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This study investigates associations of building dampness indicators, and perceptions of moldy odor, humidity and dryness (Dampness and Dryness, D&D) with children's asthma and allergies. Data were obtained from a cross-sectional study in Tianjin and Cangzhou, China from 2013 to 2014. Completed surveys were returned by 7366 families with children 0–8 years old. We studied D&D factors both in the current residence and the residence where the children lived immediately after birth. A total of 4.4% of the children had doctor-diagnosed asthma; 9.5% had doctor-diagnosed rhinitis; and 39.1% had doctor-diagnosed eczema. Most of the dampness indicators, perceptions of odors, and perceived dryness, were significantly associated with children's asthma and allergies. A reporting bias in parents (or guardians) who themselves had allergies was not found to be the reason for the associations between D&D and health effects. Compared with either previous or current exposure to D&D, continuous exposure to D&D was a greater risk for children's asthma and allergies. Perceived dryness was the most important studied risk factor for children's allergies in either current or previous homes. [ABSTRACT FROM AUTHOR]

Air change rate data for dwellings in China are scarce. We carried out a study of ventilation rates in 399 homes in Tianjin and Cangzhou, China. Carbon dioxide concentration was continuously measured for 24 h in bedrooms and living rooms. The air change rate at night was calculated using a single zone mass balance model. In the whole home, the median air change rates during sleeping time for spring, summer, autumn and winter were 0.27 h −1 , 1.11 h −1 , 0.29 h −1 , 0.30 h −1 . In the child's bedroom with closed window and door, the median air change rates during sleeping time for spring, summer, autumn and winter were 0.25 h −1 , 0.25 h −1 , 0.30 h −1 , 0.37 h −1 . Air change rates in homes with open windows were significantly higher than those in homes with closed windows ( p  = 0.000). [ABSTRACT FROM AUTHOR]

The urbanization and industrialization in China is accompanied by bad air quality, and the prevalence of asthma in Chinese children has been increasing in recent years. To investigate the associations between ambient PM 2.5 levels and asthmatic and allergic diseases or symptoms in preschool children in China, we assigned PM 2.5 exposure data from the Global Burden of Disease (GBD) project to 205 kindergartens at a spatial resolution of 0.1° × 0.1° in six cities in China (Shanghai, Nanjing, Chongqing, Changsha, Urumqi, and Taiyuan). A hierarchical multiple logistical regression model was applied to analyze the associations between kindergarten-level PM 2.5 exposure and individual-level outcomes of asthmatic and allergic symptoms. The individual-level variables, including gender, age, family history of asthma and allergic diseases, breastfeeding, parental smoking, indoor dampness, interior decoration pollution, household annual income, and city-level variable-annual temperature were adjusted. A total of 30,759 children (average age 4.6 years, 51.7% boys) were enrolled in this study. Apart from family history, indoor dampness, and decoration as predominant risk factors, we found that an increase of 10 μg/m 3 of the annual PM 2.5 was positively associated with the prevalence of allergic rhinitis by an odds ratio (OR) of 1.20 (95% confidence interval [CI] 1.11, 1.29) and diagnosed asthma by OR of 1.10 (95% CI 1.03, 1.18). Those who lived in non-urban (vs. urban) areas were exposed to more severe indoor air pollution arising from biomass combustion and had significantly higher ORs between PM 2.5 and allergic rhinitis and current rhinitis. Our study suggested that long-term exposure to PM 2.5 might increase the risks of asthmatic and allergic diseases or symptoms in preschool children in China. Compared to those living in urban areas, children living in suburban or rural areas had a higher risk of PM 2.5 exposure. [ABSTRACT FROM AUTHOR]

Phthalates (PAEs) are SVOCs (Semi Volatile Organic Compounds), which are used as plasticizers in industrial products and home daily supplies. Phthalates are ubiquitous in indoor environment, consequently affect human health, especially children’s health. This study is part of CCHH (China, Children, Home, Health) projects. The study consisted of two phases. Phase Ⅰ, the home environment and health information of children aged 1-8 years old in Tianjin area and Cangzhou area were surveyed with questionnaire. Phase Ⅱ, the home environment were measured and the dust samples were collected. Finally, 6928 questionnaires were collected back and analyzed, and 410 dust samples were collected from children’s bedrooms in Tianjin and Cangzhou areas. The concentration of PAEs in dust samples were measured by GC-MS method. The six target PAEs were Diethyl phthalate (DEP), Diisobutyl phthalate (DiBP), Di-n-butyl phthalate (DnBP), Butyl benzyl phthalate (BBzP), Di-(2-ethylhexyl) phthalate (DEHP), Diisononyl phthalate (DiNP). It was found that the median values of DEP, DiBP, DnBP, BBzP, DEHP and DiNP were 0.31µg/g, 16.38µg/g, 42.6µg/g, 0.11µg/g, 127.11µg/g and 0.28µg/g, respectively. Indoor “modern” decoration and frequent use of household cleaning products were related to higher PAE concentrations, consequently to children’s asthma and allergy. Higher concentrations of DEP, DiBP were significantly associated to children’s diagnosed asthma (DEP AOR 2.08; DiBP AOR 2.48). [ABSTRACT FROM AUTHOR]

Air change rate is an important factor in indoor environment with regards to occupants’ health. In order to study the association of air change rate in homes and building characteristics, a large scale air change rate measurements were carried out during Sept. 2013-Jan. 2016 in Tianjin, China. 410 homes were investigated and indoor environment were measured. Carbon dioxide concentration in homes was continuously measured for 24 hours. Air change rate was calculated by using CO 2 produced by occupants as tracer gas. In the whole home, air change rates during sleeping time averaged 0.61±1.05 h -1 (median=0.32 h -1 , n=340). In the bedrooms, air change rate during sleeping time were substantially higher, averaging 0.81±1.33 h -1 (median=0.43 h -1 , n=390). Months trends of whole home and bedroom air change rates differed. Air change rates were higher in smaller homes. Formaldehyde and TVOC concentration in homes with higher air change rate were lower. [ABSTRACT FROM AUTHOR]

This study aimed to find out the relationship between pets keeping in the first year of life (early life) and asthma and allergy among young children aged 0-8 years old in Tianjin, China. It investigated 7366 children and used logistical regression to analyse the self-reported questionnaires containing the questions on asthma, asthma-related and other allergic symptoms and completed by children’s parents. And it shows the highest prevalence of the allergic symptoms was found in urban area, followed by countryside and people in rural area showed the healthiest. However, the rate of pets keeping was contrary, people from rural area keep the most pets. Most importantly, it revealed that exposure to a pet in the early life was positively associated with asthma and allergy in Tianjin, especially for urban area. In conclusion, this study revealed that pet exposure in early in Tianjin was a risk factor for children’s health in later life. [ABSTRACT FROM AUTHOR]

We analyzed perceptions of odors and dryness and their associations with asthma and allergic symptoms in 1–8 year-old children in Baotou, China. In this cross-sectional study, parents returned 4801 completed questionnaires. Odors reported frequently or sometimes were stuffy odor,45.2%; unpleasant odor,33.8%; pungent odor, 9.7%; moldy odor, 9.2%; tobacco smoke odor, 33.2%; dry air, 72.4% and humid air,22.5%.Perceptions of all odors and of dry air (POD)were strongly associated with the risk of children’s asthma and allergies but the perception of humid air was not. Dwelling owners reported significantly less odor perception than renters. Significant risk factors for POD were family history of asthma or allergies, living near a main road or highway, evidence of moisture related problems and never exposing bedding to sunshine. A higher proportion of women and allergic persons reported POD. The perception of dryness positively correlated with the use of humidifiers. We conclude that perception of odors and/or dryness can be proxies for indoor pollution, and as such, indicators of increased risk for children’s asthma and allergic symptoms. Reducing moisture related signs and keeping good sanitary habits, both of which can be at least partially accomplished by ventilation, are likely effective strategies for addressing odors and dryness problems in residences. [ABSTRACT FROM AUTHOR]

