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Xing Y, Wang MH, Leung TF, Wong CK, Roponen M, Schaub B, Li J, Wong GWK. Poultry exposure and environmental protection against asthma in rural children. Allergy 2022; 77:2949-2960. [PMID: 35531632 DOI: 10.1111/all.15365] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 03/17/2022] [Accepted: 04/02/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Asthma is one of the most common chronic diseases in childhood, and the prevalence has been increasing over the past few decades. One of the most consistent epidemiological findings is that children living in a farming or rural environment are protected from development of asthma and allergies, but the protective factors in rural China are not clear. METHODS A community-based, cross-sectional epidemiological study was performed in a total of 17,587 children aged 5-8 years, 3435 from Hong Kong (urban) and 14,152 from Conghua (rural county in southern China). Asthma and allergic symptoms as well as environmental exposures were ascertained by using a standardized and validated questionnaire. RESULTS The prevalence of current wheeze was significantly lower in rural Conghua than that of urban Hong Kong (1.7% vs. 7.7%, p < 0.001). A lower rate of asthma ever was also reported in rural children compared with their urban counterparts (2.5% vs. 5.3%, p < 0.001). After adjusting for confounding factors, exposure to agricultural farming (adjusted odds ratio 0.74, 95% confidence interval: 0.56-0.97) and poultry (0.75, 0.59-0.96) were the most important factors associated with the asthma-protective effect in the rural area. Further propensity score-adjusted analysis indicated that such protection conferred by living in the rural environment was mainly attributable to poultry exposure. CONCLUSIONS We confirmed that the prevalence of asthma and atopic disorders was significantly lower in rural children when compared with their urban peers. Exposure to poultry and agricultural farming are the most important factors associated with asthma protection in the rural area.
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Affiliation(s)
- Yuhan Xing
- Department of Paediatrics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Maggie H Wang
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
| | - Ting-Fan Leung
- Department of Paediatrics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Chun-Kwok Wong
- Department of Chemical Pathology, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Marjut Roponen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Bianca Schaub
- Pediatric Allergology, Department of Pediatrics, Dr von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany
| | - Jing Li
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Gary W K Wong
- Department of Paediatrics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
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Shahunja KM, Sly PD, Begum T, Biswas T, Mamun A. Family, neighborhood and psychosocial environmental factors and their associations with asthma in Australia: a systematic review and Meta-analysis. J Asthma 2021; 59:2539-2552. [PMID: 34905415 DOI: 10.1080/02770903.2021.2018707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Various associations between different environmental exposures and asthma have been reported in different countries and populations. We aimed to investigate the associations between family, neighborhood and psychosocial environmental factors and asthma-symptoms in Australia by conducting a systematic review and meta-analysis. DATA SOURCES We analyzed the primary research studies conducted in Australia across multiple databases, including PubMed, EMBASE and Scopus, published between 2000 and 2020. STUDY SELECTIONS The reviews and analyses focused on the overall association of different environmental exposures with the exacerbation of asthma-symptoms or asthma-related hospital visits. Quality-effect meta-analysis was done to estimate the pooled odds ratio for different environmental exposures for asthma-symptoms. RESULTS Among the 4799 unique published articles found, 46 were included here for systematic review and 28 for meta-analysis. Our review found that psychosocial factors, including low socioeconomic condition, maternal depression, mental stress, ethnicity, and discrimination, are associated with asthma-symptoms. Pooled analysis was conducted on family and neighborhood environmental factors and revealed that environmental tobacco smoking (ETS) (OR 1·69, 95% CI 1·19-2·38), synthetic bedding (OR 1·91, 95% CI 1·48-2·47) and gas heaters (OR 1·40, 95% CI 1·12-1·76) had significant overall associations with asthma-symptoms in Australia. CONCLUSION Although the studies were heterogeneous, both systematic review and meta-analysis found several psychosocial and family environmental exposures significantly associated with asthma-symptoms. Further study to identify their causal relationship and modification may reduce asthma-symptoms in the Australian population.
