| 1. |
- 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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| 2. |
- 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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| 3. |
- Lu, Chan, et al.
(författare)
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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
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Ingår i: Environment International. - : Elsevier BV. - 0160-4120 .- 1873-6750. ; 144
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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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| 4. |
- Lu, Chan, et al.
(författare)
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Interaction effect of prenatal and postnatal exposure to ambient air pollution and temperature on childhood asthma
- 2022
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Ingår i: Environment International. - : Elsevier. - 0160-4120 .- 1873-6750. ; 167
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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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| 5. |
- Norbäck, Dan, et al.
(författare)
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Asthma and rhinitis among Chinese children - Indoor and outdoor air pollution and indicators of socioeconomic status (SES)
- 2018
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Ingår i: Environment International. - : PERGAMON-ELSEVIER SCIENCE LTD. - 0160-4120 .- 1873-6750. ; 115, s. 1-8
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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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| 6. |
- Norbäck, Dan, et al.
(författare)
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Common cold among pre-school children in China - associations with ambient PM10 and dampness, mould, cats, dogs, rats and cockroaches in the home environment
- 2017
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Ingår i: Environment International. - : Elsevier BV. - 0160-4120 .- 1873-6750. ; 103, s. 13-22
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is some evidence that dampness, mould and cockroaches can increase the risk of respiratory infections in children but few studies exist from China on this topic.Aim: To study associations between domestic early life exposure to biological indoor factors (dampness, mould, cats, dogs, rats, cockroaches), cleaning habits and common cold among pre-school children across China.Methods: Children aged 3-6 years (n = 39,782) were recruited from randomly selected day care centres in seven cities in China. Data on common cold and prenatal and postnatal exposure to dampness, mould, windowpane condensation inwintertime (WPC), cats, dogs, cockroaches and rats were assessed by a parentally administered questionnaire. Data on annual ambient temperature and PM10 was assessed on city level. Associations between high frequency (>5 colds per year) and long duration (>= 2 weeks) of common colds in the past year and exposure were calculated by multilevel logistic regression.Results: A total of 9.2% had a high frequency and 11.9% had long duration of common cold. Exposure to mould (OR= 1.38, 95% CI 1.24-1.53) and WPC (OR 1.23, 95% CI 1.13-1.33) at birth was associated with frequent common cold. Exposure to dogs at birth was associated with long duration of common cold. (OR= 1.22, 95% CI 1.06-1.41). Exposure tomould (OR= 1.36, 95% CI 1.22-1.54), WPC (OR= 1.27, 95% CI 1.17-1.39) and water leakage (OR 1.34, 95% CI 1.20-1.49) in the current home was associated with frequent common cold. Presence of cockroacheswere positively (OR= 1.12, 95% CI 1.02-1.24) and presence of rats (OR= 0.86, 95% CI 0.77-0.96) negatively associated with high frequency of common cold. Daily cleaning was negatively associated with frequent common cold (OR= 0.89, 95% CI 0.81-0.97). Similar associations formould, WPC, cockroaches and rats were found for long duration. Ambient PM10 (OR = 1.21, 95% CI 1.21-1.35 per 10 mu g/m(3)) and temperature (OR = 1.13, 95% CI 1.06-1.35 degrees C) on city level were associated with high frequency of common cold. Associations between cat keeping and high frequency of common cold were found only in southern China. Associations with cockroaches were stronger in northern China. Associations with dampness and mould were the same in the north and south.Conclusions: Indoormould, water damage, windowpane condensation, cockroaches and keeping cats or dogs as pets can be risk factors for common cold while daily cleaning can be protective factor. PM10 and a warmer climate zone can be other risk factors for common cold.
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| 7. |
- Norbäck, Dan, et al.
(författare)
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Onset and remission of childhood wheeze and rhinitis across China : Associations with early life indoor and outdoor air pollution
- 2019
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Ingår i: Environment International. - : Elsevier BV. - 0160-4120 .- 1873-6750. ; 123, s. 61-69
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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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| 8. |
- Norbäck, Dan, et al.
(författare)
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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
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Ingår i: Environment International. - : Elsevier BV. - 0160-4120 .- 1873-6750. ; 125, s. 252-260
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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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| 9. |
- Shi, Wenming, et al.
