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Objective: Phthalate acid esters (PAEs) have been identified to be associated with children's health. Present study was conducted to assess associations between PAEs in household dust and childhood rhinitis. Methods: Based on phase II of CCHH study (China, Children, Home, Health) conducted in Shanghai, China, 266 indoor dust samples were collected from participants' families. Concentrations of PAEs in dust samples were measured by chemical treatment and gas chromatograph–mass spectrometer. Information about individuals and residences was surveyed by questionnaires. Logistic regression models were applied to obtain the associations between PAEs and childhood rhinitis. Results: Higher concentrations of benzyl butyl phthalate (BBP) were found in those families with children who had diagnosed rhinitis. Significantly higher concentrations of bis(2-ethylhexyl) phthalate (DEHP) and PAEs with high molecular weight (HMW-PAEs) were found in the positive group of lifetime rhinitis. Using the multiple and ordinal logistic regression models adjusted by covariates, dibutyl phthalate (DBP), DEHP, and HMW-PAEs were found to be significantly associated with diagnosed rhinitis. Boys who exposure to higher concentrations of DBP, DEHP, HMW-PAEs, and total PAEs have significant associations with diagnosed rhinitis compared with girls who exposure to lower concentration of PAEs. Conclusions: Present observational study indicated that exposure to high concentrations of DBP, DEHP, and HMW-PAEs in house settled dust was a risk factor for rhinitis for children, especially for boys. [ABSTRACT FROM AUTHOR]

Associations of household airborne fungi with allergies in childhood were inconsistent in the epidemiologic studies. During 2013–2014, we conducted a case-control study (phase two), which was nested in a cross-sectional study (phase one) during 2011–2012 in Shanghai, China. We inspected indoor air quality of 454 residences for 5–10 years old children. We defined cases as those children who were reported illnesses in the questionnaire of phase one or phase two and defined controls as those children who were not reported illnesses in both phases. A total of 436 living rooms and 445 bedrooms had valid data of household airborne fungi, and their mean concentrations were 301 cfu/m3 and 310 cfu/m3, respectively. In the multiple logistic regression analyses with adjusting for potential confounders, most associations of 16 studied illnesses with airborne fungi concentration were not statistically significant. Taking children in the 1st quartile that was stratified according to airborne fungi concentration in the living room as reference, only children in the 3rd quartile were significantly associated with a higher odd of lifetime-ever ear infections (adjusted OR, 95% CI 3.05, 1.29–7.21), and children in the 4th quartile were significantly associated with a higher odd of lifetime-ever wheeze (2.72, 1.28–5.75); but children in the 3rd quartile (0.33, 0.17–0.68) and in the 4th quartile (0.47, 0.23–0.97) were significantly associated with a lower odd of rhinitis in the past 12 months prior to the home inspection. Our results indicate that exposures to indoor airborne fungi in low concentrations seemingly have no significant impacts on the risks of most allergic and airway illnesses in childhood. Since families with sick participants might pay more attention to improve indoor air quality, effects of "avoidance behavior" on associations between indoor pollutants and childhood health should be considered in the data analysis and design of the nested case-control study. [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]

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]

With on-site measurements, this paper analyzed the current status of airborne fungi in the child's bedroom of the residences in Shanghai and its associations with the characteristics of residences. The average concentration of airborne fungi in the 446 children's bedrooms was 310 CFU/m 3 (range: 6 to 3184 CFU/m 3 ). Only one bedroom had higher concentration of airborne fungi than the standard concentration of 2500 CFU/m 3 with 3180 CFU/m 3 . Compared to the residences with building areas ≤ 75 m 2 , those residences > 100 m 2 had significant higher average concentrations (mean ± standard deviation: 270 ± 183 vs. 354 ± 409). The children's bedrooms at the ground floor or the attic floor of the residential building had higher average concentration of airborne fungi than others. The results indicate that building characteristics of residences may be associated with the concentrations of airborne fungi in the child's bedroom. [ABSTRACT FROM AUTHOR]

