR = 1.47). Perinatal indoor mould increased reported onset of wheeze (OR = 1.51), rhinitis (OR = 1.65) and eczema (OR = 1.91). Perinatal mould odour increased reported onset of wheeze (OR = 1.85). Perinatal window pane condensation increased reported onset of wheeze (OR = 1.54) and rhinitis (OR = 1.24). Perinatal stuffy air and dry air in the home increased reported onset of all three symptoms (ORs 1.46-2.24). Dog keeping increased reported onset of wheeze (OR = 1.69) and eczema (OR = 2.13). Based on principal component analysis, four exposure scores were calculated (renovation, new furniture, mould and indoor air quality scores). Dose-response relationships were observed between these exposure scores and reported onset of symptoms. In conclusion, prenatal and postnatal exposure to emissions from renovation and new furniture can increase reported onset of childhood wheeze, rhinitis and eczema. Perinatal indoor mould, mould odour, condensation on window panes and impaired indoor air quality at home can be associated with reported development of wheeze, rhinitis and eczema in preschoolers in northern China.
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Affiliation(s)
- Dan Norbäck
- Institute of Environmental Science, Shanxi University, Taiyuan, China; Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
| | - Xin Zhang
- Institute of Environmental Science, Shanxi University, Taiyuan, China.
| | - Li Tian
- Institute of Environmental Science, Shanxi University, Taiyuan, China
| | - Yifei Zhang
- Institute of Environmental Science, Shanxi University, Taiyuan, China
| | - Zefei Zhang
- Institute of Environmental Science, Shanxi University, Taiyuan, China
| | - Liu Yang
- Institute of Environmental Science, Shanxi University, Taiyuan, China
| | - Xingyi Chen
- Institute of Environmental Science, Shanxi University, Taiyuan, China
| | - Zhaohua Zeng
- School of Public Health, Xiamen University, Xiamen, China
| | - Chan Lu
- XiangYa School of Public Health, Central South University, Changsha, China
| | - Zhuohui Zhao
- School of Public Health, Fudan University, Shanghai, China
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Codina R, Esch RE, Lockey RF. The Clinical Relevance of Pollen Versus Fungal Spores in Allergic Diseases. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:3615-3620. [PMID: 34146748 DOI: 10.1016/j.jaip.2021.06.004] [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: 04/03/2021] [Revised: 05/10/2021] [Accepted: 06/08/2021] [Indexed: 11/17/2022]
Abstract
Pollen and fungal spores are associated with seasonal and perennial allergies. However, most scientific literature thus far suggests that pollen allergy is more clinically relevant than fungal allergy. Several environmental and biological factors and the difficulty in producing reliable fungal extracts account for this. Biodiversity, taxonomy, and meteorology are responsible for the types and levels of pollen and fungal spores, their fragments, and the presence of free airborne allergens. Therefore, it is difficult to accurately measure both pollen and fungal allergen exposure. In addition, understanding the enzymatic nature of fungal and some pollen allergens, the presence of allergenic and nonallergenic substances that may modulate the allergic immune response, and allergen cross-reactivity are all necessary to appropriately evaluate both sensitivity and exposure. The raw materials and manufacturing processes used to prepare pollen versus fungal extracts differ, further increasing the complexity to properly determine allergic sensitivity and degrees of exposure. The pollen extracts used for diagnosis and treatment are relatively consistent, and some have been standardized. However, obtaining clinically relevant fungal extracts is more difficult. Doing so will allow for the proper selection of such extracts to more appropriately diagnose and treat both pollen- and fungal-induced allergic diseases.
