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1.
  • Liu, Wei, et al. (författare)
  • Household renovation before and during pregnancy in relation to preterm birth and low birthweight in China
  • 2019
  • Ingår i: Indoor Air. - : WILEY. - 0905-6947 .- 1600-0668. ; 29:2, s. 202-214
  • 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.
  • Lu, Chan, et al. (författare)
  • Long-term exposure to mould/damp stains and mouldy odour increases low birth weight
  • 2022
  • Ingår i: Building and Environment. - : Elsevier. - 0360-1323 .- 1873-684X. ; 222
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Low birth weight (LBW), as a major concern in public health, is now increasing worldwide, but its main indoor environmental factors remain unclear.Objective: We examined whether LBW including term-LBW (T-LBW) and preterm-LBW (P-LBW) was associated with maternal exposure to indoor environmental factors, with a purpose to identify the key indoor environmental factor(s) contributing to LBW.Methods: A nationwide retrospective cohort study of 30,735 pre-schoolers in six Chinese cities was performed from 2010 to 2012. One questionnaire survey was conducted to collect information on the pre-schoolers' birth outcomes and their maternal exposure of indoor environmental factors including new furniture, house redecoration, cooking fuels, mould/damp stains, and mouldy odour during pregnancy. Maternal exposure of trafficrelated air pollutant (NO2), industrial pollutant (SO2), and inhalable particulate matter (PM10), as well as meteorological parameters, was estimated in pregnancy. Associations of LBW, T-LBW and P-LBW with indoor environmental factors were evaluated by two-level (city-child) logistic regression models with an odds ratio (OR) and 95% confidence interval (CI).Results: We found that P-LBW (1.0%) and T-LBW (1.4%) prevalence were respectively associated with persistent mould/damp stains and mouldy odour exposure in utero, ORs = 1.81 (95% CI: 1.01-3.24) and 1.49 (95% CI: 1.01-2.21). Exposure to high temperature and PM2.5 in pregnancy significantly enhanced the effect of persistent mould/damp stains and/or mouldy odour on P-LBW and LBW, ORs (95% CI) = 2.92 (1.40-6.07) and 1.78 (1.00-3.15) with significant interaction p values of 0.067 and 0.094 respectively. Sensitivity analysis suggested that raising cats and dogs significantly increased LBW risk of persistent mould/damp stains and mouldy odour exposure.
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3.
  • Zhao, Yuxuan, et al. (författare)
  • The CHECH study : A prospective pregnancy cohort study on CHemical exposure and children’s health in Tianjin, China
  • 2024
  • Ingår i: Hygiene and Environmental Health Advances. - : Elsevier. - 2773-0492. ; 9
  • Tidskriftsartikel (refereegranskat)abstract
    • The CHemical Exposure and Children’s Health (CHECH) study is an ongoing pregnancy cohort study in Tianjin, China. This paper describes the background, aim and the study design, which can be followed by future researchers to design and conduct similar studies. The abundance and the potential adverse health outcomes of endocrine disrupting chemicals (EDCs) is concerning. More notably, developing fetuses and infants are more vulnerable to EDCs exposure. The CHECH study aims to investigate the importance of early life exposure to multiple EDCs (phthalates and their metabolites, bisphenol A and their substitutes, perfluorinated compounds and poly brominated diphenyl ethers) for multiple health outcomes in Chinese children, namely sexual development, neurodevelopment, metabolism and growth, as well as asthma and allergy. A total of 2238 pregnant women were recruited in Tianjin from May 2017 to April 2021 with a response rate of 90 %. Among these women, 2255 children were born with available information, including 47 pairs of twins. Urine samples were collected from pregnant women and children, while air and dust samples were obtained from the home environment during pregnancy and infancy periods. Information on children’s health was gathered through physical examinations and questionnaires. The CHECH study, which collected exposure information and health outcomes at multiple time points, will contribute to the understanding of prenatal exposure to EDCs and their impact on children’s health, thereby facilitating the development of risk assessments aimed at reducing exposure and associated health risks. 
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4.
  • Cai, Jiao, et al. (författare)
  • Household dampness-related exposures in relation to childhood asthma and rhinitis in China : A multicentre observational study
  • 2019
  • Ingår i: Environment International. - : Elsevier BV. - 0160-4120 .- 1873-6750. ; 126, s. 735-746
  • 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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5.
  • Chen, Fei'er, et al. (författare)
  • 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
  • Ingår i: Environmental Pollution. - : Elsevier BV. - 0269-7491 .- 1873-6424. ; 232, s. 329-337
  • 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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6.
