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.
Highlights
Respiratory infection was the leading cause of global children mortality, accounting for 15–16% of under-five mortality, second only to prematurity [1]
It was found that modern floor covering, perceived dry air, condensation on windowpanes, less sun-curing bedsheets and cesarean delivery are significantly associated with childhood infections
With respect to biological factors, we found that cesarean delivery and not being born on the due day were significant risk factors with high population attributable fractions (PAF) for childhood pneumonia
Summary
Respiratory infection was the leading cause of global children mortality, accounting for 15–16% of under-five mortality, second only to prematurity [1]. In 2017 alone, an estimated 1.6 million children under age 5 died worldwide from respiratory infections, including 39,000 deaths in China [2]. There is no evidence for a robust relationship between respiratory infections and genetic or racial factors [3]. People spend most of their time indoors, especially children [4,5]. Infants and young children, compared to adults, are more vulnerable to environmental exposure because their immune systems are not fully developed [6]. Household activities and environmental exposure at home are suspected risk factors for respiratory infections among children, especially in low income countries [7]. A global study on home environments and children’s health was launched in eight countries/areas in
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