From March 2013 to December 2014, we conducted a case-control study and inspected 454 residences with asthmatic or non-asthmatic children from six districts in Shanghai. Carbon dioxide (CO 2 ) were passively measured 24 hours in the child's bedroom. We took the average concentration of CO 2 during 00:00 to 06:00 as an indicator for the status of natural ventilation in the child's bedroom during night and investigated its association with childhood asthma. A total of 45.6% ( n = 203) residences had CO 2 average concentrations higher than 1000 ppm . The mean CO 2 concentration ± standard deviation was 1123 ± 741 ppm (range: 367 to 4595 ppm ). CO 2 average concentrations in the residences measured in autumn and in summer were significantly lower than measured in winter. No significant differences were found among CO 2 average concentrations among Case group and Control group in total and in different measured seasons. More deeply analyses were warranted. [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 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]

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

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]

Dampness-related exposures have been widely discovered in household, which are associated with childhood health. This study employed the Back-Propagation (BP) neural network to develop prediction models of overall dampness evaluation based on the on-site dampness inspection in 454 families. The trained models were then used to predict the overall dampness exposure in 15,266 families with five parent-reported dampness-related indicators. Two indices, including the overall-dampness- exposure-based (ODEB) score and combination-of parent-reported- based (CPRB) score, were introduced to reflect the household dampness exposure in Shanghai, and were used to build the relationship with different childhood respiratory diseases and allergies. The results indicated that the trained model of BP neural network had a reasonable accuracy with the coefficient of determination R2 greater than 0.5, and the standard deviation ratios were approaching 1.0. Both the ODEB score predicted by trained model and CPRB score were developed based on parent reported dampness indicators in the cross-sectional survey, and were significantly associated with childhood respiratory diseases after adjusting the confounders (AOR >1.3, p < 0.01, SDS factor >0). Exposure-response relationships were also found between the dampness exposure indices and health outcomes. A continuous dampness evaluation index with a reasonable accuracy was proposed based on BP neural network prediction of on-site dampness scoring, which was consistent with the CPRB score, showing an exposure-response relationship with childhood diseases. These findings provide us an approach to predict the household dampness and its related adverse health outcomes. • Dampness exposures are common in residential buildings in China. • Home dampness-related exposure is a risk for childhood allergies and respiratory diseases. • The parent-reported dampness can be linked to the inspector-observed dampness. • There are exposure-response relationships between dampness indicators and children health. • Two developed dampness indices can predict the dampness-related health outcomes. [ABSTRACT FROM AUTHOR]

Findings for impacts of outdoor air pollutants on birth outcomes were controversial. We performed a retrospective observational study in 2527 preschoolers of Shanghai, China and investigated associations of duration-averaged concentrations of outdoor sulphur dioxide (SO 2), nitrogen dioxide (NO 2), and particulate matter with an aerodynamic diameter ≤ 10 μm (PM 10) in different months and trimesters of gestation, with preterm birth (PB), low birth weight (LBW), term low birth weight (T-LBW), and small for gestational age (SGA). Daily concentrations of outdoor air pollutants were collected in each residence-located district. Parents reported health information. In the multivariate logistic regression analyses, exposures to outdoor NO 2 were consistently associated with the higher odds of LBW and T-LBW. These associations were generally stronger for early months than for later months of the gestation. Adjusted odds ratios generally were larger in multi-pollutant model than in single-pollutant model. Exposure to NO 2 in the first month of the gestation was significantly associated with T-LBW (adjusted OR, 95%CI: 1.91, 1.02–3.58 for increment of interquartile range (18.5 μg/m3); p -value = 0.044) in multi-pollutant model. This association was stronger in girls, renters, and children whose mothers ≥30 years-old, with household dampness-related exposures, and with parental smoking during pregnancy. Our results indicate that exposure to NO 2 during gestation perhaps is a risk factor for LBW and T-LBW, and effects of NO 2 exposures could be greater during early periods than during later periods of gestation. • A retrospective observational study in 2527 preschoolers was conducted. • Exposures to outdoor NO 2 consistently associated with LBW and T-LBW. • These associations were stronger for early months than for later months. • Adjusted ORs were larger in multi-pollutant than single-pollutant model. • No significant associations were found of SO 2 and PM 10 with all outcomes. [ABSTRACT FROM AUTHOR]

