Breastfeeding modifies the effects of environment tobacco smoke exposure on respiratory diseases and symptoms in Chinese children: the Seven Northeast Cities Study

To evaluate the potential effect of interaction between breastfeeding and environmental tobacco smoke (ETS) exposure on respiratory health, we studied 31 049 children (aged 2–14 years) from 25 districts of seven cities in northeast China. Parents of the children completed standardized questionnaires that characterized the children's histories of respiratory symptoms and illness, feeding methods, ETS exposure, and other associated risk factors. Breastfeeding was defined as having been mainly breastfed for 3 months or more. The results showed that the association of ETS exposure with childhood respiratory conditions/diseases was modified by breastfeeding, and the association for nonbreastfed children was stronger than that for breastfed children. In particular, for nonbreastfed children, the odds ratios (ORs) for the effect of current ETS exposure asthma was 1.71 (95% CI: 1.43–2.05); however, the OR for breastfed children was 1.33 (95% CI: 1.20–1.48), indicating that the interactions between breastfeeding and current ETS exposure on asthma were statistically significant (P = 0.019). When stratified by school (kindergarten vs. elementary school), breastfeeding was more protective for asthma‐related symptoms among children from kindergarten. In conclusion, this study shows that breastfeeding is associated with smaller associations between ETS exposure and respiratory conditions in children, suggesting that breastfeeding reduces susceptibility to the respiratory effects of ETS.     

Fungal and endotoxin measurements in dust associated with respiratory symptoms in a water-damaged office building

We investigated the associations of fungal and endotoxin levels in office dust with respiratory health in 888 (67% participation) occupants of a water-damaged building. We analyzed floor and chair dusts from 338 workstations for culturable fungi and endotoxin. Based on averages, we ranked each floor of the building as low, medium, or high for occupants' exposure to each of these agents. Multivariate logistic regression models for building-related symptoms included this ranking of fungi and endotoxin, age, gender, race, smoking status, and duration of occupancy. Using floor dust measures, we found significantly increased odds for lower respiratory symptoms [wheeze, chest tightness, attacks of shortness of breath, and attacks of cough: odds ratios (OR) = 1.7 (95% confidence interval (CI): 1.02-2.77) to 2.4 (95% CI: 1.29-4.59)], throat irritation [OR = 1.7, (95% CI: 1.06-2.82)], and rash/itchy skin [OR = 3.0, (95% CI: 1.47-6.19)] in the highest fungal exposure group compared to the lowest, with generally linear exposure-response relationships. Nonlinear relationships were observed for many of these symptoms and endotoxin in floor dust. Interaction models showed that endotoxin modified effects of fungi on respiratory symptoms. Our findings of exposure interactions and exposure-response relationships of fungal and endotoxin with increased risk of building-related symptoms contribute to an understanding of the role of microbial agents in building-related asthma and respiratory and systemic symptoms. PRACTICAL IMPLICATIONS: Our demonstration of exposure-response relationships between measurements of fungi and/or endotoxin in floor dusts and building-related symptoms implies that microbial agents in floor dust may be a good surrogate measure for dampness-related bioaerosol exposure, considering that measurements of microbial agents in air often fail to demonstrate the associations between exposure and health. In addition, our finding that endotoxin exposure may change the effect of fungal exposure (and vice versa) on respiratory heath suggests that exposure to both fungi and endotoxin should be assessed in epidemiological investigations examining the effect of fungal or endotoxin exposure on respiratory health in indoor environments.     