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Affiliation(s)
- K M Shahunja
- Institute for Social Science Research, The University of Queensland, Brisbane, Australia.,ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Australia.,The Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Brisbane, Australia
| | - Peter D Sly
- Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Tahmina Begum
- Institute for Social Science Research, The University of Queensland, Brisbane, Australia.,ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Australia
| | - Tuhin Biswas
- Institute for Social Science Research, The University of Queensland, Brisbane, Australia.,ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Australia
| | - Abdullah Mamun
- Institute for Social Science Research, The University of Queensland, Brisbane, Australia.,ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Australia.,The Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Brisbane, Australia
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Ponsonby AL. Reflection on modern methods: building causal evidence within high-dimensional molecular epidemiological studies of moderate size. Int J Epidemiol 2021; 50:1016-1029. [PMID: 33594409 DOI: 10.1093/ije/dyaa174] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2020] [Indexed: 12/29/2022] Open
Abstract
This commentary provides a practical perspective on epidemiological analysis within a single high-dimensional study of moderate size to consider a causal question. In this setting, non-causal confounding is important. This occurs when a factor is a determinant of outcome and the underlying association between exposure and the factor is non-causal. That is, the association arises due to chance, confounding or other bias rather than reflecting that exposure and the factor are causally related. In particular, the influence of technical processing factors must be accounted for by pre-processing measures to remove artefact or to control for these factors such as batch run. Work steps include the evaluation of alternative non-causal explanations for observed exposure-disease associations and strategies to obtain the highest level of causal inference possible within the study. A systematic approach is required to work through a question set and obtain insights on not only the exposure-disease association but also the multifactorial causal structure of the underlying data where possible. The appropriate inclusion of molecular findings will enhance the quest to better understand multifactorial disease causation in modern observational epidemiological studies.
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Borg D, Rae K, Fiveash C, Schagen J, James-McAlpine J, Friedlander F, Thurston C, Oliveri M, Harmey T, Cavanagh E, Edwards C, Fontanarosa D, Perkins T, de Zubicaray G, Moritz K, Kumar S, Clifton V. Queensland Family Cohort: a study protocol. BMJ Open 2021; 11:e044463. [PMID: 34168023 PMCID: PMC8231060 DOI: 10.1136/bmjopen-2020-044463] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION The perinatal-postnatal family environment is associated with childhood outcomes including impacts on physical and mental health and educational attainment. Family longitudinal cohort studies collect in-depth data that can capture the influence of an era on family lifestyle, mental health, chronic disease, education and financial stability to enable identification of gaps in society and provide the evidence for changes in government in policy and practice. METHODS AND ANALYSIS The Queensland Family Cohort (QFC) is a prospective, observational, longitudinal study that will recruit 12 500 pregnant families across the state of Queensland (QLD), Australia and intends to follow-up families and children for three decades. To identify the immediate and future health requirements of the QLD population; pregnant participants and their partners will be enrolled by 24 weeks of gestation and followed up at 24, 28 and 36 weeks of gestation, during delivery, on-ward, 6 weeks postpartum and then every 12 months where questionnaires, biological samples and physical measures will be collected from parents and children. To examine the impact of environmental exposures on families, data related to environmental pollution, household pollution and employment exposures will be linked to pregnancy and health outcomes. Where feasible, data linkage of state and federal government databases will be used to follow the participants long term. Biological samples will be stored long term for future discoveries of biomarkers of health and disease. ETHICS AND DISSEMINATION Ethical approval has been obtained from the Mater Research Ethics (HREC/16/MHS/113). Findings will be reported to (1) QFC participating families; (2) funding bodies, institutes and hospitals supporting the QFC; (3) federal, state and local governments to inform policy; (4) presented at local, national and international conferences and (5) disseminated by peer-review publications.
