Indoor Risk Factors Research Articles

Prenatal risk factors of indoor environment and incidence of childhood eczema in the Japan Environment and Children's Study

The quality of indoor environment is a risk factor for early childhood eczema and atopic dermatitis; however, its influence during pregnancy on childhood eczema in Japan has not been investigated. In this study, we aimed to determine the indoor environmental factors that are associated with eczema in children up to 3 years of age, using national birth cohort data from the Japan Environment and Children's Study (JECS).Information on indoor environments and eczema symptoms until 3 years of age was collected using self-administered questionnaires to the mothers. A total of 71,883 and 58,639 mother-child pairs at 1.5- and 3-years-old, respectively, were included in the former analyses. To account for prenatal indoor risk factors, 17,568 (1.5-years-old) and 7063 (3-years-old) children without indoor mold and/or ETS exposure were included in the final analysis. A higher mold index, gas heater use, parquet flooring use, and frequent insecticide use showed significantly increased risks for childhood eczema up to 3 years of age. These associations were consistent after stratification analysis among children whose parents did not have a history of allergies. The updated WHO guidelines on indoor air quality should be implemented based on recent findings regarding the effects of prenatal exposure to indoor dampness on health effects of children further in life, including asthma, respiratory effects, eczema, and other immunological effects.

Living Alone, Environmental Hazards, and Falls Among U.S. Older Adults.

Physical conditions of living environments can affect the incidence of falls; however, prior work has focused typically on 1 domain at a time-either neighborhood or home, capturing limited environmental boundaries of older adults. We examined how neighborhood together with the home environment affect the incidence of falls over time and whether living arrangement modifies the influence of the environmental risks on falls. Using the 2012-2020 waves of the Health and Retirement Study (HRS; N = 1,893), we fitted logistic regression to estimate the incidence of falls over an 8-year study period. We used the neighborhood and housing data that are collected systematically by trained observers in the HRS to assess environmental hazards. Sidewalk quality, neighborhood disorder, and the presence of green space were measured to capture outdoor environmental hazards. Indoor environmental hazards included the presence of housing decay and poorly maintained stairways. All models were stratified by living arrangement. Neighborhood and housing environment were independently associated with the odds of falls net of demographic characteristics and preexisting health conditions, and effects were significant for people living alone only. The presence of green space and poorly maintained stairways were associated with greater odds of falling, net of covariates during 8 years of follow-up (odds ratios = 2.10 and 2.65, p < .05, respectively). None of the environmental risk factors were significant for those living with others. Falls in old age may be determined in part by a combination of outdoor and indoor risk factors. More research is needed to understand pathways that lead to greater vulnerability among older adults living alone to environmental hazards.

The Stroll Safe outdoor falls prevention program: Participant experiences in eight community sites

Background and objectivesOutdoor falls can negatively impact the quality of life of community-dwelling older adults. Although there are differences in risk factors for indoor and outdoor falls, none of the existing evidence-based fall prevention programs specifically targets outdoors falls. To fill this gap, the Stroll Safe program was developed. The purpose of this study was to explore participant's experiences in the Stroll Safe program Research design and methodsIn this qualitative study, we conducted focus groups at eight community program sites with Stroll Safe program participants. Thematic analysis, with both deductive and inductive coding were used. Researcher triangulation was employed to increase trustworthiness of the findings ResultsFour major themes emerged from the data, including (1) Precipitants of behavioral change, (2) Behavioral change, (3) Program design, and 4) Enjoyment of program experience. Several sub-themes were also uncovered Discussion and implicationsAlthough the qualitative findings are consistent with the quantitative findings from the efficacy trial, the results also reveal benefits that were not captured by the quantitative analysis. In addition, the findings related to the influence of the group leader and program design can be used to guide future implementation science studies.