  • Chen, Tianyi, et al. (författare)
  • Maternal exposure to PM2.5/BC during pregnancy predisposes children to allergic rhinitis which varies by regions and exclusive breastfeeding
  • 2022
  • Ingår i: Environment International. - : Elsevier. - 0160-4120 .- 1873-6750. ; 165
  • 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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7.
  • Choi, Jieun, et al. (författare)
  • Associations between building characteristics and children's allergic symptoms : A cross-sectional study on child's health and home in Seoul, South Korea
  • 2014
  • Ingår i: Building and Environment. - : Pergamon Elsevier. - 0360-1323 .- 1873-684X. ; 75, s. 176-181
  • Tidskriftsartikel (refereegranskat)abstract
    • A cross-sectional study on the home environment and asthma and allergy in children was carried out among children 1-8 years old in Seoul, South Korea from 2009 to 2010. Questionnaires were distributed to 5107 parents through daycare centers and kindergartens; 2755 parents responded, a response rate of 54%. Seven percent and 23% of children were reported to have doctor-diagnosed asthma and hay fever, respectively. A majority (57%) of the families reported having PVC flooring in child's or parents' bedroom. More than 96% of homes used a floor heating system. PVC was used more often as a floor covering in single family houses than in apartments (67% vs. 49%, p < 0.001). PVC flooring was significantly associated with eczema in the previous 6 months (AOR 1.54,95% Cl 1.13-2.09) when adjusted for gender, age, family allergy, socioeconomic status and environmental tobacco smoke. Older buildings tended to have dampness problems, and, consequently, were positively correlated with the prevalence of wheeze. Floor moisture significantly increased the association between PVC and symptoms of wheezing (AOR 2.57, 95% Cl 1.36-4.82) and eczema (AOR 1.97, 95% Cl 1.18-3.28). Apartments without mechanical ventilation in bedrooms were associated with a slight increase in asthma and allergy among children. This study suggests that building characteristics and home exposure can partly explain recent increases in asthma and allergy among children in Seoul. (c) 2014 Elsevier Ltd. All rights reserved.
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8.
  • Fu, Xiaoli, et al. (författare)
  • Effect of prenatal and postnatal exposure to home renovation on the risk of common cold in preschool children
  • 2022
  • Ingår i: Indoor Air. - : John Wiley & Sons. - 0905-6947 .- 1600-0668. ; 32:6
  • Tidskriftsartikel (refereegranskat)abstract
    • Common cold is usually considered to be associated with outdoor climate, but the evidence linking with indoor environmental factors is lacking. The role of indoor renovations during which critical timing window on childhood common cold remains unclear. Therefore, we investigated the effect of exposure to new furniture and/or redecoration during prenatal and postnatal periods on the occurrence and duration of common cold in preschool children. We conducted a retrospective cohort study of 39 782 children aged 3-6 years in seven cities of China. The occurrence and duration of common cold in children, and their lifetime exposures to indoor new furniture and redecoration (including pregnancy, the first year of life, and after one year old) were assessed using a questionnaire administered by the parents. Associations between high frequency (>5 colds) and long duration (>= 2 weeks per cold) of common cold during past 12 months and exposure to indoor new furniture/redecoration were examined by logistic regression models in terms of odds ratio (OR) and 95% confidence interval (CI). We found that the prevalence of high frequency and long duration of common cold in preschool children in China were, respectively, 9.2% and 11.9%. Frequent common cold was significantly associated with exposure to indoor new furniture/redecoration during pregnancy, first year, and after 1 year old, respectively, with the ORs (95% CI) = 1.25 (1.12-1.39), 1.11 (1.00-1.25), and 1.09 (1.01-1.18). Furthermore, childhood long duration per cold was associated with exposure to indoor new furniture/redecoration during pregnancy with OR (95% CI) of 1.14 (1.03-1.25) but not with postnatal exposure. We identified that prenatal exposure to home renovation was more critical than postnatal exposure for an increased risk of high frequency and long duration of common cold. Sensitivity analysis showed that the association between prenatal exposure to indoor renovations and the risk of childhood common cold was consistent and robust, and the associations were modified by some personal and indoor environmental factors. Our findings indicated that prenatal and postnatal exposure to home renovation played an important role in the risk of childhood common cold, supporting the hypothesis of "fetal origin of childhood infection."
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9.