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Affiliation(s)
- Danielle Borg
- Mother and Baby, Mater Medical Research Institute, South Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Kym Rae
- Mother and Baby, Mater Medical Research Institute, South Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Corrine Fiveash
- Gallipoli Medical Research Foundation, Greenslopes, Queensland, Australia
| | - Johanna Schagen
- Mother and Baby, Mater Medical Research Institute, South Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Janelle James-McAlpine
- Mother and Baby, Mater Medical Research Institute, South Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Frances Friedlander
- Maternity Unit, Greenslopes Private Hospital, Greenslopes, Queensland, Australia
| | - Claire Thurston
- Mother and Baby, Mater Medical Research Institute, South Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Maria Oliveri
- Mother and Baby, Mater Medical Research Institute, South Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Theresa Harmey
- Mother and Baby, Mater Medical Research Institute, South Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Erika Cavanagh
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
- Centre for Maternal Fetal Medicine, Mater Hospital Brisbane, Brisbane, Queensland, Australia
- Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Christopher Edwards
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
- Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Davide Fontanarosa
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
- Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Tony Perkins
- School of Medical Science, Griffith University - Gold Coast Campus, Southport, Queensland, Australia
| | - Greig de Zubicaray
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
- Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Karen Moritz
- Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
- The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia
| | - Sailesh Kumar
- Mother and Baby, Mater Medical Research Institute, South Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Vicki Clifton
- Mother and Baby, Mater Medical Research Institute, South Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
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Pulmonary Health Effects of Indoor Volatile Organic Compounds-A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041578. [PMID: 33562372 PMCID: PMC7914726 DOI: 10.3390/ijerph18041578] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 12/26/2022]
Abstract
Volatile organic compounds (VOCs) are commonly found in consumer products, including furniture, sealants and paints. Thus, indoor VOCs have become a public health concern, especially in high-income countries (HICs), where people spend most of their time indoors, and indoor and outdoor air exchange is minimal due to a lack of ventilation. VOCs produce high levels of reaction with the airway epithelium and mucosa membrane and is linked with pulmonary diseases. This paper takes a stock of the literature to assess the strength of association (measured by effect size) between VOCs and pulmonary diseases with the focus on asthma and its related symptoms by conducting a meta-analysis. The literature was searched using the PubMed database. A total of 49 studies that measured VOCs or VOC types and pulmonary health outcomes were included in the analysis. The results of these studies were tabulated, and standard effect size of each study was computed. Most studies were conducted in high-income countries, including France (n = 7), Japan (n = 7) and the United States (n = 6). Our analysis suggests that VOCs have a medium-sized effect on pulmonary diseases, including the onset of asthma (effect size (or Cohen's d) ~0.37; 95% confidence interval (CI) = 0.25-0.49; n = 23) and wheezing (effective size ~0.26; 95% CI = 0.10-0.42; n = 10). The effect size also varied by country, age and disease type. Multiple stakeholders must be engaged in strategies to mitigate and manage VOC exposure and its associated pulmonary disease burden.
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Dick S, Friend A, Dynes K, AlKandari F, Doust E, Cowie H, Ayres JG, Turner SW. A systematic review of associations between environmental exposures and development of asthma in children aged up to 9 years. BMJ Open 2014; 4:e006554. [PMID: 25421340 PMCID: PMC4244417 DOI: 10.1136/bmjopen-2014-006554] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Childhood asthma is a complex condition where many environmental factors are implicated in causation. The aim of this study was to complete a systematic review of the literature describing associations between environmental exposures and the development of asthma in young children. SETTING A systematic review of the literature up to November 2013 was conducted using key words agreed by the research team. Abstracts were screened and potentially eligible papers reviewed. Papers describing associations between exposures and exacerbation of pre-existing asthma were not included. Papers were placed into the following predefined categories: secondhand smoke (SHS), inhaled chemicals, damp housing/mould, inhaled allergens, air pollution, domestic combustion, dietary exposures, respiratory virus infection and medications. PARTICIPANTS Children aged up to 9 years. PRIMARY OUTCOMES Diagnosed asthma and wheeze. RESULTS 14,691 abstracts were identified, 207 papers reviewed and 135 included in the present review of which 15 were systematic reviews, 6 were meta-analyses and 14 were intervention studies. There was consistent evidence linking exposures to SHS, inhaled chemicals, mould, ambient air pollutants, some deficiencies in maternal diet and respiratory viruses to an increased risk for asthma (OR typically increased by 1.5-2.0). There was less consistent evidence linking exposures to pets, breast feeding and infant dietary exposures to asthma risk, and although there were consistent associations between exposures to antibiotics and paracetamol in early life, these associations might reflect reverse causation. There was good evidence that exposures to house dust mites (in isolation) was not associated with asthma risk. Evidence from observational and intervention studies suggest that interactions between exposures were important to asthma causation, where the effect size was typically 1.5-3.0. CONCLUSIONS There are many publications reporting associations between environmental exposures and modest changes in risk for asthma in young children, and this review highlights the complex interactions between exposures that further increase risk.