From March 2013 to December 2014, we collected air samples of airborne culturable fungi from 454 residences with young children (mean age: 6.9 years-old) in Shanghai, China. We also measured indoor air temperature and relative humidity, and compiled information regarding dwelling characteristics, lifestyle habits, and dampness-related indicators. Mean concentrations (mean ± SD) of culturable fungi in the child's bedrooms ( n = 445) and in the living rooms ( n = 436) were 310 ± 313 (range: 6–3184) cfu/m 3 and 300 ± 288 (range: 19–3044) cfu/m 3 , respectively. The concentrations of airborne fungi were higher in spring and winter than in other seasons, but were only slightly correlated with indoor air temperature and relative humidity in any season. Higher levels of airborne culturable fungi in the child's bedroom were significantly associated with location in a rural area, constructed before 2000, ground/top floor of the residential building, and building area <10 m 2 . Among those residences inspected in winter, rooms with poor ventilation and residences with spiders and cockroaches, damp spots and moldy spots on the wall surface were associated with higher concentrations of indoor airborne culturable fungi. We found that the household level of airborne fungi was acceptable in most of Shanghai's current residences. The possibility of indoor airborne culturable fungi during cold spring and winter requires more attention than in other seasons. Preventing dampness-related damage, improving indoor ventilation, and maintaining a dwelling free of spiders and cockroaches may decrease indoor level of airborne culturable fungi. [ABSTRACT FROM AUTHOR]

In China, the prevalence rates of asthma and allergies have been increasing in past 50 years. Several epidemiological investigations have indicated that dampness is associated with health effects such as respiratory infections, asthma and allergy. This study aims to find the associations between home dampness and asthma, rhinitis and eczema among children. A cross-sectional study on dampness and asthma and allergy at Tianjin was launched in 2013. Questionnaires were used to survey indoor dampness and health outcomes of occupants. 3.5% parents reported that they have noticed visible mildew/mold in child's rooms. The association between water leakage and asthma among children was seemingly strong (AOR: 3.29, 95% CI: 1.75-6.19). The dampness in home may have influence on asthma, rhinitis and eczema among children. [ABSTRACT FROM AUTHOR]

To identify risk factors for allergy and their contribution in the indoor environment, a population based cross sectional study was carried on among children 1-8 years old in Beijing, China during 2010-2011. The health condition, life style and home environment of children were surveyed by questionnaires. The response rate of the questionnaire was 64.8% corresponding to the number of 5763 children. The prevalence of doctor diagnosed allergic rhinitis and pneumonia was reported to be 7.8% and 26.2% respectively. 45.3% of the parents reported symptoms of rhinitis (sneezing and blocked nose) among their children in the last 12 months and 19.5% reported dry cough in the last year. Family allergy was the strongest risk factor for doctor diagnosed pneumonia, eczema, dry cough, and rhinitis in the last year. The neighborhood environment, house type, flooring, decoration, house dampness, and family member smoking are significantly associated with most reported diseases. [ABSTRACT FROM AUTHOR]

Gas, coal and biomass fuels are the dominant energy fuels for cooking in China. Exposure to the smoke released from gas, coal and biomass fuels contributes to respiratory diseases in childhood. To identify the association between asthma and allergy and cooking fuels at homes in China, an epidemiological questionnaire study on the home environment and children's health was launched in Tianjin in 2013. Data for 7,865 children and homes are included in the study. The prevalence rate of diagnosed asthma, diagnosed pneumonia, diagnosed eczema, and diagnosed rhinitis among children was 4.5%, 27.9%, 38.6%and 19.6% respectively. Coal fuels used for daily cooking did have a significantly increased likelihood of asthma-related symptoms, doctor-diagnosed pneumonia and rhinitis ever. Children in families that used gas fuel for daily cooking had more pneumonia. Biomass/wood fuel was associated with a reduced risk for rhinitis. [ABSTRACT FROM AUTHOR]

Indoor air quality is significantly associated with ventilation. In China, natural ventilation system is the norm in residential buildings. In China this means only leakage and opening of windows, doors. The present study developed a practical and feasible method to measure air change rate in residential buildings. The air change rates in residential buildings were calculated by using CO 2 produced by occupants as tracer gas. Portable CO 2 monitors were located in representative rooms and measured CO 2 concentration for 24 hours continuously. Single zone model and multiple zone model were developed to calculate air change rates. 266 dwellings were measured. The air change rates in 40% dwellings were calculated as single zone since the CO 2 concentration differences in representative rooms were less than 10%. [ABSTRACT FROM AUTHOR]

The prevalence of allergic rhinitis (AR) among children has increased markedly in Beijing during the last two decades. The purpose of this study was to estimate the prevalence of AR and to identify indoor risk factors for AR among preschool children. A cross-sectional questionnaire survey was conducted in Beijing, 2011. Parents of 5388 3–6 years old children (65% response rate) from randomly selected kindergartens in Beijing participated in this study. A Chi-square test and multiple logistic regressions were used to identify risk factors. Our survey found that the prevalences of “AR symptoms ever,” “AR symptoms current” (AR symptoms in the last 12 months) and “doctor-diagnosed AR” are 49.5%, 45.6% and 7.8%, respectively. Confounding factors for “AR symptoms” and/or “doctor-diagnosed AR” are gender, age, family allergic history, breastfeeding and current environmental tobacco smoke (ETS). New furniture, condensation on window pane and cockroaches are risk factors for both “AR symptoms ever” and “AR symptoms current”. Risk factors for “AR symptoms ever” include the use of humidifier and incense. A risk factor for “AR symptoms current” is mosquitoes/flies. Risk factors for “doctor-diagnosed AR” include living close to a main road or highway, visible mold spots and current pet keeping. A protective factor against doctor-diagnosed AR is opening the child's bedroom window in winter (aOR 0.66, 95% CI 0.48, 0.92). We found that the greater the number of home environmental risk factors, the higher risk of AR. A number of home environmental factors are associated with AR among preschool children. [ABSTRACT FROM AUTHOR]

A total of 15,266 questionnaires from 1 to 8 year-old children was used to investigate the prevalences of home dampness-related indicators and their associations with the respondent's residential characteristics and lifestyle behaviors in Shanghai, China. Most of the questionnaires were filled out by one of the child's parents (69.0% by mother and 24.9% by father). The prevalence of visible mold (VMS) was 7.9%, visible damp stains (VDS) 15.2%, windows pane condensation (WPC) 54.9%, water damage (WD) 11.9%, damp clothing and/or bedding (DCB) 42.0%, and moldy odor (MO) 11.9%, respectively. Questionnaires submitted by the child's mother noted significantly more dampness-related indicators than those submitted by the father and other respondents. Residences on the ground floor or top floor were strongly and positively associated with VMS and VDS in comparison with residences on the other floors of the dwelling building. Keeping fish in the current residence also had significant and positive associations with VDS, WPC, and WD. Having exhaust fan in the bathroom and/or opening the windows of the child’ bedroom, and frequently cleaning rooms was strongly associated with reduced dampness-related indicators in the child’ bedroom. Most of these associations among families without asthmatic children were similar to among the whole samples. Therefore, we concluded that studies regarding to home dampness-related evaluation by questionnaire should carefully considered report bias. Living on the ground floor or top floor and fish-keeping are risk factors for home dampness-related exposures. Improving home ventilation and increasing frequency of home cleaning could effectively reduce these exposures. [ABSTRACT FROM AUTHOR]

Abstract: A cross-sectional study on the home environment and asthma and allergy in children was carried out among children 1–8 years old in Seoul, South Korea from 2009 to 2010. Questionnaires were distributed to 5107 parents through daycare centers and kindergartens; 2755 parents responded, a response rate of 54%. Seven percent and 23% of children were reported to have doctor-diagnosed asthma and hay fever, respectively. A majority (57%) of the families reported having PVC flooring in child's or parents' bedroom. More than 96% of homes used a floor heating system. PVC was used more often as a floor covering in single family houses than in apartments (67% vs. 49%, p < 0.001). PVC flooring was significantly associated with eczema in the previous 6 months (AOR 1.54, 95% CI 1.13–2.09) when adjusted for gender, age, family allergy, socioeconomic status and environmental tobacco smoke. Older buildings tended to have dampness problems, and, consequently, were positively correlated with the prevalence of wheeze. Floor moisture significantly increased the association between PVC and symptoms of wheezing (AOR 2.57, 95% CI 1.36–4.82) and eczema (AOR 1.97, 95% CI 1.18–3.28). Apartments without mechanical ventilation in bedrooms were associated with a slight increase in asthma and allergy among children. This study suggests that building characteristics and home exposure can partly explain recent increases in asthma and allergy among children in Seoul. [Copyright &y& Elsevier]

