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House dust mites produce well‐known allergens for asthma and allergy among children. To study house dust mite allergen exposure level in northeast China and characterize its association with indoor environmental factors and cleaning habits, we inspected 399 homes in Tianjin area and collected dust from mattresses. Dermatophagoides farinae (Der f) and Dermatophagoides pteronyssinus (Der p) were detected by the enzyme‐linked immunosorbent assay (ELISA) method. The medians of total allergen concentrations for spring, summer, autumn, and winter were 524 ng/g, 351 ng/g, 1022 ng/g, and 1010 ng/g. High indoor air relative humidity (RH), low air change rate, indoor dampness, and frequent changing of quilt cover/bedsheet/pillow case were significantly associated with high house dust mite allergen concentration (relative risk [RR]: RH, 1.18–1.34; air change rate, 0.97–1.00; dampness, 2.92–3.83; changing quilt cover/bedsheet/pillow case, 0.66–0.75). The decrease in the absolute humidity gradient between indoors and outdoors that occurs with increased air change rate may explain why a high ventilation reduces house dust mite allergen concentration. The findings of this study show the importance of ventilation and cleaning for controlling house dust mite allergens. We found that the decrease in additional absolute humidity (e.g., humidity indoor‐humidity outdoor) with increased air change rate may be the main reason that a high ventilation rate reduces house dust mite allergen concentration. Ventilation and cleaning should be both considered for creating a healthy home environment. [ABSTRACT FROM AUTHOR]

A questionnaire survey on dermal symptoms and home environment was performed in eight Chinese cities (40 279 participants). Data on city level temperature, precipitation, PM10, NO2, and gross domestic product (GDP) per capita were collected. In total, 2.2% had eczema, 2.4% facial erythema (FE) and 2.6% seborrheic dermatitis symptoms (SD). Higher temperature was associated with eczema (OR = 1.09). Higher GDP per capita was related to less SD. Higher PM10 was related to SD. Suburban living was protective for eczema (OR = 0.77) (vs. urban). Living in old buildings (built before 1991) was related to eczema (OR = 1.42). Living near heavily trafficked roads was related to FE (OR = 1.33) and SD (OR = 1.35). Having new furniture was related to all symptoms (OR = 1.26–1.47). Burning mosquito coils (OR = 1.37–1.57) and incense (OR = 1.33–1.37) were associated with eczema, FE, or SD. Presence of cockroaches and rats/mice was associated with FE or SD (OR = 1.31–1.40). Using air conditioner, daily cleaning and frequently exposing bedding to sunshine were protective (OR = 0.60–0.83). In conclusion, higher temperature, higher PM10, urban living, living near heavily trafficked roads, old buildings, new furniture, burning mosquito coils and incense, and presence of cockroaches/rats/mice increased the risk of eczema, FE, or SD. Higher GDP, air conditioner, daily cleaning, and exposing bedding to sunshine were protective. [ABSTRACT FROM AUTHOR]

Building ventilation is important for occupants' health. There are few studies of associations between home ventilation and occupant's health in China. During 2013‐2016, we measured ventilation in 399 homes in Tianjin and Cangzhou, China, and surveyed the health history of children. Ventilation rates were measured using mass balance of occupant generated CO2. The associations of home ventilation with children's asthma and allergy were analyzed in different strata of time and space. A low bedroom ventilation at night was significantly associated with an increased proportion of rhinitis among children (rhinitis current, adjusted odds ratio (AOR): 1.59; 95% confidence interval (CI): 1.01‐2.49; diagnosed rhinitis, AOR: 3.02 (1.16‐7.89)). Our findings suggest a dose‐response relationship between ventilation rate at night in children's bedrooms and rhinitis current. The night‐time ventilation rate in bedrooms has a greater association with rhinitis than the whole home ventilation rate during daytime. [ABSTRACT FROM AUTHOR]

During 2010‐2012, we surveyed 40,010 3‐ to 6‐year‐old children in seven Chinese cities (Beijing, Taiyuan, Urumqi, Shanghai, Nanjing, Changsha, and Chongqing). Their parents reported information on household renovation, including the timing of renovation and the choice of materials for walls and floors in the child's room, and the incidence of their child's rhinitis. Multivariate and two‐level (city‐child) logistic regression analyses yielding adjusted odds ratios (AOR) with 95% confidence intervals were performed. Sensitivity analyses stratifying data for location and economic level were also performed. About 48.0% of the children had ever had allergic rhinitis, 41.2% had current allergic rhinitis, and 9.0% had had doctor‐diagnosed rhinitis. Exposure to household renovation during early lifetime (birth to 1‐year‐old) had an AOR of 1.43 (1.04‐1.9) for allergic rhinitis. The incidence of allergic rhinitis was significantly different in children exposed to different floor and wall covering materials. Floor or wall covering material composed of organic materials significantly increased the risk of childhood allergic rhinitis compared with tile flooring or lime wall covering. Oil paint had an AOR of 1.66 (1.28‐2.14) for diagnosed rhinitis compared with lime wall covering. Adding new furniture the year before pregnancy was associated with an AOR of 1.18 (1.10‐1.27) and 1.18 (1.11‐1.25) for lifetime and current rhinitis. Solid wood or tiles/ceramic as floor materials, and using wallpaper, oil paint, or emulsion panels as wall materials were risk factors for doctor‐diagnosed rhinitis. Sensitivity analyses showed that children living in southern or higher economic level China cities were more likely to have allergic rhinitis with household renovation. [ABSTRACT FROM AUTHOR]

The extensive literature has reported adverse effects on environmental tobacco smoke (ETS) on children's health. We aim to analyze associations of ETS with dry night cough, croup, pneumonia, and frequent common cold and to disentangle the effects of prenatal, infancy and childhood exposure by multilevel logistic regression. A cross-sectional study was conducted among 41,176 children aged 3–8 years in 8 major cities of China during 2010–2011, and obtained demographic information, smoke exposure information, and respiratory outcomes. Parents' smoking habit and indoor tobacco smoke odor were considered as two indicators of ETS. The prevalences of respiratory outcomes were 6.0% for croup, 9.5% for frequency common cold, 17.1% for dry night cough and 32.3% for pneumonia respectively in the study. The associations between respiratory outcomes and parental smoking were not obvious, while indoor tobacco smoke odor was clearly and strongly associated with most respiratory outcomes, with adjusted odds ratios ranging from 1.06 to 1.95. Both infancy and childhood exposure to tobacco smoke odor were independent risk factors, but infancy exposure had a higher risk. The results explore that ETS increased the risk of respiratory outcomes in children, highlighting the need for raising awareness about the detrimental effects of tobacco smoke exposure. [ABSTRACT FROM AUTHOR]

We surveyed 40 010 three‐ to six‐year‐old children in seven Chinese cities (Beijing, Taiyuan, Urumqi, Shanghai, Nanjing, Changsha, and Chongqing) during 2010‐2012 so as to investigate possible links between home renovation and childhood eczema. Their parents responded to questions on home renovation and childhood eczema. Multivariate and two‐level (city‐child) logistic regression analyses yielding odds ratios with 95% confidence intervals were performed. Sensitivity analyses stratifying data for region, climate, and income level were also performed. The prevalences of childhood eczema in children with different floor and wall covering materials were significantly different and were significantly higher with home renovation during early lifetime. Exposure to synthetic materials significantly increased the risk of childhood eczema by 20%‐25%. The risks (AOR, 95% CI) of current eczema among children in families with solid wood flooring and oil paint wall covering were 1.25 (1.04‐1.49) and 1.35 (1.14‐1.60), respectively. Home renovation during pregnancy was related to children's lifetime and current eczema. [ABSTRACT FROM AUTHOR]