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Affiliation(s)
- S Dick
- Occupational and Environmental Medicine, University of Aberdeen, Aberdeen, UK
| | - A Friend
- Department of Child Health, University of Aberdeen, Aberdeen, UK
| | - K Dynes
- Department of Child Health, University of Aberdeen, Aberdeen, UK
| | - F AlKandari
- Department of Child Health, University of Aberdeen, Aberdeen, UK
| | - E Doust
- Institute of Occupational Medicine, Edinburgh, UK
| | - H Cowie
- Institute of Occupational Medicine, Edinburgh, UK
| | - J G Ayres
- Occupational and Environmental Medicine, University of Aberdeen, Aberdeen, UK
- Environmental and Respiratory Medicine, University of Birmingham, Birmingham, UK
| | - S W Turner
- Department of Child Health, University of Aberdeen, Aberdeen, UK
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Bajeux E, Cordier S, Garlantézec R, Monfort C, Rouget F, Pelé F. Perinatal exposure to solvents and wheezing, eczema and food allergies at age 2. Occup Environ Med 2014; 71:636-41. [PMID: 24996679 DOI: 10.1136/oemed-2013-102036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES The time from the prenatal period through early childhood is an important window of vulnerability for the developing immune and respiratory systems, both sensitive to environmental chemicals such as solvents. This study sought to examine the effects of solvent exposure during the prenatal and postnatal periods on wheezing, eczema and food allergies in early childhood. METHODS This study, based on the PELAGIE cohort, included 1505 mother-child pairs with measurements of prenatal and postnatal solvent exposures and data on wheezing, eczema or food allergies. The maternal occupation reported at inclusion, in early pregnancy allowed us to define prenatal occupational solvent exposure (by three specific job-exposure matrices). Data on prenatal and postnatal domestic solvent exposure, that is exposure to products that contain solvents, were obtained from self-administered questionnaires, once at inclusion and again when the child was 2 years old. Outcome data was collected at the 2-year follow-up. Associations between exposures and outcomes were estimated by logistic regression models, after adjustment for potential confounders. RESULTS No association was observed between prenatal exposure to solvents and the outcomes studied. Postnatal exposure was associated with an increased risk of wheezing (OR=1.80 (95% CI 1.25 to 2.59)) which persisted after adjustment for prenatal exposure. No significant association was observed with eczema or food allergies. CONCLUSIONS Postnatal exposure to solvent-containing products in the home may increase the risk of wheezing in early childhood. Follow-up studies are needed to determine if the health effects observed at age 2 persist at later ages.
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Affiliation(s)
- Emma Bajeux
- Inserm (Institut National de la Santé et de la Recherche Médicale) UMR 1085, IRSET (Institut de Recherche Santé Environnement & Travail), Université de Rennes 1, Rennes Cedex, France
| | - Sylvaine Cordier
- Inserm (Institut National de la Santé et de la Recherche Médicale) UMR 1085, IRSET (Institut de Recherche Santé Environnement & Travail), Université de Rennes 1, Rennes Cedex, France
| | - Ronan Garlantézec
- Inserm (Institut National de la Santé et de la Recherche Médicale) UMR 1085, IRSET (Institut de Recherche Santé Environnement & Travail), Université de Rennes 1, Rennes Cedex, France Département Santé Environnement Travail et Génie Sanitaire (DSET&GS), Ecole des Hautes Etudes en Santé Publique (EHESP), Rennes, France
| | - Christine Monfort
- Inserm (Institut National de la Santé et de la Recherche Médicale) UMR 1085, IRSET (Institut de Recherche Santé Environnement & Travail), Université de Rennes 1, Rennes Cedex, France
| | - Florence Rouget
- Inserm (Institut National de la Santé et de la Recherche Médicale) UMR 1085, IRSET (Institut de Recherche Santé Environnement & Travail), Université de Rennes 1, Rennes Cedex, France Département de Pédiatrie, Centre Hospitalier Universitaire de Rennes (CHU), Rennes, France
| | - Fabienne Pelé
- Inserm (Institut National de la Santé et de la Recherche Médicale) UMR 1085, IRSET (Institut de Recherche Santé Environnement & Travail), Université de Rennes 1, Rennes Cedex, France Service d'Epidémiologie et de Santé Publique, Centre Hospitalier Universitaire de Rennes (CHU), Rennes, France
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Wang J, Li B, Yu W, Yang Q, Wang H, Huang D, Sundell J, Norbäck D. Rhinitis symptoms and asthma among parents of preschool children in relation to the home environment in Chongqing, China. PLoS One 2014; 9:e94731. [PMID: 24733290 PMCID: PMC3986232 DOI: 10.1371/journal.pone.0094731] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 03/18/2014] [Indexed: 11/18/2022] Open
Abstract