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Affiliation(s)
- Rosa Codina
- Allergen Science & Consulting, Lenoir, NC; Division of Allergy and Immunology, Department of Internal Medicine, Morsani College of Medicine, University of south Florida, Tampa, Fla.
| | - Robert E Esch
- School of Natural Sciences, Lenoir-Rhyne University, Hickory, NC
| | - Richard F Lockey
- Division of Allergy and Immunology, Department of Internal Medicine, Morsani College of Medicine, University of south Florida, Tampa, Fla
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Van Mason J, Portnoy JM. Immunologic Strategies for Prevention of Asthma. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 8:834-847. [PMID: 32147137 DOI: 10.1016/j.jaip.2019.11.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 11/25/2019] [Accepted: 11/26/2019] [Indexed: 12/16/2022]
Abstract
A new understanding of factors leading to the development of asthma has pointed to potential primary, secondary, and tertiary prevention strategies. Some, such as genetic makeup, are not yet modifiable. Interventions targeting other factors such as maternal intake of vitamin D or environmental control can be used to decrease the risk of asthma development (primary prevention). The benefits of a diversified microbiome could be considered when recommending allergen avoidance and pet ownership. In addition to reducing symptoms, allergen immunotherapy is also worth considering for prevention of new sensitivities (secondary prevention) in addition to the development of asthma. Ongoing studies involving the use of bacterial vaccines and biologics may provide additional strategies for primary prevention of asthma and for reducing symptoms once it has developed (tertiary prevention). As the relative benefits of these strategies are defined, they should have an increasingly important place in the prevention and management of asthma.
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Affiliation(s)
- Jessica Van Mason
- Section of Allergy, Asthma & Immunology, Children's Mercy Hospital, Kansas City, Mo
| | - Jay M Portnoy
- Section of Allergy, Asthma & Immunology, Children's Mercy Hospital, Kansas City, Mo.
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Baeza F, Vives Vergara A, González F, Orlando L, Valdebenito R, Cortinez-O’Ryan A, Slesinski C, Diez Roux AV. The Regeneración Urbana, Calidad de Vida y Salud - RUCAS project: a Chilean multi-methods study to evaluate the impact of urban regeneration on resident health and wellbeing. BMC Public Health 2021; 21:728. [PMID: 33858373 PMCID: PMC8047526 DOI: 10.1186/s12889-021-10739-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 03/30/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The available evidence of the health effects of urban regeneration is scarce In Latin America, and there are no studies focused on formal housing that longitudinally evaluate the impact of housing and neighborhood interventions on health. The "Regeneración Urbana, Calidad de Vida y Salud" (Urban Regeneration, Quality of Life, and Health) or RUCAS project is a longitudinal, multi-method study that will evaluate the impact of an intervention focused on dwellings, built environment and community on the health and wellbeing of the population in two social housing neighborhoods in Chile. METHODS RUCAS consists of a longitudinal study where inhabitants exposed and unexposed to the intervention will be compared over time within the study neighborhoods (cohorts), capitalizing on interventions as a natural experiment. Researchers have developed a specific conceptual framework and identified potential causal mechanisms. Proximal and more distal intervention effects will be measured with five instruments, implemented pre- and post-interventions between 2018 and 2021: a household survey, an observation tool to evaluate dwelling conditions, hygrochrons for measuring temperature and humidity inside dwellings, systematic observation of recreational areas, and qualitative interviews. Survey baseline data (956 households, 3130 individuals) is presented to describe sociodemographics, housing and health characteristics of both cohorts, noting that neighborhoods studied show worse conditions than the Chilean population. DISCUSSION RUCAS' design allows for a comprehensive evaluation of the effects that the intervention could have on various dimensions of health and health determinants. RUCAS will face some challenges, like changes in the intervention process due to adjustments of the master plan, exogenous factors -including COVID-19 pandemic and associated lockdowns- and lost to follow-up. Given the stepped wedge design, that the study capitalizes on within household changes over time, the possibility of adjusting data collection process and complementarity of methods, RUCAS has the flexibility to adapt to these circumstances. Also, RUCAS' outreach and retention strategy has led to high retention rates. RUCAS will provide evidence to inform regeneration processes, highlighting the need to consider potential health effects of regeneration in designing such interventions and, more broadly, health as a key priority in urban and housing policies.