Abstract: A study of “dorm environment and college students' health” was carried out in Tianjin, China, 2006–2007. It consisted of two phases. In Phase I, 3712 students in 1569 dorm rooms reported sick building syndrome (SBS) symptoms. One out of three students reported general SBS symptoms, and one out of four reported mucosal or skin problems. Males and females represented the same age group; had the same kind of dwellings in the same geographical area; and led similar student lifestyles. Nonetheless, female students reported slightly more SBS symptoms than males. A “moldy odor” or “dry air” was perceived by occupants in 31% and 76% dorm rooms respectively. The adjusted odds ratio (AOR) of perceived moldy odor for general SBS symptoms was 2.4, for mucosal symptoms 2.2, and for skin symptoms 2.0. A sensation of “dry air”, was a significant risk factor for general and skin symptoms. In Phase II, 238 dorm rooms were inspected and measured. Local moldy odor around room corners or under radiators was reported by inspectors in 26% dorm rooms. The median air change rate, indoor air temperature and relative humidity in winter were 0.7 h−1, 21 °C and 40%, respectively. Local moldy odor perceived by inspectors was a significant risk factor for nose irritation (AOR 2.8). In winter, higher air change rate was associated with a slight decrement of general and skin SBS symptoms, while higher indoor air temperature and relative humidity were slightly associated with reduced SBS symptoms. [Copyright &y& Elsevier]

Abstract: A high prevalence and racial disparities in asthma and allergy have been observed in American children. This study aimed to identify risk factors for asthma and allergy among children, and their contribution to racial disparities in allergy prevalence. A population-based cross-sectional study was carried out among children aged 1–8years in Northeast Texas 2008–2009. The health conditions, life style and home environment of 3766 children were surveyed by parental questionnaires through e.g. daycares, elementary school, and medical clinics. Among participants who indicated their ethnicity, 255 were Mexican-Americans, 178 Afro-Americans and 969 Caucasians. Afro-American children had a significantly higher prevalence of asthma and eczema. Caucasian had the highest prevalence of rhinitis. Compared to Mexican-American children, Afro-American and Caucasian children were breast fed shorter time, more often went to day care center, had pets and environmental tobacco smoke exposure at home more often. For all children, being at a day care center, being exposed to dampness and environmental tobacco smoke at home were strong risk factors for asthma and allergy. Central air conditioning system was associated with an increased prevalence of wheeze among Mexican-American children, while pets were associated with an increased risk of rhinitis among Afro-American and Caucasian children. Caucasian children were generally not healthier than relatively poor Mexican-American children. Differences in the prevalence of asthma and allergy between races cannot be explained by socioeconomic status only. Life style and home environmental exposures are important risk factors for asthma and allergy in Northeast Texas children. [Copyright &y& Elsevier]

A self-administrated questionnaire used in a cross-sectional study on associations between environmental factors and allergies was validated by building inspections and physical measurements. The agreement was good between the reports from occupants and inspectors regarding technical characteristics, such as type of surface materials etc., but a poor to slight agreement (kappa<0.2) regarding on assessments of moisture damages, such as mould or damp spots, and a mouldy smell, between occupants and inspectors. Dampness problems reported by occupants were associated with health effects (case status), while such problems observed by inspectors were not. The air relative humidity was slightly higher, during winter time, in rooms with condensation on windowpanes. The results indicate that questionnaire surveys give valid data regarding most technical characteristics. With regard to moisture damages, occupants reports seem more relevant than inspector reports, in a study of health. [Copyright &y& Elsevier]

Abstract: Objective: Positive family history as a risk factor for coronary artery disease seems to be most important in subjects who otherwise are at low risk. We examined the association between family history of coronary artery disease and myocardial vasoreactivity in healthy men. Methods: 35 non-smoking healthy men (age 35±7 years) were studied: 16 had positive family history of coronary artery disease and 19 had negative family history. The myocardial blood flow measurements were performed basally and during adenosine infusion (140 μg/kg/min) with and without simultaneous physiological hyperinsulinemia (insulin infusion at a rate of 1 mU/kg/min) using positron emission tomography and O-15-water. Results: Basal myocardial blood flow was similar between the subjects with positive and negative family history of coronary artery disease (0.79±0.19 and 0.79±0.21 mL g−1 min−1, NS). Adenosine stimulated flow was significantly reduced in subjects with positive family history (3.0±0.5 vs 4.0±1.2 mL g−1 min−1, respectively, p =0.003). During physiological hyperinsulinemia adenosine stimulated flow was further enhanced in both groups but significantly blunted in subjects with positive family history (3.7±0.9 vs 5.2±1.5 mL g−1 min−1, respectively, p =0.001). These differences remained significant after simultaneous controlling for age, BMI, HbA1c, LDL-cholesterol, HDL-cholesterol and blood pressure (p =0.002). Conclusions: Healthy non-smoking men with positive family history of coronary artery disease are characterized by impaired myocardial vasoreactivity. [Copyright &y& Elsevier]

Abstract: Objectives and Background:: We examined the association between lipoprotein(a) and myocardial vasoreactivity in healthy men. Methods:: Thirty non-smoking healthy men (age 34±6 years) were studied: 9 had increased lipoprotein(a) (>200mg/L) concentrations (lipoprotein(a) 317 (range 218–550)mg/L) and 21 had normal lipoprotein(a) (&#60;200mg/L) concentrations (lipoprotein(a) 57 (range 13–156)mg/L). The myocardial blood flow measurements were performed basally and during adenosine infusion (140μg/kg/min) with or without simultaneous physiological hyperinsulinemia (insulin infusion at a rate of 1mU/kg/min) using positron emission tomography and [15O]H2O. Results:: Basal myocardial blood flow was similar between the subjects with increased and normal lipoprotein(a) (0.76±0.20 and 0.79±0.20mLg−1 min−1, NS). Adenosine-stimulated flow tended to be reduced in subjects with increased lipoprotein(a) (3.1±0.7mLg−1 min−1 versus 3.7±1.1mLg−1 min−1, respectively, p =0.1). During physiological hyperinsulinemia adenosine-stimulated flow was further enhanced in both groups but significantly blunted in subjects with increased lipoprotein(a) (3.7±0.8mLg−1 min−1 versus 4.8±1.4mLg−1 min−1, respectively, p =0.03). This difference remained significant after simultaneous controlling for BMI, HbA1c, LDL-cholesterol, HDL-cholesterol and blood pressure (p =0.04). Conclusions:: Already young healthy men with lipoprotein(a) concentrations greater than 200mg/L are characterized by impaired myocardial vasoreactivity. [Copyright &y& Elsevier]

: ObjectivesThe effects of long-term cardiac resynchronization therapy (CRT) on left ventricular (LV) energetics and metabolic reserve were evaluated.: BackgroundCardiac resynchronization therapy is a new therapy for patients with drug-refractory severe heart failure (HF).: MethodsTen patients with idiopathic dilated cardiomyopathy who had undergone implantation of biventricular pacemaker 8 ± 5 months earlier were studied during two conditions: CRT switched on, and after CRT was switched off for 24 h. Left ventricular function was measured using echocardiography and oxidative metabolism using [11C]acetate positron emission tomography. Both measurements were performed at rest and during dobutamine-induced stress (5 μg/kg/min). Basal- and adenosine-stimulated (140 μg/kg/min) myocardial blood flow were quantitated using [15O]water.: ResultsDuring CRT off, LV stroke volume was significantly reduced at rest (72 ± 18 ml vs. 63 ± 15 ml, p < 0.05), but LV oxidative metabolism (Kmono) remained unchanged (0.046 ± 0.008 vs. 0.054 ± 0.016 min−1) leading to a significant deterioration of myocardial efficiency of forward work (from 48.2 ± 16.7 to 36.6 ± 11.7 mm Hg·l/g, p < 0.05). During dobutamine-induced stress, stroke volume and Kmono values were not different whether CRT was on or off. However, myocardial efficiency (56.1 ± 16.1 vs. 49.8 ± 18.0 mm Hg·ml·g−1·min−1, p = 0.099) and metabolic reserve, the response of Kmono to dobutamine (0.023 ± 0.014 vs. 0.013 ± 0.014 min−1, p = 0.09), tended to reduce when CRT was switched off. Cardiac resynchronization therapy had no effects on myocardial perfusion. Natriuretic peptides increased significantly during CRT-off period.: ConclusionsLong-term CRT has beneficial effects on LV function and myocardial efficiency at rest in patients with HF. These effects are not associated with changes in myocardial perfusion or oxygen consumption. During dobutamine-induced stress, CRT does not affect functional parameters, but myocardial efficiency and metabolic reserve may be increased. [Copyright &y& Elsevier]