Risk factors for rhinitis and asthma in the home environment were studied by a questionnaire survey. Parents of 4530 1-8 year old children (one parent per child) from randomly selected kindergartens in Chongqing, China participated. 70.4% were females; 47.1% had rhinitis symptoms in the last three months (current rhinitis, CR); 1.6% reported a history of allergic asthma (AA); 2.7% reported a history of allergic rhinitis (AR); 16.4% were current smokers; 50.8% males and 2.4% females were current smokers. Stuffy odor, unpleasant odor, tobacco smoke odor and dry air were associated with CR (adjustment for gender, current smoking and other perceptions of odor or humidity). Associations between home environment and CR, AR, and AA were studied by multiple logistic regression analyses, adjusting for gender, current smoking and other significant home factors. Living near a main road or highway was a risk factor for both CR (OR(95%CI): 1.31(1.13,1.52)) and AR (OR(95%CI): 2.44(1.48,4.03)). Other risk factors for CR included living in rural areas (OR(95%CI): 1.43(1.10,1.85)), new furniture (OR(95%CI): 1.28(1.11,1.49)), water damage (OR(95%CI): 1.68(1.29,2.18)), cockroaches (OR(95%CI): 1.46(1.23,1.73)), and keeping pets (OR(95%CI): 1.24(1.04,1.49)). Other risk factors for AR included redecoration (OR(95%CI): 2.14(1.34,3.41)), mold spots (OR(95%CI): 2.23(1.06,4.68)), window pane condensation (OR(95%CI): 2.04(1.28,3.26)). Water damage was the only home factor associated with AA (2.56(1.34,4.86)). Frequently put bedding to sunshine was protective for CR (OR(95%CI): 0.79(0.68,0.92); cleaning every day was protective for AR (OR(95%CI): 0.40(0.22,0.71)). In conclusion, parents' CR and AR were related to a number of factors of the home environment.
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Affiliation(s)
- Juan Wang
- Department of Medical Sciences, Uppsala University and University Hospital, Uppsala, Sweden
- Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Ministry of Education, Chongqing University, Chongqing, China
| | - Baizhan Li
- Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Ministry of Education, Chongqing University, Chongqing, China
- * E-mail:
| | - Wei Yu
- Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Ministry of Education, Chongqing University, Chongqing, China
| | - Qin Yang
- Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Ministry of Education, Chongqing University, Chongqing, China
| | - Han Wang
- Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Ministry of Education, Chongqing University, Chongqing, China
| | - Duchai Huang
- Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Ministry of Education, Chongqing University, Chongqing, China
| | - Jan Sundell
- Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Ministry of Education, Chongqing University, Chongqing, China
- Department of Building Science, Tsinghua University, Beijing, China
| | - Dan Norbäck
- Department of Medical Sciences, Uppsala University and University Hospital, Uppsala, Sweden
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The influence of home environmental factors and life style on children’s respiratory health in Xi’an. ACTA ACUST UNITED AC 2014. [DOI: 10.1007/s11434-014-0241-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Canova C, Jarvis D, Walker S, Cullinan P. Systematic review of the effects of domestic paints on asthma related symptoms in people with or without asthma. J Asthma 2013; 50:1020-30. [PMID: 23991710 DOI: 10.3109/02770903.2013.834931] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
INTRODUCTION The association of respiratory problems with chemical emissions from common indoor materials has been studied but the specific effect of domestic paint has not been widely investigated. The aim of this review is to provide a comprehensive evaluation of experimental, occupational and epidemiological studies that examine the adverse respiratory effects of exposure to domestic paints. METHODS A literature search of PubMed together with consultation with an expert resulted in 997 articles published up to May 2011 of which 3 experimental, 4 occupational and 13 epidemiological studies met selection criteria and were included in the review. RESULTS The occupational literature suggested that work as a (non-spray) painter increases the risk of asthma, but it provides little insight to the risks of painting in the domestic setting. All epidemiological studies, except one, reported associations with some asthma-like symptoms. In children at least there was evidence that painting was associated with wheezing, but the study designs and the exposure assessment were unsuitable to differentiate between acute and longer terms affects. We found the epidemiological evidence to be weak and certainly insufficient to infer causality. CONCLUSION The variable quality of the exposure assignment and heterogeneous study design makes it difficult to draw firm conclusions on whether domestic paint exposures cause or exacerbate asthma in children and/or adults.