Pre‐ and postnatal exposure to tobacco smoke and respiratory outcomes during the first year

The different role of prenatal and postnatal exposure to tobacco smoke in respiratory outcomes in infants has not yet been clearly established. Our objective is to assess the effects of these exposures on the risk of respiratory outcomes during the first year of life of infants from a Spanish multicenter cohort study. A total of 2506 women were monitored until delivery. About 2039 infants made up the final population. The outcomes were caused by the occurrence of the following: otitis, cough persisting for more than 3 weeks, lower respiratory tract symptoms (wheezing or chestiness), and lower respiratory tract infections (bronchitis, bronchiolitis, or pneumonia). The relationship between prenatal and postnatal exposure and health outcomes was explored using logistic regression analysis. Maternal smoking during pregnancy increased the odds for wheezing (OR: 1.41, 95% CI: 0.99–2.01) and chestiness (OR: 1.46, 95% CI: 1.03–2.01). Postnatal exposure from fathers was associated with otitis (OR: 1.25, 95% CI: 1.01–1.54). Passive exposure at work of non‐smoking mothers during pregnancy was related to cough (OR: 1.62, 95% CI: 1.05–2.51). Exposure to tobacco smoke was related to a higher risk of experiencing respiratory outcomes in young infants. Prenatal exposure was that most clearly associated with the respiratory outcomes analyzed.     

Indoor Environmental Risk Factors for Respiratory Health in Children

Abstract The indoor environment of 80 houses in the Latrobe Valley, Victoria, Australia was assessed during six visits performed bi-monthly over a period of one year. Children between 7 and 14 years of age residing in the houses were included, resulting in 148 study children, 53 of whom were asthmatic. A respiratory health questionnaire was completed and skin prick tests performed. Significant risk factors for asthma were: exposure to a gas stove (OR=3.15, 95% CI 1.28-7.72), and indoor pets (OR = 2.68, 95% CI 1.07-6.70). Exposure to airborne Aspergillus spores (+10 CFU/m³, OR=1.51, 95% CI 1.05-2.18) was a risk factor for atopy, while exposure to a gas stove (OR=2.32, 95% CI 1.04-5.18) was a risk factor for respiratory symptoms. In conclusion, exposure to gas stoves, fungal spores and pets in the home were identified as statistically significant risk factors for respiratory health in children.     

Home dampness,childhood asthma,hay fever,and airway symptoms in Shanghai,China: associations,dose‐response relationships,and lifestyle's influences

Numerous studies of associations between dampness and respiratory diseases have been conducted, but their implications remain inconclusive. In this study of 13,335 parent‐reported questionnaires (response rate: 85.3%), we analyzed associations between home dampness and asthma and related symptoms in 4‐ to 6‐year‐old children in a cross‐sectional study of Shanghai. Indicators of home dampness were strongly and significantly associated with dry cough, wheeze, and rhinitis symptoms. In the current residence, children with visible mold spots (VMS) exposure had 32% higher risk of asthma (adjusted OR, 95% CI: 1.32, 1.07–1.64); damp clothing and/or bedding (frequently) was strongly associated with dry cough (1.78, 1.37–2.30); condensation on windows was strongly associated with hay fever (1.60, 1.27–2.01). In the early‐life residence, VMS or damp stains (frequently) were strongly associated with dry cough (2.20, 1.55–3.11) and rhinitis ever (1.57, 1.11–2.21). Associations between dampness and diseases among children with or without family history of atopy were similar. The total number of dampness indicators had strong dose‐response relationships with investigated health outcomes. Actions, including opening windows of the child's room at night and cleaning the child's room frequently, could potentially mitigate 25% of home VMS, thereby preventing more than 1.5% of attributable risk of the studied symptoms.     

Respiratory responses to diverse indoor combustion air pollution sources

Diverse indoor combustion sources contribute to the indoor air environment. To evaluate the effect of these sources on human respiratory health, we examined associations between respiratory conditions and household factors in the 2360 children's fathers (mean = 38.4 years old) and associations between lung function and household factors in 463 primary school children (mean = 8.3 years old) from Wuhan, China. Factor analysis developed new uncorrelated 'factor' variables. Unconditional logistic regression models or linear regression models, controlling for important covariates, estimated the respiratory health effects. Coal smoke derived from home heating ('heating coal smoke') was associated with high adult reporting of persistent cough, persistent phlegm, and wheeze. Cooking coal smoke was associated with physician-diagnosed adult asthma and decreased forced vital capacity (FVC), and forced expiratory volume at 1 s (FEV(1)) in children. The presence of any home cigarette smoker was associated with more reports of persistent cough, persistent phlegm, cough with phlegm, and bronchitis. Our study suggests that in Wuhan, there may be independent respiratory health effects of different indoor combustion sources and their exposure factors for these study populations. PRACTICAL IMPLICATIONS: We conclude that multiple indoor air pollution sources could have adverse respiratory health effects on both children and middle-aged men in the city of Wuhan, China. These results may have implications for the Wuhan local government, the Chinese government, or other related organizations in efforts on protecting public health through regulation of indoor air pollution from indoor combustion sources.     

