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Li W, Long C, Fan T, Anneser E, Chien J, Goodman JE. Gas cooking and respiratory outcomes in children: A systematic review. GLOBAL EPIDEMIOLOGY 2023; 5:100107. [PMID: 37638371 PMCID: PMC10446006 DOI: 10.1016/j.gloepi.2023.100107] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 08/29/2023] Open
Abstract
The most recent meta-analysis of gas cooking and respiratory outcomes in children was conducted by Lin et al. [93] in 2013. Since then, a number of epidemiology studies have been published on this topic. We conducted the first systematic review of this epidemiology literature that includes an in-depth evaluation of study heterogeneity and study quality, neither of which was systematically evaluated in earlier reviews. We reviewed a total of 66 relevant studies, including those in the Lin et al. [93] meta-analysis. Most of the studies are cross-sectional by design, precluding causal inference. Only a few are cohort studies that could establish temporality and they have largely reported null results. There is large variability across studies in terms of study region, age of children, gas cooking exposure definition, and asthma or wheeze outcome definition, precluding clear interpretations of meta-analysis estimates such as those reported in Lin et al. [93]. Further, our systematic study quality evaluation reveals that a large proportion of the studies to date are subject to multiple sources of bias and inaccuracy, primarily due to self-reported gas cooking exposure or respiratory outcomes, insufficient adjustment for key confounders (e.g., environmental tobacco smoke, family history of asthma or allergies, socioeconomic status or home environment), and unestablished temporality. We conclude that the epidemiology literature is limited by high heterogeneity and low study quality and, therefore, it does not provide sufficient evidence regarding causal relationships between gas cooking or indoor NO2 and asthma or wheeze. We caution against over-interpreting the quantitative evidence synthesis estimates from meta-analyses of these studies.
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Affiliation(s)
- Wenchao Li
- Gradient, One Beacon St., 17 Floor, Boston, MA 02108, United States of America
| | - Christopher Long
- Gradient, One Beacon St., 17 Floor, Boston, MA 02108, United States of America
| | - Tongyao Fan
- Penn State College of Medicine, Department of Pharmacology, 500 University Drive, Hershey, PA 17033, United States of America
| | - Elyssa Anneser
- Gradient, One Beacon St., 17 Floor, Boston, MA 02108, United States of America
| | - Jiayang Chien
- Gradient, One Beacon St., 17 Floor, Boston, MA 02108, United States of America
| | - Julie E. Goodman
- Gradient, One Beacon St., 17 Floor, Boston, MA 02108, United States of America
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Cao C, Wang Y, Peng L, Wu W, Yang H, Li Z. Asthma and Other Respiratory Diseases of Children in Relation to Personal Behavior, Household, Parental and Environmental Factors in West China. TOXICS 2023; 11:964. [PMID: 38133365 PMCID: PMC10747494 DOI: 10.3390/toxics11120964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 11/23/2023] [Accepted: 11/24/2023] [Indexed: 12/23/2023]
Abstract
Asthma and other respiratory diseases, which are of great concern in public health, are paid less attention in areas that are less economically developed. This research aimed to study the prevalence of critical respiratory diseases of children living in West China and figure out the potential influencing factors. A total of 575 children under the age of 14 were recruited from Xinjiang, China, to participate in the study in 2022. Information on activity patterns, socioeconomic and parental factors, and household and surrounding environment situations was obtained using a questionnaire survey. Logistic regression models were applied to estimate the odds ratios of respiratory disease prevalence in relation to behavior patterns, household, parental and environmental factors, respectively. The prevalence of ever doctor-diagnosed asthma, doctor-diagnosed bronchitis and current bronchitis were 4.7%, 19.0% and 14.4%, respectively. The prevalence of doctor-diagnosed pneumonia was 8.2%, which was two times higher in urban than rural areas. Longer annual heating duration was significantly associated with higher risks in children's asthma and bronchitis, with an odds ratio (OR) and 95% confidence interval (95% CI) of 3.363 (95% CI: 1.215-9.298) and 1.267 (95% CI: 1.002-1.601), respectively. Opening the window longer in autumn would lead to higher risks of bronchitis, with ORs of 1.165 and 1.133, respectively, for doctor-diagnosed bronchitis and current bronchitis. Residential air pollution and having a residence close to waste incineration plant or garbage station were, respectively, significantly associated with higher risks of doctor-diagnosed bronchitis and asthma. Parental disease history was associated with a higher prevalence of children's asthma and respiratory diseases, whereas breastfeeding and doing physical exercise were, respectively, significantly associated with a lower risk of asthma. A high prevalence of respiratory diseases in children in West China may be partly attributed to longer annual heating time, opening windows longer in autumn, surrounding environmental pollution, as well as parental disease history, whereas promoting physical activity and breastfeeding could be an effective measure to reduce the risk of childhood asthma in West China.
