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Sökning: hsv:(MEDICIN OCH HÄLSOVETENSKAP) hsv:(Klinisk medicin) hsv:(Lungmedicin och allergi) > Norbäck Dan

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1.
  • Deng, Qihong, et al. (författare)
  • Early life exposure to ambient air pollution and childhood asthma in China
  • 2015
  • Ingår i: Environmental Research. - : Elsevier BV. - 0013-9351 .- 1096-0953. ; 143, s. 83-92
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Early life is suggested to be a critical time in determining subsequent asthma development, but the extent to which the effect of early-life exposure to ambient air pollution on childhood asthma is unclear. Objectives: We investigated doctor-diagnosed asthma in preschool children due to exposure to ambient air pollution in utero and during the first year of life. Methods: In total 2490 children aged 3-6 years participated in a questionnaire study regarding doctor-diagnosed asthma between September 2011 and January 2012 in China. Children's exposure to critical air pollutants, sulfur dioxide (SO2) as proxy of industrial air pollution, nitrogen dioxide (NO2) as proxy of traffic pollution, and particulate matter <= 10 mu m in diameter (PM10) as a mixture, was estimated from the concentrations measured at the ambient air quality monitoring stations by using an inverse distance weighted (IDW) method. Logistic regression analysis was employed to determine the relationship between early-life exposure and childhood asthma in terms of odds ratio (OR) and 95% confidence interval (CI). Results: Association between early-life exposure to air pollutants and childhood asthma was observed. SO2 and NO2 had significant associations with adjusted OR (95% CI) of 1.45 (1.02-2.07) and 1.74 (1.15-2.62) in utero and 1.62 (1.01-2.60) and 1.90 (1.20-3.00) during the first year for per 50 mu g/m(3) and 15 mu g/m(3) increase respectively. Exposure to the combined high level of SO2 and NO2 in China significantly elevated the asthmatic risk with adjusted OR (95% CI) of 1.76 (1.18-2.64) in utero and 1.85 (1.22-2.79) during the first year compared to the low level exposure. The associations were higher for males and the younger children aged 3-4 than females and the older children aged 5-6. Conclusions: Early-life exposure to ambient air pollution is associated with childhood asthma during which the level and source of air pollution play important roles. The high level and nature of combined industrial and traffic air pollution in China may contribute to the recent rapid increase of childhood asthma. (C) 2015 Elsevier Inc. All rights reserved.
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2.
  • Shi, Haonan, et al. (författare)
  • 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
  • Ingår i: BMC Medicine. - : BioMed Central (BMC). - 1741-7015. ; 21
  • 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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3.
  • Wang, Juan, et al. (författare)
  • Exacerbation of asthma among adults in relation to the home environment in multi-family buildings in Sweden
  • 2017
  • Ingår i: The International Journal of Tuberculosis and Lung Disease. - : INT UNION AGAINST TUBERCULOSIS LUNG DISEASE (I U A T L D). - 1027-3719 .- 1815-7920. ; 21:2, s. 223-229
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To study the association between the home environment and asthma medication and exacerbation of asthma among adults with physician-diagnosed asthma. METHODS: Adults aged >= 18 years in a stratified sample of multi-family buildings throughout Sweden were invited to respond to a postal questionnaire (the BETSI Study). A total of 639 adults (11.5%) with physician-diagnosed asthma were included. RESULTS: Of the 639 adults, 62.0% were females, 10.8% were current smokers, 62.6% had pollen or furry pet allergy, 61.7% were on current asthma medication and 48.6% had experienced an asthma exacerbation in the past year. Logistic regression models were applied to study the association between the home environment and asthma medication and asthma exacerbation, adjusting for sex, age and smoking status. Asthma medication was more commonly prescribed for those who kept dogs as pets (OR 2.66, 95 % CI 1.05-6.75) and in homes with mouldy odour (OR 5.72, 95%CI 1.29-25.4). Asthma exacerbation was more frequent among those living in buildings constructed in 1961-1975 (OR 2.56, 95%CI 1.22-5.34), in areas with a high population density (OR 4.69, 95%CI 1.42-15.5), in rented apartments (OR 1.77, 95 %CI 1.12-2.78) and in homes with a greater degree of window opening (OR 1.47, 95 % CI 1.12-1.94). CONCLUSIONS: Factors in the home environment were associated with exacerbation of asthma in adults. Certain construction periods (1961-1975), rented apartments, mould, having dogs as pets and living in urban areas were associated with asthma exacerbations.
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4.
  • Wang, Lexiang, et al. (författare)
  • Prenatal and postnatal decoration in residence are associated with childhood allergies and respiratory diseases : A 10-year repeated retrospective observational study
  • 2023
  • Ingår i: Building and Environment. - : Elsevier. - 0360-1323 .- 1873-684X. ; 234
  • 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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5.