  • Hou, Jing, et al. (författare)
  • Air change rates measured by two different tracer gases of residential building in China and its association with asthma and allergy of children
  • 2023
  • Ingår i: Healthy Buildings 2023: Asia and Pacific Rim. - : International Society of Indoor Air Quality and Climate. - 9781713890850
  • Konferensbidrag (refereegranskat)abstract
    • Ventilation of buildings is important for occupants' health. Few studies have been conducted on associations between home ventilation and occupant's health in China. During 2013-2016, we measured air change rate in 98 homes by both mass balance of occupant generated CO2 method and PFT method in Tianjin and Cangzhou, China. Questionnaires were used to survey the health data for children. We found that air change rates measured by CO2 method in whole day were higher than those measured by PFT method and those measured during night. Lower air change rates measured by CO2 method during night were significantly associated with perceived unpleasant odor (p=0.04). Lower levels of air change rate measured by CO2 method during night were risk factors for croup (AOR: 7.30(1.25, 42.60)). Air change rate measured in a certain period especially at night may be more representative in analysis of the association with occupants' health. 
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10.
  • Hou, Jing, et al. (författare)
  • Associations of indoor carbon dioxide concentrations, air temperature, and humidity with perceived air quality and sick building syndrome symptoms in Chinese homes
  • 2021
  • Ingår i: Indoor Air. - : John Wiley & Sons. - 0905-6947 .- 1600-0668. ; 31:4, s. 1018-1028
  • Tidskriftsartikel (refereegranskat)abstract
    • The indoor environment influences occupants' health. From March 1, 2018, to February 28, 2019, we continuously monitored indoor temperature (T), relative humidity (RH), and CO2 concentration in bedrooms via an online system in 165 residences that covered all five climate zones of China. Meanwhile, we asked one specific occupant in each home to complete questionnaires about perceived air quality and sick building syndrome (SBS) symptoms at the end of each month. Higher CO2 concentration was significantly associated with a higher percentage of perceived stuffy odor and skin SBS symptoms. Higher relative humidity was associated with higher percentage of perceived moldy odor and humid air, while lower RH was associated with a higher percentage of perceived dry air. Occupants who lived in residences with high RH were less likely to have mucosal and skin SBS symptoms (adjusted odds ratio (AOR): 0.73-0.78). However, the benefit of high humidity for perceived dry air and skin dryness symptoms is weaker if there is a high CO2 concentration level.
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11.
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12.
  • Lou, Xinyuan, et al. (författare)
  • A study on human perception in aircraft cabins and its association with volatile organic compounds
  • 2022
  • Ingår i: Building and Environment. - : Elsevier. - 0360-1323 .- 1873-684X. ; 219
  • Tidskriftsartikel (refereegranskat)abstract
    • More than 8 million people fly on commercial aircraft each day with approximately 5% having a pre-existing respiratory disease. Thus it is necessary to provide high air quality in aircraft to protect public health. Volatile organic compounds (VOCs) present in aircraft cabins are suspected to contribute to the reported complaints. We investigated concentrations of VOCs, air temperature, relative humidity, and CO2 concentrations in a total of 46 flights, including 26 Chinese domestic flights and 20 international flights. We focused on the data from the cruising phase without meal serving in which the air supply and air recirculation were steady. A total of 284 passengers (i.e., 101 on international flights and 183 on Chinese domestic flights) were invited to participate in questionnaire surveys in this phase. We performed a linear mixed model analysis by controlling for potential confounders (age, gender, smoke habits, and history of allergy) to study associations between VOCs exposures and passengers' complaints. Xylene was significantly associated with irritations of the eyes, nose, and throat on both international and domestic flights, with antilog beta values from 1.12 to 1.28 (p < 0.05). The association of some aldehydes (i.e., nonanal, decanal, and heptanal), which are potential oxidation products with ozone, with passengers' sensory irritations was also significant, especially during international flights (antilog beta values: 1.19-1.22). It indicates that VOCs, especially xylene and aldehydes, in aircraft cabins may influence the perceived indoor air quality and complaints among passengers.
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13.