OUTDOOR FALLS PREVENTION: PROMOTING SAFETY IN URBAN NEIGHBORHOODS

Abstract Outdoor falls present a significant challenge to the well-being of community dwelling older adults. There are a number of existing evidence-based programs that address fall risk, including multifactorial and exercise-based programs. However, despite the difference in risk factors for indoor and outdoor falls, no existing program specifically targets outdoor falls. To fill this gap, the Stroll Safe program was developed and refined based on a prior feasibility study. The 7-week group-based manualized program is focused on promoting safe behavioral strategies to reduce the risk of outdoor falls. In addition to presentations and community mobility coaching by the group leader, an occupational therapist, the program includes group discussion and problem solving, capitalizing on the life experiences of participants. Action planning facilitates implementation of the strategies discussed. Given that the neighborhood environment impacts both risk and fear of falling, a walkability audit (i.e. the SWAN) focused on environmental hazards is included and is used to promote awareness of hazards and as a tool for self-advocacy. Data science and machine learning facilitate the creation of resources for route planning. Vision Zero resources help to identify hotspots for pedestrian injuries, and a map of shadow is used to create a user friendly map of potential hotspots for black ice. In this symposium, we will present 1) Findings from the efficacy trial for Stroll Safe, and 2) Describe data science research that can be used to inform outdoor falls prevention programs.

Efficacy of the Stroll Safe Outdoor Fall Prevention Program: A Randomized Controlled Trial.

Outdoor falls can negatively affect the independence and well-being of community-dwelling older adults. Although there is some overlap, there are also differences in risk factors for indoor and outdoor falls. There are no existing community-based fall prevention programs that specifically target outdoor fall prevention. To fill this gap, the Stroll Safe program was developed. A cluster-randomized controlled trial design was used with randomization at the site level. Participants (N = 86) were aged 60 and older, with a history of an outdoor fall or who had a fear of falling outdoors. Eight naturally occurring retirement community program sites were randomly assigned to the treatment or wait list control group. Outcome measures included the Outdoor Falls Questionnaire, the Falls Behavioral Scale for the Older Person, and the Falls Efficacy Scale-International to examine knowledge of risks, safe strategy use, protective behaviors, and fear of falling. An Analysis of Covariance (ANCOVA) was used to compare change scores between groups with covariates included for any initial differences between groups. A linear mixed model was also conducted to account for any clustering effects. Significant differences (ps < .05) were found between groups for knowledge of outdoor fall risks and safe strategy use. Effect sizes were large (Cohen's d = 1.2-1.9). Results were retained at 6-week follow-up. Stroll Safe is effective in improving knowledge of outdoor fall risks and increasing safe strategy use for community mobility. Stroll Safe fills a gap in outdoor fall prevention programs. Clinical Trials Registration Number: NCT03624777.

Thinness negatively affects lung function among Sri Lankan children.

BackgroundThere have been conflicting findings on the effect of body mass index (BMI) on lung functions in children. Therefore, we studied the relationship between spirometry parameters and BMI among healthy Sri Lankan school children aged 5–7 years.MethodsA cross-sectional study was conducted among 296 school children (5–7-year-old) without apparent lung disease. Recruitment was done with stratified random sampling. Spirometry parameters, FEV1, FVC, PEFR, and FEV1/FVC ratio were determined. The acceptable and reproducible spirometry recordings were included in the analysis. Simple and multivariate linear regression analysis examined possible associations of lung function parameters with BMI, socio‐demographic variables and indoor risk factors. Also, the mediator effect of gender on lung function through BMI was explored.ResultsThe participants’ mean age (SD) was 6.4 (0.65) years. One-third were thin/severely thin (37%). A statistically significant difference in FVC (p = 0.001) and FEV1 (p = 0.001) was observed between BMI groups (obesity/overweight, normal, and thinness). Yet, PEFR or FEV1/FVC did not significantly differ among BMI groups (p = 0.23 and p = 0.84). Multivariate regression analysis showed that FEV1 and FVC were significantly associated with BMI, child’s age, gender, family income, father’s education, having a pet, and exposure to mosquito coil smoke. Interaction between gender and BMI for lung functions was not significant. The thin children had significantly lower FVC (OR: -0.04, 95%CI: -0.077, -0.012, p = 0.008) and FEV1 (OR: -0.04, 95%CI: -0.075, -0.014, p = 0.004) than normal/overweight/obese children. Family income demonstrated the greatest effect on lung functions; FVC and FEV1 were 0.25L and 0.23L smaller in low-income than the high-income families.ConclusionLower lung function parameters (FVC and FEV1) are associated with thinness than normal/overweight/obese dimensions among children without apparent lung disease. It informs that appropriate nutritional intervention may play a role in improving respiratory health.