  • Yu, Wei, et al. (författare)
  • Increased risk of respiratory and allergic diseases in preschoolers from building envelope dampness exposure : Repeated cross-sectional surveys in multicity China
  • 2023
  • Ingår i: Building and Environment. - : Elsevier. - 0360-1323 .- 1873-684X. ; 241
  • Tidskriftsartikel (refereegranskat)abstract
    • Building envelope dampness exposure is correlated with children's respiratory and allergic diseases. However, little research has compared the variation in the health impact of dampness exposure across multiple cities from a longitudinal perspective. A cross-sectional survey and a repeated one were conducted in children's residences in six cities: Chongqing, Shanghai, Nanjing, Wuhan, Changsha and Taiyuan, China, in 2010 (Phase I) and 2019 (Phase II). We selected 17,810 preschoolers during Phase I and 26,001 preschoolers during Phase II aged 3-6 years without changing residence since birth in the study. The proportion of residences with building envelope dampness exposure and the prevalence of respiratory and allergic diseases, except allergic rhinitis, in preschoolers significantly declined from Phase I to Phase II. Dampness exposure increased the risk for most childhood respiratory diseases in Phase II, with a 34% greater risk of lifetime-ever asthma in early residences and a 36% greater risk of current eczema in current residences. Most diseases showed a significantly positive exposureresponse relationship to the cumulative period of building envelope dampness exposure (p < 0.05). The risk of developing current eczema was approximately 1.35 and 1.73 times higher in children exposed to both early and current dampness in Phase I and Phase II, respectively, than in children who had never been exposed. These findings provide new insights into the respiratory and allergic diseases in Chinese preschoolers because of building envelope dampness exposure over the last decade. The increased risk in Phase II raises concerns about the household's dampness environment.
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6.
  • Triebner, K., et al. (författare)
  • Menopause as a predictor of new-onset asthma: A longitudinal Northern European population study
  • 2016
  • Ingår i: Journal of Allergy and Clinical Immunology. - : Elsevier BV. - 0091-6749 .- 1097-6825. ; 137:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: There is limited and conflicting evidence on the effect of menopause on asthma. Objectives: We sought to study whether the incidence of asthma and respiratory symptoms differ by menopausal status in a longitudinal population-based study with an average follow-up of 12 years. Methods: The Respiratory Health in Northern Europe study provided questionnaire data pertaining to respiratory and reproductive health at baseline (1999-2001) and follow-up (2010-2012). The study cohort included women aged 45 to 65 years at follow-up, without asthma at baseline, and not using exogenous hormones (n = 2322). Menopausal status was defined as nonmenopausal, transitional, early postmenopausal, and late postmenopausal. Associations with asthma (defined by the use of asthma medication, having asthma attacks, or both) and respiratory symptoms scores were analyzed by using logistic (asthma) and negative binomial (respiratory symptoms) regressions, adjusting for age, body mass index, physical activity, smoking, education, and study center. Results: The odds of new-onset asthma were increased in women who were transitional (odds ratio, 2.40; 95% CI, 1.09-5.30), early postmenopausal (odds ratio, 2.11; 95% CI, 1.06-4.20), and late postmenopausal (odds ratio, 3.44; 95% CI, 1.31-9.05) at follow-up compared with nonmenopausal women. The risk of respiratory symptoms increased in early postmenopausal (coefficient, 0.40; 95% CI, 0.06-0.75) and late postmenopausal (coefficient, 0.69; 95% CI, 0.15-1.23) women. These findings were consistent irrespective of smoking status and across study centers. Conclusions: New-onset asthma and respiratory symptoms increased in women becoming postmenopausal in a longitudinal population-based study. Clinicians should be aware that respiratory health might deteriorate in women during reproductive aging. RAMSON MJ, 1991, JOURNAL OF ASTHMA, V28, P129
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7.