  • Lu, Chan, et al. (författare)
  • Common cold among young adults in China without a history of asthma or allergic rhinitis : associations with warmer climate zone, dampness and mould at home, and outdoor PM10 and PM2.5
  • 2020
  • Ingår i: Science of the Total Environment. - : Elsevier BV. - 0048-9697 .- 1879-1026. ; 749
  • Tidskriftsartikel (refereegranskat)abstract
    • This paper studied associations between reported common cold and home dampness and mould, cleaning habits and ventilation, climate and outdoor air pollution in China among young adults without asthma or allergic rhinitis. Parents of children attending day care in eight Chinese cities answered a questionnaire on their health and home environment (75% response rate). We restricted the population to subject without asthma or allergic rhinitis (N = 37,275). Temperature and air pollution data was obtained from monitoring stations. Associations were estimated by multilevel logistic regression. Totally 12.5% reported common cold (≥3 colds) and 1.6% frequent common cold (≥5 colds) in the past 12 months. Female gender (OR = 1.53; 95% CI 1.37–1.71), residents in southern China (OR = 1.89; 95% CI 1.16–3.07) and living in homes with water leakage (OR = 1.32; 95% CI 1.16–1.50), mould odour (OR = 1.48; 95% CI 1.28–1.72), indoor mould (OR = 1.47; 95% CI 1.28–1.70), condensation on window panes (OR = 1.42; 95% CI 1.32–1.52) and damp bed clothing (OR = 1.19; 95% CI 1.11–1.28) were associated with common cold. Having many signs of dampness increased ORs. Daily cleaning (OR = 0.91; 95% CI 0.85–0.97) and mechanical ventilation in kitchen or bathroom (OR = 0.75; 95% CI 0.64–0.89) were protective. Higher mean ambient temperature (OR = 1.11 per °C; 95% CI 1.02–1.21), PM10 (OR = 1.17 per 10 μg/m3 ; 95% CI 1.14–1.21) and PM2.5 (OR = 1.28 per 10 μg/m3 ; 95% CI 1.20–1.37) were associated with common cold. The association with particulate air pollution was stronger in southern China. Similar associations were found for frequent common cold. In conclusion, indoor dampness and mould, a warmer climate and PM10 and PM2.5 can be associated with reported common cold. Further intervention and prospective studies are needed to verify causality of observed association in this cross-sectional study.
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14.
  • Lu, Chan, et al. (författare)
  • Furry pet-related wheeze and rhinitis in pre-school children across China : Associations with early life dampness and mould, furry pet keeping, outdoor temperature, PM10 and PM2.5
  • 2020
  • Ingår i: Environment International. - : Elsevier BV. - 0160-4120 .- 1873-6750. ; 144
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundFew Chinese population studies exist on early life risk factors for furry pet allergy.ObjectivesWe studied childhood respiratory symptoms when in contact with furry pets in relation to early life exposure. Moreover, we studied similar environmental associations for rhinitis not related to furry pets.MethodsChildren aged 3–6 y from day care centres in seven Chinese cities participated (N = 39,782). Parents answered a questionnaire on home environment and children’s health, including rhinoconjunctivitis and wheeze when in contact with furry pets, and diagnosed rhinitis. Prenatal and postnatal outdoor temperature, PM2.5, PM10, and NO2 were calculated using data from monitoring stations. Associations were estimated by multilevel logistic regression.ResultsTotally 2% had cats, 4% dogs, and 3.2% had rhinoconjunctivitis or wheeze when in contact with furry pets (FP symptoms). Moreover, 1.1% had furry pet related diagnosed rhinitis and 7.5% had diagnosed rhinitis not related to furry pets (other diagnosed rhinitis). Prenatal PM2.5 and PM10, especially in second trimester, and a colder climate were risk factors for FP symptoms. ETS, dampness and mould, condensation on windows in wintertime, and cats and dog keeping were associated with FP symptoms. Breast feeding and frequent window opening were protective. Similar indoor associations were found for furry pet related diagnosed rhinitis. ETS, dampness and mould, window condensation, urbanization and mechanical exhaust ventilation were risk factors for other diagnosed rhinitis. Cooking with an electric stove and early life exposure to animals (cats, dogs, farm environment during pregnancy) were protective for diagnosed rhinitis not related to furry pets.ConclusionsPrenatal outdoor PM10 and PM2.5 can be risk factors for symptoms suggestive of furry pet allergy. Early life dampness and mould can be risk factors for rhinitis related and not related to furry pets. Exposure to animals (cats, dogs, farm environment) may reduce diagnosed rhinitis not related to furry pets.
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15.