SBS (Sick Building Syndrome) has been studied since the 1970s, mostly in workplaces. To comprehensively characterize associations between the home environment and SBS, we performed a study in the Tianjin area, China. Seven thousand eight hundred and sixty-five (7865) families with infants participated in a questionnaire survey. Information on their lifestyles, home environment and health outcomes was obtained. Fourteen percent (14%) of parents reported general symptoms, followed by 11% for mucosal symptoms and 9% for skin symptoms. There was no gender difference in reports of SBS symptoms. People living in apartments, compared to Pingfang, reported more SBS symptoms. Indoor risk factors for SBS symptoms were perceived dry air (AOR:2.71–3.85), condensation on windows (AOR:1.44–2.11), less frequent window opening (AOR:1.71–1.73) and dampness (AOR:1.44–1.93). Our findings suggest that the home environment impacts occupants' health. • A comprehensive analysis of sick building syndrome (SBS) symptoms in homes. • There was no gender difference for SBS symptoms. • Dry air perception, not due to physical dryness, was a strong and consistent risk factor for SBS symptoms. • Low ventilation and dampness were also risks for SBS symptoms. [ABSTRACT FROM AUTHOR]

The prevalence of asthma and allergic diseases has increased rapidly in urban China since 2000. There has been limited study of associations between home environmental and lifestyle factors with asthma and symptoms of allergic disease in China. In a cross-sectional analysis of 2214 children in Beijing, we applied a two-step hybrid Least Absolute Shrinkage and Selection Operator (LASSO) algorithm to identify environmental and lifestyle-related factors associated with asthma, rhinitis and wheeze from a wide range of candidates. We used group LASSO to select variables, using cross-validation as the criterion. Effect estimates were then calculated using adaptive LASSO. Model performance was assessed using Area Under the Curve (AUC) values. We found a number of environmental and lifestyle-related factors significantly associated with asthma, rhinitis or wheeze, which changed the probability of asthma, rhinitis or wheeze from −5.76% (95%CI: −7.74%, −3.79%) to 27.4% (95%CI: 16.6%, 38.3%). The three factors associated with the largest change in probability of asthma were short birth length, carpeted floor and paternal allergy; for rhinitis they were maternal smoking during pregnancy, paternal allergy and living close to industrial area; and for wheeze they were carpeted floor, short birth length and maternal allergy. Other home environmental risk factors identified were living close to a highway, industrial area or river, sharing bedroom, cooking with gas, furry pets, cockroaches, incense, printer/photocopier, TV, damp, and window condensation in winter. Lifestyle-related risk factors were child caretakers other than parents, and age<3 for the day-care. Other risk factors included use of antibiotics, and mother's occupation. Major protective factors for wheeze were living in a rural/suburban region, air conditioner use, and mother's occupation in healthcare. Our findings suggest that changes in lifestyle and indoor environments associated with the urbanization and industrialization of China are associated with asthma, rhinitis, and wheeze in children. Image 1 • We investigated home environmental and lifestyle factors associated with children's allergy. • We used a global variable procedure (LASSO) to select potential influencing factors. • We assessed associated factors in common for asthma, wheeze and rhinitis. • We calculated the probability change due to each risk factor. • Our model has sufficient statistic power and strong predicting performance. [ABSTRACT FROM AUTHOR]

There has been an increased concern on indoor air quality (IAQ) in residences since the majority of individuals' time is mainly spent indoors. We inspected and measured indoor environmental parameters in 399 homes in northeast China in order to study IAQ. We systematically measured multilevel environmental parameters (physical, chemical, and biological) in children's bedrooms during all seasons. The results indicated that the median values for indoor temperature, relative humidity, total volatile organic compounds (TVOC), and formaldehyde concentrations throughout the year were within the Chinese national standards. However, the median carbon dioxide concentrations exceeded 1000 ppm during spring, autumn, and winter. In the same seasons, the air change rate (ACR) was below the minimum required level of 0.5 h−1. Di-2-ethylhexyl phthalate (DEHP), di-n-butyl phthalate (DnBP), and di-isobutyl phthalate (DiBP) were predominantly detected in settled dust, displaying median concentrations of 126.9, 41.5, and 16.3 μg/g, respectively. Notably, phthalate concentrations were significantly higher in urban houses as compared to rural houses. Furthermore, median concentrations of Dermatophagoides farinae (Der f) and endotoxin were 689.4 ng/g and 3689.1 EU/g, respectively, trending higher in winter than summer. There was a negative correlation between ACR and chemical pollutants (TVOC, formaldehyde, and DiBP). In conclusion, northeast Chinese homes had poor indoor air quality with ubiquitous exposure to modern chemical compounds and insufficient ventilation. [ABSTRACT FROM AUTHOR]

Few studies exist from China on associations between home environment and adult health. We studied associations between home environment factors (other than dampness and mould) and rhinitis, throat and dermal symptoms and headache and fatigue among young parents in six cities across China (N = 36,541). They were recruited as parents from day care centers selected randomly and answered a questionnaire on medical symptoms and the home environment. Odds ratios (OR) were calculated by multilevel logistic regression adjusting for gender, atopy, smoking, home size and dampness/mould. Overall, 4.8% had skin symptoms 3.1% rhinitis, 2.8% eye, 4.1% throat symptoms, 3.0% headache and 13.9% had fatigue (all as weekly symptoms). Redecoration was associated with rhinitis, eye and skin symptoms, headache and fatigue. New furniture was associated with eye, throat and skin symptoms and fatigue. Gas cooking was associated with eye and throat symptoms, headache and fatigue. Biomass cooking was associated with eye and throat symptoms and headache. Burning incense was associated with eye, throat and skin symptoms, headache and fatigue. Presence of cockroaches and mosquitos or flies was associated with all six symptoms. Rats or mice were associated with eye and dermal symptoms. Cat keeping was associated with eye symptoms while dog keepers had less fatigue. Living near major roads was associated with rhinitis, eye, throat and skin symptoms and fatigue. Daily cleaning, a mechanical ventilation system in the kitchen or in the bathroom, living in older buildings and living in less urbanized areas were protective factors. In conclusion, urbanization, traffic exhaust, indoor emissions from redecoration and new furniture, gas cooking and air pollution from burning incense and biomass may cause dermal and mucosal symptoms, headache and fatigue among adults in China. Indoor animals (cats, mice/rats, cockroaches) were other risk factors. Daily cleaning, mechanical ventilation and living in older buildings can be protective. Unlabelled Image • Redecoration and new furniture in China may cause rhinitis and other medical symptoms. • Emissions from biomass and gas cooking and incense burning may cause medical symptoms. • Indoor animals (cats, mice/rats, cockroaches, mosquitos/flies) can increase symptoms. • Mechanical ventilation systems in kitchen and bathroom may reduce symptoms. • Daily cleaning, living in older buildings and in less urbanized areas can be protective. [ABSTRACT FROM AUTHOR]

To study the association of indoor air quality and ventilation in Chinese homes with occupants' sick building syndrome (SBS) symptoms, we performed a study in 32 homes over four seasons in Tianjin, China. Measured indoor environmental parameters were ventilation rate, and concentrations of volatile organic compounds (VOCs), formaldehyde, PM 2.5 , ultrafine particle and ozone. Occupants reported any sick building syndrome symptoms for the previous three months. Ventilation rates at night in bedrooms were 0.35 h−1, 0.78 h−1, 0.37 h−1 and 0.41 h−1 in spring, summer, autumn and winter, respectively. A low ventilation rate at night (below the median value of 0.45 h−1) significantly increased the risk (adjusted odds ratio, aOR) of mucosal symptom to 2.65 (95% Confidence Interval (CI): 1.16–6.06). The aOR of ultrafine particle for mucosal symptom was 2.37 (95% CI: 1.02–5.49) and for dermal symptoms 3.96 (95% CI: 1.63–9.60). The aOR of ozone for dermal symptoms was 5.86 (95% CI: 1.19–28.99). Dry air perception that indicated a polluted indoor environment was a risk factor for SBS symptoms in Chinese homes. [ABSTRACT FROM AUTHOR]

Abstract During 2010–2012, we conducted an observational study on household environment and health outcomes among 40,010 preschool children from seven cities of China. Here we examined associations of six dampness-related indicators (visible mold spots, visible damp stains, damp clothing and/or bedding, water damage, condensation on windowpane, moldy odor) in the current residence and three dampness-related indicators (visible mold spots, condensation on windowpane, moldy odor) in the early residence with childhood asthma and rhinitis. In the multi-level logistic regression analyses, visible mold spots and visible damp stains in the current residence were significantly associated with the increased odds of doctor-diagnosed asthma and allergic rhinitis during lifetime-ever (adjusted odd ratios (AORs) range: 1.18–1.35). All dampness-related indicators were significantly associated with increased odds of wheeze and rhinitis during lifetime-ever and in the past 12 months (AORs range: 1.16–2.64). The cumulative numbers of damp indicators had positively dose-response relationships with the increased odds of the studied diseases. These associations for wheeze and rhinitis were similar between northern children and southern children. Similar results were found in the sensitive analyses among children without a family history of allergies and among children without asthma and allergic rhinitis. For 3–6 years-old children in mainland of China in 2011, we speculated that about 90,000 (2.02%) children with asthma and about 59,000 (1.09%) children with allergic rhinitis could be attributable to exposing to visible mold spots in the current residence. Our results suggested that early and lifetime exposures to household dampness indicators are risk factors for childhood asthma and rhinitis. Graphical abstract Unlabelled Image Highlights • We studied associations of dampness with asthma and rhinitis in children from seven cities. • Home dampness significantly associated and dose-response related with asthma and rhinitis. • The associations had no substantial differences in children from different climate zones. • We estimated burdens of the studied diseases attributable to home visible mold spots. [ABSTRACT FROM AUTHOR]