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Affiliation(s)
- Cristina Canova
- Department of Molecular Medicine, University of Padova , Padova , Italy
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Abstract
Asthma is a complex condition that requires individualized interventions. The purpose of this article is to describe the relationship between the physical and social environments with asthma symptoms, present evidence that supports environmental interventions in asthma control and the implications for asthma management. There is evidence that indoor and outdoor allergens relate to asthma morbidity. Knowledge about which environmental exposures present risk is essential because many of these exposures can be modified, reduced, or eliminated. The community health nurse should provide care relative to the client's indoor and outdoor environment and existing allergens.
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Affiliation(s)
- Yvonne M Sterling
- LSU Health New Orleans School of Nursing, New Orleans, Louisiana 70112, USA.
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Abstract
Exposure to allergens early in life can lead to sensitization and the development of childhood asthma. It is thought that increased exposure with the advent of modern housing is likely contributing to the rise in prevalence of childhood asthma during the past few decades. The progression from allergen exposure to sensitization and asthma development has been noted with respect to dust mites, pets, cockroach, mouse, mold, tobacco smoke, endotoxin, and air pollution, although some have found a protective effect with pet and endotoxin exposure. Recent studies have shown that allergen remediation may be beneficial in reducing asthma morbidity and development, although there is also some evidence to the contrary. Examples of allergen remediation that have been studied include the use of dust mite-impermeable covers, high-efficiency particulate air filtration, integrated pest management, home repairs, ventilation improvement, and pet removal. Several multifaceted, randomized controlled trials have shown that reducing multiple early allergen exposures with environmental controls is associated with a decreased risk of asthma.
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Heinrich J. Influence of indoor factors in dwellings on the development of childhood asthma. Int J Hyg Environ Health 2010; 214:1-25. [PMID: 20851050 DOI: 10.1016/j.ijheh.2010.08.009] [Citation(s) in RCA: 155] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Revised: 08/18/2010] [Accepted: 08/18/2010] [Indexed: 01/21/2023]
Abstract
Asthma has become the most common, childhood chronic disease in the industrialized world, and it is also increasing in developing regions. There are huge differences in the prevalence of childhood asthma across countries and continents, and there is no doubt that the prevalence of asthma was strongly increasing during the past decades worldwide. Asthma, as a complex disease, has a broad spectrum of potential determinants ranging from genetics to life style and environmental factors. Environmental factors are likely to be important in explaining the regional differences and the overall increasing trend towards asthma's prevalence. Among the environmental conditions, indoor factors are of particular interest because people spend more than 80% of their time indoors globally. Increasing prices for oil, gas and other sources of primary energy will further lead to better insulation of homes, and ultimately to reduced energy costs. This will decrease air exchange rates and will lower the dilution of indoor air mass with ambient air. Indoor air quality and potential health effects will therefore be an area for future research and for gaining a better understanding of asthma epidemics. This strategic review will summarize the current knowledge of the effects of a broad spectrum of indoor factors on the development of asthma in childhood in Western countries based on epidemiological studies. In conclusion, several epidemiological studies point out, that indoor factors might cause asthma in childhood. Stronger and more consistent findings are seen when exposure to these indoor factors is assessed by surrogates for the source of the actual toxicants. Measurement-based exposure assessments for several indoor factors are less common than using surrogates of the exposure. These studies, however, mainly showed heterogeneous results. The most consistent finding for an induction of asthma in childhood is related to exposure to environmental tobacco smoke, to living in homes close to busy roads, and in damp homes where are visible moulds at home. The causing agents of the increased risk of living in damp homes remained uncertain and needs clarification. Exposure to pet-derived allergens and house dust mites are very commonly investigated and thought to be related to asthma onset. The epidemiological evidence is not sufficient to recommend avoidance measures against pet and dust mites as preventive activities against allergies. More research is also needed to clarify the potential risk for exposure to volatile and semi-volatile organic compounds due to renovation activities, phthalates and chlorine chemicals due to cleaning.
