| 1. |
- Liu, Wei, et al.
(författare)
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Household renovation before and during pregnancy in relation to preterm birth and low birthweight in China
- 2019
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Ingår i: Indoor Air. - : WILEY. - 0905-6947 .- 1600-0668. ; 29:2, s. 202-214
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Tidskriftsartikel (refereegranskat)abstract
- From October 2010 to April 2012, we conducted a cross-sectional study of associations between household environments and childhood health among preschool children in eight Chinese cities. Here, we analyze associations of early household renovation with preterm birth (PTB), low birthweight (LBW), term low birthweight (Term-LBW), and small for gestational age (SGA). Parents responded to questions about household renovation and their children's gestational age and birthweight. In the multivariate logistic regression analyses, household renovation in the year before pregnancy was significantly associated with LBW (sample size: N = 25 813; adjusted odds ratio (OR) with 95% confidence intervals (CIs): 1.23, 1.01-1.50) and Term-LBW (N = 24 823; 1.29, 1.01-1.67). Household renovation during pregnancy was significantly associated with PTB (N = 25 202; 1.28, 1.01-1.69). These significant associations were also found in the two-level (city-child) logistic regression analyses and in the sensitivity analyses among 21 009 children with complete data in all studied variates. Stronger associations were found in certain subgroups. Our findings indicate that household renovation within one year before pregnancy might be a risk factor for LBW and Term-LBW, while household renovation during pregnancy could be a risk factor for PTB.
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| 2. |
- Zhang, Yinping, et al.
(författare)
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Ten cities cross-sectional questionnaire survey of children asthma and other allergies in China
- 2013
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Ingår i: Chinese Science Bulletin. - : Springer Science and Business Media LLC. - 1001-6538 .- 1861-9541. ; 58:34, s. 4182-4189
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Tidskriftsartikel (refereegranskat)abstract
- Asthma, rhinitis and eczema (allergic or non-allergic) have increased throughout the world during the last decades, especially among children. Changes in the indoor environment are suspected to be important causes. China has experienced a dramatic change in indoor environmental exposures during the past two decades. However, such changes and their associations with children's asthma and other health aspects have not been thoroughly studied. China, Children, Homes, Health (CCHH), Phase I, was a cross-sectional questionnaire survey of 48219 children 1-8 years old in 10 Chinese cities during 2010-2012. The questionnaire includes the International Study of Asthma and Allergies in Childhood (ISAAC) core health questions and additional questions regarding housing, life habits and outdoor environment. In health analyses, children aged 3-6 years old were included. The prevalences of doctor diagnosed asthma varied from 1.7% to 9.8% (mean 6.8%), a large increase from 0.91% in 1999 and 1.50% in 2000. The prevalence of wheeze, rhinitis and atopic eczema (last 12 months) varied from 13.9% to 23.7%, 24.0% to 50.8% and 4.8% to 15.8%, respectively. Taiyuan had the lowest prevalences of all illnesses and Shanghai the highest, except for wheezewhere the highest value was for Urumqi. We found (1) no obvious association between disease prevalences and ambient PM10 concentrations and (2) higher prevalences of disease in humid climates with hot summers and cold winters, but with no centrally heated buildings. Associations between the diseases and economic status as indexed by Gross Domestic Product (GDP) requires further study.
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| 3. |
- Cai, Jiao, et al.
(författare)
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Household dampness-related exposures in relation to childhood asthma and rhinitis in China : A multicentre observational study
- 2019
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Ingår i: Environment International. - : Elsevier BV. - 0160-4120 .- 1873-6750. ; 126, s. 735-746
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Tidskriftsartikel (refereegranskat)abstract
- During 2010-2012, we conducted an observational study on household environment and health outcomes among 40,010 preschool children from seven cities of China. Here we examined associations of six dampness-related indicators (visible mold spots, visible damp stains, damp clothing and/or bedding, water damage, condensation on windowpane, moldy odor) in the current residence and three dampness-related indicators (visible mold spots, condensation on windowpane, moldy odor) in the early residence with childhood asthma and rhinitis. In the multi-level logistic regression analyses, visible mold spots and visible damp stains in the current residence were significantly associated with the increased odds of doctor-diagnosed asthma and allergic rhinitis during lifetime-ever (adjusted odd ratios (AORs) range: 1.18-1.35). All dampness-related indicators were significantly associated with increased odds of wheeze and rhinitis during lifetime-ever and in the past 12 months (AORs range: 1.16-2.64). The cumulative numbers of damp indicators had positively dose-response relationships with the increased odds of the studied diseases. These associations for wheeze and rhinitis were similar between northern children and southern children. Similar results were found in the sensitive analyses among children without a family history of allergies and among children without asthma and allergic rhinitis. For 3-6 years-old children in mainland of China in 2011, we speculated that about 90,000 (2.02%) children with asthma and about 59,000 (1.09%) children with allergic rhinitis could be attributable to exposing to visible mold spots in the current residence. Our results suggested that early and lifetime exposures to household dampness indicators are risk factors for childhood asthma and rhinitis.