Current wheeze,asthma, respiratory infections,and rhinitis among adults in relation to inspection data and indoor measurements in single‐family houses in Sweden—The BETSI study

In the Swedish Building Energy, Technical Status and Indoor environment study, a total of 1160 adults from 605 single‐family houses answered a questionnaire on respiratory health. Building inspectors investigated the homes and measured temperature, air humidity, air exchange rate, and wood moisture content (in attic and crawl space). Moisture load was calculated as the difference between indoor and outdoor absolute humidity. Totally, 7.3% were smokers, 8.7% had doctor’ diagnosed asthma, 11.2% current wheeze, and 9.5% current asthma symptoms. Totally, 50.3% had respiratory infections and 26.0% rhinitis. The mean air exchange rate was 0.36/h, and the mean moisture load 1.70 g/m³. Damp foundation (OR=1.79, 95% CI 1.16‐2.78) was positively associated while floor constructions with crawl space (OR=0.49, 95% CI 0.29‐0.84) was negatively associated with wheeze. Concrete slabs with overlying insulation (OR=2.21, 95% CI 1.24‐3.92) and brick façade (OR=1.71, 95% CI 1.07‐2.73) were associated with rhinitis. Moisture load was associated with respiratory infections (OR=1.21 per 1 g/m³, 95% CI 1.04‐1.40) and rhinitis (OR=1.36 per 1 g/m³, 95% CI 1.02‐1.83). Air exchange rate was associated with current asthma symptoms (OR=0.85 per 0.1/h, 95% CI 0.73‐0.99). Living in homes with damp foundation, concrete slabs with overlying insulation, brick façade, low ventilation flow, and high moisture load are risk factors for asthma, rhinitis, and respiratory infections.     

Building-related respiratory symptoms can be predicted with semi-quantitative indices of exposure to dampness and mold

Using a semi-quantitative mold exposure index, the National Institute for Occupational Safety and Health (NIOSH) investigated 13 college buildings to examine whether building-related respiratory symptoms among employees are associated with environmental exposure to mold and dampness in buildings. We collected data on upper and lower respiratory symptoms and their building-relatedness, and time spent in specific rooms with a self-administered questionnaires. Trained NIOSH industrial hygienists classified rooms for water stains, visible mold, mold odor, and moisture using semi-quantitative scales and then estimated individual exposure indices weighted by the time spent in specific rooms. The semi-quantitative exposure indices significantly predicted building-related respiratory symptoms, including wheeze [odds ratio (OR) = 2.3; 95% confidence interval (CI) = 1.1-4.5], chest tightness (OR = 2.2; 95% CI = 1.1-4.6), shortness of breath (OR = 2.7; 95% CI = 1.2-6.1), nasal (OR = 2.5; 95% CI = 1.3-4.7) and sinus (OR = 2.2; 95% CI = 1.2-4.1) symptoms, with exposure-response relationships. We found that conditions suggestive of indoor mold exposure at work were associated with building-related respiratory symptoms. Our findings suggest that observational semi-quantitative indices of exposure to dampness and mold can support action to prevent building-related respiratory diseases. PRACTICAL IMPLICATIONS: Current air sampling methods have major limitations in assessing exposure to mold and other biological agents that may prevent the demonstration of associations of bioaerosol exposure with health. Our study demonstrates that semi-quantitative dampness/mold exposure indices, based solely on visual and olfactory observation and weighted by time spent in specific rooms, can predict existence of excessive building-related respiratory symptoms and diseases. Relative extent of water stains, visible mold, mold odor, or moisture can be used to prioritize remediation to reduce potential risk of building-related respiratory diseases. From a public health perspective, these observational findings justify action to correct water leaks and repair water damage in order to prevent building-related respiratory diseases. This approach can also be a basis for developing practical building-diagnostic tools for water-incursion.     