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Affiliation(s)
- Changan Cao
- School of Medicine, Xiamen University, Xiamen 361104, China;
| | - Yuna Wang
- School of Chemical and Environmental Sciences, YiLi Normal University, Yining 835000, China; (Y.W.)
| | - Li Peng
- School of Energy and Environmental Engineering, University of Science of Technology Beijing, Beijing 10083, China;
| | - Weiqi Wu
- Department of Geography, University College London, London WC1E 6BT, UK;
| | - Huimin Yang
- School of Chemical and Environmental Sciences, YiLi Normal University, Yining 835000, China; (Y.W.)
| | - Zhigang Li
- Chinese Research Academy of Environmental Sciences, Beijing 100012, China
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Mai D, Xu C, Lin W, Yue D, Fu S, Lin J, Yuan L, Zhao Y, Zhai Y, Mai H, Zeng X, Jiang T, Li X, Dai J, You B, Xiao Q, Wei Q, Hu Q. Association of abnormal-glucose tolerance during pregnancy with exposure to PM 2.5 components and sources. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 292:118468. [PMID: 34748887 DOI: 10.1016/j.envpol.2021.118468] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 10/15/2021] [Accepted: 11/03/2021] [Indexed: 06/13/2023]
Abstract
Maternal exposure to PM2.5 has been associated with abnormal glucose tolerance during pregnancy, but little is known about which constituents and sources are most relevant to glycemic effects. We conducted a retrospective cohort study of 1148 pregnant women to investigate associations of PM2.5 chemical components with gestational diabetes mellitus (GDM) and impaired glucose tolerance (IGT) and to identify the most harmful sources in Heshan, China from January 2015 to July 2016. We measured PM2.5 using filter-based method and analyzed them for 28 constituents, including carbonaceous species, water-soluble ions and metal elements. Contributions of PM2.5 sources were assessed by positive matrix factorization (PMF). Logistic regression model was used to estimate composition-specific and source-specific effects on GDM/IGT. Random forest algorithm was applied to evaluate the relative importance of components to GDM and IGT. PM2.5 total mass and several chemical constituents were associated with GDM and IGT across the early to mid-gestation periods, as were the PM2.5 sources fossil fuel/oil combustion, road dust, metal smelting, construction dust, electronic waster, vehicular emissions and industrial emissions. The trimester-specific associations differed among pollutants and sources. The third and highest quartile of elemental carbon, ammonium (NH4+), iron (Fe) and manganese (Mn) across gestation were consistently associated with higher odds of GDM/IGT. Maternal exposures to zinc (Zn), titanium (Ti) and vehicular emissions during the first trimester, and vanadium (V), nickel (Ni), road dust and fossil fuel/oil combustion during the second trimester were more important for GDM/IGT. This study provides important new evidence that maternal exposure to PM2.5 components and sources is significantly related to elevated risk for abnormal glucose tolerance during pregnancy.
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Affiliation(s)
- Dejian Mai
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Chengfang Xu
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510630, Guangdong, China
| | - Weiwei Lin
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China.