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| 4. |
- Cheng, Hong, et al.
(författare)
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Home environment exposure and sick building syndrome (SBS) symptoms among adults in southern China : Health associations in 2010 and 2019
- 2024
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Ingår i: Building and Environment. - : Elsevier. - 0360-1323 .- 1873-684X. ; 248
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Tidskriftsartikel (refereegranskat)abstract
- We studied time trends in home environment and sick building syndrome (SBS) symptoms in a repeat study in five cities in southern China. Moreover, we studied associations between home environment exposure and SBS symptoms. Parents from randomly selected day care centers were invited. One parent per family answered a questionnaire on the home environment and their own SBS symptoms. Data collection was performed in two surveys in 2010 and 2019 (27,292 participants in 2010 and 32,073 in 2019). We used two-level logistic regression to analyze health associations. Asthma decreased from 1.7% to 1.5% (P < 0.05) but allergic rhinitis increased from 6.5% to 16.4% (P < 0.001). All SBS symptoms decreased from 2010 to 2019 (all P < 0.001). Most aspects of the home environment improved from 2010 to 2019 but there were less cleaning, more cats, dogs, and urbanization in 2019. Redecoration, new furniture, and pests were associated with most types of SBS symptoms, similarly in 2010 and 2019. Environmental tobacco smoke (ETS) was associated with SBS symptoms in 2019 only. In conclusion, prevalence of SBS symptoms among young parents in southern China decreased from 2010 to 2019 but allergic rhinitis increased. Cockroaches, rats, mice, mosquitoes or flies can be consistent biological risk factors for SBS symptoms. Redecoration, buying new furniture and traffic air pollution are other risk factors for SBS symptoms. Daily cleaning, frequently putting bedding to sunshine, and having a fan in the bathroom can be protective factors. ETS is an emerging risk factor for SBS symptoms.
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| 5. |
- Shi, Haonan, et al.
(författare)
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Prevalence, risk factors, impact and management of pneumonia among preschool children in Chinese seven cities : a cross-sectional study with interrupted time series analysis
- 2023
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Ingår i: BMC Medicine. - : BioMed Central (BMC). - 1741-7015. ; 21
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pneumonia is a common disease worldwide in preschool children. Despite its large population size, China has had no comprehensive study of the national prevalence, risk factors, and management of pneumonia among preschool children. We therefore investigated the prevalence of pneumonia among preschool children in Chinese seven representative cities, and explore the possible risk factors of pneumonia on children, with a view to calling the world's attention to childhood pneumonia to reduce the prevalence of childhood pneumonia.Methods: Two group samples of 63,663 and 52,812 preschool children were recruited from 2011 and 2019 surveys, respectively. Which were derived from the cross-sectional China, Children, Homes, Health (CCHH) study using a multi-stage stratified sampling method. This survey was conducted in kindergartens in seven representative cities. Exclusion criteria were younger than 2 years old or older than 8 years old, non-permanent population, basic information such as gender, date of birth and breast feeding is incomplete. Pneumonia was determined on the basis of parents reported history of clearly diagnosed by the physician. All participants were assessed with a standard questionnaire. Risk factors