  • Lu, Chan, et al. (författare)
  • Interaction effect of prenatal and postnatal exposure to ambient air pollution and temperature on childhood asthma
  • 2022
  • Ingår i: Environment International. - : Elsevier. - 0160-4120 .- 1873-6750. ; 167
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Although mounting evidence has associated air pollution and environmental temperature with children's health problems, it is unclear whether there is an interaction between these factors on childhood asthma.Objectives: To explore the effects of temperature-pollution interactions during pre- and post-natal periods on asthma among pre-schoolers.Methods: A retrospective cohort study of 39,782 pre-schoolers was performed during 2010-2012, in seven cities in China. Exposure to three temperature indicators (TI) and three critical ambient air pollutants, including particulate matter with aerodynamic diameter <= 10 mu m (PM10), sulfur dioxide (SO2) and nitrogen dioxide (NO2) as proxies of industrial and vehicular air pollution, was estimated by an inverse distance weighted (IDW) method. Two-level logistical regression analysis was used to examine the association between both pre- and post-natal exposure and childhood asthma in terms of odds ratio (OR) and 95 % confidence interval (CI).Results: Asthma prevalence in pre-schoolers at age of 3-6 years (6.9 %) was significantly associated with traffic-related air pollutant (NO2) exposure, with ORs (95 % CI) of 1.17 (1.06, 1.28), 1.19 (1.05-1.34) and 1.16 (1.03-1.31) for an IQR increase in NO2 exposure during lifetime, pregnancy, and entire postnatal period respectively. Furthermore, childhood asthma was positively associated with exposure to increased temperature during lifetime, pregnancy, and entire postnatal period with ORs (95 % CI) = 1.89 (1.66, 2.16), 1.47 (1.34, 1.61), and 1.15 (1.11, 1.18) respectively, while was negatively associated with decreased temperatures. Childhood asthma was positively related with exposure to extreme heat days (EHD) during postnatal period particularly in first year of life respectively with ORs (95 % CI) = 1.23 (1.04, 1.46) and 1.26 (1.07, 1.47), but was not related with extreme cold days (ECD) exposure. A combination of high air pollutant levels and high temperatures significantly increased the risk of asthma during both pre- and post-natal periods. Strikingly, we found a significantly positive interaction of temperature and PM10 or SO2 on asthma risk among boys and younger children.Conclusions: Prenatal and postnatal exposure to ambient air pollution and high temperatures are independently and jointly associated with asthma risk in early childhood.
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16.
  • Lu, Chan, et al. (författare)
  • Onset and remission of eczema at pre-school age in relation to prenatal and postnatal air pollution and home environment across China
  • 2021
  • Ingår i: Science of the Total Environment. - : Elsevier. - 0048-9697 .- 1879-1026. ; 755:Part 1
  • Tidskriftsartikel (refereegranskat)abstract
    • We investigated associations between prenatal and postnatal environmental factors and onset and remission of preschool childhood eczema across China. The study population was preschoolers in randomized day care centers in seven cities (N = 39,782). Data on eczema and prenatal and postnatal indoor and outdoor environment were obtained from a cross-sectional questionnaire sent to parents or other guardians. Reports on eczema in the first 2 years and in the past year was used to retrospectively calculate onset and remission (changes of reported eczema). Prenatal and postnatal outdoor temperature, NO2 and PM10 were modelled from official air pollution data. Associations were estimated by two-level logistic regression. Calculated onset rate was 3.2%/y and remission rate 29.2%/y. Exposure to NO2 during pregnancy was associated with onset of eczema, similarly for all trimesters. Postnatal PM10 and NO2 were related to decreased remission. Postnatal outdoor temperature was associated with onset of eczema. Pre-natal and current redecoration or buying new furniture, and perinatal as well as current dampness and indoor mould, were associated with increased onset and decreased remission. Cockroaches in current home was another indoor risk factors. Prenatal exposure to farm environment and large family size were all negatively associated with eczema. In conclusion, a warmer climate and prenatal NO2 can be associated with increased onset of eczema in Chinese preschoolers. Postnatal PM10 and NO2 can be associated with reduced remission. Perinatal and current dampness, indoor mould and cockroaches may increase onset and decrease remission. Exposure to chemical emissions from indoor materials after first year of life may increase onset. Prenatal exposure to farm environment and large family size could be protective.
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17.