Abstract We studied indoor sources of indoor particulate matter (PM), outdoor air pollution and antibiotic use in relation to asthma, rhinitis and eczema among pre-school children and investigated synergistic effects between PM and antibiotics use. Children (3-6y) from randomly selected day care centres in seven cities across China were included (n = 39,782). Data on ambient temperature and air pollution were collected from local monitoring stations. Data on indoor PM sources (ETS, burning of incense or mosquito coils and biomass for cooking), antibiotics use and health (doctor diagnosed asthma and rhinitis, lifetime eczema, current wheeze and current rhinitis) were assessed by a parental questionnaire. Associations were calculated by multilevel logistic regression. Asthma diagnosis was associated with outdoor temperature, NO 2 and burning mosquito coils. Rhinitis diagnosis was associated with NO 2 , ETS, gas cooking and burning biomass for cooking. Lifetime eczema was associated with temperature, PM 10, NO 2 , ETS, biomass cooking and burning mosquito coils. Burning incense was associated with current wheeze and current rhinitis. Children using antibiotics had more asthma, wheeze, rhinitis, and eczema. Excluding children with respiratory infections did not change associations with antibiotics use. Antibiotics use enhanced the effects of ETS and PM 10 (a synergistic effect). In conclusion, a warmer climate, outdoor NO 2 and PM 10, ETS, gas cooking and burning biomass, incense and mosquito coils can increase the risk of asthma, wheeze, rhinitis and eczema among pre-school children in China. Antibiotics use is a risk factor for childhood asthma, wheeze, rhinitis and eczema and ETS and outdoor PM 10 can enhance the effect. Highlights • Burning incense and mosquito coils can increase asthma, rhinitis, wheeze and eczema. • Outdoor PM 10 can increase the risk of childhood eczema. • Traffic-related air pollution (NO 2) can increase the risk of asthma, rhinitis and eczema. • Early life antibiotics use can increase the risk of asthma, rhinitis and eczema. • PM10 and ETS can enhance the adverse health effects of antibiotics use. [ABSTRACT FROM AUTHOR]

Abstract Objective Few longitudinal studies exist on childhood exposure to indoor and outdoor air pollution and respiratory illness in China. We studied associations between indoor and outdoor environment and prevalence, onset and remission of wheeze and rhinitis among children across China. Methods Children (3–6 y) were recruited from randomized day care centres in six cities. The main data analysis was restricted to children not moving since birth (N = 17,679). Data on wheeze, rhinitis and the home environment were assessed by a parental questionnaire. Prevalence in the first two years of life (baseline) and the last year (follow-up) was used to calculate onset and remission. Outdoor PM 2.5 , PM 10 , and NO 2 at the day care centre were modelled from monitoring station data. Associations were calculated by multilevel logistic regression. Results Prenatal NO 2 was associated with decreased remission of wheeze and increased prevalence and increased onset of rhinitis. Prenatal PM 2.5 was associated with increased prevalence of wheeze. Postnatal NO 2 and postnatal PM 10 were associated with increased prevalence and lower remission of wheeze and rhinitis. Mould, window pane condensation, renovation and cockroaches at home were associated with increased prevalence and increased onset of wheeze and rhinitis. Gas cooking was associated with increased onset of rhinitis. Children of mothers with industrial work had more wheeze. Conclusions Outdoor PM 2.5 , PM 10 and NO 2 can increase childhood wheeze and rhinitis. Dampness and mould can increase onset and decrease remission. Crowdedness, cockroaches at home and emissions from new building materials and gas cooking can be risk factors for wheeze and rhinitis. Highlights • Outdoor air pollution (PM 2.5 , PM 10 and NO 2) can increase wheeze and rhinitis symptoms among pre-school children in China. • Indoor mould, and dampness and window pane condensation can increase onset and decrease remission of wheeze and rhinitis. • Chemical emissions from renovation and cockroaches at home can increased onset of wheeze and rhinitis. • Gas cooking can increase onset of rhinitis. [ABSTRACT FROM AUTHOR]

Background Children's pneumonia is a heavy health burden. Few studies have been carried out on residential risk factors for pneumonia in children. Potential risks associated with dwelling characteristics are still unknown. Methods A cross-sectional study was conducted among children in 8 cities in China during 2010–2011 and 41,176 valid data on children aged 3–8 years old were used in this analysis. To obtain the lifetime-ever incidence of pneumonia in children and identify associations between pneumonia and residential risk factors, chi -square analysis and logistic regression methods were employed. Adjusted odds ratios were used as measures of effect with a 95% confidence interval. Confounding variables in the regression model include children's gender, birthweight, breastfeeding duration, parental smoking and family history of atopy. Results The average lifetime-ever incidence of childhood pneumonia was 32.3%. Urban children (33.6%) had more pneumonia than suburban (29.9%) and rural children (24.9%). More residential risk factors were found in urban-dwellings. Boys, low birthweight (<2500 g), breastfeeding duration <6 months, family allergic history, and exposure to parental smoking were found to be associated with higher pneumonia lifetime-ever incidences. Various indicators of dampness, including visible mold spots, damp stains, water damage, water condensation, damp clothing or bedding and mold odor, were also positively associated with pneumonia. Pneumonia incidence increased as the number of dampness indicators increased. Both natural gas and solid cooking fuels were positively associated with pneumonia compared with electricity. Compared with cement, construction materials including synthetic fiber, laminated wood, real wood, paint, emulsion paint and wall paper were positively associated with pneumonia. Daily living habits such as putting bedding to sunshine frequently and cleaning the child's bedroom every day could be effective preventive strategies. A dose-response relationship between the number of residential risk factors and pneumonia was observed when the risk factors number ranged from 7 to 11. Residences with more risk factors had higher lifetime-ever pneumonia odds ratios. Conclusions Indoor environmental factors including dampness, use of solid fuels or natural gas for cooking and use of new construction materials are risk factors for childhood pneumonia. This study gives evidence for the importance of home environment exposures in the occurrence of childhood pneumonia. Actions against the residential risk factors described in this study may help to prevent pneumonia in children. [ABSTRACT FROM AUTHOR]

Background Few data exist on asthma and rhinitis across China in relation to indoor and outdoor air pollution, climate and socioeconomic factors. The main aim was to study associations between asthma, rhinitis and current respiratory symptoms among pre-school children across China and selected indoor and outdoor exposure and indicators of socio-economic status (SES) in mutually adjusted models. Methods Chinese children (3–6 yr.) (n = 39,782) were recruited from randomly selected day care centres in seven cities in China. Data on asthma, respiratory symptoms, rhinitis, indoor and outdoor exposure at home and SES were assessed by a parentally administered questionnaire. Lifetime mean ambient temperature, PM 10 , NO 2, and GDP per capita on city level were calculated. Results Totally 7.4% had ever doctors' diagnosed (DD) asthma and 8.7% DD-rhinitis, 19.7% had current wheeze, 45.0% rhinitis and 16.9% cough. DD-asthma was associated with ambient temperature (OR = 1.15, 95% CI 1.11–1.20 per °C), NO 2 (OR = 1.16, 95% CI 1.02–1.33 per 10 μg/m 3 ), indoor mould/dampness (OR = 1.25, 95% CI 1.13–1.39) and living near major roads (OR = 1.13, 95% CI 1.02–1.25). DD-rhinitis was associated with ambient temperature (OR = 1.07, 95% CI 1.05–1.10 per °C), NO 2 (OR = 1.20, 95% CI 1.09–1.32 per 10 μg/m 3 ), GDP (OR = 1.03, 95% CI 1.01–1.06 per 10,000 RenMinBi/year), indoor mould/dampness (OR = 1.23, 95% CI 1.11–1.35), passive smoking (OR = 1.11, 95% CI 1.01–1.21), and living near major roads (OR = 1.14, 95% CI 1.03–1.25). Children in suburban or rural areas, in larger families (≥5 persons) and with prenatal farm exposure had less DD-asthma and DD-rhinitis. Conclusions Economic development level of the city, higher SES, ambient temperature, NO 2 , PM 10 , traffic air pollution and mould/dampness can be risk factors for asthma and rhinitis and respiratory symptoms among pre-school children in China. Breastfeeding, large family size and early-life farm exposure could be protective factors. [ABSTRACT FROM AUTHOR]