for pneumonia, and association between pneumonia and other respiratory diseases were examined by multivariable-adjusted analyses done in all participants for whom data on the variables of interest were available. Disease management was evaluated by the parents' reported history of physician diagnosis, longitudinal comparison of risk factors in 2011 and 2019.Results: In 2011 and 2019, 31,277 (16,152 boys and 15,125 girls) and 32,016 (16,621 boys and 15,395 girls) preschool children aged at 2-8 of permanent population completed the questionnaire, respectively, and were thus included in the final analysis. The findings showed that the age-adjusted prevalence of pneumonia in children was 32.7% in 2011 and 26.4% in 2019. In 2011, girls (odds ratio [OR] 0.91, 95%CI [confidence interval]0.87-0.96; p = 0.0002), rural (0.85, 0.73-0.99; p = 0.0387), duration of breastfeeding & GE; 6 months(0.83, 0.79-0.88; p < 0.0001), birth weight (g) & GE; 4000 (0.88, 0.80-0.97; p = 0.0125), frequency of putting bedding to sunshine (Often) (0.82, 0.71-0.94; p = 0.0049), cooking fuel type (electricity) (0.87, 0.80-0.94; p = 0.0005), indoor use air-conditioning (0.85, 0.80-0.90; p < 0.0001) were associated with a reduced risk of childhood pneumonia. Age (4-6) (1.11, 1.03-1.20; p = 0.0052), parental smoking (one) (1.12, 1.07-1.18; p < 0.0001), used antibiotics (2.71, 2.52-2.90; p < 0.0001), history of parental allergy (one and two) (1.21, 1.12-1.32; p < 0.0001 and 1.33, 1.04-1.69; p = 0.0203), indoor dampness (1.24, 1.15-1.33; p < 0.0001), home interior decoration (1.11, 1.04-1.19; p = 0.0013), Wall painting materials (Paint) (1.16, 1.04-1.29; p = 0.0084), flooring materials (Laminate / Composite wood) (1.08, 1.02-1.16; p = 0.0126), indoor heating mode(Central heating)(1.18, 1.07-1.30, p = 0.0090), asthma (2.38, 2.17-2.61; p < 0.0001), allergic rhinitis (1.36, 1.25-1.47; p < 0.0001), wheezing (1.64, 1.55-1.74; p < 0.0001) were associated with an elevated risk of childhood pneumonia; pneumonia was associated with an elevated risk of childhood asthma (2.53, 2.31-2.78; p < 0.0001), allergic rhinitis (1.41, 1.29-1.53; p < 0.0001) and wheezing (1.64, 1.55-1.74; p < 0.0001). In 2019, girls (0.92, 0. 87-0.97; p = 0.0019), duration of breastfeeding & GE; 6 months (0.92, 0.87-0.97; p = 0.0031), used antibiotics (0.22, 0.21-0.24; p < 0.0001), cooking fuel type (Other) (0.40, 0.23-0.63; p = 0.0003), indoor use air-conditioning (0.89, 0.83-0.95; p = 0.0009) were associated with a reduced risk of childhood pneumonia. Urbanisation (Suburb) (1.10, 1.02-1.18; p = 0.0093), premature birth (1.29, 1.08-1.55; p = 0.0051), birth weight (g) < 2500 (1.17, 1.02-1.35; p = 0.0284), parental smoking (1.30, 1.23-1.38; p < 0.0001), history of parental asthma (One) (1.23, 1.03-1.46; p = 0.0202), history of parental allergy (one and two) (1.20, 1.13-1.27; p < 0.0001 and 1.22, 1.08-1.37; p = 0.0014), cooking fuel type (Coal) (1.58, 1.02-2.52; p = 0.0356), indoor dampness (1.16, 1.08-1.24; p < 0.0001), asthma (1.88, 1.64-2.15; p < 0.0001), allergic rhinitis (1.57, 1.45-1.69; p < 0.0001), wheezing (2.43, 2.20-2.68; p < 0.0001) were associated with an elevated risk of childhood pneumonia; pneumonia was associated with an elevated risk of childhood asthma (1.96, 1.72-2.25; p < 0.0001), allergic rhinitis (1.60, 1.48-1.73; p < 0.0001) and wheezing (2.49, 2.25-2.75; p < 0.0001).Conclusions: Pneumonia is prevalent among preschool children in China, and it affects other childhood respiratory diseases. Although the prevalence of pneumonia in Chinese children shows a decreasing trend in 2019 compared to 2011, a well-established management system is still needed to further reduce the prevalence of pneumonia and reduce the burden of disease in children.
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| 6. |
- Wang, Lexiang, et al.