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Affiliation(s)
- Joachim Heinrich
- Helmholtz Zentrum München, National Research Center for Environmental Health, Institute of Epidemiology, Munich, Germany.
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Herbarth O, Matysik S. Decreasing concentrations of volatile organic compounds (VOC) emitted following home renovations. INDOOR AIR 2010; 20:141-6. [PMID: 20409192 DOI: 10.1111/j.1600-0668.2009.00631.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Volatile organic compounds (VOC) play an important role indoors since they have been linked to health symptoms and disorders. Particularly, after renovation activities, high indoor VOC concentrations have been observed. The study will give an indication, for the first time under real conditions, of the to-be-expected time frame for renovation-derived indoor pollution decreases when the exposure to it will reach a reference level. The decrease in the concentrations of investigated 26 VOC after renovations was assessed under real-life situations. Both the daily VOC concentration was measured by active sampling for 30 days in selected homes which had undergone various renovations and, as part of an epidemiologic study, the same VOC were collected monthly using passive samplers in 243 homes. An exponential function was used to interpret the concentration decay. The average time range which has to elapse following renovation activities before a guideline value or reference load is reached showed a time range between 2 and 8 weeks. This waiting time had at least be applicable to public buildings and institutions (especially relevant in case of nurseries, playschools etc.) with increasingly being implemented in private homes as well. Practical Implications After renovation an optimal waiting period had to be up to 60 days before the rooms will be used again. Fourteen days are possible, but increased ventilation is recommended. These had to be applicable at least for public buildings used by risk groups like young children. Renovations had to be carried out in summer season to ensure optimal ventilation to reduce the waiting time.
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Affiliation(s)
- O Herbarth
- Faculty of Medicine, Environmental Medicine and Hygiene, University Leipzig, 04103 Leipzig, Germany.
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Dom S, Droste JHJ, Sariachvili MA, Hagendorens MM, Bridts CH, Stevens WJ, Desager KN, Wieringa MH, Weyler JJ. The influence of parental educational level on the development of atopic sensitization, wheezing and eczema during the first year of life. Pediatr Allergy Immunol 2009; 20:438-47. [PMID: 19220768 DOI: 10.1111/j.1399-3038.2008.00834.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Several studies have investigated the association between socioeconomic status and the occurrence of allergies. Nevertheless, the results remain contradictory. The aim of this study was to evaluate the associations between parental education and the occurrence of atopic sensitization, recurrent wheezing and eczema during the first year of life, differentiating between atopic and non-atopic disorders based on specific serum IgE. We conducted an aetiological study in 690 children, based on a prospective birth cohort project in which environmental and health information was gathered using questionnaires. At the age of 1 yr a blood sample was taken for quantification of specific IgE. Adjusted odds ratios and 95% confidence intervals were computed as measures of association between the outcomes and parental education. Parental educational level was positively associated with the occurrence of atopic sensitization (OR: 2.1; 95% CI: 1.0-4.4) and eczema (OR: 1.9; 95% CI: 1.1-3.4), but negatively with the occurrence of recurrent wheezing (OR: 0.4; 95% CI: 0.2-0.8) in the first year of life. Atopic recurrent wheezing was positively associated with the education of the parents, whereas non-atopic recurrent wheezing was negatively associated. When maternal and paternal education were considered separately, only maternal education had a significant influence. Our results suggest that aspects associated with a high maternal educational level may play an important role in the development of atopic disorders.