The ventilation modalities in most Chinese residences are infiltration and opening windows. We measured infiltration rates and air change rates at night, with no attempt to change occupants' behaviors, of urban residences in five climate zones of China during four seasons. Using the CO2 decay method, we found the median infiltration rate for 294 residences to be 0.34 h−1. Using occupant‐generated CO2 as tracer gas, we determined air change rates over the course of 1 year in 46 bedrooms at night from mass balance considerations. In 54% of the measurements, windows were closed, so ventilation was only by infiltration. Windows were mainly closed when the outdoor temperature was below 15°C and above 26°C. The median infiltration rates did not differ appreciably among seasons and climate zones and were always less than 0.45 h−1. [ABSTRACT FROM AUTHOR]

I soon started a study with the best person in industrial ventilation in Sweden, Göran Allhammar, to see whether mechanical ventilation works. This led Sweden to set the mandatory ventilation to stop the back draught in natural ventilation systems. The solution was mechanical ventilation with heat recovery - a simple solution to get reasonable ventilation and save energy. [Extracted from the article]

Purpose: In the past 60 years, the prevalences of asthma and allergy among children have increased around the world. Neither genetic nor outdoor environmental factors can explain this increase. Methods: We performed a cross-sectional study of 7366 children in Tianjin, China, on associations of home environment and lifestyles with asthma and allergy. Results: The prevalences of diagnosed asthma, rhinitis and eczema among 0- to 8-year-old children in the Tianjin area were 4%, 9% and 39%. Home environment and lifestyle, together with infections, were strong risk factors. For asthma and allergy, the population attributable fraction (PAF) due to modern floors and wall coverings (i.e., laminated wooden floors and painted walls compared to tile floors and lime-coated walls) was 22%. Window condensation in winter and air conditioner use in summer, both of which are proxies for less ventilation, accounted for 7–17% of rhinitis and eczema. Cesarean delivery accounted for 10% of eczema symptoms. We developed a modern life index from appropriate home characteristics and lifestyle and food consumption habits and found it to have a clear dose–response relationship with asthma and allergy in Tianjin children. Conclusions: The results indicate that a "modern" home environment together with a modern lifestyle is associated with increased prevalences of asthma and allergies among children. Appropriate indoor environmental interventions and education of children's caregivers are important in the management of childhood asthma and allergy. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

This study investigated the association of building characteristics and occupant behaviours with building dampness indicators. Data were from a cross-sectional study in urban Tianjin and rural Cangzhou, China, from 2013 to 2014. We studied two fundamental types of Chinese dwellings: bungalows typical of rural locales and apartments in low- and high-rise buildings typical of urban settings. Occupants of bungalows reported more dampness indicators than apartment dwellers. Risk factors for one or more dampness indicators included natural ventilation without fans, older dwellings and coal stove or Kang heating system (a brick bed installed in the bedroom for heating and sleeping). All these factors were typical of bungalows, which generally used older building technologies including non-insulated external walls, wooden frame windows, electric fans for cooling and no exhaust fan ventilation. Occupant behaviours that decreased the risk for dampness indicators included frequent window opening and daily cleaning, regardless of the type of dwelling. Indoor dampness was highly correlated with mouldy and humid odour, and paradoxically (although not a new finding) with the perception of air dryness. [ABSTRACT FROM AUTHOR]

We studied dampness and mold in China in relation to rhinitis, ocular, throat and dermal symptoms, headache and fatigue. A questionnaire study was performed in six cities including 36 541 randomized parents of young children. Seven self‐reported signs of dampness were evaluated. Multilevel logistic regression models were used to calculate odds ratios (ORs). Totally, 3.1% had weekly rhinitis, 2.8% eye, 4.1% throat and 4.8% skin symptoms, 3.0% headache and 13.9% fatigue. Overall, 6.3% of the homes had mold, 11.1% damp stains, 35.3% damp bed clothing, 12.8% water damage, 45.4% window pane condensation, 11.1% mold odor, and 37.5% humid air. All dampness signs were associated with symptoms (ORs from 1.2 to 4.6; P < 0.001), including rhinitis (ORs from 1.4 to 3.2; P < 0.001), and ORs increased by number of dampness signs. The strongest associations were for mold odor (ORs from 2.3 to 4.6) and humid air (ORs from 2.8 to 4.8). Associations were stronger among men and stronger in Beijing as compared to south China. In conclusion, dampness and mold are common in Chinese homes and associated with rhinitis and ocular, throat and dermal symptoms, headache and fatigue. Men can be more sensitive to dampness and health effects of dampness can be stronger in northern China. [ABSTRACT FROM AUTHOR]

This study aims to find out the relationship between pet keeping in childhood and asthma and allergy among children aged 0–8 years old in Tianjin, China. Parental or guardians reports of 7360 children were analyzed. 1490 (21.6%) families kept pets at the time of the survey (current), among them 4.0% cats, and 14.7% dogs. For the first year of life of children (early), 1196 (18.4%) families kept pets, and among them 3.2% cats, and 13.7% dogs. Exposure to a pet in early childhood significantly increased the risk of current wheeze, current dry cough, and diagnosed rhinitis. 17.9% of parents reported an avoidance behavior, i.e., had removed or refrained a pet due to asthma or allergy in the family. After adjustment for avoidance behavior, the negative effect of pet keeping on children’s health became even more obvious, with e.g. an AOR of 3.37 (1.58–7.19) for diagnosed asthma, 3.60 (2.07–6.27) for diagnosed rhinitis, 1.92 (1.31–2.81) for diagnosed eczema. A dose-response relationship between pet keeping at current and current wheeze, current eczema and diagnosed eczema was found. In conclusion, pet exposure in early life of children in Tianjin is a risk factor for asthma and allergies among children aged 0–8 years old. [ABSTRACT FROM AUTHOR]

Objectives: We investigated patterns of multimorbidities among asthma, allergies, and respiratory illnesses in preschool children. We investigated multimorbidities of lifetime asthma, allergic rhinitis, eczema, food allergy, pneumonia, and ear infections; and multimorbidities of current (in the last year before the survey) wheeze, dry cough, rhinitis, eczema, and common cold during childhood. We further analyzed whether prevalences of these multimorbidities were due to chance.Methods: A cross-sectional study was conducted in 72 kindergartens of Shanghai, China. Parents of preschool children were surveyed with a modified ISAAC questionnaire. Observed prevalences (OPs), expected prevalences (EPs), absolute excess comorbidities (AECs), and relative excess comorbidities (RECs) of various combinations of illnesses were calculated to indicate whether the combined illnesses were related.Results: We analyzed questionnaires for children aged 4–6 years, whose 13,335 questionnaires were the majority of the total 15,266 returned questionnaires (response rate: 85.3%). The studied illnesses were common. For children who had more than three lifetime or current illnesses, OPs tended to be higher than EPs. Most OPs and EPs were higher in boys than in girls, and were higher in children with a family history of atopy (FHA) than in children without FHA. AECs and RECs between boys and girls as well as between children with and without FHA were substantially different.Conclusions: Our findings suggest that multimorbidities among childhood asthma, allergies, and respiratory illnesses are likely not random, but rather share etiology. Specific patterns of childhood asthma multimorbidities perhaps differ between boys and girls and between children with and without FHA. [ABSTRACT FROM PUBLISHER]