Effects of farrowing hut design on maternal and thermoregulatory behaviour in outdoor housed sows and piglets

This study aimed to determine the effect of three different farrowing huts on the behaviour of outdoor housed sows and piglets during summer in Eastern Canada, with a focus on thermoregulatory and crushing behaviours. Forty-two second parity sows were housed outdoors in groups of three during lactation (N = 42). Within each group, sows had access to three farrowing huts: a Wood modified A-frame hut, a Plastic round calf hutch, and a Metal ark English-style hut. Cameras were installed in the huts to observe behaviour on days 1, 2, 7 and 14 of lactation. Temperature and humidity were recorded outside and inside the huts. Hourly temperature averages were analysed for the effect of the hut type for day and night separately. Sows farrowed in the huts between August and October and observations of sow and piglet location, posture, nursing, and crushing events were collected in the morning and afternoon. The Wood huts showed the least variation in temperature between days and nights, with the Metal huts showing similar thermal properties to the Wood huts (P < 0.05). The Plastic hut was hotter and drier during the day, but cooler and more humid during the night (P < 0.05). No hut type effect was observed on sow use of the hut, posture, or nursing behaviour. Piglets showed greater expression of thermoregulating behaviour in the morning on day two in the Wood hut as it was the coolest (P = 0.03). Huddling was found to be the most common technique employed by piglets for thermoregulation in all huts, representing 61.2–73.8% of their time. Piglets were in contact with the sow 10.6–16.1% of the time while not nursing. The percentages of sows killing at least one piglet by crushing or trauma during the first week after farrowing were 93%, 86% and 43% for Wood, Plastic, and Metal huts, respectively (P = 0.02). Mortalities during the first week due to crushing or trauma were 18%, 15%, and 11% of liveborn piglets for the Wood, Plastic, and Metal huts, respectively (P = 0.44). The riskiest time for piglets, in terms of being crushed was found to be when the sow was standing (P = 0.04). This study suggests that the indoor risk factors for crushing change when sows are housed in huts. The Metal hut appears to be the best compromise considering thermal environment, behaviour, and litter survival, but the results suggest a need for future research into hut designs for farrowing sows on pasture to reduce crushing risks.

The home environment and current dermatitis in Japanese junior high school children in Kansai area

There is little information on indoor risk factors for dermatitis in Japan. We studied associations between dermatitis in Japanese junior high school students in Hyogo prefecture and the home environment. A standardised questionnaire was sent to students in four schools (12–15 years old), 1048 (99%) participated. Data on the home environment was collected by the questionnaire. Associations were analysed by multilevel logistic regression in mutually adjusted models, calculating odds ratio (OR) with 95% confidence intervals. A total of 15.2% reported current dermatitis, 8.8% cat allergy, 6.1% dog allergy, 6.0% mould allergy, 25.7% pollen allergy and 32.3% any allergy (a history of atopy). Female gender (OR 1.65), a history of atopy (OR 2.14), new building materials (indoor paint or floor materials) (OR 1.59), dampness or indoor mould (OR 1.51) and windowpane condensation in winter (OR 1.45) were associated with current dermatitis. The association between window pane condensation and dermatitis was stronger in students without a history of atopy (interaction p=0.02). In conclusion, dampness, indoor mould and window pane condensation in wintertime can be household risk factors for dermatitis in adolescents. Chemical emissions from new building materials, especially paint and floor materials, can be another risk factor.

Cross-Sectional Study to Identify Potential Risk Factors for Eczema within the Common Household Environment in Taiwan.