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Affiliation(s)
- Sandra Dom
- Department of Epidemiology and Community Medicine, University of Antwerp, Universiteitsplein 1 B-2610, Antwerp, Belgium.
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Tanaka K, Miyake Y, Kiyohara C. Environmental factors and allergic disorders. Allergol Int 2007; 56:363-96. [PMID: 17965579 DOI: 10.2332/allergolint.r-07-143] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2007] [Indexed: 12/19/2022] Open
Abstract
Despite numerous studies on possible associations between environmental exposure and allergic disorders, any conclusions made remain a matter of controversy. We conducted a review of evidence in relation to environmental and nutritional determinants and wheeze, asthma, atopic dermatitis, and allergic rhinitis. Identified were 263 articles for analysis after consideration of 1093 papers that were published since 2000 and selected by electronic search of the PubMed database using keywords relevant to epidemiological studies. Most were cross-sectional and case-control studies. Several prospective cohort studies revealed inconsistent associations between various environmental factors and the risk of any allergic disorder. Therefore, the evidence was inadequate to infer the presence or absence of a causal relationship between various environmental exposures and allergic diseases. However, evidence is suggestive of positive associations of allergies with heredity. Because almost all the studies were performed in Western countries, the application of these findings to people in other countries, including Japan, may not be appropriate. Further epidemiological information gained from population-based prospective cohort studies, in particular among Japanese together with other Asians, is needed to assess causal relationships between various environmental factors and allergic diseases.
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Affiliation(s)
- Keiko Tanaka
- Department of Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
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Mendell MJ. Indoor residential chemical emissions as risk factors for respiratory and allergic effects in children: a review. INDOOR AIR 2007; 17:259-77. [PMID: 17661923 DOI: 10.1111/j.1600-0668.2007.00478.x] [Citation(s) in RCA: 208] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
UNLABELLED Most research into effects of residential exposures on respiratory health has focused on allergens, moisture/mold, endotoxin, or combustion products. A growing body of research from outside the US; however, has associated chemical emissions from common indoor materials with risk of asthma, allergies, and pulmonary infections. This review summarizes 21 studies in the epidemiologic literature on associations between indoor residential chemical emissions, or emission-related materials or activities, and respiratory health or allergy in infants or children. Associations, some strong, were reported between many risk factors and respiratory or allergic effects. Risk factors identified most frequently included formaldehyde or particleboard, phthalates or plastic materials, and recent painting. Findings for other risk factors, such as aromatic and aliphatic chemical compounds, were limited but suggestive. Elevated risks were also reported for renovation and cleaning activities, new furniture, and carpets or textile wallpaper. Reviewed studies were entirely observational, limited in size, and variable in quality, and specific risk factors identified may only be indicators for correlated, truly causal exposures. Nevertheless, overall evidence suggests a new class of residential risk factors for adverse respiratory effects, ubiquitous in modern residences, and distinct from those currently recognized. It is important to confirm and quantify any risks, to motivate and guide necessary preventive actions. PRACTICAL IMPLICATIONS Composite wood materials that emit formaldehyde, flexible plastics that emit plasticizers, and new paint have all been associated with increased risks of respiratory and allergic health effects in children. Although causal links have not been documented, and other correlated indoor-related exposures may ultimately be implicated, these findings nevertheless point to a new class of little recognized indoor risk factors for allergic and respiratory disease, distinct from the current set of indoor risk factors. The available evidence thus raises initial questions about many common residential practices: for instance, using pressed wood furnishings in children's bedrooms, repainting infant nurseries, and encasing mattresses and pillows with vinyl for asthmatic children. The findings summarized here suggest a need for substantially increased research to replicate these findings, identify causal factors, and validate preventive strategies.
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Affiliation(s)
- M J Mendell
- Lawrence Berkeley National Laboratory, Indoor Environment Department, Berkeley, CA 94720, USA.
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Current World Literature. Curr Opin Allergy Clin Immunol 2006. [DOI: 10.1097/01.all.0000244802.79475.bd] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Bibliography. Current world literature. Outcome measures. Curr Opin Allergy Clin Immunol 2006; 6:241-4. [PMID: 16670521 DOI: 10.1097/01.all.0000225167.72842.fd] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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