Association of air-conditioning with respiratory symptoms in office workers in tropical climate

To evaluate the association of heating, ventilation and air-conditioning systems (HVAC) and respiratory symptoms in a tropical city, self-administered questionnaires were given to 2000 individuals working in air-conditioned office buildings and to 500 control workers in naturally ventilated buildings. Reported symptoms from the two populations were analyzed using chi-square tests, univariate and multiple logistic regressions models. Symptoms were the outcome variable and the odds ratios were adjusted by gender, age, accumulated work time, smoking habits and atopic background. There was a 79.8% response rate and there was a positive association of nasal symptoms (odds ratio, OR = 1.59, 95% confidence interval, CI = 1.11-2.28), naso-ocular symptoms (OR = 1.58, 95% CI = 1.05-2.38), persistent cough (OR = 3.04, 95% CI = 2.00-4.63) sinusitis symptoms (OR = 1.85, 95% CI = 1.27-2.71) and building-related worsening of the symptoms (OR = 4.92, 95% CI = 2.93-8.27) with working in air-conditioned buildings. In conclusion, our study suggests that artificial air-conditioning is a matter of concern for respiratory symptoms in cities with hot and humid climate. PRACTICAL IMPLICATIONS: This study suggests that indoor air-related respiratory symptoms are a matter of concern in places with hot and humid climate. The regression models were adjusted by confounders that could be used in further reanalysis of indoor air quality related symptoms and ventilation systems with expanded variety of climatic conditions.     

Indoor air pollution and self-reported diseases - a case study of NCT of Delhi

People in modern societies often spend 80-90% of their time in indoor environments. It is, therefore, imperative to analyze indoor air quality (IAQ) and its determinants and to consider the contribution of IAQ to possible health outcomes at the household level. Based on empirical data collected from 5949 households from 35 wards of Delhi, it can be summarized that higher proportions of residents live in degraded indoor environmental conditions. The highest risks to health were attached to use of traditional fuels (64%), lack of a kitchen (59%), exposure to environmental tobacco smoke (ETS) (55%), and poor ventilation (55%). Acute respiratory infections (43%) were identified as one of the most prevalent health problems confronted by residents and are strongly associated with use of traditional fuels (adjusted OR 2.7, 95% CI 2.3-3.1). Asthma shows a significant relationship with the use of traditional fuels (adjusted OR 3.8, 95% CI 3.4-4.3), exposure to ETS (adjusted OR 2.5, 95% CI 2.2-2.7), and poor ventilation (adjusted OR 1.26, 95% CI 1.13-1.41). Lung cancer (adjusted OR 1.54, 95% CI 1.38-1.71) and cardiovascular diseases (adjusted OR 2.25, 95% CI 2.01-2.53) also show a strong relationship with ETS exposure. More research is needed. PRACTICAL IMPLICATIONS: The present study can help to create new insights in understanding the gravity of indoor air quality problems in Delhi and can therefore provide interesting material to social scientists, public health officers, planners, and decision makers. The information can be utilized to help formulate comprehensive policies and planning with a humanistic approach for proper urban indoor environments that will be applicable at all administrative levels, viz. local, national, and international, and will also provide an important background for additional research in this area.     