Objectives: We investigated associations of breastfeeding (BF) durations and patterns and of timing of other dietary introductions with prevalence of asthma, wheeze, hay fever, rhinitis, pneumonia, and eczema among preschool children.Methods: During April 2011-April 2012, we conducted a cross-sectional study in 72 kindergartens from five districts of Shanghai, China and obtained 13,335 questionnaires of children 4–6-years-old. We used multiple logistic regression models to evaluate the target associations.Results: Compared to children who were never BF, children who were exclusively breastfed 3–6 months had the lowest risk of asthma (adjusted odds ratio and 95% confidence interval: 0.81, 0.72–0.91) and wheeze (0.93, 0.87–0.99); and exclusive BF >6 months was significantly associated with a reduced risk of hay fever (0.93, 0.89–0.97), rhinitis (0.97, 0.94–0.99), pneumonia (0.97, 0.94–0.99), and eczema (0.96, 0.93–0.99). No significant associations were found between time when fruits or vegetables were introduced and the studied diseases. Associations were independent of the child's sex and parent's ownership of the current residence. Longer duration BF was only significantly protective when there was no family history of atopy.Conclusions: This study suggests that heredity, but not sex and socioeconomic status, may negatively impact the effect of BF on childhood airway and allergic diseases. Our findings support China's national recommendation that mothers provide exclusive BF for the first four months, and continue partial BF for more than 6 months. [ABSTRACT FROM AUTHOR]

Objectives: To compare the proportion of Beijing children who have ever had pneumonia (%Pneumonia) to those in other locations, and to estimate by how much national vaccine coverage with Pneumococcal Conjugate Vaccine (PCV) and Haemophilus Influenzae Type b (Hib) could reduce Beijing %Pneumonia. Methods: %Pneumonia was obtained for each age group from 1 to 8 years inclusive from 5,876 responses to a cross-sectional questionnaire. Literature searches were conducted for world-wide reports of %Pneumonia. Previous vaccine trials conducted worldwide were used to estimate the pneumococcal (S. pneumoniae) and Hib (H. influenzae) burdens and %Pneumonia as well as the potential for PCV and Hib vaccines to reduce Beijing children’s %Pneumonia. Findings: The majority of pneumonia cases occurred by the age of three. The cumulative %Pneumonia for 3–8 year-old Beijing children, 26.9%, was only slightly higher than the 25.4% for the discrete 3 year-old age group, similar to trends for Tianjin (China) and Texas (USA). Beijing’s %Pneumonia is disproportionally high relative to its Gross National Income (GNI) per capita, and markedly higher than %Pneumonia in the US and other high GNI per capita countries. Chinese diagnostic guidelines recommend chest X-ray confirmation while most other countries discourage it in favor of clinical diagnosis. Literature review shows that chest X-ray confirmation returns far fewer pneumonia diagnoses than clinical diagnosis. Accordingly, Beijing’s %Pneumonia is likely higher than indicated by raw numbers. Vaccine trials suggest that national PCV and Hib vaccination could reduce Beijing’s %Pneumonia from 26.9% to 19.7% and 24.9% respectively. Conclusion: National PCV and Hib vaccination programs would substantially reduce Beijing children’s pneumonia incidence. [ABSTRACT FROM AUTHOR]

The increasing prevalence of respiratory diseases in Chinese children has focused attention on indoor environmental quality. We investigated associations between perceived air quality in domestic environments and children’s allergic diseases with a questionnaire survey study. A total of 4017 children aged 1–8 years old from 23 kindergartens in urban, suburban and industrial areas in Nanjing were randomly recruited for this study. Parents’ perceived odors, including stuffy odor, unpleasant odor, pungent odor, moldy odor, humid air and dry air were found to be associated with asthma, wheeze, dry cough and rhinitis (P < 0.05). Both perceived dry and humid air were found to be positively associated with dampness indices, and we present evidence that the sensation of dryness may not be due to the actual indoor relative humidity, but rather to indoor air irritants. Parents’ perception of odors and relative humidity may be indicators of environment pollutants, which are likely the real factors associated with children’s allergic diseases. [ABSTRACT FROM AUTHOR]

Objective: Ambient fine particulate matter (PM2.5) pollution is currently a major public health concern in Chinese urban areas. However, PM2.5 exposure primarily occurs indoors. Given such, we conducted this study to characterize the indoor-outdoor relationship of PM2.5 mass concentrations for urban residences in Beijing. Methods: In this study, 24-h real-time indoor and ambient PM2.5 mass concentrations were concurrently collected for 41 urban residences in the non-heating season. The diurnal variation of pollutant concentrations was characterized. Pearson correlation analysis was used to examine the correlation between indoor and ambient PM2.5 mass concentrations. Regression analysis with ordinary least square was employed to characterize the influences of a variety of factors on PM2.5 mass concentration. Results: Hourly ambient PM2.5 mass concentrations were 3–280 μg/m3 with a median of 58 μg/m3, and hourly indoor counterpart were 4–193 μg/m3 with a median of 34 μg/m3. The median indoor/ambient ratio of PM2.5 mass concentration was 0.62. The diurnal variation of residential indoor and ambient PM2.5 mass concentrations tracked with each other well. Strong correlation was found between indoor and ambient PM2.5 mass concentrations on the community basis (coefficients: r≥0.90, p<0.0001), and the ambient data explained ≥84% variance of the indoor data. Regression analysis suggested that the variables, such as traffic conditions, indoor smoking activities, indoor cleaning activities, indoor plants and number of occupants, had significant influences on the indoor PM2.5 mass concentrations. Conclusions: PM2.5 of ambient origin made dominant contribution to residential indoor PM2.5 exposure in the non-heating season under the high ambient fine particle pollution condition. Nonetheless, the large inter-residence variability of infiltration factor of ambient PM2.5 raised the concern of exposure misclassification when using ambient PM2.5 mass concentrations as exposure surrogates. PM2.5 of indoor origin still had minor influence on indoor PM2.5 mass concentrations, particularly at 11:00–13:00 and 22:00–0:00. The predictive models suggested that particles from traffic emission, secondary aerosols, particles from indoor smoking, resuspended particles due to indoor cleaning and particles related to indoor plants contributed to indoor PM2.5 mass concentrations in this study. Real-time ventilation measurements and improvement of questionnaire design to involve more variables subject to built environment were recommended to enhance the performance of the predictive models. [ABSTRACT FROM AUTHOR]

Introduction: Sick building syndrome (SBS) includes general, mucosal and skin symptoms. It is typically associated with an individual's place of work or residence. The aim of this study was to explore the effect of traffic exposure on SBS symptoms in Beijing, China. Methods: From January to May, 2011, recruitment occurred at kindergartens in 11 districts in Beijing. Self-administered questionnaires were distributed by teachers to legal guardians of children and then returned to teachers. The questionnaire asked them to recall the presence of 12 SBS symptoms from the previous three months. Living near a highway or main road (within 200 meters) was used as a proxy for traffic exposure. Multivariable logistic regression was used to test the association between traffic exposure and a higher number of SBS symptoms, controlling for key covariates. Results: There were 5487 valid questionnaires (65.0% response rate). Univariate analysis showed that living near a main road or highway (OR = 1.40), female gender (OR = 1.44), and environmental tobacco smoking (ETS) (OR = 1.13) were significant risk factors for general symptoms. Grandparent’s generation (OR = 0.32) and home ownership (owner vs. renter) (OR = 0.89) were significant protective factors. The adjusted odds ratio (aOR) for the association between living close to a highway and general symptoms remained significant in the multivariable model (aOR = 1.39; 95% CI = 1.21: 1.59). ORs and aORs were similar for mucosal and skin symptoms. Conclusions: This study found traffic exposure to be significantly associated with SBS symptoms. This finding is consistent with current literature that indicates an association between adverse health effects and living near highway or main road. [ABSTRACT FROM AUTHOR]

