Indoor environmental quality and the prevalence of childhood asthma and rhinitis in Wuhan area of China

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

Pet-keeping and its impact on asthma and allergies among preschool children in Shanghai, China

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.     

Sick building syndrome among parents of preschool children in relation to home environment in Chongqing, China

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

Housing characteristics and indoor environment in relation to children’s asthma, allergic diseases and pneumonia in Urumqi, China

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

Prenatal and early life home environment exposure in relation to preschool children’s asthma, allergic rhinitis and eczema in Taiyuan, China

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

The influence of home environmental factors and life style on children＇s respiratory health in Xi＇an

To assess associations between home indoor air environments and asthma,allergies and pneumonia,children aged 1–8 years were surveyed from 12 kindergartens in the city of Xi’an.2,020 questionnaires were responded with a response rate of 83.5%.The prevalences of doctor diagnosed asthma,hay fever,and pneumonia were 2.9%,3.6%,and 28.3%,respectively.Living close to a highway was a risk factor for current rhinitis(AOR 1.5,95%CI 1.2–1.8),eczema(AOR 1.7,95%CI 1.2–2.5),and diagnosed pneumonia(AOR 1.3,95%CI 1.0–1.6).Dampness problems in the home were associated with 50%–130%increases in the prevalences of asthma and allergy.Airing bed linen under sun-shine was protective,especially against rhinitis.Pet avoidance was consistently and significantly associated with asthma and allergy(AOR 1.3–2.4).Decoration of the home during children’s early life is a risk factor for current rhinitis(AOR 1.9,95%CI 1.3–2.9)and eczema(AOR 1.9,95%CI1.1–3.6).Risk factors for pneumonia were living in an apartment(AOR 1.4,95%CI 1.1–1.8),latex wall paint(AOR 1.3,95%CI 1.0–1.7),dampness(AOR 1.4–1.5),breast feeding\3 months(AOR 1.3,95%CI 1.0–1.7),never airing bed linen in sunshine(AOR 1.3,95%CI1.3–1.6),and cleaning children’s room less frequently than once per day(AOR 1.4,95%CI 1.1–1.7).This study demonstrates that home indoor environmental and life style factors may influence the health of children in Xi’an.     

Home risk factors for childhood pneumonia in Nanjing, China

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

Increasing prevalence of asthma and allergy in Beijing pre-school children: Is exclusive breastfeeding for more than 6 months protective?

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

Effects of home environment and lifestyles on prevalence of atopic eczema among children in Wuhan area of China

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

Effects of ambient air pollution on allergic rhinitis among preschool children in Changsha, China

Prevalence of allergic rhinitis has rapidly increased among Chinese children,but the reasons are unclear.Recent findings have suggested that exposure to outdoor air pollutants may increase the risk of allergic rhinitis,but the results were inconsistent.This study further investigated the effect of outdoor air pollutants on allergic rhinitis among preschool children.A standardized questionnaire on health,home and environmental factors was conducted for 4988 children aged 1–8 in the city of Changsha,and the concentrations of PM10(particle diameter 10 m),sulfur dioxide(SO2)and nitrogen dioxide(NO2)during 2006–2011 were acquired from the official web of Changsha Environmental Protection Agency.Results showed that the prevalence of children’s doctor diagnosed rhinitis was 8.4%(95%confidence interval[CI]7.0%–10.0%).It was found that the prevalence of rhinitis was not associated with site-specific background concentrations of air pollutants,but significantly positively correlated with age-related accumulative personal exposure of PM10,SO2and NO2.We conclude that age-related accumulative personal exposure to ambient air pollution may play an important role in the development of rhinitis.     

Ten cities cross-sectional questionnaire survey of children asthma and other allergies in China

Asthma,rhinitis and eczema(allergic or non-allergic)have increased throughout the world during the last decades,especially among children.Changes in the indoor environment are suspected to be important causes.China has experienced a dramatic change in indoor environmental exposures during the past two decades.However,such changes and their associations with children’s asthma and other health aspects have not been thoroughly studied.China,Children,Homes,Health(CCHH),Phase I,was a cross-sectional questionnaire survey of 48219 children 1–8 years old in 10 Chinese cities during 2010–2012.The questionnaire includes the International Study of Asthma and Allergies in Childhood(ISAAC)core health questions and additional questions regarding housing,life habits and outdoor environment.In health analyses,children aged 3–6 years old were included.The prevalences of doctor diagnosed asthma varied from 1.7%to 9.8%(mean 6.8%),a large increase from 0.91%in 1999 and 1.50%in2000.The prevalence of wheeze,rhinitis and atopic eczema(last 12 months)varied from 13.9%to 23.7%,24.0%to 50.8%and4.8%to 15.8%,respectively.Taiyuan had the lowest prevalences of all illnesses and Shanghai the highest,except for wheezewhere the highest value was for Urumqi.We found(1)no obvious association between disease prevalences and ambient PM10concentrations and(2)higher prevalences of disease in humid climates with hot summers and cold winters,but with no centrally heated buildings.Associations between the diseases and economic status as indexed by Gross Domestic Product(GDP)requires further study.     

Associations between indoor environmental smoke and respiratory symptoms among preschool children in Shanghai, China

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.     