Respiratory symptoms, asthma and allergen levels in schools--comparison between Korea and Sweden

We studied reports on respiratory symptoms, asthma and atopic sensitisation in relation to allergen contamination in Korean schools and compared with data from a previous Swedish study performed in eight primary schools. Korean pupils (n = 2365) in 12 primary schools first completed a questionnaire. Then airborne and settled dust were collected from 34 classrooms and analyzed for allergens by ELISA. In both countries, boys reported more symptoms. The prevalence of wheeze was similar, while daytime [odds ratio (OR) = 14.0, 95% confidence interval (CI) = 9.0-21.9] and nocturnal breathlessness (OR = 3.1, 95% CI = 1.5-6.4) were much higher among Korean students. In Korean schools, dog allergen (Can f 1) was the most common followed by mite allergen (Der f 1), while cat (Fel d 1), dog, and horse allergen (Equ cx) were abundant in Sweden. Moreover, CO(2) levels were high in most Korean schools (range 907-4113 ppm). There was an association between allergen levels in dust and air samples, and number of pet-keepers in the classrooms. In conclusion, allergen contamination in Korean schools may be an important public issue. PRACTICAL IMPLICATIONS: This study showed that furry pet allergen contamination was common in both Korean and Swedish schools. In addition, house dust-mite (Der f 1) allergen contamination was common in Korean schools, probably because of transport of allergen from other environments. Transfer should therefore be minimized. Korean schools had high CO(2) levels and the concept of mechanical ventilation should be introduced. Measurement of airborne allergen levels is quite new and seems to be a more convenient and correct way to monitor allergen exposure in classrooms.     

Rhinosinusitis and mold as risk factors for asthma symptoms in occupants of a water-damaged building

Abstract Mold exposure in damp buildings is associated with both nasal symptoms and asthma development, but the progression of building-related (BR) rhinosinusitis symptoms to asthma is unstudied. We examined the risk of developing BR-asthma symptoms in relation to prior BR-rhinosinusitis symptoms and microbial exposure among occupants of a damp building. We conducted four cross-sectional health and environmental surveys among occupants of a 20-story water-damaged office building. We defined BR-rhinosinusitis symptom (N?=?131) and comparison (N?=?361) groups from participants' first questionnaire responses. We compared the odds for the development of BR-asthma symptoms between these two groups over the subsequent surveys, using logistic regression models adjusted for demographics, smoking, building tenure, and first-survey exposures to fungi, endotoxin, and ergosterol. The BR-rhinosinusitis symptom group had higher odds for developing BR-asthma symptoms [odds ratio (OR)?=?2.2; 95% confidence interval (CI)?=?1.3-3.6] in any subsequent survey compared to those without BR-rhinosinusitis symptoms. The BR-rhinosinusitis symptom group with higher fungal exposure within the building had an OR of 7.4 (95% CI?=?2.8-19.9) for developing BR-asthma symptoms, compared to the lower fungal exposure group without BR-rhinosinusitis symptoms. Our findings suggest that rhinosinusitis associated with occupancy of water-damaged buildings may be a sentinel for increased risk for asthma onset in such buildings. PRACTICAL IMPLICATIONS: Exposure to mold is associated with the development of asthma in damp building occupants, and rhinitis is known to be a risk factor for asthma. However, there is little information about the degree of risk for the progression of rhinosinusitis to asthma owing to mold exposures in damp buildings. Our study of damp building occupants demonstrates that building-related (BR) rhinosinusitis symptoms were a risk factor for the development of BR asthma symptoms and that exposure to mold (fungi) or other dampness-related agents augments risk for the development of BR asthma symptoms among those with BR rhinosinusitis symptoms. Our findings suggest that occurrence of BR upper respiratory illness in water-damaged buildings may presage future endemic asthma.     