Background: The prevalence of asthma among Shanghai children has increased over time. This increase might be associated with changes in environmental exposures. Investigation of the time-trend of asthma and current prevalences is essential to understanding the causes. Objective: To estimate the current prevalences of asthma, allergies and other respiratory symptoms among Shanghai preschool children, and to investigate the time-trend of childhood asthma prevalence of from 1990 to 2011. Methods: From April 2011 to April 2012, the CCHH (China, Children, Homes, Health) cross-sectional study was conducted in Shanghai. Questionnaires were distributed to 17,898 parents or guardians of preschool children from 72 kindergartens in 5 districts. Previous similar studies were also summarized by a systematic literature review. Results: From a total of 14,884 questionnaires for 3–7 year old children, prevalences of the following diseases and symptoms were calculated: asthma 10.2%, wheeze (ever) 28.1%, pneumonia (ever) 33.5%, otitis media 11.0%, rhinitis (ever) 54.1%, hay fever 12.2%, eczema (ever) 22.7%, and food allergy 15.7%. Urban children had higher prevalences of most symptoms than suburban children. The prevalence of asthma has increased significantly, almost five-fold, from 2.1% in 1990 to 10.2% in the present study. The prevalence of asthma in boys was higher than in girls in the present study and in all reviewed studies. Conclusions: Asthma, allergy and airway symptoms are common among preschool children in Shanghai. The prevalence of childhood asthma in Shanghai has increased rapidly from 1990 to 2011. [ABSTRACT FROM AUTHOR]

In order to evaluate the perceived home indoor air quality, as well as sick building syndrome (SBS) in areas with typical arid continental climate such as Urumqi, northwest of China, a cross-sectional study including 4,260 parents of children (1-8 years) was performed by a questionnaire survey in winter season in 2011. The sensation of air dryness (weekly/sometimes) in the last 3 months had the highest proportion of reports by more than half of the parents (57.4 %), followed by perceived stuffy odor (40.6 %), unpleasant odor (27.0 %), tobacco smoke odor (25.5 %), sensation of humid air (17.9 %), pungent odor (11.7 %) and moldy odor (9.5 %), respectively. The prevalence of SBS symptoms in the same time period was 40.4 % for general symptom, 47.7 % for mucosal symptom and 9.5 % for skin symptom, respectively. There were significant associations between perceived odors/sensation of air dryness and SBS symptoms (ORs range 1.39-1.42). Additionally, the OR values increased with an increase of the OH score ( P < 0.05). Dampness, the presence of cockroaches and mosquitoes/flies, prenatal exposure to decoration and close to traffic were all risk factors of SBS symptoms. However, frequently putting bedding to sunshine was potentially a protective factor. In conclusion, adults' perceptions of odors and sensation of air dryness are related to SBS symptoms and home environmental factors in Urumqi, China. [ABSTRACT FROM AUTHOR]

To assess associations between home indoor air environments and asthma, allergies and pneumonia, children aged 1-8 years were surveyed from 12 kindergartens in the city of Xi'an. 2,020 questionnaires were responded with a response rate of 83.5 %. The prevalences of doctor diagnosed asthma, hay fever, and pneumonia were 2.9 %, 3.6 %, and 28.3 %, respectively. Living close to a highway was a risk factor for current rhinitis (AOR 1.5, 95 % CI 1.2-1.8), eczema (AOR 1.7, 95 % CI 1.2-2.5), and diagnosed pneumonia (AOR 1.3, 95 % CI 1.0-1.6). Dampness problems in the home were associated with 50 %-130 % increases in the prevalences of asthma and allergy. Airing bed linen under sun-shine was protective, especially against rhinitis. Pet avoidance was consistently and significantly associated with asthma and allergy (AOR 1.3-2.4). Decoration of the home during children's early life is a risk factor for current rhinitis (AOR 1.9, 95 % CI 1.3-2.9) and eczema (AOR 1.9, 95 % CI 1.1-3.6). Risk factors for pneumonia were living in an apartment (AOR 1.4, 95 % CI 1.1-1.8), latex wall paint (AOR 1.3, 95 % CI 1.0-1.7), dampness (AOR 1.4-1.5), breast feeding <3 months (AOR 1.3, 95 % CI 1.0-1.7), never airing bed linen in sunshine (AOR 1.3, 95 % CI 1.3-1.6), and cleaning children's room less frequently than once per day (AOR 1.4, 95 % CI 1.1-1.7). This study demonstrates that home indoor environmental and life style factors may influence the health of children in Xi'an. [ABSTRACT FROM AUTHOR]

Risk factors for rhinitis and asthma in the home environment were studied by a questionnaire survey. Parents of 4530 1–8 year old children (one parent per child) from randomly selected kindergartens in Chongqing, China participated. 70.4% were females; 47.1% had rhinitis symptoms in the last three months (current rhinitis, CR); 1.6% reported a history of allergic asthma (AA); 2.7% reported a history of allergic rhinitis (AR); 16.4% were current smokers; 50.8% males and 2.4% females were current smokers. Stuffy odor, unpleasant odor, tobacco smoke odor and dry air were associated with CR (adjustment for gender, current smoking and other perceptions of odor or humidity). Associations between home environment and CR, AR, and AA were studied by multiple logistic regression analyses, adjusting for gender, current smoking and other significant home factors. Living near a main road or highway was a risk factor for both CR (OR(95%CI): 1.31(1.13,1.52)) and AR (OR(95%CI): 2.44(1.48,4.03)). Other risk factors for CR included living in rural areas (OR(95%CI): 1.43(1.10,1.85)), new furniture (OR(95%CI): 1.28(1.11,1.49)), water damage (OR(95%CI): 1.68(1.29,2.18)), cockroaches (OR(95%CI): 1.46(1.23,1.73)), and keeping pets (OR(95%CI): 1.24(1.04,1.49)). Other risk factors for AR included redecoration (OR(95%CI): 2.14(1.34,3.41)), mold spots (OR(95%CI): 2.23(1.06,4.68)), window pane condensation (OR(95%CI): 2.04(1.28,3.26)). Water damage was the only home factor associated with AA (2.56(1.34,4.86)). Frequently put bedding to sunshine was protective for CR (OR(95%CI): 0.79(0.68,0.92); cleaning every day was protective for AR (OR(95%CI): 0.40(0.22,0.71)). In conclusion, parents' CR and AR were related to a number of factors of the home environment. [ABSTRACT FROM AUTHOR]

A China, Children, Homes, Health (CCHH) study was conducted in Shanghai to investigate the associations between residential characteristics and childhood asthma, wheeze and dry cough of 4- to 6-year-old children. In the present study, 13,335 children participated in the questionnaire survey, and the questionnaires were completed by children’s parents with a response rate of 85.3%. Multiple logistic regression analysis was the main method for analyses. Using wood as fuel for cooking was shown to have a strong positive association with asthma (adjusted odds ratio, 95% confidence interval: 2.84, 1.24–6.54). Existence of a highway within 200 m of the residence could have a positive association with wheeze ever (1.20, 1.02–1.41) and dry cough (1.22, 1.02–1.40). Children having suffered wheeze symptom ever was negatively associated with the use of fume exhaust ventilator in the kitchen (0.85, 0.73–0.99) and exhaust fan in the bathroom (0.86, 0.78–0.95) but positively associated with the use of home air purifier (1.22, 1.05–1.41). The results indicated that the residential characteristics such as surrounding environment and household equipments could have notable association with children’s health in Shanghai. Using clean fuel for home cooking, living far away from a highway or increasing home ventilation could possibly reduce the children’s risk of suffering asthmatic symptoms. [ABSTRACT FROM PUBLISHER]

