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      Children’s Respiratory Infections in Tianjin Area, China: Associations with Home Environments and Lifestyles

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          Abstract

          Children spend most of their indoors time at home, which may have substantial influence on their health. We conducted a cross-sectional study in the Tianjin area, China to quantify the incidence of respiratory infections among children, and its association with home environments and lifestyles. The lifetime-ever incidences of croup, pneumonia and ear infection among children aged 0–8 in Tianjin area was 9.2%, 28.7% and 11.6%, respectively. The incidence of common cold infections more than twice per year was 31.3%. Home environments and lifestyles included strong risk factors for childhood respiratory infections. Perceived dry air had the greatest association with childhood common colds (population attributable fraction (PAF = 15.0%). Modern floor covering had the greatest association with croup (PAF = 14.7%) and ear infection (PAF = 34.5%), while infrequent bedding sun-curing had the greatest association with pneumonia (PAF = 18.7%). Condensation (a proxy of poor ventilation) accounted for 12.2% of the incidence of croup (PAF = 12.2%) and frequent common colds (PAF = 8.4%). Our findings indicate that factors related to “modern” home environments and lifestyles are risks for childhood respiratory infections. Modifying such factors might reduce the incidence of respiratory infections among children.

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          Respiratory risks from household air pollution in low and middle income countries.

          A third of the world's population uses solid fuel derived from plant material (biomass) or coal for cooking, heating, or lighting. These fuels are smoky, often used in an open fire or simple stove with incomplete combustion, and result in a large amount of household air pollution when smoke is poorly vented. Air pollution is the biggest environmental cause of death worldwide, with household air pollution accounting for about 3·5-4 million deaths every year. Women and children living in severe poverty have the greatest exposures to household air pollution. In this Commission, we review evidence for the association between household air pollution and respiratory infections, respiratory tract cancers, and chronic lung diseases. Respiratory infections (comprising both upper and lower respiratory tract infections with viruses, bacteria, and mycobacteria) have all been associated with exposure to household air pollution. Respiratory tract cancers, including both nasopharyngeal cancer and lung cancer, are strongly associated with pollution from coal burning and further data are needed about other solid fuels. Chronic lung diseases, including chronic obstructive pulmonary disease and bronchiectasis in women, are associated with solid fuel use for cooking, and the damaging effects of exposure to household air pollution in early life on lung development are yet to be fully described. We also review appropriate ways to measure exposure to household air pollution, as well as study design issues and potential effective interventions to prevent these disease burdens. Measurement of household air pollution needs individual, rather than fixed in place, monitoring because exposure varies by age, gender, location, and household role. Women and children are particularly susceptible to the toxic effects of pollution and are exposed to the highest concentrations. Interventions should target these high-risk groups and be of sufficient quality to make the air clean. To make clean energy available to all people is the long-term goal, with an intermediate solution being to make available energy that is clean enough to have a health impact.
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            Use and misuse of population attributable fractions.

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              Respiratory and Allergic Health Effects of Dampness, Mold, and Dampness-Related Agents: A Review of the Epidemiologic Evidence

              Objectives Many studies have shown consistent associations between evident indoor dampness or mold and respiratory or allergic health effects, but causal links remain unclear. Findings on measured microbiologic factors have received little review. We conducted an updated, comprehensive review on these topics. Data sources We reviewed eligible peer-reviewed epidemiologic studies or quantitative meta-analyses, up to late 2009, on dampness, mold, or other microbiologic agents and respiratory or allergic effects. Data extraction We evaluated evidence for causation or association between qualitative/subjective assessments of dampness or mold (considered together) and specific health outcomes. We separately considered evidence for associations between specific quantitative measurements of microbiologic factors and each health outcome. Data synthesis Evidence from epidemiologic studies and meta-analyses showed indoor dampness or mold to be associated consistently with increased asthma development and exacerbation, current and ever diagnosis of asthma, dyspnea, wheeze, cough, respiratory infections, bronchitis, allergic rhinitis, eczema, and upper respiratory tract symptoms. Associations were found in allergic and nonallergic individuals. Evidence strongly suggested causation of asthma exacerbation in children. Suggestive evidence was available for only a few specific measured microbiologic factors and was in part equivocal, suggesting both adverse and protective associations with health. Conclusions Evident dampness or mold had consistent positive associations with multiple allergic and respiratory effects. Measured microbiologic agents in dust had limited suggestive associations, including both positive and negative associations for some agents. Thus, prevention and remediation of indoor dampness and mold are likely to reduce health risks, but current evidence does not support measuring specific indoor microbiologic factors to guide health-protective actions.

                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                07 June 2020
                June 2020
                : 17
                : 11
                : 4069
                Affiliations
                Tianjin Key Laboratory of Indoor Air Environmental Quality Control, School of Environmental Science and Engineering, Tianjin University, Tianjin 300350, China; jing_houj@ 123456163.com (J.H.); lvdachao914@ 123456tju.edu.cn (D.L.); panwang@ 123456tju.edu.cn (P.W.); qingnanstar@ 123456126.com (Q.Z.); sundellcc@ 123456gmail.com (J.S.)
                Author notes
                [* ]Correspondence: yuexiasun@ 123456tju.edu.cn ; Tel.: +86-22-85356721
                Author information
                https://orcid.org/0000-0002-0534-7471
                https://orcid.org/0000-0001-6303-5436
                Article
                ijerph-17-04069
                10.3390/ijerph17114069
                7312194
                32517360
                e71a7a3e-e069-4273-839b-a11ff65caa7a
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 17 April 2020
                : 03 June 2020
                Categories
                Article

                Public health
                respiratory infections,perceived dry air,condensation,sun-cure bedding,modern floor covering

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