• Dust mites (Der f 1 and Der p 1) in 453 children's beddings were analyzed by ELISA. • Bed Der p 1, but not Der f 1, had a dose-response relationship with household dampness. • Often using air conditioner had significant associations with bed Der f 1 and Der p 1. • Frequently cleaning the bedclothes may effectively reduce bed Der f 1, but not Der p 1. During 2013–2014, we collected bed dust samples from 453 children's bedclothes in Shanghai, China, and analyzed two mite types (Der p 1 and Der f 1) in these dusts, using the enzyme-linked immune-sorbent assay (ELISA). In this study, we explored associations between dust mite concentrations and different family lifestyle aspects and dwelling characteristics. Der p 1 concentration was positively dose-related with cumulative numbers of dampness-related indicators in bedrooms. Use of household air conditioners often had significant associations with increased likelihood of above median concentrations of both Der f 1 (AOR, 95 % CI: 3.71, 2.07–6.63) and Der p 1 (1.93, 1.03–3.61). Changing bed sheets with a frequency of less than once per week was significantly associated with an increased likelihood of higher concentration of Der f 1 (2.42, 1.23–4.77). No significant dust mite concentration differences were found between families with different habits in relation to exposing bedclothes to sunshine, using household humidifiers, or pet-keeping. Our results indicate that Der p 1 in bedding dust was associated with home dampness-related indicators, such that controlling home dampness could effectively reduce Der p 1 numbers. Bedclothes treatments alone were insufficient to avoid the presence of Der p 1 and Der f 1 in bedding. [ABSTRACT FROM AUTHOR]

Several studies have reported that certain aspects of the household environments are associated with adverse birth outcomes, but associations have been inconsistent. Few of these studies have been conducted in China. During 2011–2012, we conducted a retrospective cross-sectional study and collected 13,335 parents-reported questionnaires for 4–6-year-olds children in Shanghai, China. We investigated associations of household environmental factors (environmental tobacco smoke (ETS), cooking fuel, dampness, pet-keeping, and home renovation) during gestation with preterm birth (PTB, gestational age < 37 weeks), low birth weight (LBW, birth weight < 2500 g), term low birth weight (T-LBW, LBW when the gestational age was ≥ 37 weeks), and small for gestational age (SGA, birth weight < 10th percentile of birth weight for gestational age). A total of 4.1% children were premature; 2.9% had LBW and 1.6% had T-LBW; 8.1% were SGA. In the multiple logistic regression analyses, home renovation during gestation was associated with PTB (adjusted odds ratio (OR), 95% confidence intervals (CI): 1.68, 1.11–2.54) and LBW (1.64, 0.99–2.72). Paternal smoking was associated with PTB (1.18, 0.98–1.43). No significant associations were found for SGA. Neither household dampness nor cooking fuel were significantly associated with birth outcomes. For boys, paternal smoking was associated with PTB (1.31, 1.02–1.69); home renovation during gestation was associated with PTB (2.14, 1.27–3.61) and LBW (2.19, 1.09–4.43). Among children whose mothers were ≥ 34-year-olds during gestation, paternal smoking (1.73, 1.04–2.76) and home renovation during gestation (1.80, 1.18–2.76) was associated with PTB. Our findings demonstrate that home renovation and ETS during gestation may be risk factors for adverse birth outcomes. Associations of these factors with adverse birth outcomes appear to be stronger in boys and among mothers older than 34 years during gestation. Home renovation and ETS exposure should be avoided during gestation, especially for pregnancies with male fetuses and older pregnant women. [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]