  • Adman, M. A., et al. (författare)
  • Associations between air pollutants and peak expiratory flow and fractional exhaled nitric oxide in students
  • 2020
  • Ingår i: The International Journal of Tuberculosis and Lung Disease. - : INT UNION AGAINST TUBERCULOSIS LUNG DISEASE (I U A T L D). - 1027-3719 .- 1815-7920. ; 24:2, s. 189-
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Studies on the effects of outdoor air pollution on the respiratory health of students in tropical countries such as Malaysia are limited. OBJECTIVE: To assess associations between outdoor air pollutants and peak expiratory flow (PEF) and fractional exhaled nitric oxide (FeNO). METHOD: PEF and FeNO levels of 487 students recruited in Melaka and Putrajaya, Malaysia, were measured in April and June 2014. Multiple linear regression with mutual adjustment was used to analyse the associations between exposure to air pollution and health. RESULTS: PEF was significantly associated with ozone for 1-day exposure (beta = -13.3 l/min, 95% CI -22.7 to -3.8), carbon monoxide for 2-day exposure (beta =-57.2 l/min, 95% CI -90.7 to -23.7) and particulate matter <= 10 mu m in diameter for 3-day exposure (beta =-6.0 l/min, 95% CI -9.2 to -2.8) and 7-day exposure (beta = -8.6 l/min, 95% CI -13.0 to -4.1). Stratified analysis showed that associations between PEF and outdoor air pollutant exposures were similar in students with and without elevated FeNO levels. CONCLUSION: Outdoor air pollution in Malaysia may cause airway obstruction unrelated to eosinophilic airway inflammation among students as measured using FeNO.
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8.
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9.
  • Ahlroth Pind, Caroline, et al. (författare)
  • Patient-reported signs of dampness at home may be a risk factor for chronic rhinosinusitis : A cross-sectional study
  • 2017
  • Ingår i: Clinical and Experimental Allergy. - Hoboken : Wiley. - 0954-7894 .- 1365-2222. ; 47:11, s. 1383-1389
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: An association between dampness at home and respiratory conditions has been convincingly demonstrated in children. Fewer studies have been performed in adults, and data are lacking for chronic rhinosinusitis (CRS). With a prevalence of 10.9% in Europe, CRS imposes a significant burden on quality of life, as well as economy.OBJECTIVE: Our aim was to study CRS and other respiratory conditions in relation to dampness at home in a representative sample of adults.METHODS: The Swedish GA2 LEN questionnaire was answered by 26 577 adults (16-75 years) and included questions on respiratory symptoms, smoking, education and environmental exposure. CRS was defined according to the EP3 OS criteria. Dampness was defined as reporting water damage, floor dampness or visible moulds in the home during the last 12 months. The dampness score was ranked from 0 to 3, counting the number of signs of dampness reported.RESULTS: Dampness at home was reported by 11.3% and was independently related to respiratory conditions after adjustment for demographic and socio-economic factors and smoking: CRS odds ratio (OR) 1.71; allergic rhinitis OR 1.24; current asthma OR 1.21; wheeze OR 1.37; nocturnal dyspnoea OR 1.80; nocturnal coughing OR 1.34; and chronic bronchitis OR 1.64. The risk of CRS and most of the other respiratory conditions was further elevated in subjects reporting multiple signs of dampness.CONCLUSIONS AND CLINICAL RELEVANCE: This study demonstrated an independent association between dampness at home and CRS in adults. The high burden of this and the other respiratory conditions studied is a strong argument in favour of countering indoor dampness by improving building standards.
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10.
  • Amaral, Andre F. S., et al. (författare)
  • Interaction between gas cooking and GSTM1 null genotype in bronchial responsiveness : results from the European Community Respiratory Health Survey
  • 2014
  • Ingår i: Thorax. - : BMJ. - 0040-6376 .- 1468-3296. ; 69:6, s. 558-564
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Increased bronchial responsiveness is characteristic of asthma. Gas cooking, which is a major indoor source of the highly oxidant nitrogen dioxide, has been associated with respiratory symptoms and reduced lung function. However, little is known about the effect of gas cooking on bronchial responsiveness and on how this relationship may be modified by variants in the genes GSTM1, GSTT1 and GSTP1, which influence antioxidant defences. Methods The study was performed in subjects with forced expiratory volume in one second at least 70% of predicted who took part in the multicentre European Community Respiratory Health Survey, had bronchial responsiveness assessed by methacholine challenge and had been genotyped for GSTM1, GSTT1 and GSTP1-rs1695. Information on the use of gas for cooking was obtained from interviewer-led questionnaires. Effect modification by genotype on the association between the use of gas for cooking and bronchial responsiveness was assessed within each participating country, and estimates combined using meta-analysis. Results Overall, gas cooking, as compared with cooking with electricity, was not associated with bronchial responsiveness (beta=-0.08, 95% CI -0.40 to 0.25, p=0.648). However, GSTM1 significantly modified this effect (beta for interaction=-0.75, 95% CI - 1.16 to -0.33, p=4x10(-4)), with GSTM1 null subjects showing more responsiveness if they cooked with gas. No effect modification by GSTT1 or GSTP1-rs1695 genotypes was observed. Conclusions Increased bronchial responsiveness was associated with gas cooking among subjects with the GSTM1 null genotype. This may reflect the oxidant effects on the bronchi of exposure to nitrogen dioxide.
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