  • Marasinghe, Samali Ayoma, et al. (författare)
  • Indoor environment in Sri Lankan university dormitories : Associations with ocular, nasal, throat and dermal symptoms, headache, and fatigue among students
  • 2024
  • Ingår i: Building and Environment. - : Elsevier. - 0360-1323 .- 1873-684X. ; 251
  • Tidskriftsartikel (refereegranskat)abstract
    • This study investigated the prevalence of medical symptoms, including headache, fatigue, ocular, nasal, throat, and dermal symptoms, among university students and their associations with the indoor environment of Sri Lankan dormitories. The study included 2234 students from seven different dormitory buildings. The association between dormitory environmental factors and students' medical symptoms was determined using multi-level logistic regression. General symptoms (22.8%) were reported more frequently than other symptoms. Headaches (11.6%) and fatigue (11.3%) were the most common specific individual symptoms. The most frequent dampness-related problems were visible mold (29.6%) and visible damp stains (28.8%). Significant gender differences were observed. Suspected moisture problems were a major risk factor for ocular (AOR: 2.65), fatigue (AOR: 1.83), and throat symptoms (AOR: 2.49). Damp stains were also associated with an increased risk of fatigue (AOR: 1.52), ocular (AOR: 1.72), throat (AOR: 2.26), and dermal symptoms (AOR: 1.61). The mutual adjustment model revealed that any type of dampness, as well as being on a lower floor level of the building, was a significant risk factor for the occurrence of throat, dermal, general, and mucosal symptoms. Residing in older buildings was a protective factor for ocular and nasal symptoms. Infrequent window opening was associated with increased medical symptoms. The findings suggested that the dormitory environment has an effect on students' health. Opening windows on a regular basis may improve airflow in dormitories. Future dormitory designs should consider large windows in areas with lower levels of outdoor air pollution, and mechanical ventilation systems should be considered.
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18.
  • Marasinghe, Samali Ayoma, et al. (författare)
  • Validity of questionnaire survey in evaluating residence’s characteristics and dampness in contemporary human dwellings in Tianjin, China
  • 2023
  • Ingår i: Science and Technology for the Built Environment. - : Taylor & Francis. - 2374-4731 .- 2374-474X. ; 29:2, s. 241-249
  • Tidskriftsartikel (refereegranskat)abstract
    • Many researchers used questionnaires to evaluate associations between indoor environment and human health. However, research on validated occupant’s reported information using home inspections is still lacking. This study aims to validate the data regarding building characteristics and dampness signs obtained from a questionnaire survey in Tianjin, China. Kappa values were used to test the evaluation agreement between occupants and inspectors. A perfect to moderate concordances were reported between the occupants’ and the inspectors’ reports for building characteristics of the child’s room. The floor covering material was reported in almost perfect agreement (cement and stone: k = 0.860). There were substantial to moderate agreements for wall covering (wallpaper: k = 0.731; painting and latex paint: k = 0.408). Slight to moderate agreements were reported for dampness indicators in the child’s bedroom, and consistency was higher in homes with sick children. The findings of this study suggest that questionnaire surveys can give valid and reliable data regarding technical parameters of the home, but not mostly for visible signs of dampness in the home environment. To increase the validity of future questionnaires for studying dampness problems, clear digital photos, moisture-sensitive devices, or more details information should be used.
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19.
  • Norbäck, Dan, et al. (författare)
  • Asthma and rhinitis among Chinese children - Indoor and outdoor air pollution and indicators of socioeconomic status (SES)
  • 2018
  • Ingår i: Environment International. - : PERGAMON-ELSEVIER SCIENCE LTD. - 0160-4120 .- 1873-6750. ; 115, s. 1-8
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Few data exist on asthma and rhinitis across China in relation to indoor and outdoor air pollution, climate and socioeconomic factors. The main aim was to study associations between asthma, rhinitis and current respiratory symptoms among pre-school children across China and selected indoor and outdoor exposure and indicators of socio-economic status (SES) in mutually adjusted models.Methods: Chinese children (3-6 yr.) (n = 39,782) were recruited from randomly selected day care centres in seven cities in China. Data on asthma, respiratory symptoms, rhinitis, indoor and outdoor exposure at home and SES were assessed by a parentally administered questionnaire. Lifetime mean ambient temperature, PM10, NO2, and GDP per capita on city level were calculated.Results: Totally 7.4% had ever doctors' diagnosed (DD) asthma and 8.7% DD-rhinitis, 19.7% had current wheeze, 45.0% rhinitis and 16.9% cough. DD-asthma was associated with ambient temperature (OR = 1.15, 95% CI 1.11-1.20 per degrees C), NO2 (OR = 1.16, 95% CI 1.02-1.33 per 10 mu g/m(3)), indoor mould/dampness (OR = 1.25, 95% CI 1.13-1.39) and living near major roads (OR = 1.13, 95% CI 1.02-1.25). DD-rhinitis was associated with ambient temperature (OR= 1.07, 95% CI 1.05-1.10 per degrees C), NO2 (OR= 1.20, 95% CI 1.09-1.32 per 10 mu g/m(3)), GDP (OR= 1.03, 95% CI 1.01-1.06 per 10,000 RenMinBi/year), indoor mould/dampness (OR= 1.23, 95% CI 1.11-1.35), passive smoking (OR= 1.11, 95% CI 1.01-1.21), and living near major roads (OR= 1.14, 95% CI 1.03-1.25). Children in suburban or rural areas, in larger families (>= 5 persons) and with prenatal farm exposure had less DD-asthma and DD-rhinitis.Conclusions: Economic development level of the city, higher SES, ambient temperature, NO2, PM10, traffic air pollution and mould/dampness can be risk factors for asthma and rhinitis and respiratory symptoms among preschool children in China. Breastfeeding, large family size and early-life farm exposure could be protective factors.