(författare)
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Prenatal and postnatal decoration in residence are associated with childhood allergies and respiratory diseases : A 10-year repeated retrospective observational study
- 2023
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Ingår i: Building and Environment. - : Elsevier. - 0360-1323 .- 1873-684X. ; 234
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Tidskriftsartikel (refereegranskat)abstract
- The previous studies reported inconsistent associations of early residential decoration with childhood allergies and respiratory diseases. In this study, we conducted a 10-year retrospective observational survey among preschoolers from three urban districts in Chongqing of China in 2010 and in 2019, to investigate the associations of the prenatal and postnatal residential decorations with the childhood asthma, allergic rhinitis, eczema, wheeze, rhinitis, and pneumonia. We collected data from 4976 to 3971 of 3-6-year-olds preschoolers in the 2010 and 2019 surveys, respectively. The results showed that proportions of prenatal and postnatal residential decorations in different durations in 2010 were significantly higher than in 2019 (4.1%-19.6% vs. 2.1-5.3%). Except for allergic rhinitis (6.1% vs. 9.5%), prevalences of the studied diseases in 2010 also were significantly higher than in 2019 (for example: asthma: 8.2% vs. 6.1%; wheeze: 17.1% vs. 7.7%; rhinitis: 40.6% vs. 24.0%). In the two-level (district-child) logistic regression analyses, surveys in both 2010 and 2019 revealed that residential renovation and buying new furniture in prenatal and postnatal periods consistently increased odds of most studied diseases (ranges of adjusted odds ratio (AOR): 1.31-1.86). The prenatal decoration exposures had stronger associations with childhood allergies and respiratory diseases than the postnatal decoration exposures. The early residential decoration activities had stronger associations with allergies and respiratory diseases among girls and preschoolers without history of family allergy. Our findings indicate that prenatal and postnatal household decoration behaviors are risk factors for childhood airway diseases and allergies. Girls and children without family history of allergy are vulnerability groups.
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| 7. |
- Zhang, Bin, et al.
(författare)
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Dampness and mould in Chinese homes and sick building syndrome (SBS) symptoms - Associations with climate, family size, cleaning and ventilation
- 2023
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Ingår i: Building and Environment. - : Elsevier. - 0360-1323 .- 1873-684X. ; 245
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Tidskriftsartikel (refereegranskat)abstract
- We investigated associations between dampness in Chinese homes and sick building syndrome (SBS) symptoms and studied the role of climate, family size, cleaning and ventilation for dampness, mould and SBS. A questionnaire survey was done in 2019-2020 among adults in five cities (32349 participants) and data on outdoor climate was collected. Multilevel logistic regression was used to calculate adjusted odds ratios (ORs). In total, 2.2% had rhinitis, 1.8% eye, 1.6% throat and 2.9% skin symptoms, 2.1% headache and 8.7% fatigue (weekly symptoms). Overall, 12.1% reported indoor mould, 5.7% damp bedding, 5.3% mould odour and 33.8% humid air in current home. Mould was associated with all symptoms (ORs 1.86-2.15 for minor mold growth and 1.65-3.45 for major mould growth). Damp bedding was associated with all symptoms (ORs 2.18-2.80 for minor dampness and 2.51-8.03 for major dampness). Mould odour was associated with all symptoms (ORs 1.84-2.77 for sometimes odour and ORs 3.78-7.80 for weekly odour). Perception of humid air was associated with all symptoms. ORs increased by number of dampness signs. Precipitation, outdoor relative air humidity and temperature increased dampness, mould and SBS symptoms. Large family size increased dermal symptoms. Daily floor cleaning, airing in winter, putting bedding to sunshine and mechanical ventilation in the bathroom reduced dampness, mould and SBS symptoms. In conclusion, mould and dampness in Chinese homes can increase rhinitis and SBS-symptoms in a dose-response manner. A warmer and more humid climate can increase, and cleaning and ventilation in the home can decrease dampness, mould and SBS symptoms.
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| 8. |
- Chen, Fei'er, et al.
(författare)
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The effects of PM2.5 on asthmatic and allergic diseases or symptoms in preschool children of six Chinese cities, based on China, Children, Homes and Health (CCHH) project
- 2018
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Ingår i: Environmental Pollution. - : Elsevier BV. - 0269-7491 .- 1873-6424. ; 232, s. 329-337
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Tidskriftsartikel (refereegranskat)abstract
- The urbanization and industrialization in China is accompanied by bad air quality, and the prevalence of asthma in Chinese children has been increasing in recent years. To investigate the associations between ambient PM2.5 levels and asthmatic and allergic diseases or symptoms in preschool children in China, we assigned PM2.5 exposure data from the Global Burden of Disease (GBD) project to 205 kindergartens at a spatial resolution of 0.1° × 0.1° in six cities in China (Shanghai, Nanjing, Chongqing, Changsha, Urumqi, and Taiyuan). A hierarchical multiple logistical regression model was applied to analyze the associations between kindergarten-level PM2.5 exposure and individual-level outcomes of asthmatic and allergic symptoms. The individual-level variables, including gender, age, family history of asthma and allergic diseases, breastfeeding, parental smoking, indoor dampness, interior decoration pollution, household annual income, and city-level variable-annual temperature were adjusted. A total of 30,759 children (average age 4.6 years, 51.7% boys) were enrolled in this study. Apart from family history, indoor dampness, and decoration as predominant risk factors, we found that an increase of 10 μg/m3 of the annual PM2.5 was positively associated with the prevalence of allergic rhinitis by an odds ratio (OR) of 1.20 (95% confidence interval [CI] 1.11, 1.29) and diagnosed asthma by OR of 1.10 (95% CI 1.03, 1.18). Those who lived in non-urban (vs. urban) areas were exposed to more severe indoor air pollution arising from biomass combustion and had significantly higher ORs between PM2.5 and allergic rhinitis and current rhinitis. Our study suggested that long-term exposure to PM2.5 might increase the risks of asthmatic and allergic diseases or symptoms in preschool children in China. Compared to those living in urban areas, children living in suburban or rural areas had a higher risk of PM2.5 exposure.