Background Childhood asthma is prevalent in China. However, there is a lack of evidence on whether household renovation, including the materials used and the periods, are associated with the disease. Objectives To investigate the associations between household decoration materials and renovation periods, and childhood asthma and its related symptoms. Methods During 2010–2012, a retrospective cohort study was initiated in seven cities of China, and 40,010 children, aged 3–6 years, were recruited. Data on demographics, health status, and home decoration conditions were collected using a parent-administered questionnaire. Two-level (city-child) logistic regression analyses with adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were performed to show the target associations. Sensitivity analysis was performed by stratifying data for children in the southern and northern cities. Results Children whose homes underwent renovation or the addition of new furniture within 1 year before pregnancy, during pregnancy, at age 0–1 year, and after age 1 year had significantly ( p  < 0.05) higher prevalence of childhood asthma and its related symptoms. The use of solid wood floors and wallpaper had significant associations (cement: AOR, 95% CI: 1.59, 1.17–2.17; lime: AOR, 95% CI: 1.31, 1.00–1.71) with an increased risk of lifetime asthma. Household renovation and the addition of new furniture during pregnancy had significant associations with lifetime asthma (renovation: AOR, 95% CI: 1.23, 1.01–1.51); lifetime wheeze (renovation: AOR, 95% CI: 1.21, 1.05–1.39; furniture: AOR, 95% CI: 1.24, 1.14–1.36), current wheeze (renovation: AOR, 95% CI, 1.21 1.05–1.40; furniture: AOR, 95% CI: 1.23, 1.12–1.34), and current dry cough (renovation: AOR, 95% CI: 1.41, 1.23–1.63; furniture: AOR, 95% CI: 1.28, 1.17–1.41). Similar associations were found between the addition of new furniture during early childhood and lifetime asthma and its related symptoms. Except for the association between lifetime wheeze and flooring materials, the studied associations were generally stronger among children from the northern cities. Conclusions We confirmed that using cellulose based materials in home decoration and renovation, and adding new furniture during early childhood and pregnancy could be risk factors for childhood asthma. The association between household decoration during early childhood and childhood asthma may be stronger in the northern cities of China. [ABSTRACT FROM AUTHOR]

Background There is some evidence that dampness, mould and cockroaches can increase the risk of respiratory infections in children but few studies exist from China on this topic. Aim To study associations between domestic early life exposure to biological indoor factors (dampness, mould, cats, dogs, rats, cockroaches), cleaning habits and common cold among pre-school children across China. Methods Children aged 3–6 years (n = 39,782) were recruited from randomly selected day care centres in seven cities in China. Data on common cold and prenatal and postnatal exposure to dampness, mould, windowpane condensation in wintertime (WPC), cats, dogs, cockroaches and rats were assessed by a parentally administered questionnaire. Data on annual ambient temperature and PM 10 was assessed on city level. Associations between high frequency (> 5 colds per year) and long duration (≥ 2 weeks) of common colds in the past year and exposure were calculated by multilevel logistic regression. Results A total of 9.2% had a high frequency and 11.9% had long duration of common cold. Exposure to mould (OR = 1.38, 95% CI 1.24–1.53) and WPC (OR 1.23, 95%CI 1.13–1.33) at birth was associated with frequent common cold. Exposure to dogs at birth was associated with long duration of common cold. (OR = 1.22, 95% CI 1.06–1.41). Exposure to mould (OR = 1.36, 95% CI 1.22–1.54), WPC (OR = 1.27, 95%CI 1.17–1.39) and water leakage (OR 1.34, 95% CI 1.20–1.49) in the current home was associated with frequent common cold. Presence of cockroaches were positively (OR = 1.12, 95% CI 1.02–1.24) and presence of rats (OR = 0.86, 95% CI 0.77–0.96) negatively associated with high frequency of common cold. Daily cleaning was negatively associated with frequent common cold (OR = 0.89, 95% CI 0.81–0.97). Similar associations for mould, WPC, cockroaches and rats were found for long duration. Ambient PM 10 (OR = 1.21, 95% CI 1.21–1.35 per 10 μg/m 3 ) and temperature (OR = 1.13, 95% CI 1.06–1.35 °C) on city level were associated with high frequency of common cold. Associations between cat keeping and high frequency of common cold were found only in southern China. Associations with cockroaches were stronger in northern China. Associations with dampness and mould were the same in the north and south. Conclusions Indoor mould, water damage, windowpane condensation, cockroaches and keeping cats or dogs as pets can be risk factors for common cold while daily cleaning can be protective factor. PM 10 and a warmer climate zone can be other risk factors for common cold. [ABSTRACT FROM AUTHOR]

Background Otitis media (OM) is a common infection in early childhood with repeated attacks that lead to long-term complications and sequelae, but its etiology still remains unclear. Objective To examine the association between early life exposure to air pollution and childhood OM, with the purpose of identifying critical windows of exposure and key components of air pollution in the development of OM. Methods We conducted a prospective cohort study of 1617 children aged 3–4 years in Changsha, China (2011–2012). The prevalence of OM was assessed by a questionnaire administered by the parents. Individual exposures to nitrogen dioxide (NO 2 ), sulfur dioxide (SO 2 ) and particulate matter with an aerodynamic diameter ≤ 10 μm (PM 10 ) during prenatal, postnatal, and current windows were estimated using the measured concentrations at monitoring stations. We used logistic regression model to examine the OM risk in terms of odds ratio (OR) and 95% confidence interval (CI) for exposure to different air pollutants during different timing windows, adjusting for covariates, multi-pollutants, and multi-windows. Results Life-time prevalence of doctor-diagnosed OM in preschool children in Changsha was 7.3%. Childhood OM was associated only with prenatal exposure to the industrial air pollution with adjusted OR (95% CI) = 1.44 (1.09–1.88) for a 27 μg/m3 increase in SO 2 , particularly during the first trimester of pregnancy. We further found that prenatal SO 2 exposure was not associated with the repeated attacks but was associated with the onset of OM, adjusted OR (95% CI) = 1.47 (1.10–1.96). The association between prenatal SO 2 exposure and early childhood OM was robust after adjusting for other pollutants and windows. Sensitivity analysis indicated that the association was stronger in females, children with parental atopy, and children living in houses with cockroaches, new redecoration, and condensation on window pane during winter. Conclusion We provide new evidence that prenatal exposure to industrial air pollution is associated with early childhood OM in China and may contribute to the onset of childhood OM. Our findings are helpful in developing more effective preventative strategies for childhood OM. [ABSTRACT FROM AUTHOR]

Whether ambient air pollution is associated with childhood atopic eczema is controversial. In this paper, we selected 3358 preschool children who had not altered residences since pregnancy from a cross-sectional study during 2011–2012 in Shanghai, China, and obtained parent-reported data regarding childhood atopic eczema using an improved ISAAC questionnaire. We recorded daily concentrations of SO 2 , NO 2 , and PM 10 throughout the child's lifetime (2006–2012), and calculated period-averaged concentrations for each district where the child lived to represent the child's exposure levels of these pollutants during different periods. In the multiple logistic regression analyses adjusted for potential confounders as well as for the other pollutants in the same periods, childhood atopic eczema was significantly associated with increments of NO 2 in the approximate interquartile range (20 μg/m 3 ) during gestational period (adjusted OR, 95% CI for eczema lifetime-ever: 1.80, 1.29–2.49; for eczema in the year prior to the survey: 2.32, 1.57–3.43) and during the first year of life (2.00, 1.40–2.84; 2.16, 1.43–3.28). Exposure to elevated NO 2 in the first two years, three years and total lifetime, as well as exposure to mixtures containing NO 2 in each of these periods, were consistently associated with increased likelihood of childhood eczema. The highest odds ratios were found between exposure to a mixture of SO 2 and NO 2 during total lifetime (increment: 35 μg/m 3 ) and childhood eczema (adjusted OR, 95% CI: 2.80, 1.75–4.48; 3.50, 1.98–6.19). No significant associations were found between childhood eczema and ambient SO 2 and PM 10 individually or in mixtures. This study indicates that gestational and lifetime exposures to ambient NO 2 are risk factors for atopic eczema in childhood. Exposure to ambient SO 2 and PM 10 may enhance the effect of NO 2 exposure on childhood eczema. [ABSTRACT FROM AUTHOR]