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21.
  • Norbäck, Dan, et al. (författare)
  • Home environment and health : Domestic risk factors for rhinitis, throat symptoms and non-respiratory symptoms among adults across China
  • 2019
  • Ingår i: Science of the Total Environment. - : ELSEVIER SCIENCE BV. - 0048-9697 .- 1879-1026. ; 681, s. 320-330
  • Tidskriftsartikel (refereegranskat)abstract
    • Few studies exist from China on associations between home environment and adult health. We studied associations between home environment factors (other than dampness and mould) and rhinitis, throat and dermal symptoms and headache and fatigue among young parents in six cities across China (N = 36,541). They were recruited as parents from day care centers selected randomly and answered a questionnaire on medical symptoms and the home environment. Odds ratios (OR) were calculated by multilevel logistic regression adjusting for gender, atopy, smoking, home size and dampness/mould. Overall, 4.8% had skin symptoms 3.1% rhinitis, 2.8% eye, 4.1% throat symptoms, 3.0% headache and 13.9% had fatigue (all as weekly symptoms). Redecoration was associated with rhinitis, eye and skin symptoms, headache and fatigue. New furniture was associated with eye, throat and skin symptoms and fatigue. Gas cooking was associated with eye and throat symptoms, headache and fatigue. Biomass cooking was associated with eye and throat symptoms and headache. Burning incense was associated with eye, throat and skin symptoms, headache and fatigue. Presence of cockroaches and mosquitos or flies was associated with all six symptoms. Rats or mice were associated with eye and dermal symptoms. Cat keeping was associated with eye symptoms while dog keepers had less fatigue. Living near major roads was associated with rhinitis, eye, throat and skin symptoms and fatigue. Daily cleaning, a mechanical ventilation system in the kitchen or in the bathroom, living in older buildings and living in less urbanized areas were protective factors. In conclusion, urbanization, traffic exhaust, indoor emissions from redecoration and new furniture, gas cooking and air pollution from burning incense and biomass may cause dermal and mucosal symptoms, headache and fatigue among adults in China. Indoor animals (cats, mice/rats, cockroaches) were other risk factors. Daily cleaning, mechanical ventilation and living in older buildings can be protective. 
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22.
  • Norbäck, Dan, et al. (författare)
  • Lifetime-ever pneumonia among pre-school children across China - Associations with pre-natal and post-natal early life environmental factors
  • 2018
  • Ingår i: Environmental Research. - : ACADEMIC PRESS INC ELSEVIER SCIENCE. - 0013-9351 .- 1096-0953. ; 167, s. 418-427
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Biomass burning is associated with childhood pneumonia but few studies exist on other indoor factors.Aim: To study pneumonia in relation to pre-natal and post-natal exposure among children across China.Methods: Children (3-6 y) (n = 39,782) from randomized day care centres in seven cities in China. Information on pneumonia and pre-natal and post-natal exposure to home environment factors were assessed by a parental questionnaire. Life-time outdoor temperature and GDP per capita were assessed on city level. Associations were calculated by multilevel logistic regression adjusting for fourteen co-variates.Results: Totally 32.0% had ever had pneumonia diagnosed by a physician. Children of farmer mothers (OR = 0.65), with breastfeeding (OR = 0.91) and living in rural (OR = 0.85) or suburban (OR = 0.90) areas had less pneumonia. Buying new furniture one year before conception (OR = 1.11) and after first year of life (OR = 1.10) increased the risk. Redecoration one year before conception (OR = 1.20), during pregnancy (OR = 1.18) and after first year of life (OR = 1.17) increased pneumonia risk. Children with mould (OR = 1.17), window pane condensation (WPC) (OR = 1.20) and mould odour (OR = 1.15) at home at birth only had a higher risk of pneumonia. Similar associations were seen for dampness and mould in the current home. Children in the oldest and newest homes had less pneumonia. Cockroaches (OR = 1.08), mosquitos or flies in the current home (OR = 1.18), an exhaust fan in the bathroom (OR = 1.10) and higher economic development level, measured as GDP per capita on city level (OR 1.11 per 10,000 RMB/year) were associated with childhood pneumonia.Conclusions: Perinatal and postnatal exposure to mould, mould odour and window pane condensation at home can be early life risk factors for childhood pneumonia in China. Moreover, pre-natal and post-natal exposure to chemical emissions from new furniture and renovation could increase the risk of childhood pneumonia. Breastfeeding, farm exposure, and living in rural or suburban areas could be protective.