Background:Much attention has been focused on environmental risk factors and their roles in eczema development. In this regard, the specific eczema risk factors in Taiwan were relatively unknown. As such, this study investigated the common indoor risk factors present in Taiwanese households.Aims:To discuss the effects of several indoor risk factors on the prevalence of atopic eczema in Taiwan.Materials and Methods:A cross-sectional, population-based study was performed in Kaohsiung, Taiwan, using both survey investigation and fungal culturing. A total of 998 participants were enrolled in the survey, with 513 participants selected for fungal culture. Risks of atopic eczema were calculated as odds ratios for various risk factors using logistic regression. The correlation between potential risk factors and the fungal level was analyzed with linear regression.Results:Pet and house plants have an adjusted odds ratio of 1.434 (95% CL: 1.011–2.033) and 1.820 (95% CL: 1.229-2.696), respectively. Additionally, smoking was shown to possess an odds ratio of 1.461 (95% CL: 1.064-2.006). Wood wall has an adjusted odds ratio of 2.143 (95% CL: 1.235-3.658). Frequent bedroom shower use (β = 0.254) and hours of opened windows (β = 0.106) have shown significant positive associations with indoor fungal level.Conclusion:Pets, house plants, and smoking were concluded to be major risk factors for atopic eczema. Wood wall remained controversial due to its limited sample size and possible confounders. Bedroom shower and window-opening have been shown to increase mold growth, but the lack of association with eczema suggested other allergens besides mold to be the primary eczema trigger.

Neighborhood and Housing Conditions and Risk of Falls

Physical conditions of living environments can impact risk of falls, however, prior work has focused typically on one domain at a time—either neighborhood or home, capturing limited environmental boundaries of older adults. We extend prior work by considering both neighborhood and home as important residential contexts and examine their impact on the onset of falls over time. Data are drawn from two waves of the Health and Retirement Study (2012 and 2016; N = 2,244). We used interviewers’ report on outdoor and indoor dwelling conditions to assess environmental risk factors. One-third of respondents reported at least one fall years later. The presence of green space such as a park near the housing unit and clutter in the home appears to increase the risk of falls over a four-year period. This finding suggests that falls in old age may be determined by a combination of outdoor and indoor risk factors.

Onset and remission of eczema at pre-school age in relation to prenatal and postnatal air pollution and home environment across China

We investigated associations between prenatal and postnatal environmental factors and onset and remission of preschool childhood eczema across China. The study population was preschoolers in randomized day care centers in seven cities (N = 39,782). Data on eczema and prenatal and postnatal indoor and outdoor environment were obtained from a cross-sectional questionnaire sent to parents or other guardians. Reports on eczema in the first 2 years and in the past year was used to retrospectively calculate onset and remission (changes of reported eczema). Prenatal and postnatal outdoor temperature, NO2 and PM10 were modelled from official air pollution data. Associations were estimated by two-level logistic regression. Calculated onset rate was 3.2%/y and remission rate 29.2%/y. Exposure to NO2 during pregnancy was associated with onset of eczema, similarly for all trimesters. Postnatal PM10 and NO2 were related to decreased remission. Postnatal outdoor temperature was associated with onset of eczema. Pre-natal and current redecoration or buying new furniture, and perinatal as well as current dampness and indoor mould, were associated with increased onset and decreased remission. Cockroaches in current home was another indoor risk factors. Prenatal exposure to farm environment and large family size were all negatively associated with eczema. In conclusion, a warmer climate and prenatal NO2 can be associated with increased onset of eczema in Chinese preschoolers. Postnatal PM10 and NO2 can be associated with reduced remission. Perinatal and current dampness, indoor mould and cockroaches may increase onset and decrease remission. Exposure to chemical emissions from indoor materials after first year of life may increase onset. Prenatal exposure to farm environment and large family size could be protective.

