Search

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]

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 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]

Few studies have estimated the effects of dampness-related exposures and its interaction effects with poor household ventilation on common colds of preschool children. During April 2011–April 2012, we conducted a cross-sectional survey on home environment and childhood health and collected 13,335 parents-reported questionnaires of 4–6 year-old children in Shanghai, China. In this paper, we investigated associations between the incidence and duration of common colds among these children during the past 12 months before the survey and frequency of opening windows, as well as household dampness-related exposures (indicated by six dampness indicators). Significantly higher incidence (≥3 times) and longer duration (≥2 weeks) of common cold were found among children with than without these dampness exposures (p-value <0.01 for mold spots and p-value <0.001 for all other indicators). The number of dampness-related indicators had a positive and strong dose-response relationship with common colds (p-trend <0.01). Low frequency of ventilation was also a risk factor for children common colds. After adjusted for the potential confounders in the multiple logistic regression analyses, all dampness-related indicators were significantly associated with the increased odds of common colds and the highest odds ratios was 1.21 (95% CI: 1.16–1.27). We also found that dampness-related exposures and household ventilation habits (p-value for interaction <0.001) had a strong interaction effect on the incidence and duration of common cold. The stratified analysis of ventilation condition displays that the influence of dampness-related exposures has been modified by ventilation. Therefore, good household ventilation habits may have an effect of modification for dampness-related exposures. [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]

In recent years, prevalence of eczema has been increasing among preschool children in China. It's urgent to find associated factors. On basis of 13,335 questionnaires from parents or guardians for 4-6 year-old children (response rate 85.3%) in a cross-sectional study from April 2011 to April 2012 in Shanghai, the associations between home dampness related indicators and the prevalence of childhood eczema was investigated. There were 7.8%, 15.3%, 42.1%, 55.7%, and 30.7% of the surveyed residences who had visible mold spots, visible damp stains, damp clothing and/or bedding, water damage, condensation on window in winter, and moldy odor (six home dampness-related indicators), respectively. The prevalence of eczema (ever) and eczema (in the past 12 months) was 22.9% and 13.2%, respectively. These home dampness indicators had significant and strong associations with the increased risk of childhood eczema. With regard to the same indicators, the increased risk of eczema in girls was higher than in boys. Total numbers of home dampness-related indicators had notable dose-response relationships with the prevalence of childhood eczema. In conclusion, home dampness-related exposures are strong risk factors for childhood eczema. [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]

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]

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]

From April 2011 to April 2012, we conducted a cross-sectional study in Shanghai, China. A total of 13,335 modified ISAAC questionnaires (response rate: 85.3%) were returned by parents or guardians for 4–6 year-old children. Six dampness-related indicators (visible mold spots, visible damp stains, damp bed clothing, water damage, window pane condensation, and moldy odor) were used to evaluate home dampness-related exposures. In the present study, we applied logistic regression model to reveal associations, dose–response relationships, and statistical interaction effects of these dampness-related exposures, with childhood eczema, during lifetime since birth (ever) and in the last 12 months before the questionnaire. The dampness-related indicators were frequently reported in the perinatal and current residences. Prevalences of eczema ever and in the last 12 months were 22.9% and 13.2%, respectively. The dampness-related indicators were robustly associated and dose–response related with increased risk of eczema ever and in the last 12 months in the logistic regression analyses, with adjusted for potential confounders. Specifically, in the perinatal residence, visible mold spots or damp stains could increase 46% (OR, 95% CI: 1.46, 1.29–1.66) odds of childhood eczema (ever); in the current residence, visible mold spots and visible damp stains could increase 34% (1.34, 1.14–1.58) and 38% (1.38, 1.22–1.56) odds of childhood eczema (ever), respectively. Associations were not appreciably different between boys and girls, nor were they different between children with and without parental history of atopy. In conclusion, perinatal and current dampness-related exposures in the residence perhaps are risk factors for childhood eczema. [ABSTRACT FROM AUTHOR]