Indoor environment is associated with the sick building syndrome (SBS), but little is known about the contribution of outdoor air pollution and meteorological conditions to SBS. We studied associations between outdoor air pollution, meteorological parameters and selected indoor exposure and building characteristics at home and weekly SBS symptoms in a standardized questionnaire study among 3485 randomly selected adults in China. Outdoor factors included particulate matters with diameter < 10 μm (PM 10 ), sulfur dioxide (SO 2 ), nitrogen dioxide (NO 2 ), outdoor temperature (T), relative air humidity (RH), and wind speed (WS) during last three months. Multiple logistic regression was applied calculating odds ratios (OR) with 95% confidence interval (95% CI). Asthma or allergic rhinitis (atopy) was associated with all types of SBS symptoms except fatigue. Indoor factors played a major role in SBS symptoms. Mold/dampness on the floor/ceiling was associated with fatigue OR = 1.60 (1.11–2.30) and headache OR = 1.80 (1.07–3.04). Moldy odor was associated with fatigue OR = 1.59 (1.07–2.37) and dermal symptoms OR = 1.91 (1.21–3.02). Window pane condensation in winter was associated with fatigue OR = 1.73 (1.30–2.31) and throat symptoms OR = 1.53 (1.01–2.31). Damp bed clothing was related with throat symptom OR = 1.62 (1.09–2.40). Home redecoration was associated with fatigue OR = 1.49 (1.07–2.06). Frequent window opening was associated with less nose symptoms OR = 0.54 (0.36–0.82) and mechanical ventilation in the bathroom reduced dermal symptoms OR = 0.66 (0.44–0.99). Females were more susceptible to redecoration and window pane condensation than men. No associations with SBS were observed for outdoor air pollutants or meteorological parameters in the final models combining indoor and outdoor factors, although SO 2 , T, and RH were associated with some SBS symptoms (fatigue, eyes and nose symptoms) in the separate outdoor models. In conclusion, indoor mold/dampness, air pollution from redecoration and poorer ventilation conditions in dwellings can be risk factors for SBS symptoms in an adult Chinese population, especially among females. [ABSTRACT FROM AUTHOR]

Background Associations of ambient air pollutants with respiratory health are inconsistent. Objectives We analyzed the associations of gestational and early life exposures to air pollutants with doctor-diagnosed asthma, allergic rhinitis, and pneumonia in children. Methods We selected 3358 preschool children who did not alter residences after birth from a cross-sectional study in 2011–2012 in Shanghai, China. Parents reported children's respiratory health history, home environment, and family lifestyle behaviors. We collected daily concentrations of sulphur dioxide (SO 2 ), nitrogen dioxide (NO 2 ), and particulate matter with an aerodynamic diameter ≤ 10 μm (PM 10 ) during the child's total lifetime (2006–2012) for each district where the children lived. We analyzed the associations using logistic regression models. Results After adjusting for covariates and the other studied pollutants, we found that exposure to NO 2 (increment of 20 μg/m 3 ) during the first year of life was significantly associated with asthma [odds ratio (OR) = 1.77; 95% confidence interval (CI): 1.29–2.43] and allergic rhinitis (OR = 1.67; 95% CI: 1.07–2.61). Exposure to NO 2 during gestation, the first two and three years, and over total lifetimewas all consistently associated with increased odds of allergic rhinitis. Quartiles of NO 2 concentration during different exposure periods showed a slight dose–response relationship with the studied diseases. These diseases had significant associations with pollutant mixtures that included NO 2 , but had no significant association with exposures to SO 2 and PM 10 individually or in mixtures. Conclusions Gestational and early life exposures to ambient NO 2 are risk factors for childhood respiratory diseases. [ABSTRACT FROM AUTHOR]

Abstract: Air cleaning techniques have been applied worldwide with the goal of improving indoor air quality. The effectiveness of applying these techniques varies widely, and pollutant removal efficiency is usually determined in controlled laboratory environments which may not be realized in practice. Some air cleaners are largely ineffective, and some produce harmful by-products. To summarize what is known regarding the effectiveness of fan-driven air cleaning technologies, a state-of-the-art review of the scientific literature was undertaken by a multidisciplinary panel of experts from Europe, North America, and Asia with expertise in air cleaning, aerosol science, medicine, chemistry and ventilation. The effects on health were not examined. Over 26,000 articles were identified in major literature databases; 400 were selected as being relevant based on their titles and abstracts by the first two authors, who further reduced the number of articles to 160 based on the full texts. These articles were reviewed by the panel using predefined inclusion criteria during their first meeting. Additions were also made by the panel. Of these, 133 articles were finally selected for detailed review. Each article was assessed independently by two members of the panel and then judged by the entire panel during a consensus meeting. During this process 59 articles were deemed conclusive and their results were used for final reporting at their second meeting. The conclusions are that: (1) None of the reviewed technologies was able to effectively remove all indoor pollutants and many were found to generate undesirable by-products during operation. (2) Particle filtration and sorption of gaseous pollutants were among the most effective air cleaning technologies, but there is insufficient information regarding long-term performance and proper maintenance. (3) The existing data make it difficult to extract information such as Clean Air Delivery Rate (CADR), which represents a common benchmark for comparing the performance of different air cleaning technologies. (4) To compare and select suitable indoor air cleaning devices, a labeling system accounting for characteristics such as CADR, energy consumption, volume, harmful by-products, and life span is necessary. For that purpose, a standard test room and condition should be built and studied. (5) Although there is evidence that some air cleaning technologies improve indoor air quality, further research is needed before any of them can be confidently recommended for use in indoor environments. [Copyright &y& Elsevier]

Phthalate esters are chemical compounds with a broad range of applications. Recently, we have shown that significantly higher dust concentration of di(2-ethylhexyl) phthalate (DEHP) was found in Bulgarian homes of children with asthma or allergies compared to healthy children. The concentration of DEHP was found to be significantly associated with wheezing in the last 12 months as reported by parents. The objective of the current study was to examine the associations between concentrations of phthalates in settled dust collected in Bulgarian homes and building characteristics and cleaning habits. Dust samples from the child''s bedroom were collected in 177 homes and analysed for the content of dimethyl phthalate (DMP), diethyl phthalate (DEP), di-n-butyl phthalate (DnBP), butyl benzyl phthalate (BBzP), di-n-octyl phthalate (DnOP) and DEHP. Information on building characteristics and family habits were collected from parental reports in questionnaires and from inspectors'' observations in the homes. Significantly higher concentrations of BBzP, DEHP and DnOP in indoor dust were found in homes where polishing agents were used, compared to homes where such products were not used. The highest concentrations of DEHP, BBzP and DnOP were found in homes with the combination of a low frequency of dusting and the use of polish. There was no difference in phthalate concentrations between inspector-observed balatum flooring (PVC or linoleum) and wood flooring as well as between PVC, as determined by Raman spectra, and wood flooring. However, in a sub-group of homes with no use of polish, the concentration of DEHP was higher in homes with inspector-observed balatum compared with wood flooring but the difference was not significant may be due to a too small sample size. [Copyright &y& Elsevier]

Abstract: A novel technique, gas chromatography-UV spectrometry (GC-UV), was used to quantify volatile organic compounds (VOCs) in settled dust from 389 residences in Sweden. The dust samples were thermally desorbed in an inert atmosphere and evaporated compounds were concentrated by solid phase micro extraction and separated by capillary GC. Eluting compounds were then detected, identified, and quantified using a diode array UV spectrophotometer. Altogether, 28 compounds were quantified in each sample; 24 of these were found in more than 50% of the samples. The compounds found in highest concentrations were saturated aldehydes (C5–C10), furfuryl alcohol, 2,6-di-tert-butyl-4-methylphenol (BHT), 2-furaldehyde, and benzaldehyde. Alkenals were also found, notably 2-butenal (crotonaldehyde), 2-methyl-propenal (methacrolein), hexenal, heptenal, octenal, and nonenal. The concentrations of each of the 28 compounds ranged between two to three orders of magnitude, or even more. These results demonstrate the presence of a number of VOCs in indoor dust, and provide, for the first time, a quantitative determination of these compounds in a larger number of dust samples from residents. The findings also illustrate the potential use of GC-UV for analysing volatile compounds in indoor dust, some of which are potential irritants (to the skin, eyes or respiratory system) if present at higher concentrations. The potential use of GC-UV for improving survey and control of the human exposure to particle-bound irritants and other chemicals is inferred. [Copyright &y& Elsevier]