Association between indoor environment and common cold among children aged 7–9 years in five typical cities in China

The common cold is an acute, self-limited viral infection of the upper respiratory tract, it is a heterogeneous group of diseases caused by numerous viruses that belong to several different families. A total of 292 households with children aged 7–9 years from Harbin, Xi’an, Ningbo, Nanning, and Shenzhen, China were investigated and 877 air samples from both bedrooms and living rooms in study area were tested to reveal indoor air quality level in 2017. The mean indoor temperature, relative humidity, CO, CO 2 , NO 2 , formaldehyde, total count of colonies, and total count of fungi levels were 21.00 ​± ​4.05 ​°C, 54.66 ​± ​16.28%, 0.85±+2.99 mg/m 3 , 0.08 ​± ​0.06%, 0.03 ​± ​0.02 ​mg/m 3 , 0.03 ​± ​0.02 ​mg/m 3 , 173.14 ​± ​4.28 ​cfu/m 3 , and 241.21 ​± ​4.20 ​cfu/m 3 , respectively. Of the 292 children, 1.72% had >5 common colds in the past year, 12.04% 3–5 per year, and rest <3 per year. The average prevalence of the common cold in five cities was 1.68 times per year with an average duration of 5.62 days. The main symptoms of a common cold in children are cough and expectoration, which are significantly influenced by indoor relative humidity, formaldehyde, and total count of fungi. The total count of fungi as well as relative humidity are also significantly correlated with the duration of children common cold. And significant correlation was found between indoor temperature and the prevalence of a common cold. This study systematically analyzed influence of indoor environment, including physical variables, chemical variables, and biological variables, on common cold in children and identified essential indoor risk factors in China. • The average prevalence of the common cold in five typical cities in China was 1.68 times per year with an average duration of 5.62 days. •The main symptoms of a common cold in children are cough and expectoration. •The main symptoms, duration, and prevalence of a common cold in children are significantly influenced by indoor temperature, relative humidity, formaldehyde, and total count of fungi. •The socioeconomic status (SES) of the family affects indoor environment as well as respiratory health status of the child to some extent.

Sick building syndrome symptoms among young parents in Chinese homes

SBS (Sick Building Syndrome) has been studied since the 1970s, mostly in workplaces. To comprehensively characterize associations between the home environment and SBS, we performed a study in the Tianjin area, China. Seven thousand eight hundred and sixty-five (7865) families with infants participated in a questionnaire survey. Information on their lifestyles, home environment and health outcomes was obtained. Fourteen percent (14%) of parents reported general symptoms, followed by 11% for mucosal symptoms and 9% for skin symptoms. There was no gender difference in reports of SBS symptoms. People living in apartments, compared to Pingfang, reported more SBS symptoms. Indoor risk factors for SBS symptoms were perceived dry air (AOR:2.71–3.85), condensation on windows (AOR:1.44–2.11), less frequent window opening (AOR:1.71–1.73) and dampness (AOR:1.44–1.93). Our findings suggest that the home environment impacts occupants’ health.

Correlation between indoor air pollution and adult respiratory health in Zunyi City in Southwest China: situation in two different seasons

BackgroundIndoor environmental quality significantly influences the occurrence of asthma attack. Zunyi District has abundant coal reserves and is regarded as one of the cities that are most severely polluted by high levels of particulate matter in China. This study aimed to examine the correlation of indoor exposure with adult respiratory health, as well as the differences in effect between winter and summer.MethodsA cross-sectional epidemiological study was conducted among 1207 adult residents in Zunyi, Guizhou Province of Southwest China in winter and summer. Data on health variables related to asthma and home environmental factors were collected using a modified European Community Respiratory Health Survey II questionnaire. The following data were obtained: samples of particulate matter 2.5 (PM2.5) inside and outside the households under study (n = 20); lung function status, including peak expiratory flow rate, forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and FEV1/FVC ratio.ResultThe odds ratio (OR) for asthma-like symptoms and asthma in adults using coal stove for cooking or warming, relative to non-users, was 1.73 (95% CI, 1.11–2.69) in winter vs. 1.30 (95% CI, 0.79–2.14) in summer. Adult residents with exposure to cooking oil fumes were at a considerably higher risk of asthma-like symptoms and asthma [OR = 2.65 (95% CI, 1.25 to 5.61) in winter vs. OR = 7.93 (95% CI, 2.54 to 24.75] in summer] than those without such exposure. The prevalence of asthma-like symptoms and asthma was significantly higher in adults with high kitchen risk scores or high sleeping-area risk scores than in those with low scores in both seasons (p < 0.05). The relative kitchen and sleeping area PM2.5 concentrations were higher in winter than in summer (p < 0.05). Lung function was negatively associated with indoor kitchen and sleeping area relative PM2.5 concentration in winter rather than summer (p < 0.001). The effect of exposure to indoor risk factors on lung function among the residents was greater in winter than in summer (p < 0.001).ConclusionExposure to indoor risk factors, such as aerocontaminants from coal combustion, causes asthma symptoms and reduces pulmonary function. The effect of indoor risk factors on respiratory health among adults with such exposure was greater in winter than in summer.