[Display omitted] This study aimed to explore the thermal comfort situation in children's bedrooms and its association with the prevalence of respiratory diseases among children. On basis of field measurements in 454 families conducted by CCHH (China, Children, Home, Health) study group in Shanghai during 2013–2014, 167 samples inspected in transition season were selected to study the thermal sensation and thermal comfort of children in residential environments. Pearson χ2 test and multiple logistic regression were employed to examine the thermal comfort and respiratory diseases among children. In the transition season, 24% of the residents had the predicted percentage of dissatisfied (PPD) higher than 40%. The prevalence of children with asthma, dry cough, and pneumonia were 37.7%, 31.1%, and 31.7%, respectively, where boys had a higher prevalence than girls. Children's thermal discomfort (indicators: PMV, PPD, SET) had a dose–response relationship with respiratory diseases. Compared with the neutral thermal environment (PMV[-1, 0, +1]), cold environment (PMV [-3, −2]) was associated with a higher risk of asthma, dry cough and pneumonia in children for odds ratio (95%CI, P < 0.05) of 1.19 (1.07–1.32), 1.15 (1.03–1.29) and 1.89 (1.16–3.09) respectively. After adjusting for confounders, the significant associations were also found between children in cold environment and asthma, dry cough and pneumonia (AOR is 1.34, 1.11, 1.23, P < 0.05). In transition season, the thermal conditions in children's bedrooms in Shanghai were worse than expected, where PMV presented as cool to cold and high PPD. The risk of asthma and pneumonia increased significantly with the thermal discomfort and showing the sensitivity to "gender" and "weight" of children. The dose–response relationship suggested paying more attention to thermal comfort and adverse health outcomes caused by relative cold environment in transition season. [ABSTRACT FROM AUTHOR]

Findings are inconsistent in studies for impacts of outdoor air pollutants on airway health in childhood. In this paper, we collected data regarding airway and allergic symptoms in the past year before a survey in 13,335 preschoolers from a cross-sectional study. Daily averaged concentrations of ambient sulphur dioxide (SO 2), nitrogen dioxide (NO 2), and particulate matter with an aerodynamic diameter ≤10 μm (PM 10) in the past year before the survey were collected in the kindergarten-located district. We investigated associations of 12-month average concentrations of these pollutants with childhood airway and allergic symptoms. In the two-level (district-child) logistic regression analyses, exposure to higher level of NO 2 and of PM 10 increased odds of wheeze symptoms (adjusted OR, 95%CI: 1.03, 1.01–1.05 for per 3.0 μg/m3 increase in NO 2 ; 1.22, 1.09–1.39 for per 7.6 μg/m3 increase in PM 10), wheeze with a cold (1.03, 1.01–1.06; 1.22, 1.08–1.39), dry cough during night (1.05, 1.03–1.08; 1.23, 1.09–1.40), rhinitis symptoms (1.11, 1.08–1.13; 1.32, 1.07–1.63), rhinitis on pet (1.11, 1.05–1.18; 1.37, 0.95–1.98) and pollen (1.12, 1.03–1.21; 1.23, 0.84–1.82) exposure, eczema symptoms (1.09, 1.05–1.12; 1.22, 0.98–1.52), and lack of sleep due to eczema (1.12, 1.07–1.18; 1.58, 1.25–1.98). Exposures to NO 2 and PM 10 were also significantly and positively associated with the accumulative score of airway symptoms. Similar positive associations were found of NO 2 and of PM 10 with the individual symptoms and symptom scores among preschoolers from different kindergarten-located district. These results indicate that ambient NO 2 and PM 10 likely are risk factors for airway and allergic symptoms in childhood in Shanghai, China. • We surveyed 13,335 preschoolers from five districts of Shanghai, China. • We studied effects of ambient NO 2 , SO 2 and PM 10 on airway and allergic diseases. • Periods of pollutant exposures and disease appearances were same in one year. • NO 2 and PM 10 was associated with increased risks of most studied diseases. [ABSTRACT FROM AUTHOR]