Pneumonia is the most important cause of child death in the world today. Recent findings suggest that exposure to outdoor air pollutants may increase the pneumonia occurrence, but so far the associations have not been clearly illustrated. Therefore, the effects of outdoor air pollutants and the episode day on childhood pneumonia were investigated by this study. A standardized questionnaire on health, home and environmental factors of 4988 children was conducted in the city of Changsha, China. Average exposure to ambient air pollutants during 2008–2011 was monitored by the air pollution monitoring stations of Changsha Environmental Protection Agency. A two-stage hierarchical regression approach was adopted to estimate the effects of PM10, SO2 and NO2 on pneumonia risk. The prevalence of pneumonia in children aged 3–6 years was 38.2%, which is greatly higher than the developed countries but lower than some developing countries. Furthermore, the increased risk of childhood pneumonia was significantly associated with elevated NO2 concentration (odds ratio (OR) = 1.157, 95% confidence interval (CI): 1.121–1.195) and the episode day (OR = 1.038, 95% CI: 1.024–1.051), but not significantly associated with PM10 and SO2. Exposure to traffic-related air pollution could play an important role in the development of pneumonia in preschool children. The revised National Ambient Air Quality Standards (2012) for NO2 has provided a better control strategy for ambient air quality to reduce the risk of adverse health effects such as pneumonia for children. [ABSTRACT FROM AUTHOR]

Whether indoor environmental smoke is harmful for preschool children’s respiratory health in a society where female smoking is rare has not been determined. This study is part of a cross-sectional study (CCHH study-phase one in Shanghai) and investigated associations between parental smoking and incense-burning and respiratory symptoms among 4–6 year old children in Shanghai, China. A number of 13335 valid questionnaires (response rate: 85.3%) were analyzed. A number of 56.1% (as reported by a parent) of preschool children in Shanghai are exposed to environmental tobacco smoke (ETS). A number of 40.3% of fathers and 0.9% of mothers are smokers. A number of 53.7% and 12.6% of Shanghai residents have used mosquito-repellent incense and incensation respectively. Children exposed to any parental smoking have higher prevalence of wheeze and croup than those not exposed. Current maternal smoking has a significant and positive association with wheeze (in the last 12 months, AOR, 95% CI: 1.83, 1.11–2.99). However, paternal smoking either currently or at child’s birth had only weak associations with wheeze and croup. Incense-burning (mosquito-repellent incense and incensation) had significant and negative association with doctor-diagnosed asthma (AOR, 95% CI: 0.85, 0.73–0.99) and hay fever (AOR, 95% CI: 0.80, 0.70–0.93). The results indicate that maternal smoking perhaps is a stronger risk factor for children’s respiratory health than paternal smoking. [ABSTRACT FROM AUTHOR]

Atopic eczema is a common health problem in children. The prevalence has increased in the past decades. Besides a genetic predisposition, lifestyle factors, dietary habits and indoor environments are thought to be related to its high prevalence. A cross-sectional questionnaire study was carried out in 2011 in the Wuhan area to study associations between home environments and children’s health. The questionnaires were replied to by parents of 2193 children 1–8 years old and the response rate was 91.4% (2193/2400). The results show: (1) The prevalence of “eczema symptom ever that lasted for 6 months” was 23.2%; “eczema symptom in the last 12 months” 7.4% and “awake at night due to itchy rash” 3.4%. (2) Risk factors: Closer to business area (AOR 1.4), moisture related problems (AOR 1.3–2.2), moldy and stuffy odor perception (AOR 1.5), mice observed (AOR 1.8), pet keeping (AOR 1.3), exposure to environmental tobacco smoke (AOR 1.3) and incense (AOR 1.8) were significant risk factors for atopic eczema symptoms ever. Living in an apartment, compared to single family house, was related to more eczema symptom in the last 12 months. Damp clothing/bed sheets and perception of stuffy odor were risk factors for both “eczema symptom in the last 12 months” and “awake due to itchy rash (severe eczema)”. The odds ratio of mice observed for severe eczema was 3.1 (95% CI: 1.4–6.7). It suggests that urbanization, life style and dampness problems at home were significant risk factors for eczema symptoms among children in Wuhan, China. [ABSTRACT FROM AUTHOR]

The city of Chongqing has high outdoor temperatures and humidity throughout the year and consequently a high risk of dampness and mold problems in dwellings. As part of the China, Children, Homes, Health (CCHH), associations between home characteristics and children’s asthma, allergies, and related symptoms were investigated in Chongqing, China. A cross-sectional questionnaire survey on home characteristics including dampness and symptoms of asthma and allergies in 5299 children was performed. Data for 4754 children (3–6 years) and their homes were analyzed. Results showed that 35.1% of homes were reported to have “damp bedding”, 14.3% “condensation on window panes (higher than 5 cm)”, 11.6% “mouldy odor”, 9.3% “water leakage”, 8.3% “damp stains” and 5.3% “visible mould”. Wheezing and rhinitis ever were reported for 27.0% and 51.1% children respectively, and rhinitis, wheezing, cough at night and eczema in the last 12 months were reported for 38.1%, 20.5%, 18.9% and 13.2% respectively. Doctor-diagnosed asthma was reported for 8.3% of children, and doctor-diagnosed rhinitis for 6.2%. Dampness in homes was generally strongly associated with asthma and allergies among Chongqing children. The strongest association was found between “visible mould” and doctor-diagnosed rhinitis, and the adjusted Odds Ratio (OR A) was 2.27 (95% CI: 1.48, 3.49). “Damp bedding” was significantly associated with all asthma and allergic symptoms, but doctor-diagnosed asthma and rhinitis. The behavior of “putting bedding to sunshine” could effectively reduce the prevalence of asthma and allergic symptoms, and the risk of bedding affected with damp was reduced significantly when bedding was put to sunshine frequently. [ABSTRACT FROM AUTHOR]

Indoor environmental quality is suspected to be at least part of the cause of the increasing prevalence of childhood asthma and allergy. This study is part of the China, Children, Homes, Health (CCHH) project, which was designed to identify the risk factors indoors that are associated with prevalence of asthma and allergy among children in China. A cross-sectional questionnaire study was carried out in Wuhan in 2011. The questionnaire was a modified (to Chinese building characteristics) version of a questionnaire used first in Sweden. The parents of 2193 children, aged 1–8 years, replied, a response rate of 91.4% (2193/2400). Prevalences of asthma and allergic symptoms were calculated, and a Chi-square test and multiple logistic regression were used to identify risk factors. Prevalences of health outcomes are “wheezing last 12 months” 18.5%, “cough at night last 12 months” 15.4%, “doctor-diagnosed asthma” 6.0%, “rhinitis last 12 months” 48.7%, “doctor-diagnosed allergic rhinitis” 17.5%. Factors associated with increased risk for asthma, allergy and related symptoms include living in an urban area, dampness (significant), use of gas for cooking, new dwelling decoration (paint and furniture obtained during pregnancy), keeping pets and breast feeding less than 3 months. Factors associated with reduced risk as installing an exhaust fan in the bathroom. Home environmental factors are significantly associated with the prevalence of childhood asthma and rhinitis in Wuhan. Urbanization and dampness problems at home are significant risk factors for doctor diagnosed asthma and allergic rhinitis among children in Wuhan. [ABSTRACT FROM AUTHOR]

Prenatal and early life home environment might be related to children’s asthma or allergic diseases later in life. A cross-sectional epidemiological study was designed and a questionnaire survey was performed in 3700 preschool children in urban areas in Taiyuan, Shanxi Province, China. Questions on children’s asthma and allergic diseases from the International Study on Asthma and Allergies in Childhood (ISAAC) were integrated with questions on home environment from the Swedish Dampness in Buildings and Health (DBH) study, appropriately modified for Chinese life habits. By multivariate regression analyses controlling for age, gender, heredity, location in urban/suburban or rural areas, environmental tobacco smoke (ETS) and breastfeeding, we found that home new furniture (HNF) before birth (referring to 1 year before pregnancy and during pregnancy) was positively associated with wheezing ever (odds ratio(OR) 1.23 with 95% CI of 1.03–1.48) and wheezing last 12 months (1.24,1.00–1.54), allergic rhinitis (AR) (1.26,1.06–1.51), and eczema (1.42,1.01–1.99). HNF between 0–1 years old was also positively associated with wheezing last 12 months. Home new decoration (HND) during 0–1 years old was positively associated with AR symptoms and eczema symptoms, more in the last 12 months. Stronger positive associations were found for signs of home mold and dampness with almost all children’s asthmatic and allergic symptoms (OR ranging from 1.23–1.85, P<0.05). By mutual adjustment between HNF before children’s birth and home mold or dampness, all the significance remained unchanged. Prenatal HNF and home mold or dampness was independently associated with children’s asthmatic and allergic diseases later in life. [ABSTRACT FROM AUTHOR]

