Associations of Plasticized Wall and Floor Coverings With Asthma and Allergies Among Tropical Preschool Children

Abstract

ISEE-441 Objective: Recent epidemiologic studies carried out in Scandinavia and Russia have shown relations between the amount of wall material and plasticized polyvinyl chloride materials at home, and asthma, bronchial obstruction, lower respiratory symptoms and allergies among children. We are interested to see if there are similar associations among preschool children in the tropics. Material and Methods: A cross-sectional study design involving 4759 randomly selected preschool children aged 1.5- to 6-years-old was undertaken. The International Study of Asthma and Allergies in Children (ISAAC) written questionnaire was used for asthma and allergies outcomes. Exposure to emissions from home wall covering and plastic flooring materials, respectively, was assessed by questionnaire information on the presence of wall papers and vinyl flooring in the room the child sleeps. Computation of adjusted prevalence ratios (PR) and 95% CI is by using modified Cox proportional hazard regression model with constant risk period assumption controlled for other confounders. Results: Wall papers in the children's bedroom was significantly associated with increased risk for doctor-diagnosed asthma (PR 2.21, 95% CI: 1.14–4.39), current rhinitis (PR 1.68, 95% CI: 1.01–2.78), current eczema (PR 2.54, 95% CI: 1.44–4.47), and current flexural rash (PR 2.12, 95% CI: 1.12–4.02). The risks for symptoms were higher to children exposed to more than 1 room with wall papers in the homes highlighting a dose-response relation. No relation was observed for symptoms with vinyl floor coverings. Conclusions: These findings are coherent with increasing evidences from other countries demonstrating increased risk of asthma and allergic symptoms with wall paper exposures. Phthalate esters in plasticizers used in wall papers could be responsible in driving the associations. Degradation products of phthalates have been shown to contribute to inflammatory processes whereas murine studies have demonstrated showed enhanced allergy-related immune response.