Preconceptional, prenatal, and postnatal exposure to home environmental factors and childhood otitis media

Abstract

BackgroundOtitis media (OM) is a common pediatric infectious disease worldwide. Increasing evidence have associated indoor environment with OM, yet the role of home environmental factor(s) exposure during which critical window(s) on childhood OM are unclear. ObjectiveTo examine the association between indoor environmental factors exposure and childhood OM, to identify main indoor factor(s) and key window(s). MethodsA retrospective cohort study involving 8689 preschoolers aged 3–6 was performed in Changsha, China. The data about each child's health outcome and home environments was obtained through a standard questionnaire. Exposure timing windows included 1 year before pregnancy, pregnancy, first year of life, and past year. Multiple logistic regression models were used to analyze the association between indoor environmental factors and childhood OM. ResultsWe found that exposure to mold/damp stains and mold/damp clothes or bedding during preconceptional, prenatal, and postnatal periods was consistently associated with childhood OM, with ORs ranged from 1.25 (1.02–1.54) to 1.38 (1.13–1.68). Past year was identified as a critical time window for mold/damp stains exposure in relation to OM risk. We further found that exposures to new furniture during pregnancy and environmental tobacco smoke (ETS) and grandparental smoking during first year were significantly associated with an increase in childhood OM, with ORs (95% CI) = 1.28 (1.00–1.64), 1.20 (1.01–1.42), and 1.21 (1.00–1.48). Moreover, current exposure to total plants especially for non-flowering plants significantly increased OM risk, with ORs (95% CI) = 1.23 (1.05–1.44) and 1.25 (1.06–1.46). The association between early life exposure to indoor environmental factors and OM was stronger among children living near traffic roads. Outdoor air pollution and temperature could modify the effect of indoor environmental exposure on childhood OM. Our sensitivity analysis indicated that some subgroups were more susceptible to OM risk of indoor exposure. ConclusionOur findings suggest that exposure to home environmental factors played an important role in childhood OM, and the association can be interacted by outdoor air pollution and temperature.