We investigated associations between prenatal and postnatal environmental factors and onset and remission of preschool childhood eczema across China. The study population was preschoolers in randomized day care centers in seven cities (N = 39,782). Data on eczema and prenatal and postnatal indoor and outdoor environment were obtained from a cross-sectional questionnaire sent to parents or other guardians. Reports on eczema in the first 2 years and in the past year was used to retrospectively calculate onset and remission (changes of reported eczema). Prenatal and postnatal outdoor temperature, NO 2 and PM 10 were modelled from official air pollution data. Associations were estimated by two-level logistic regression. Calculated onset rate was 3.2%/y and remission rate 29.2%/y. Exposure to NO 2 during pregnancy was associated with onset of eczema, similarly for all trimesters. Postnatal PM 10 and NO 2 were related to decreased remission. Postnatal outdoor temperature was associated with onset of eczema. Pre-natal and current redecoration or buying new furniture, and perinatal as well as current dampness and indoor mould, were associated with increased onset and decreased remission. Cockroaches in current home was another indoor risk factors. Prenatal exposure to farm environment and large family size were all negatively associated with eczema. In conclusion, a warmer climate and prenatal NO 2 can be associated with increased onset of eczema in Chinese preschoolers. Postnatal PM 10 and NO 2 can be associated with reduced remission. Perinatal and current dampness, indoor mould and cockroaches may increase onset and decrease remission. Exposure to chemical emissions from indoor materials after first year of life may increase onset. Prenatal exposure to farm environment and large family size could be protective. Unlabelled Image • Exposure to NO 2 during pregnancy was associated with onset of eczema. • Postnatal PM 10 and NO 2 were related to decreased remission of eczema. • Dampness and mould were associated with increased onset and decreased remission. • Pre-natal and current redecoration and new furniture were other risk factors. • Prenatal farm environment and large family size could be protective factors. [ABSTRACT FROM AUTHOR]

We estimated associations between ambient air pollution, home environment and asthma as well as rhinitis among adults across China. A total of 40,279 young adults from eight Chinese cities participated in a questionnaire survey (participation rate 75%). There were questions on health and home environment. Information on city level gross domestic product (GDP) per capita, ambient temperature and PM 10 and NO 2 were collected from registers. Two-level logistic regression models were used to study health associations. Totally 1.6% reported asthma and 6.6% reported allergic rhinitis (AR). Higher temperature was associated with more asthma but less AR. Higher GDP was associated with less asthma but more AR. Higher degree of urbanization, higher level of NO 2 and living near heavily trafficked road were risk factors for asthma and AR. Participants in older buildings reported more asthma. Redecoration and buying new furniture were related to more asthma and AR (OR = 1.15–1.91). Using natural gas (OR = 1.34) and biomass (OR = 1.35) for cooking were risk factors for AR. Burning mosquito coils and incense increased the risk of asthma and AR. Cat keeping (OR = 2.88), dog keeping (OR = 2.04), cockroaches (OR = 1.54) and rats or mice (OR = 1.46) were associated with asthma. Cockroaches increased the risk of AR (OR = 1.22). Air humidifier and air cleaner were linked to asthma and AR. Frequent cleaning and exposing bedding to sunshine were protective. In conclusion, urbanization, NO 2 and traffic exhaust can increase the risk of adult asthma and AR. Higher ambient temperature was related to more asthma but less AR. Indoor animals such as cats, dogs, rats/mice and presence of cockroaches were associated with asthma or AR. Indoor chemical sources such as redecoration and new furniture were other risk factors. Cooking with natural gas or biomass and burning mosquito coils and incense were associated with asthma or AR. Frequent cleaning and exposing bedding to sunshine were protective. Unlabelled Image • Traffic air pollution can increase adult asthma and allergic rhinitis. • Cats and dogs and presence of pests at home were risk factors. • Redecoration and obtaining of new furniture were risk factors. • Indoor combustion sources were risk factors. • Frequent cleaning was protective for asthma and allergic rhinitis. [ABSTRACT FROM AUTHOR]

This paper studied associations between reported common cold and home dampness and mould, cleaning habits and ventilation, climate and outdoor air pollution in China among young adults without asthma or allergic rhinitis. Parents of children attending day care in eight Chinese cities answered a questionnaire on their health and home environment (75% response rate). We restricted the population to subject without asthma or allergic rhinitis (N = 37,275). Temperature and air pollution data was obtained from monitoring stations. Associations were estimated by multilevel logistic regression. Totally 12.5% reported common cold (≥3 colds) and 1.6% frequent common cold (≥5 colds) in the past 12 months. Female gender (OR = 1.53; 95% CI 1.37–1.71), residents in southern China (OR = 1.89; 95% CI 1.16–3.07) and living in homes with water leakage (OR = 1.32; 95% CI 1.16–1.50), mould odour (OR = 1.48; 95% CI 1.28–1.72), indoor mould (OR = 1.47; 95% CI 1.28–1.70), condensation on window panes (OR = 1.42; 95% CI 1.32–1.52) and damp bed clothing (OR = 1.19; 95% CI 1.11–1.28) were associated with common cold. Having many signs of dampness increased ORs. Daily cleaning (OR = 0.91; 95% CI 0.85–0.97) and mechanical ventilation in kitchen or bathroom (OR = 0.75; 95% CI 0.64–0.89) were protective. Higher mean ambient temperature (OR = 1.11 per °C; 95% CI 1.02–1.21), PM 10 (OR = 1.17 per 10 μg/m3; 95% CI 1.14–1.21) and PM 2.5 (OR = 1.28 per 10 μg/m3; 95% CI 1.20–1.37) were associated with common cold. The association with particulate air pollution was stronger in southern China. Similar associations were found for frequent common cold. In conclusion, indoor dampness and mould, a warmer climate and PM 10 and PM 2.5 can be associated with reported common cold. Further intervention and prospective studies are needed to verify causality of observed association in this cross-sectional study. Unlabelled Image • Indoor dampness and mould were associated with adult common cold in China. • Daily cleaning and mechanical ventilation in kitchen or bathroom were protective. • Adult common cold was more prevalent in a warmer climate. • Outdoor PM 10 and PM 2.5 were associated with adult common cold. • The association with particulate air pollution was stronger in southern China. [ABSTRACT FROM AUTHOR]

• Prenatal air pollution (PM 2.5 and PM 10) can increase furry pet related symptoms among pre-school children in China. • Indoor mould, dampness and window pane condensation can increase furry pet related symptoms and diagnosed rhinitis. • Early life cat and dog keeping can increase furry pet related symptoms and diagnosed rhinitis. • Prenatal farm exposure and living in less urbanized areas can protect against rhinitis not related to furry pets. Few Chinese population studies exist on early life risk factors for furry pet allergy. We studied childhood respiratory symptoms when in contact with furry pets in relation to early life exposure. Moreover, we studied similar environmental associations for rhinitis not related to furry pets. Children aged 3–6 y from day care centres in seven Chinese cities participated (N = 39,782). Parents answered a questionnaire on home environment and children's health, including rhinoconjunctivitis and wheeze when in contact with furry pets, and diagnosed rhinitis. Prenatal and postnatal outdoor temperature, PM 2.5 , PM 10 , and NO 2 were calculated using data from monitoring stations. Associations were estimated by multilevel logistic regression. Totally 2% had cats, 4% dogs, and 3.2% had rhinoconjunctivitis or wheeze when in contact with furry pets (FP symptoms). Moreover, 1.1% had furry pet related diagnosed rhinitis and 7.5% had diagnosed rhinitis not related to furry pets (other diagnosed rhinitis). Prenatal PM 2.5 and PM 10 , especially in second trimester, and a colder climate were risk factors for FP symptoms. ETS, dampness and mould, condensation on windows in wintertime, and cats and dog keeping were associated with FP symptoms. Breast feeding and frequent window opening were protective. Similar indoor associations were found for furry pet related diagnosed rhinitis. ETS, dampness and mould, window condensation, urbanization and mechanical exhaust ventilation were risk factors for other diagnosed rhinitis. Cooking with an electric stove and early life exposure to animals (cats, dogs, farm environment during pregnancy) were protective for diagnosed rhinitis not related to furry pets. Prenatal outdoor PM 10 and PM 2.5 can be risk factors for symptoms suggestive of furry pet allergy. Early life dampness and mould can be risk factors for rhinitis related and not related to furry pets. Exposure to animals (cats, dogs, farm environment) may reduce diagnosed rhinitis not related to furry pets. [ABSTRACT FROM AUTHOR]