Feasibility of the Stroll Safe Outdoor Fall Prevention Program

Although half of falls occur outdoors, existing prevention programs focus primarily on risk factors for indoor falls. The purpose of this study was to evaluate the feasibility of the Stroll Safe outdoor fall prevention program and to obtain feedback to refine the program and research methods to plan a larger scale study. A quasi-experimental design (N = 24) was used. A fidelity checklist, attendance records, a focus group, and a reflective log were used to conduct a process, resource, and project management assessment. Preliminary outcomes were examined using fall calendars and standardized measures of fall prevention strategy use. Needed modifications were determined. Preliminary outcomes reveal increased use of fall prevention strategies and decreased stumbles, trips, slips, and falls outdoors among program participants. The Stroll Safe program is an innovative new program that is feasible to implement among community-dwelling older adults. Further study is warranted.

Relationship between indoor environment and children's common cold in Baotou, Inner Mongolia

The common cold is the most common disease in children and is associated with viruses, bacterial infections and low immunity in children. As a susceptible population, children are very sensitive to the common cold. The survey shows that children have an average of 6−8 times a year, usually lasting 7 to 15 days. However, there are few studies in this area in China. This paper discusses the relationship between the indoor environment in Baotou City and the preschool children’s cold. This study is part of the China, Children, Homes, Health (CCHH) program, which aims to identify indoor risk factors associated with asthma and allergies in children. From March to July 2014, a cross-sectional study was conducted on 4709 children aged 3−7 years (74.0% response rate) randomly selected from 37 kindergartens in Baotou City. We found that a total of 4.8% had a high frequency (>5 colds per year) and 6.1% had long duration (≥2 weeks) of common cold in Baotou. A Chi-square test was used for univariate analysis of common cold-related risk factors. A P -value <0.05 was considered as significant. All statistical analysis was performed by SPSS 20.0. Low age children had more common cold than high age children ( P <0.05). Children who received antibiotics and had a family history of allergies had more colds and longer durations ( P <0.001). We analyzed the association between indoor exposure and the common cold. These associations were performed by multiple logistic regression after adjusting for six covariates, including gender, age, family allergy history, breastfeeding, birth patterns, and smoking environment. Odds ratios (ORs) with 95% confidence interval (95% CI) were calculated for the logistic regression models. Family allergy history and exposure to condensation were associated with frequent common cold and long duration of common cold. However, bedding that is often exposed to sunlight is negatively correlated with frequent colds (aOR, 95% CI: 0.67, 0.58 to 0.79) and prolonged colds (aOR, 95% CI: 0.59, 0.40 to 0.87). Family history of allergies and contact condensation may be a risk factor for the common cold, and exposure to bedding from the sun may be a protective factor. This study shows that in Baotou, the indoor environment and lifestyle of modern apartments are related to the frequency of the common cold in children and the duration of the cold. To prevent a child from catching a cold, it is important to reduce signs of moisture and often expose the bedding to the sun. Further follow-up studies of indoor environment could verify more about the influence of environmental exposure on the children’s health.