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| 9. |
- Chen, Tianyi, et al.
(författare)
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Maternal exposure to PM2.5/BC during pregnancy predisposes children to allergic rhinitis which varies by regions and exclusive breastfeeding
- 2022
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Ingår i: Environment International. - : Elsevier. - 0160-4120 .- 1873-6750. ; 165
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIncreasing prevalence of childhood allergic rhinitis(AR) needs a deeper understanding on the potential adverse effects of early life exposure to air pollution.ObjectivesThe main aim was to evaluate the effects of maternal exposure to PM2.5 and chemical constituents during pregnancy on preschool children’s AR, and further to explore the modification effects of regions and exclusive breastfeeding.MethodsA multi-center population-based study was performed in 6 cities from 3 regions of China in 2011–2012. Maternal exposure to ambient PM2.5 and main chemical constituents(BC, OM, SO42−, NO3−, NH4+) during pregnancy was assessed and a longitudinal prospective analysis was applied on preschool children’s AR. The modification effects of regions and exclusive breastfeeding were investigated.ResultsA total of 8.8% and 9.8% of children reported doctor-diagnosed allergic rhinitis(DDAR) and current hay fever, respectively, and 48.6% had less than 6 months of exclusive breastfeeding. The means of PM2.5 during pregnancy were 52.7 μg/m3, 70.3 μg/m3 and 76.4 μg/m3 in the east, north and central south of China, respectively. Multilevel log-binomial model regression showed that each interquartile range(IQR) increase of PM2.5 during pregnancy was associated with an average increase in prevalence ratio (PR) of DDAR by 1.43(95% confidence interval(CI): 1.11, 1.84) and current hay fever by 1.79(95% CI: 1.26, 2.55), respectively. Among chemical constituents, black carbon (BC) had the strongest associations. Across 3 regions, the eastern cities had the highest associations, followed by those in the central south and the north. For those equal to or longer than 6 months of exclusive breastfeeding, the associations were significantly reduced.ConclusionsChildren in east of China had the highest risks of developing AR per unit increase of maternal exposure to PM2.5 during pregnancy, especially BC constituent. Remarkable decline was found in association with an increase in breastfeeding for ≥6 months, in particular in east of China.
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| 10. |
- Du, Chenqiu, et al.
(författare)
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Home dampness/mold(D/M) improvement in children's residences over the past decade in China-a comparison of repeated surveys in 2010 and 2019
- 2021
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Ingår i: Building and Environment. - : Elsevier. - 0360-1323 .- 1873-684X. ; 205
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Tidskriftsartikel (refereegranskat)abstract
- There is mounting evidence that exposure to household dampness/mold (D/M) is the cause of respiratory, allergic diseases for children. While few research focuses on the effects caused by building environment changes, from a longitudinal investigation perspective, especially for China experiencing a rapid development in recent years. This study aimed to explore the changes of D/M in Chinese homes over the past 10 years and identify the impacts of climate, building energy efficiency and residents' behaviors. The cross-sectional surveys were repeatedly conducted in children' residences in 2010 (Period I) and 2019 (Period II), among Taiyuan, Urumqi in northern China, and Nanjing, Shanghai, Wuhan, Changsha, Chongqing in southern China. Finally, 23465 children in Period I and 34720 children in Period II were involved, with no changes of residences since birth. The results showed that the proportions for reported D/M indicators were significantly reduced in Period II: e.g., 93.8% and 84.1% residents respectively answered no visible mold spots and damp stains in current residences, compared to only 78.3% and 62.2% in Period I. Southern homes accounted for high proportions for D/M indicator occurrences; warm-humid climate, annual higher precipitation and lower sunshine hours, etc., exacerbated the indoor D/M exposure risks. While residents' behaviors like ventilation, airing quilt/beddings, regular cleaning ameliorated the reported D/M significantly. The findings, from a temporal and spacious dimension perspective, advance our understanding of indoor D/M changes, precisely improvement in children' homes over the past 10 years, benefiting to promote indoor air quality standards in China.
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