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Affiliation(s)
- Fernando Baeza
- Department of Public Health, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 8330077 Santiago, Chile
- Institute of Geography, Pontificia Universidad Católica de Chile, Vicuña Mackenna 4860, 7820436 Santiago, Chile
| | - Alejandra Vives Vergara
- Department of Public Health, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 8330077 Santiago, Chile
- Centre for Sustainable Urban Development (CEDEUS), Los Navegantes 1963, 7520246 Santiago, Chile
| | - Francisca González
- Department of Public Health, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 8330077 Santiago, Chile
| | - Laura Orlando
- Department of Public Health, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 8330077 Santiago, Chile
| | - Roxana Valdebenito
- Department of Public Health, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 8330077 Santiago, Chile
| | - Andrea Cortinez-O’Ryan
- Department of Public Health, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 8330077 Santiago, Chile
- Department of Physical Education, Sports and Recreation, Universidad de La Frontera, Moneda 673, 8320216 Santiago, Chile
| | - Claire Slesinski
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3215 Market St, Philadelphia, PA 19104 USA
| | - Ana V. Diez Roux
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3215 Market St, Philadelphia, PA 19104 USA
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Xiao S, Ngo AL, Mendola P, Bates MN, Barcellos AL, Ferrara A, Zhu Y. Household mold, pesticide use, and childhood asthma: A nationwide study in the U.S. Int J Hyg Environ Health 2021; 233:113694. [PMID: 33556714 DOI: 10.1016/j.ijheh.2021.113694] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 01/13/2021] [Accepted: 01/22/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To investigate the associations of household mold and pesticide use with risk of childhood asthma and examine the potential effect modification by child's sex at a national level in the U.S. METHODS Nationally representative data were drawn from the cross-sectional 2017 and 2018 National Surveys of Children's Health. Household mold and pesticide exposures during the past 12 months and physician-diagnosed childhood asthma were assessed by standard questionnaires administered to primary caregivers. Multivariable logistic regression models were used to calculate adjusted odds ratios (aOR) for current asthma, adjusting for child, caregiver, and household covariates. We also examined potential effect modification by child's sex. Sampling weights accounted for the complex survey design. RESULTS Among 41,423 U.S. children in 2017-2018, the weighted prevalence of current asthma was 10.8% in household mold-exposed children, compared with 7.2% in non-exposed children (P < 0.001). After adjusting for covariates including child's obesity, children with household mold exposure compared to those with no household mold exposure had a 1.41-fold (95% CI: 1.07, 1.87) higher odds of current asthma. Associations between household mold and current asthma were pronounced among boys (aOR 1.57; 95% CI: 1.03-2.38) but not girls (aOR 1.28; 0.90-1.83; P for interaction <0.001). No significant associations were observed between household pesticide use and current asthma, after adjusting for covariates. CONCLUSIONS Our findings suggest that household mold is associated with current asthma among children, independent of other major risk factors including child's obesity status. Our findings may inform strategies targeting mitigation of household mold as an important indoor environment factor to address childhood asthma.
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Affiliation(s)
- Siyuan Xiao
- School of Public Health, University of California, Berkeley, United States
| | - Amanda L Ngo
- Kaiser Permanente Northern California Division of Research, Oakland, CA, United States
| | - Pauline Mendola
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States
| | - Michael N Bates
- School of Public Health, University of California, Berkeley, United States
| | - Anna L Barcellos
- School of Public Health, University of California, Berkeley, United States
| | - Assiamira Ferrara
- Kaiser Permanente Northern California Division of Research, Oakland, CA, United States
| | - Yeyi Zhu
- Kaiser Permanente Northern California Division of Research, Oakland, CA, United States; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, United States.