Correlation between Novel Potential Indoor Risk Factors and Frequency of Doctor's Visit for Respiratory Problem in Taiwan's Tropical Environment.

With a global rising trend in prevalence of allergic diseases, more attention has been paid to investigation of environmental risk factors. Many risk factors have so far been identified. However, novel risk factors specific to Taiwanese environment and lifestyle were still relatively unknown. To investigate the potential effects of a number of little-known indoor risk factors on the frequency of doctor's visit for respiratory problems in context of Taiwanese environment and lifestyle. A cross-sectional, population-based study was performed on a 861 participants around Kaohsiung area, Taiwan. Survey investigation was employed to assess the household environment and the frequency of doctor's visit for respiratory problems. Participants who performed "daily cleaning" was shown to have a significantly (p=0.007) higher mean number of doctor's visits in comparison to those who did not. Similar observation was made for participants who periodically took out beddings (p=0.042). Age had a significant positive correlation (linear regression β 0.089) with frequency of respiratory problems. The habit of daily cleaning was implicated as a potential indoor risk factor due to the unique nature of Taiwanese cleaning habit and close contact with cleaning supplies, which could serve as chemical irritants. Bedding takeout was predicted to be an indicator of chronic allergies rather than an actual risk factor. However, both were controversial in their role as potential indoor risk factor, and required further examination.

The role of the indoor environment: Residential determinants of allergy, asthma and pulmonary function in children from a US-Mexico border community

The El Paso Children's Health Study examined environmental risk factors for allergy and asthma among fourth and fifth grade schoolchildren living in a major United States-Mexico border city. Complete questionnaire information was available for 5210 children, while adequate pulmonary function data were available for a subset of 1874. Herein we studied indoor environmental health risk factors for allergy and asthma. Several indoor environmental risk factors were associated with allergy and asthma. In particular, we found that ant and spider pest problems, pet dogs, fireplace heat, central air conditioning, humidifier use, and cooking with gas stoves were positively associated with both allergy and asthma prevalence. With regards to asthma severity, our analysis indicated that exposure to pet dogs increased monotonically with increasing asthma severity while the lack of any heat source and gas stove use for cooking decreased monotonically with increasing asthma severity. Lung function also decreased among children who lived in homes with reported cockroach pest problem in the past year without concurrent use of pesticides. These effects on pulmonary function were present even after excluding children with a current physician's diagnosis of asthma. Clinicians and public health professionals may need to look closely at the contribution of these indoor risk factors on pulmonary health and quality of life among susceptible populations.

Indoor environmental factors associated with pulmonary function among adults in an acid rain-plagued city in Southwest China.

To assess the association of indoor environmental risk factors with respiratory function among adults in an acid rain-plagued city in China where coal use is frequent. The subjects were randomly selected in the winter season. Information on selected home environmental factors was collected through administered questionnaires. Additionally, pulmonary function tests, including Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 s (FEV1), FEV1/FVC and Peak Expiratory Flow Rate (PEFR) were also performed in participants. This study showed that, among avariety of risk factors, coal fuel use, cooking oil fumes and active and passive smoking exposure together with asthma in childhood were important factors for deterioration of pulmonary function among adults in the winter season (p< 0.05). Additionally, subjects whose kitchen was located in the living room or bedroom, who opened their windows only occasionally or never, who noted the presence of cooking oil fumes and pests, whose bedroom was shared by 3 or more residents and who kept pets tended to exhibit lower values of FVC, FEV1 and PEFR values compared with non-exposed counterparts (p< 0.05). This study demonstrated impaired pulmonary function among adults who were exposed to indoor risk factors, such as coal fires and cigarette smoking compared to non-users in the winter season and emphasizes the need for public health efforts to decrease exposure to indoor air pollution.

Creating a risk index for allergic diseases with indoor and outdoor risk factors in Seoul: Implications for targeted intervention

Creating a risk index for allergic diseases with indoor and outdoor risk factors in Seoul: Implications for targeted intervention