特异性脱敏法治疗柳树花粉引起的 过敏性鼻炎的实验研究

目的 建立柳树花粉引起的过敏性鼻炎小鼠模型,并对其进行特异性脱敏治疗。 方法 提取柳树花粉蛋白, 对小鼠腹腔注射并滴鼻激发,建立过敏性鼻炎小鼠模型;通过递增变应原剂量对小鼠皮下注射,观察小鼠行为学症 状、鼻黏膜组织形态学变化和检测血清 sIgE 的含量,探索特异性脱敏疗法的效果。 结果 治疗前小鼠出现搔鼻、打 喷嚏、流鼻涕等过敏症状,鼻黏膜中嗜酸性粒细胞明显多于对照组,血清 sIgE 含量高于激发前,成功建立了过敏性 鼻炎小鼠模型;治疗后小鼠过敏症状 逐 渐 减 轻 至 消 失,鼻 黏 膜 中 嗜 酸 性 粒 细 胞 逐 渐 减 少,血 清 sIgE 含 量 减 少。 结论 柳树花粉能够建立过敏性鼻炎小鼠模型,且特异性脱敏法可将其治疗。     

运动一组胺激发试验对支气管哮喘的诊断价值

目的探讨运动-组胺激发试验(EHIA)对支气管哮喘的诊断价值。方法对20例健康者、118例支气管哮喘、22例过敏性鼻炎、24例慢性支气管炎患者进行运动-组胺激发试验,并与单纯运动激发试验及组胺激发试验进行比较。结果运动-组胺激发试验对哮喘患者的诊断阳性率达97.4％,特异性100％,且EHIA阳性所吸入的组胺量也反映了哮喘患者非特异性气道高反应性。结论运动-组胺激发试验对提高早期或非典型支气管哮喘的确诊具有应用价值。     

运动—组胺激发试验对支气管哮喘的诊断价值

目的：探讨运动－组胺激发试验（EHIA）对支气管哮喘的诊断价值。方法：对20例健康者,118例支气管哮喘,22例过敏性鼻炎,24例慢性支气管炎患者进行运动－组胺激发试验,并与单纯运动激发试验及组胺激发试验进行比较。结果：运动－组胺激发试验对哮喘患者的诊断阳性率达97．4％,特异性100％,且EHIA阳性所吸入的组胺量也邮哮喘患者非特异性气道高反应性,结论：运动－组胺激发试验对提高早期或非典型支气管哮喘的确诊具有应用价值。     

上海地区居民健康与居住环境的关联性分析

为了解东南沿海地区居民健康的现状及其与居住环境的关联性,选取上海作为代表城市进行了问卷调查.结果显示,居民健康方面,老年人群的慢性病患病率高达70%,中年人群患病率最高的是呼吸道疾病和消化道疾病,儿童近期鼻炎自诉患病率高达45%;居住环境方面,近50%的被调查住宅存在夜间光污染、长期噪音干扰、室内灰尘过多、室内油烟过多、室内明显异味等环境问题,90%的被调查者对卧室空气品质尤为关注.关联性分析表明,良好的卫生习惯可降低居民患病率,而室内吸烟、油烟、潮湿、异味是引起居民健康问题的危险因素.     

抗过敏性鼻炎的中西药研究现状

过敏性鼻炎是一种常年发病、无季节性的慢性鼻粘膜炎症疾病。本文从免疫学角度对治疗过敏性鼻炎的中西药物进行了综述,认为西药治疗过敏性鼻炎见效快,疗效确切,但不良反应多,价格昂贵。相对而言,传统中医药的作用具有多环节多方式的特点,对过敏性鼻炎治疗总有效率高。因此,寻找具有多作用环节的抗多种组胺物质的中药活性成分将成为抗过敏性新药开发的方向。     

慢性不可预知温和应激抑郁小鼠模型的建立

抑郁症是一种以情绪低落为主要症状的情感性精神障碍.利用慢性不可预知温和应激建立抑郁症小鼠模型,以蔗糖水消耗实验作为抑郁核心症状之一——快感缺乏的检测方法.将4周龄雄性小鼠(C57BL/6)持续6周暴露于一系列轻度应激中,每周检测蔗糖水消耗.应激包括：令小鼠恐惧的气味、噪音、饲养笼倾斜、潮湿的垫料、无垫料的新饲养笼、照明...     

重庆市日照时间变化规律和特征分析

利用重庆市34个常规气象台站的1961～2000年的日照时数、总云量、低云量资料。文章采用统计结合克立格空间插值方法,研究了重庆市日照时数变化趋势和大小以及和云量的关系。研究表明：除北部巫山东北一小块地方外,其它地区都呈明显的下降趋势。40a间,年日照时数下降了约300多h,约占总日照时数的24％,日照时数下降主要表现在春、夏、冬三季,秋季变化不明显。其中,1971～1980年,日照时数出现突变,日照时数下降达150多h。从空间分布来看,西南部下降幅度最大,东南部次之,北部最小、无论是多年月平均日照时间还是年日照时间都与云量呈明显的负相关。日熙时间的变化可能与云量有关。     

鼻内镜下手术治疗常年性变应性鼻炎120例疗效分析

目的探讨手术方法治疗常年性变应性鼻炎的疗效。方法鼻腔表面麻醉和下鼻甲黏膜下浸润麻醉后,在0°鼻内镜下应用微波、低温等离子手术系统,对120例常年性变应性鼻炎患者,行筛前神经鼻中隔支切断,下鼻甲打孔消融,鼻中隔黏膜下矫正术。结果随访6个月以上,总有效率94.2%(113/120),显效90.0%(108/120)。结论通过手术方法治疗常年性变应性鼻炎近期效果良好,安全可靠,有很好的临床应用价值。