The prevalence and risk factors of sick building syndrome (SBS) symptoms in domestic environments were studied by a questionnaire survey on the home environment. Parents of 5299 3-6 years old children from randomly selected kindergartens in Chongqing, China returned completed questionnaires between December 2010 and April 2011. The prevalence of parents’ SBS symptoms (often (every week) compared with never) were: 11.4% for general symptoms, 7.1% for mucosal symptoms and 4.4% for skin symptoms. Multiple logistic regressions were applied controlling for gender and asthma/allergic rhinitis/eczema. Living near a main road or highway was a strong risk factor for general symptoms (adjusted odds ratio, aOR=2.16, P<0.001), skin symptoms (aOR=2.69, P<0.001), and mucosal symptoms (aOR=1.63, P<0.01). Redecoration was a risk factor for general symptoms (aOR=2.00, P<0.001), skin symptoms (aOR=1.66, P<0.01), and mucosal symptoms (aOR=1.66, P<0.05). New furniture was a risk factor for general symptoms (aOR=2.16, P<0.001) and skin symptoms (aOR=1.67, P<0.01). Dampness related problems (mould spot, damp stain, water damage and condensation) were all risk factors for SBS symptoms, as was the presence of cockroaches, rats, and mosquitoes/flies and use of incense. Protective factors include cleaning the child’s bedroom every day and frequently exposing bedding to sunshine. In conclusion, adults’ SBS symptoms were related to factors of the home environment. [ABSTRACT FROM AUTHOR]

Prevalence of allergic rhinitis has rapidly increased among Chinese children, but the reasons are unclear. Recent findings have suggested that exposure to outdoor air pollutants may increase the risk of allergic rhinitis, but the results were inconsistent. This study further investigated the effect of outdoor air pollutants on allergic rhinitis among preschool children. A standardized questionnaire on health, home and environmental factors was conducted for 4988 children aged 1–8 in the city of Changsha, and the concentrations of PM 10 (particle diameter ⩽10 μm), sulfur dioxide (SO 2) and nitrogen dioxide (NO 2) during 2006–2011 were acquired from the official web of Changsha Environmental Protection Agency. Results showed that the prevalence of children’s doctor diagnosed rhinitis was 8.4% (95% confidence interval [CI] 7.0%–10.0%). It was found that the prevalence of rhinitis was not associated with site-specific background concentrations of air pollutants, but significantly positively correlated with age-related accumulative personal exposure of PM 10, SO 2 and NO 2. We conclude that age-related accumulative personal exposure to ambient air pollution may play an important role in the development of rhinitis. [ABSTRACT FROM AUTHOR]

In order to evaluate the prevalence of childhood asthma, allergic diseases and pneumonia in Urumqi City, China, as well as its associations with housing and home characteristics, a cross-sectional study was performed in 4618 children (81.7% response rate, average age 4.7±0.9 year, boys accounting for 53.7%). Questions on children’s asthma and allergic diseases were from the International Study on Asthma and Allergies in Childhood (ISAAC) and were integrated with questions on the home environment from the Dampness in Buildings and Health (DBH) study, slightly modified to account for Chinese building characteristics and life habits. The prevalences of physician diagnosed asthma, allergic rhinitis (AR) and pneumonia were 3.6%, 8.7% and 40.9%, respectively. One fourth of children reported wheezing and more than 40% AR symptoms in the last 12 months. Controlling for confounding factors, positive associations were found for home mold/dampness and wheezing (adjusted odds ratio, aOR 1.33, 95% CI 1.07–1.66), AR symptoms (1.34, 1.09–1.64) last 12 months and physician diagnosed pneumonia (1.33, 1.09–1.62). Floor material by wood, PVC or carpeting; and walls by wallpaper, painting or wood material, were positively associated with AR symptoms. Home environmental tobacco smoke (ETS) was positively associated with wheezing (1.23, 1.04–1.46) and pneumonia (1.25, 1.07–1.45). In conclusion, there was a relatively high prevalence of asthmatic and AR symptoms and diagnosed pneumonia in preschool children in Urumqi. Home signs of mold growth or dampness, windowpane condensation, as well as ETS and interior surface materials emitting chemicals were risk factors for allergic symptoms and pneumonia. [ABSTRACT FROM AUTHOR]

Pneumonia is a major cause of childhood morbidity in China. Many studies of rural areas have found an association between pneumonia and air pollution from burning of bio-mass. The present study is of children living in urban, modern homes without burning of bio-mass. In order to investigate potential home risk factors associated with children’s pneumonia, China Child Home Health (CCHH) questionnaires were randomly distributed to parents of 6461 children in 23 kindergartens in all 11 districts of Nanjing, covering urban, suburban, and industrial areas. The 4014 valid questionnaires (response rate 65.7%) were returned and have been analyzed. The lifetime incidence of pneumonia in Nanjing children 1–8 years old is 26.7%. The incidence of croup, asthma and frequent common colds was strongly associated with pneumonia, as was a history of allergies in the family, and persons other than parents (for example grandparents or nanny) taking care of the child. Several home environmental factors, namely, dampness, lack of ventilation, using coal or natural gas (electricity as reference) for cooking, new furniture, and “modern” floor and wall covering materials were also significantly associated with pneumonia. The indoor environment typical of modern apartments in China was a risk factor for pneumonia among children. [ABSTRACT FROM AUTHOR]

Whether early pet-keeping is a risk factor for children’s asthma and allergies remains controversial. To investigate associations between asthma, allergies and airway symptoms among children and the indoor environment, a cross-sectional study was conducted in 5 districts of Shanghai. A number of 13335 questionnaires (response rate: 85.3%) of 4-6 year old children were analyzed. Families in urban areas have more pets except for dogs than families in suburbs. Fish are the most common pets in urban districts. The prevalence of doctor-diagnosed asthma was 10.3%, wheeze (ever) 28.3%, rhinitis (ever) 54.1%, doctor-diagnosed hay fever 12.6% and eczema (ever) 22.9%. In logistic regression analyses, early furred pet-keeping was positively associated with most of the symptoms and significantly with rhinitis (ever, adjusted OR=1.41, 95% CI=1.14–1.76) and doctor-diagnosed hay fever (1.38, 1.02–1.88). Current furred pet-keeping was significantly negatively associated with doctor-diagnosed asthma (0.57, 0.39–0.83). Persistent furred pet-keeping was significantly positively associated with rhinitis on pet or pollen exposure. However, current pet-keeping is not randomly distributed in the population. Children in families with “allergy” or with “pet avoidance behavior” (due to allergies in the family) have more symptoms, but have avoided cats and dogs, leading to the conclusion that such animals are “protective”, namely the “Healthy Pet-Keeping” effect. Moreover, rodents and birds are risks for children’s health. Fish-keeping is also seemingly a risk. This study indicates that early pet-keeping is a risk factor for asthma and allergies in families with a history of allergies, and part of residents in Shanghai have pet-avoidance behavior. [ABSTRACT FROM AUTHOR]