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Sinha IP, Brown L, Fulton O, Gait L, Grime C, Hepworth C, Lilley A, Murray M, Simba J. Empowering children and young people who have asthma. Arch Dis Child 2021; 106:125-129. [PMID: 32709687 DOI: 10.1136/archdischild-2020-318788] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 05/16/2020] [Accepted: 06/30/2020] [Indexed: 12/18/2022]
Abstract
Asthma is the most common chronic condition of childhood. In this review, we discuss an overview of strategies to empower children and young people with asthma. The key aspects of empowerment are to enable shared decision making and self-management, and help children minimise the impact of asthma on their life. The evidence behind these strategies is either sparse or heterogenous, and it is difficult to identify which interventions are most likely to improve clinical outcomes. Wider determinants of health, in high-resource and low-resource settings, can be disempowering for children with asthma. New approaches to technology could help empower young people with asthma and other chronic health conditions.
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Affiliation(s)
- Ian P Sinha
- Alder Hey Children's NHS Foundation Trust, Liverpool, UK .,Division of Child Health, University of Liverpool, Liverpool, UK
| | - Lynsey Brown
- Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Olivia Fulton
- Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Lucy Gait
- Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | | | | | - Andrew Lilley
- Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Morgan Murray
- Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Justus Simba
- Alder Hey Children's NHS Foundation Trust, Liverpool, UK.,Child Health and Paediatrics, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
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Shinohara N, Woo C, Yamamoto N, Hashimoto K, Yoshida-Ohuchi H, Kawakami Y. Comparison of DNA sequencing and morphological identification techniques to characterize environmental fungal communities. Sci Rep 2021; 11:2633. [PMID: 33514828 PMCID: PMC7846767 DOI: 10.1038/s41598-021-81996-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 01/11/2021] [Indexed: 11/09/2022] Open
Abstract
Culture-independent DNA sequencing of fungal internal transcribed spacer 2 (ITS2) region was compared to a culture-dependent morphological identification technique to characterize house dust-borne fungal communities. The abundant genera were Aspergillus, Wallemia, Cladosporium, and Penicillium. Statistically significant between-method correlations were observed for Wallemia and Cladosporium (Spearman's ρ = 0.75 and 0.72, respectively; p < 0.001). Penicillium tended to be detected with much higher (averaged 26-times) relative abundances by the culture-based method than by the DNA-based method, although statistically significant inter-method correlation was observed with Spearman's ρ = 0.61 (p = 0.002). Large DNA sequencing-based relative abundances observed for Alternaria and Aureobasidium were likely due to multicellularity of their spores with large number of per-spore ITS2 copies. The failure of the culture-based method in detectiing Toxicocladosporium, Verrucocladosporium, and Sterigmatomyces was likely due to their fastidiousness growth on our nutrient medium. Comparing between the two different techniques clarified the causes of biases in identifying environmental fungal communities, which should be amended and/or taken into consideration when the methods are used for future fungal ecological studies.
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Affiliation(s)
- Naohide Shinohara
- Research Institute of Science for Safety and Sustainability (RISS), National Institute of Advanced Industrial Science and Technology (AIST), 16-1 Onogawa, Tsukuba, Ibaraki, 305-8569, Japan.
| | - Cheolwoon Woo
- Department of Environmental Health Sciences, 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
| | - Kazuhiro Hashimoto
- Laboratory of Integrated Pest Management, FCG Research Institute Inc., 1-1-20Koto-ku, Aomi, 135-0064, Japan
| | - Hiroko Yoshida-Ohuchi
- Graduate School of Pharmaceutical Sciences, Tohoku University, 6-3 Aramaki-Aoba, Aoba-ku, Sendai, Miyagi, 980-8578, Japan
| | - Yuji Kawakami
- Laboratory of Integrated Pest Management, FCG Research Institute Inc., 1-1-20Koto-ku, Aomi, 135-0064, Japan
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Norbäck D, Wang J. Household air pollution and adult respiratory health. Eur Respir J 2021; 57:57/1/2003520. [PMID: 33446579 DOI: 10.1183/13993003.03520-2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 10/11/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Dan Norbäck
- Dept of Medical Science, Occupational and Environmental Medicine, Uppsala University and Uppsala University Hospital, Uppsala, Sweden
| | - Juan Wang
- Dept of Medical Science, Occupational and Environmental Medicine, Uppsala University and Uppsala University Hospital, Uppsala, Sweden
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