| | - Dingli Yue
- Guangdong Environmental Monitoring Center, State Environmental Protection Key Laboratory of Regional Air Quality Monitoring, Guangzhou, 510308, China
| | - Shaojie Fu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Jianqing Lin
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Luan Yuan
- Guangdong Environmental Monitoring Center, State Environmental Protection Key Laboratory of Regional Air Quality Monitoring, Guangzhou, 510308, China
| | - Yan Zhao
- Guangdong Environmental Monitoring Center, State Environmental Protection Key Laboratory of Regional Air Quality Monitoring, Guangzhou, 510308, China
| | - Yuhong Zhai
- Guangdong Environmental Monitoring Center, State Environmental Protection Key Laboratory of Regional Air Quality Monitoring, Guangzhou, 510308, China
| | - Huiying Mai
- Department of Obstetrics and Gynecology, Heshan Maternal and Child Health Hospital, Heshan, 529700, Jiangmen, Guangdong, China
| | - Xiaoling Zeng
- Department of Obstetrics and Gynecology, Heshan Maternal and Child Health Hospital, Heshan, 529700, Jiangmen, Guangdong, China
| | - Tingwu Jiang
- Department of Clinical Laboratory, Heshan Maternal and Child Health Hospital, Heshan, 529700, Jiangmen, Guangdong, China
| | - Xuejiao Li
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510630, Guangdong, China
| | - Jiajia Dai
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Boning You
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Qin Xiao
- Experimental Teaching Center, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Qing Wei
- Experimental Teaching Center, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Qiansheng Hu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
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Cao S, Wen D, Li S, Guo Q, Duan X, Gong J, Xu X, Meng X, Qin N, Wang B, Zhang JJ. Changes in children's lung function over two decades in relation to socioeconomic, parental and household factors in Wuhan, China. J Thorac Dis 2021; 13:4601-4613. [PMID: 34422385 PMCID: PMC8339758 DOI: 10.21037/jtd-21-158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 06/03/2021] [Indexed: 11/06/2022]
Abstract
Background It is important to identify risk and beneficial factors for children's lung function. This study aims to ascertain potential changes in children's lung function in relation to changes in socioeconomic, parental and household factors, based on a comparison between two periods spanning 25 years in Wuhan, the largest metropolis in central China. Methods In two cross-sectional studies, lung function measurements and questionnaire surveys were conducted on school-age children in 1993-1996 (Period I) and in 2018 (Period II). Children of 6-12 years old from elementary schools were selected by a multistage sampling method. Demographic information, socioeconomic status, feeding methods, parental illness and behavior patterns, as well as household characteristics, were collected through a questionnaire survey. Spirometric lung function was measured, including forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), forced expiratory flow at 25% and 75% of the pulmonary volume (FEF25-75), and peak expiratory flow (PEF). Wilcoxon analysis of variances was used to assess the differences in lung function indexes between Period I and Period II. Multiple linear regression models were used to estimate the association of lung function with regard to socioeconomic, parental and household factors, respectively. Results Significant prevalence reductions were observed for household coal use, paternal smoking and maternal asthma, while the prevalence increased significantly for children sleeping in their own rooms or own beds and breastfeeding, ventilation use during cooking, and parental education level from Period I to Period II. When adjusted for age, height, weight, sex and other factors assessed in the study, children had significant lower values of FVC, FEV1, and PEF in Period II than in Period I. Enclosed kitchen was significantly associated with lower lung function in children in Period I. Urban living condition and higher maternal education level were each associated with a higher FVC, while father having no fixed income was associated with a lower FVC and a lower FEV1, respectively, in Period II. In comparison with Period I, the beneficial impact of urban living and that of breastfeeding were enhanced and the detrimental effect of poor household condition was weakened in Period II. Conclusions Lung function was lower in 2018 than in 1993-1996 in school-age children living in Wuhan. Although improvements in urban living and household environmental conditions as well as increased breastfeeding in Period II could have contributed to increased lung function, other unmeasured risk factors may have played a more dominant role in leading to a net decrease in lung function from Period I to Period II. Future studies are needed to identify these risk factors.
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Affiliation(s)
- Suzhen Cao
- Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Dongsen Wen
- Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Sai Li
- Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Qian Guo
- Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Xiaoli Duan
- Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Jicheng Gong
- Beijing Innovation Center for Engineering Science and Advanced Technology, State Key Joint Laboratory for Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, And Center for Environment and Health, Peking University, Beijing, China
| | - Xiangyu Xu
- Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Xin Meng
- Beijing Innovation Center for Engineering Science and Advanced Technology, State Key Joint Laboratory for Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, And Center for Environment and Health, Peking University, Beijing, China
| | - Ning Qin
- Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Beibei Wang
- Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Junfeng Jim Zhang
- Nicholas School of the Environment and Duke Global Health Institute, Duke University, Durham, USA.,Global Health Research Center, Duke Kunshan University, Kunshan, China.,Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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