This study evaluated the prevalence and risk factors for asthma, allergy and related symptoms; and breastfeeding patterns and durations for 5479 Beijing children aged 3–6. Parents of children in randomly selected kindergartens wrote responses to a questionnaire used previously. The study aimed to evaluate trends in the prevalence of asthma and related illnesses, and to determine whether “more” breastfeeding, defined as exclusive, > 6 months, was associated with reduced prevalence. Asthma has increased in this age group between 1990 and 2011, with the steepest increase in the last 2–3 years. Of the total, 14.2% (779) children were breastfed exclusively for > 6 months. The efficacy of “more” breastfeeding was tested in a subset with two strong risk factors, positive family history (for asthma and/or allergy) and male gender. “More” breastfeeding was found to be significantly protective (aOR 0.42, P < 0.05) for this subset against Doctor-diagnosed asthma (D-asthma). Protection that did not reach statistical significance was also found for this subset against Wheeze ever, Cough at night, Rhinitis ever, Doctor-diagnosed rhinitis (D-rhinitis) and Eczema. The greatest protective effects were found for girls with no family history of asthma or allergy, reaching statistical significance for Wheeze ever (aOR 0.48, P < 0.01), Cough at night (aOR 0.47, P < 0.01), D-asthma (aOR 0.14, P < 0.01) and Rhinitis ever (aOR 0.67, P < 0.05). “More” breastfeeding was not consistently associated with either a protective or risk effect for Eczema. [ABSTRACT FROM AUTHOR]

Objective: To assess health risks associated with inhalation exposure to formaldehyde and benzene mainly emitted from building and decoration materials in newly remodeled indoor spaces in Beijing. Methods: We tested the formaldehyde and benzene concentrations in indoor air of 410 dwellings and 451 offices remodeled within the past year, in which the occupants had health concerns about indoor air quality. To assess non-carcinogenic health risks, we compared the data to the health guidelines in China and USA, respectively. To assess carcinogenic health risks, we first modeled indoor personal exposure to formaldehyde and benzene using the concentration data, and then estimated the associated cancer risks by multiplying the indoor personal exposure by the Inhalation Unit Risk values (IURs) provided by the U.S. EPA Integrated Risk Information System (U.S. EPA IRIS) and the California Office of Environmental Health Hazard Assessment (OEHHA), respectively. Results: (1) The indoor formaldehyde concentrations of 85% dwellings and 67% offices were above the acute Reference Exposure Level (REL) recommended by the OEHHA and the concentrations of all tested buildings were above the chronic REL recommended by the OEHHA; (2) The indoor benzene concentrations of 12% dwellings and 32% offices exceeded the reference concentration (RfC) recommended by the U.S. EPA IRIS; (3) The median cancer risks from indoor exposure to formaldehyde and benzene were 1,150 and 106 per million (based on U.S. EPA IRIS IURs), 531 and 394 per million (based on OEHHA IURs). Conclusions: In the tested buildings, formaldehyde exposure may pose acute and chronic non-carcinogenic health risks to the occupants, whereas benzene exposure may pose chronic non-carcinogenic risks to the occupants. Exposure to both compounds is associated with significant carcinogenic risks. Improvement in ventilation, establishment of volatile organic compounds (VOCs) emission labeling systems for decorating and refurbishing materials are recommended to reduce indoor VOCs exposure. [ABSTRACT FROM AUTHOR]

Aims We studied whether a reduced coronary flow reserve (CFR) in healthy young men independently predicts the presence of coronary artery disease as assessed by coronary artery calcification after 11 years of follow-up. Methods and results Coronary microvascular dysfunction in early stages of coronary artery disease can be detected as a reduced CFR by positron emission tomography (PET). Seventy-seven healthy, lean, normotensive, non-smoking and non-diabetic men underwent 15-Oxygen (15O) water myocardial perfusion PET at rest and during vasodilator stress at the age of 35 ± 4 years at baseline. The subjects were followed-up for 11 ± 1 years and the coronary artery calcium score (CCS) was measured with computed tomography at the end of the follow-up. At the end of the follow-up, 30 (39%) individuals had CCS >0 (average 65 ± 93), but none had clinical symptoms or evidence of ischaemia in stress echocardiography. At baseline, the average CFR was comparable in individuals with CCS >0 and CCS = 0 (4.2 ± 1.4 vs. 4.0 ± 1.2, P = 0.4). Logistic regression analysis showed no associations between CFR, serum glucose, cholesterol levels, systolic blood pressure or body mass index at baseline and CCS at the end of the follow-up (P always >0.05). The presence of CCS (CCS >0) was associated with higher systolic and diastolic blood pressures at the end of the follow-up (137 ± 18 vs. 128 ± 11 mmHg, P = 0.04 and 86 ± 12 vs. 78 ± 11 mmHg, P = 0.01). Conclusions Coronary reactivity to vasodilator-induced hyperaemia as assessed by perfusion PET was not predictive of the presence of coronary calcification after 11 years of follow-up in asymptomatic men with very low likelihood of coronary artery disease. [ABSTRACT FROM PUBLISHER]

The prevalence of perceptions of odors and sensations of air humidity and sick building syndrome symptoms in domestic environments were studied using responses to a questionnaire on the home environment. Parents of 4530 1–8 year old children from randomly selected kindergartens in Chongqing, China participated. Stuffy odor, unpleasant odor, pungent odor, mold odor, tobacco smoke odor, humid air and dry air in the last three month (weekly or sometimes) was reported by 31.4%, 26.5%, 16.1%, 10.6%, 33.0%, 32.1% and 37.2% of the parents, respectively. The prevalence of parents’ SBS symptoms (weekly or sometimes) were: 78.7% for general symptoms, 74.3% for mucosal symptoms and 47.5% for skin symptoms. Multi-nominal regression analyses for associations between odors/sensations of air humidity and SBS symptoms showed that the odds ratio for “weekly” SBS symptoms were consistently higher than for “sometimes” SBS symptoms. Living near a main road or highway, redecoration, and new furniture were risk factors for perceptions of odors and sensations of humid air and dry air. Dampness related problems (mold spots, damp stains, water damage and condensation) were all risk factors for perceptions of odors and sensations of humid air and dry air, as was the presence of cockroaches, rats, and mosquitoes/flies, use of mosquito-repellent incense and incense. Protective factors included cleaning the child’s bedroom every day and frequently exposing bedding to sunshine. In conclusion, adults’ perceptions of odors and sensations of humid air and dry air are related to factors of the home environment and SBS symptoms are related to odor perceptions. [ABSTRACT FROM AUTHOR]

A cross-sectional study on the home environment and children’s health in Northeast Texas was carried out in 2008–2009. Two thousand eight hundred and nineteen (2,819) parents of children (1–8 years) reported their housing characteristics, home interior surface materials, dampness and children’s health status. The response rate was 71%. Health outcomes studied were wheeze, dry cough, rhinitis, eczema in the last 12 months and diagnosed asthma and hay fever. Dampness was significant risk factor for wheeze and rhinitis with adjusted odds ratio (AOR) 1.3–1.7. Mould/damp spot, condensation and suspected moisture problems were more commonly reported in buildings with flat roof and pier/beam foundation in hot and humid Northeast Texas. Compared to single family houses, trailers were associated with more dampness, consequently a significant increased prevalence of asthma (AOR 1.5 with 95% confidence interval (CI) 1.0–2.3), rhinitis (AOR 1.4, 95% CI 1.0–2.0) and hay fever (AOR 1.5, 95% CI 1.1–2.1). Central air-conditioning system, which re-circulates indoor air, was associated with less dampness problems. However, an increment trend of allergic symptoms was found in homes with air-conditioning system, especially for rhinitis (AOR 1.6, 95% CI 1.1–2.2). Carpet as floor covering and laminated panel as wall covering were associated with rhinitis (AOR 1.6, 95% CI 1.0–2.5) and wheezing (AOR 4.7, 95% CI 1.8–12.7), respectively. [ABSTRACT FROM AUTHOR]