(författare)
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Ambient PM2.5 and its chemical constituents on lifetime-ever pneumonia in Chinese children : A multi-center study
- 2021
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Ingår i: Environment International. - : Elsevier. - 0160-4120 .- 1873-6750. ; 146
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Tidskriftsartikel (refereegranskat)abstract
- The long-term effects of ambient PM2.5 and chemical constituents on childhood pneumonia were still unknown. A cross-sectional study was conducted in 30,315 children in the China Children, Homes, Health (CCHH) project, involving 205 preschools in six cities in China, to investigate the long-term effects of PM2.5 constituents on lifetime-ever diagnosed pneumonia. Information on the lifetime-ever pneumonia and demographics were collected by validated questionnaires. The lifetime annual average ambient PM2.5, ozone and five main PM2.5 constituents, including SO42-, NO3-, NH4+, organic matter (OM) and black carbon (BC), were estimated according to preschool addresses by a combination of satellite remote sensing, chemical transport modeling and ground-based monitors. The prevalence of lifetime-ever diagnosed pneumonia was 34.5% across six cities and differed significantly among cities (p = 0.004). The two-level logistic regression models showed that the adjusted odds ratio for PM2.5 (per 10 µg/m3) and its constituents (per 1 µg/m3)-SO42-, NO3-, NH4+, and OM were 1.12 (95% CI:1.07-1.18), 1.02 (1.00-1.04), 1.06 (1.04-1.09), 1.05 (1.03-1.07) and 1.09 (1.06-1.12), respectively. Children in urban area, aged < 5 years and breastfeeding time < 6 months enhanced the risks of pneumonia. Our study provided robust results that long-term levels of ambient PM2.5 and its constituents increased the risk of childhood pneumonia, especially NH4+, NO3- and OM.
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| 10. |
- Shi, Wenming, et al.
(författare)
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Urinary phthalate metabolites in relation to childhood asthmatic and allergic symptoms in Shanghai
- 2018
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Ingår i: Environment International. - : PERGAMON-ELSEVIER SCIENCE LTD. - 0160-4120 .- 1873-6750. ; 121, s. 276-286
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Tidskriftsartikel (refereegranskat)abstract
- Background: Few studies can be found on phthalate exposure in relation to childhood asthma and allergic symptoms from Mainland China, where a persistent increase in prevalence of childhood asthma and allergic disease has been observed. Objectives: This study aimed to assess the exposure levels to phthalates and its relationship with asthmatic and allergic symptoms among children in Shanghai, which has the highest prevalence of childhood asthma in Mainland China. Methods: A follow-up study (2013-2014) of 434 children aged 5-10 years was conducted, based on the China, Children, Homes, Health (CCHH) study (2011-2012) in Shanghai, China. Information on asthmatic and allergic symptoms (wheeze, rhinitis, and eczema) were collected using validated questionnaires. Ten phthalate metabolites in morning urine samples were analyzed by high-performance liquid chromatography with triple quadrupole tandem mass spectrometry (HPLC-MS/MS). Multivariable logistic regression was used to estimate the associations between symptoms and urinary phthalate metabolites controlling for demographics, family history of allergic diseases and other covariates. Results: Nine out of 10 phthalate metabolites were detected in all subjects (average detection rate of 93.2%). By multivariable logistic regression analyses, the 4th quartile of Mono-n-butyl phthalate (MnBP) (reference: 1st quartile) had adjusted prevalence odds ratios (aPORs) and 95% confidence intervals (95%CIs) of 2.27(1.06-4.88), 2.14(1.02-4.46) and 2.98(1.19-7.50) for wheeze, rhinitis and eczema, respectively, while those of Mono-isobutyl phthalate (MiBP) were 2.23(1.08-4.62) and 2.96(1.02-8.60) for rhinitis and eczema, respectively. The highest quartile of mono-2-ethyl-5-hydroxyhexyl phthalate(MEHHP) and mono 2 ethyl 5 ox ohexyl phthalate(MEOHP) had aPORs and 95%CIs of 3.10(1.10-8.74) and 2.63(1.02-6.80) for eczema, respectively. By summing up the 4 low molecular weight metabolites (Sigma 4LMWP) and all 9 metabolites (Sigma(9)Total), the highest quartiles of Sigma 4LMWP and Sigma(9)Total were significantly associated with all symptoms. In most of the above associations, a significantly increasing trend from the 1st to the 4th quartile was observed. Subjects with 2 or 3 concomitant symptoms (reference: no symptoms) had significant positive associations with a higher level (the 4th quartile) of phthalate metabolites. Conclusions: Low MW metabolites such as MnBP and MiBP, high MW DEHP and the total amount of phthalate metabolites might have adverse health effects on asthma and allergic symptoms in Chinese children.
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