Day care center characteristics and children's respiratory health

Day care centers provide an important exposure arena with potential harmful health effects for children. This study has linked health effect data from a survey among 942 3-5-year-old Oslo children with information on day care center characteristics collected during inspection of the 175 day care centers these children attended. The aim of the study was to estimate associations between dampness problems and other building characteristics and several respiratory health outcomes. Dampness problems (sign of molds, water leakage, damage to floor/wall) were observed in 51% of the day care centers. In multiple logistic regression analyses none of the studied symptoms and diseases (nightly cough, blocked or runny nose without common cold, wheeze, heavy breathing or chest tightness, the common cold, tonsillitis/pharyngitis, otitis media, bronchitis, pneumonia, asthma, and allergic rhinitis) were systematically associated with dampness problems or type of ventilation in day care centers. None of the studied indicators of day care center exposures were found to have a clear effect on day care children's respiratory health. Even so this study does not rule out negative health effects of day care center exposures. The study demonstrates that population-based studies of these relations are demanding with regard to assessment of exposure and health outcomes. PRACTICAL IMPLICATIONS: Simple and easy-to-register indicators of exposures like dampness problems and type of ventilation assessed in 175 day care centers were not related to respiratory health among 3-5-year-old Norwegian children attending the day care centers. The study does not rule out negative health effects of day care center exposures, but demonstrates methodological challenges needed to be addressed in studies of health effects of the day care environment.     

The effect of ventilation strategies of child care centers on indoor air quality and respiratory health of children in Singapore

This paper reports the effects of ventilation strategies on indoor air quality (IAQ) and respiratory health of children within 104 child care centers (CCCs) in a hot and humid climate. The CCCs were categorized by ventilation strategies: natural (NV), air-conditioned and mechanically ventilated (ACMV), air-conditioned using split units (AC), and hybrid (NV and AC operated intermittently). The concentration levels of IAQ parameters in NV CCCs are characterized by the influence of the outdoors and good dilution of indoor pollutants. The lower ventilation rates in air-conditioned CCCs result in higher concentrations of occupant-related pollutants but lower outdoor pollutant ingress. This study also revealed lower prevalence for most asthma and allergy, and respiratory symptoms in children attending NV CCCs. In multivariate analyses controlled for the effects of confounders, the risk of current rhinitis among children is significantly higher if they attend mechanically ventilated CCCs compared to NV CCCs. Air-conditioned CCCs were also associated with higher adjusted prevalence ratio of severe phlegm and cough symptoms and lower respiratory illness. Finally, children attending CCCs with hybrid ventilation are at high risk for almost all the respiratory symptoms studied. PRACTICAL IMPLICATIONS: This large field study indicates that different ventilation strategies employed by child care centers can cause significant variations in the indoor air quality and prevalence of asthma, allergies and respiratory symptoms of attending children. The higher prevalence rates of allergic and respiratory symptoms among young children, whose immune system is still under-developed, in child care centers, whether fully or partially air-conditioned, suggest that ventilation and plausible growth and propagation mechanisms of allergens and infectious agents be further investigated.     

Pre‐natal and post‐natal exposure to pet ownership and lung function in children: The Seven Northeastern Cities Study

To evaluate the association between pre‐natal and post‐natal exposure to pet ownership and lung function in children, a cross‐sectional study named Seven Northeastern Cities (SNEC) study was conducted. In this study, children's lung function including the forced expiratory volume in 1 second (FEV₁), forced vital capacity (FVC), maximal mid‐expiratory flow (MMEF), and peak expiratory flow (PEF) were measured by spirometers, and pet ownership situations were collected by questionnaire. Analyzed by multiple logistic regression and generalized linear modeling, we found that for all subjects, pet exposure in the first 2 years of life was significantly associated with lung function impairment of FVC<85% predicted (adjusted odds ratio [aOR]=1.28; 95% confidence interval [CI]: 1.01, 1.63). For current pet exposure, the increased odds of lung function impairment ranged from 35% (aOR=1.35; 95%CI: 1.12, 1.62) for FVC<85% predicted to 57% (aOR=1.57; 95%CI: 1.29, 1.93) for FEV₁<85% predicted. The in utero exposure was not related to lung function impairment. Compared with other pets, higher odds were observed among children with dogs. When stratified by gender, girls with current pet exposure were more likely to have lung function impairment than boys. It implies self‐reported exposures to pets were negatively associated with lung function among the children under study.     