Few studies were conducted for associations of home environment with childhood health by on-site inspection in China. During 2013–2014, we conducted a case-control study with home inspection among 454 children (186 asthma children and 268 non-asthma children) in Shanghai, China. In this paper, we detailedly described the inspected methods and analyzed the preliminarily collected data. Except in winter, most residences meet the national standard for indoor temperature and relative humidity. Most living rooms had ≤1000 ppm CO 2 , whereas over half of the child's bedrooms had slightly >1000 ppm CO 2 during night. Most residences had notably lower than 2500 cfu/m 3 airborne culturable fungi and ≤100 μg/m 3 formaldehyde. More than 70% of the child's bedrooms had ≤75 μg/m 3 PM 2.5 and ≤150 μg/m 3 PM 10 . Indoor and outdoor concentrations of particulate matters had strong linear correlations ( r =0.891–0.922; p -value <0.001). Most differences between cases and controls were not significant with respect to CO 2 , culturable fungi, formaldehyde, and particulate matters. Before and after adjusted for potential confounders, indoor averaged concentration of CO 2 and particulate matters generally had negative associations with childhood history of doctor-diagnosed asthma in spring, summer, and autumn. Only in winter, indoor CO 2 concentration was significantly associated with the increased odds of childhood asthma. Our results indicated that air quality among most residences in Shanghai could meet the national standard for indoor air quality in warm seasons; but household air quality and ventilation status in winter should be greatly improved. We suspected that those “unexpected” negative associations could exist due to changes in lifestyle behaviors regarding indoor air quality after the child being diagnosed asthma by a doctor. [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]

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]

Phthalic acid esters (PAEs) have a negative impact on human health and are widely distributed in China. As part of the China, Children, Home, Health (CCHH) study, we investigated the associations between childhood asthmatic symptoms and PAEs in settled house dust in Shanghai, China. We found that di-2-ethylhexyl phthalate (DEHP), dibutyl phthalate (DBP), and diisobutyl phthalate (DiBP) were abundant in the indoor environment. A total of 27 % of children suffered from diagnosed asthma. The Mann-Whitney U test and multiple logistic regression were used to obtain the associations between PAEs and childhood asthmatic symptoms. Stratification analysis was performed to reveal the influence of gender on the associations between PAE exposure and target symptoms. Compared with low concentrations of PAEs, high concentrations of high molecular weight PAEs (HMW-PAEs) were significantly associated with childhood diagnosed asthma (adjusted odds ratios (AORs) > 1, P < 0.05). Moreover, significantly negative associations were found between high concentrations of DiBP and current cough (AORs<1, P < 0.05). All significantly positive associations were observed among girls, and most of the associations of dimethyl phthalate (DMP) and diethyl phthalate (DEP) exposure with the studied symptoms among girls were higher than those among boys. Exposure to PAEs may be a risk factor for asthmatic symptoms in children, especially in girls. • Phthalic acid esters are widely detected in household dust of residents in Shanghai, China. • Exposure to several kinds of PAEs would increase the risk of childhood wheeze and diagnosed asthma. • Significant higher concentration of DiBP is found in those families with children not suffered from current cough. • Significantly positive associations between PAEs and asthmatic symptoms are found only among girls. [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]

• We surveyed 3177 preschoolers who did not change residences after birth. • We studied associations of early exposures to NO 2 , SO 2 , PM 10 with airway diseases. • Prenatal and Postnatal exposures to NO 2 were associated with airway diseases. • Associations of NO 2 were generally stronger than in the early than later trimesters. It's inconsistent about associations of early exposures to outdoor air pollutants with allergies and airway diseases in childhood. Here, we investigated associations of prenatal and postnatal exposures to outdoor nitrogen dioxide (NO 2), sulphur dioxide (SO 2), and PM 10 (particulate matter with an aerodynamic diameter ≤ 10 μm) with asthma, wheeze, hay fever, rhinitis, pneumonia, and eczema in childhood. We surveyed 3,177 preschoolers who never change residences since birth in Shanghai, China. Parents reported information regarding children's health status. Daily-averaged concentrations of these pollutants in the children's gestation and in the first year of lifetime for district where children lived were collected by Shanghai Environmental Monitoring Center. After adjusting for covariates, exposures to higher level of NO 2 during different trimesters of gestation and of the first year of lifetime had significant associations with the increased odds of asthma, hay fever, rhinitis, pneumonia, and eczema in childhood. Associations of NO 2 exposures in the early trimesters of gestation and of the first year of lifetime with pneumonia were stronger than in the later trimesters, whereas associations of NO 2 exposures in the early trimesters with hay fever and eczema were weaker than in the later trimesters. Our results indicated that prenatal and postnatal exposures to outdoor NO 2 could be risk factors for allergies and airway diseases in childhood. Both dose and duration were related with the influence degree of early NO 2 exposure on childhood allergies and airway diseases. [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]