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23.
  • Norbäck, Dan, et al. (författare)
  • Onset and remission of childhood wheeze and rhinitis across China : Associations with early life indoor and outdoor air pollution
  • 2019
  • Ingår i: Environment International. - : Elsevier BV. - 0160-4120 .- 1873-6750. ; 123, s. 61-69
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: Few longitudinal studies exist on childhood exposure to indoor and outdoor air pollution and respiratory illness in China. We studied associations between indoor and outdoor environment and prevalence, onset and remission of wheeze and rhinitis among children across China.Methods: Children (3-6 y) were recruited from randomized day care centres in six cities. The main data analysis was restricted to children not moving since birth (N = 17,679). Data on wheeze, rhinitis and the home environment were assessed by a parental questionnaire. Prevalence in the first two years of life (baseline) and the last year (follow-up) was used to calculate onset and remission. Outdoor PM2.5, PM10, and NO2 at the day care centre were modelled from monitoring station data. Associations were calculated by multilevel logistic regression.Results: Prenatal NO2 was associated with decreased remission of wheeze and increased prevalence and increased onset of rhinitis. Prenatal PM2.5 was associated with increased prevalence of wheeze. Postnatal NO2 and postnatal PM10 were associated with increased prevalence and lower remission of wheeze and rhinitis. Mould, window pane condensation, renovation and cockroaches at home were associated with increased prevalence and increased onset of wheeze and rhinitis. Gas cooking was associated with increased onset of rhinitis. Children of mothers with industrial work had more wheeze.Conclusions: Outdoor PM2.5, PM10 and NO2 can increase childhood wheeze and rhinitis. Dampness and mould can increase onset and decrease remission. Crowdedness, cockroaches at home and emissions from new building materials and gas cooking can be risk factors for wheeze and rhinitis.
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24.
  • Norbäck, Dan, et al. (författare)
  • Sources of indoor particulate matter (PM) and outdoor air pollution in China in relation to asthma, wheeze, rhinitis and eczema among pre-school children : Synergistic effects between antibiotics use and PM10 and second hand smoke
  • 2019
  • Ingår i: Environment International. - : Elsevier BV. - 0160-4120 .- 1873-6750. ; 125, s. 252-260
  • Tidskriftsartikel (refereegranskat)abstract
    • We studied indoor sources of indoor particulate matter (PM), outdoor air pollution and antibiotic use in relation to asthma, rhinitis and eczema among pre-school children and investigated synergistic effects between PM and antibiotics use. Children (3-6y) from randomly selected day care centres in seven cities across China were included (n = 39,782). Data on ambient temperature and air pollution were collected from local monitoring stations. Data on indoor PM sources (ETS, burning of incense or mosquito coils and biomass for cooking), antibiotics use and health (doctor diagnosed asthma and rhinitis, lifetime eczema, current wheeze and current rhinitis) were assessed by a parental questionnaire. Associations were calculated by multilevel logistic regression. Asthma diagnosis was associated with outdoor temperature, NO2 and burning mosquito coils. Rhinitis diagnosis was associated with NO2, ETS, gas cooking and burning biomass for cooking. Lifetime eczema was associated with temperature, PM10, NO2, ETS, biomass cooking and burning mosquito coils. Burning incense was associated with current wheeze and current rhinitis. Children using antibiotics had more asthma, wheeze, rhinitis, and eczema. Excluding children with respiratory infections did not change associations with antibiotics use. Antibiotics use enhanced the effects of ETS and PM10 (a synergistic effect). In conclusion, a warmer climate, outdoor NO2 and PM10, ETS, gas cooking and burning biomass, incense and mosquito coils can increase the risk of asthma, wheeze, rhinitis and eczema among pre-school children in China. Antibiotics use is a risk factor for childhood asthma, wheeze, rhinitis and eczema and ETS and outdoor PM10 can enhance the effect.
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