Allergy and respiratory health effects of dampness and dampness‐related agents in schools and homes: a cross‐sectional study in Danish pupils

Little is known about the health effects of school‐related indoor dampness and microbial exposures. In this study, we investigated dampness and dampness‐related agents in both homes and schools and their association with allergy and respiratory health effects in 330 Danish pupils. Classroom dampness was identified based on technical inspection and bedroom dampness on parents' self‐report. Classroom and bedroom dust was analyzed for seven microbial components. Skin prick testing determined atopic sensitization. Lung function was expressed as z‐scores for forced expiratory volume in one‐second (zFEV₁), forced vital capacity (zFVC) and the ratio zFEV₁/zFVC using GLI‐2012 prediction equations. The parents reported children's allergies, airway symptoms, and doctor‐diagnosed asthma. High classroom dampness, but not bedroom dampness, was negatively associated with zFEV₁ (β‐coef. ?0.71; 95% CI ?1.17 to ?0.23) and zFVC (β‐coef. ?0.52; 95% CI ?0.98 to ?0.06) and positively with wheezing (OR 8.09; 95% CI 1.49 to 43.97). No consistent findings were found between any individual microbial components or combination of microbial components and health outcomes. Among other indoor risk factors, environmental tobacco smoke (ETS) decreased zFEV₁ (β‐coef. ?0.22; 95% CI ?0.42 to ?0.02) and zFEV₁/zFVCratio (β‐coef. ?0.26; 95% CI ?0.44 to ?0.07) and increased upper airway symptoms (OR 1.66; 95% CI 1.03–2.66). In conclusion, dampness in classrooms may have adverse respiratory health effects in pupils, but microbial agents responsible for this effect remain unknown.     

Proximity to chipboard industries increases the risk of respiratory and irritation symptoms in children: The Viadana study

Emissions related to wood production processes are a recognized health hazard for professionally exposed subjects. The health effects of living close to wood industries are not known, particularly in the pediatric population. We aimed at investigating if living close to chipboard industries is a health hazard for the children in the Viadana district (Northern Italy).In December 2006, all the children (3-14 years) living in the Viadana district, where two big chipboard industries are located, were surveyed through a parental questionnaire (n = 3854). The children were geocoded, and the distance of their houses/schools from the closest wood plant was computed.Independently of sex, age, nationality, residential area, traffic, parents' education, passive/parental smoking, questionnaire compiler and his/her environmental concern, the children living at < 2 km from chipboard industries had a greater prevalence of respiratory (OR = 1.33, 95%CI: 1.11, 1.60), cough/phlegm (OR = 1.43, 95%CI: 1.08, 1.88), nose/throat/mouth (OR = 1.47, 95%CI: 1.23, 1.75), eye (OR = 1.24, 95%CI: 1.04, 1.48) symptoms, school-days lost (OR = 1.24, 95%CI: 1.04, 1.48), and emergency (OR = 2.14, 95%CI: 1.47, 3.11) and hospital (OR = 2.21, 95%CI: 1.17, 4.18) admissions. There was an inverse dose-response relationship between the adverse health outcomes considered and the distance from the plants. The attributable fractions for the children living close to the chipboard industries were substantial, ranging from 13% (eye symptoms) to 27% (cough/phlegm).The present findings suggest that emissions from chipboard industries might have a serious impact on children's health status and should therefore be reduced and closely monitored.     

Prevalence and risk factors associated with nonspecific building‐related symptoms in office employees in Japan: relationships between work environment,Indoor Air Quality,and occupational stress