Endotoxins are microbiological agents which ubiquitously exist in an indoor environment, and are believed to be causal agents for a number of diseases. This study investigated the indoor levels and determinants of endotoxins and their impact on asthma and allergy diseases among Swedish pre-school children. House dust samples from 390 homes of 198 case children with asthma and allergy and 202 healthy control children were collected in the Dampness Building and Health (DBH) study. House dust endotoxin levels in the child's bedroom and living rooms ranged from 479–188,000 EU/g dust and from 138–942,000 EU/g dust, respectively. Pet-keeping and agricultural activities were significantly associated with the higher endotoxin concentration levels in indoor dust. Endotoxins in theindoor environment did not associate to asthma and allergy diseases in the children. However, we found an association between endotoxins and the presence of disease symptoms in the sub-group of families without indoor pets. [ABSTRACT FROM PUBLISHER]

This study aimed to examine the association between the length of use of feeding bottles or pacifiers during childhood and the prevalence of respiratory and allergic morbidities. A large-scale questionnaire survey was performed in day care centers and kindergartens (with children's ages ranging from 2 to 7 years) in southern Taiwan, and a total of 14,862 questionnaires completed by parents were finally recruited for data analysis. Effects of using feeding bottles on children's wheezing/asthma (adjusted OR: 1.05, 95% CI 1.00-1.09), allergic rhinitis (adjusted OR: 1.04, 95% CI 1.00-1.08), and eczema (adjusted OR: 1.07, 95% CI 1.01- 1.2) were found.Moreover, significant dose-dependent relationships were further established after an adjustment for confounders was performed that included children's ages, gender, gestational age, birth weight, length of breastfeeding, the age when first given infant formula or complementary foods, family history, parental educational levels, and smoking status, as well as the problem of indoor water damage. This study was the first to reveal the potential risk of using plastic consumer products such as feeding bottles on the reported health status of preschool children in Asian countries. [ABSTRACT FROM AUTHOR]

Objective: To test whether the incidence of common colds among college students in China is associated with ventilation rates and crowdedness in dormitories. Methods: In Phase I of the study, a cross-sectional study, 3712 students living in 1569 dorm rooms in 13 buildings responded to a questionnaire about incidence and duration of common colds in the previous 12 months. In Phase II, air temperature, relative humidity and CO2 concentration were measured for 24 hours in 238 dorm rooms in 13 buildings, during both summer and winter. Out-to indoor air flow rates at night were calculated based on measured CO2 concentrations. Results: In Phase I, 10% of college students reported an incidence of more than 6 common colds in the previous 12 months, and 15% reported that each infection usually lasted for more than 2 weeks. Students in 6-person dorm rooms were about 2 times as likely to have an incidence of common colds ≥6 times per year and a duration ≥2 weeks, compared to students in 3-person rooms. In Phase II, 90% of the measured dorm rooms had an out-to indoor air flow rate less than the Chinese standard of 8.3 L/s per person during the heating season. There was a dose-response relationship between out-to indoor air flow rate per person in dorm rooms and the proportion of occupants with annual common cold infections ≥6 times. A mean ventilation rate of 5 L/(s·person) in dorm buildings was associated with 5% of self reported common cold ≥6 times, compared to 35% at 1 L/(s·person). Conclusion: Crowded dormitories with low out-to indoor airflow rates are associated with more respiratory infections among college students. [ABSTRACT FROM AUTHOR]

Objectives: To study the impact of daycare attendance on airways infections and 'allergic' symptoms of children aged 1-8 years in Northeast Texas. Methods: Self-administrated questionnaires were distributed to parents through Women, Infants and Children offices, daycare centers, elementary schools, clinic centers, hospitals, and churches. The health outcomes consisted of 'allergic' symptoms, and respiratory tract disorders. Questions on child care included; type of daycare settings (proxy for the number of children in daycare), time spent at daycare centers per week, and age of entry to a daycare center. Results: A total of 3766 children participated in this study, giving a response rate of 71%. Daycare attendance was associated with more frequent respiratory tract infections and 'allergic' symptoms, compared to home care. A dose-response relationship between time spent at daycare centers and prevalence of respiratory tract disorders and asthma and allergies was observed. Earlier age exposure at daycare centers was a risk factor for rhinitis up to 7-8 years. Conclusions: Daycare attendance had a substantial negative influence on health status of children aged 1-8 years in Northeast Texas. [ABSTRACT FROM AUTHOR]

Most studies studying dampness as a risk factor for asthma are of a cross-sectional design. The aim of this study was to investigate if the association between moisture-related problems indoor and asthma found in cross-sectional questionnaire data can be confirmed in longitudinal analyses. The Dampness in Building and Health (DBH) study started in 2000 in Varmland, Sweden, with a baseline questionnaire to all children aged 1-5 y (n = 14,077) and five years later a follow-up questionnaire was distributed to children aged 6-8 y (n = 7,509). Moisture-related problems that were associated with asthma in cross-sectional analysis decreased or disappeared in the longitudinal analysis. However, the association between reports of moldy odor in the homes at baseline and incident asthma remained and became stronger. Our results suggest that cross-sectional data showing associations between moisture-related problems in homes and asthma in children partly can be explained by reporting bias. [ABSTRACT FROM AUTHOR]

Background/Aims. Natriuretic peptides are associated with the cardiovascular disease risk under a range of different circumstances. However, less is known about whether this association is found also in young healthy subjects. Methods. 9 patients with dilated cardiomyopathy and 26 healthy young subjects were studied. The myocardial blood flow measurements were performed basally and during adenosine infusion using PET. Results. S-proBNP concentrations were significantly higher (2153 ± 1964 versus 28 ± 17ng/L, P = .000002) and adenosine-stimulated flow lower (1.6 ±0.8 versus 3.6 ± 1.1 mL·g-1·min-1, P = .00001) in patients with dilated cardiomyopathy when compared to healthy subjects. S-proBNP concentration was inversely associated with adenosine stimulated flow in patients with dilated cardiomyopathy (r = -0.75, P = .019) but not in healthy subjects (r = -0.06, P = .84). Conclusions. Natriuretic peptides are inversely associated with coronary vasoreactivity in patients with dilated cardiomyopathy but not in healthy young subjects. Since reduced coronary vasoreactivity seems to be one of the earliest abnormalities in the development of coronary artery disease, this might indicate that natriuretic peptides are not predictor of cardiovascular disease risk in healthy young subjects. [ABSTRACT FROM AUTHOR]

Metabolic syndrome is a set of risk factors (abdominal obesity, insulin resistance, hypertension, and dyslipidemia) which increases markedly the risk of arteriosclerotic vascular disease. In subjects with frailty syndrome, aging-related loss of muscle (sarcopenia) and bone (osteoporosis) might progress to the extent that an older person loses his or her ability to live independently. Due to ongoing obesity pandemic and growing elderly population, metabolic and frailty syndromes are major emerging concerns in healthcare system. Recent studies show that resistance training has remarkable beneficial effects on the musculoskeletal system including prevention and treatment of these syndromes. Resistance training has favourable effect on metabolic syndrome since it decreases fat mass including abdominal fat. It also enhances insulin sensitivity, improves glucose tolerance, and reduces blood pressure values. The combination of sarcopenia and osteoporosis is often seen in the frailty syndrome. Resistance training is probably the most effective measure to prevent and treat sarcopenia. In addition, many studies show that resistance training can maintain or even increase bone mineral density. Optimal nutrition enhances the anabolic effect of resistance training. Resistance training should be a central component of public health promotion programs along with an aerobic exercise. [ABSTRACT FROM AUTHOR]