A nationwide cross‐sectional study of 3335 employees was conducted in 320 offices in Japan to estimate the prevalence of building‐related symptoms (BRSs) and determine the risk factors related to work environment, Indoor Air Quality, and occupational stress. Data were collected through self‐administered questionnaires. The prevalences of general symptoms, eye irritation, and upper respiratory symptoms were 14.4%, 12.1%, and 8.9%, respectively. Multiple logistic regression analyses revealed that eye irritation was significantly associated with carpeting [odds ratio (OR), 1.73; 95% confidence interval (CI), 1.24–2.41], coldness perception (OR, 1.28; 95% CI, 1.13–1.45), and air dryness perception (OR, 1.61; 95% CI, 1.42–1.82). General symptoms were significantly associated with unpleasant odors (OR, 1.37; 95% CI, 1.13–1.65), amount of work (OR, 1.24; 95% CI, 1.06–1.45), and interpersonal conflicts (OR, 1.44; 95% CI, 1.23–1.69). Upper respiratory symptoms were significantly associated with crowded workspaces (OR, 1.36; 95% CI, 1.13–1.63), air dryness perception (OR, 2.07; 95% CI, 1.79–2.38), and reported dustiness on the floor (OR, 1.39; 95% CI, 1.16–1.67). Although psychosocial support is important to reduce and control BRSs, maintaining appropriate air‐conditioning and a clean and uncrowded workspace is of equal importance.     

Biomarkers of exposure to passive smoking of school children: frequency and determinants

This study aims to assess the extent of children' exposure to ETS and quantify potential determinants. A total of 2767 children aged 5-14 years participated in an environmental survey in East Germany in 1998-1999 (participation rate 75.9%). A subgroup of 979 children between the ages of 11 and 14 years with complete data on nicotine and cotinine in urine were selected for this analysis. This study population consisted of 73 self-reported smokers (7.5%), 793 non-smokers (81%) and 113 children with missing data on smoking status (11.5%). Nicotine and cotinine concentrations in spontaneous urine sample were determined by high-performance liquid chromatography methods with ultraviolet-detection and corrected for creatinine. Approximately 40% of self-reported non-smokers were exposed to environmental tobacco smoke (ETS) at home. Non-smoking children exposed to parental tobacco smoke at home compared with not exposed showed in average higher nicotine and cotinine concentration (geometric mean 4.7 microg/l vs. 1.4 microg/l and 8.1 microg/l vs. 2.7 microg/l) and the adjusted odds ratio (OR) for detectable biomarkers ranged between 17 and 22. There were increased rates of detectable biomarkers in urine with increasing numbers of smoked cigarettes in the household (adjusted OR increased from 8 to 54). Maternal smoking showed a stronger effect than paternal smoking. Furthermore, low parental education, cold season, height of dwelling (相似文献   

Outdoor, but not indoor, nitrogen dioxide exposure is associated with persistent cough during the first year of life

Background and aims

Because their lungs and immune system are not completely developed, children are more susceptible to respiratory disease and more vulnerable to ambient pollution. We assessed the relation between prenatal and postnatal nitrogen dioxide (NO₂) levels and the development of lower respiratory tract infections (LRTI), wheezing and persistent cough during the first year of life.

Methods

The study population consisted of 352 children from a birth cohort in Valencia, Spain. Prenatal exposure to NO₂, a marker of traffic related air pollution was measured at 93 sampling sites spread over the study area during four different sampling periods of 7 days each. It was modeled for each residential address through land use regression using the empirical measurements and data from geographic information systems. Postnatal exposure was measured once inside and outside each home using passive samplers for a period of 14 days. Outcomes studied were any episode of LRTI during the child's first year of life diagnosed by a doctor (bronchitis, bronchiolitis or pneumonia), wheezing (defined as whistling sounds coming from the chest), and persistent cough (more than three consecutive weeks). Outcomes and potential confounders were obtained from structured questionnaires. Multiple logistic regression was used to identify associations.

Results

The cumulative incidence (CI) at first year of life was 30.4% for LRTI (23.0% bronchiolitis, 11.9% bronchitis and 1.4% pneumonia), 26.1% for wheezing and 6.3% for persistent cough. The adjusted odds ratio (95% confidence interval) per 10 μg/m³ increment in postnatal outdoor NO₂ concentration was 1.40 (1.02-1.92) for persistent cough. We also found some pattern of association with LRTI, bronchiolitis, bronchitis, wheezing and persistent cough in different prenatal periods, although it was not statistically significant.

Conclusions

Our results indicate that exposure to outdoor, but not indoor, NO₂ during the first year of life increases the risk of persistent cough.