Christina Tischer1, Payam Dadvand2, Xavier Basagana2, Elaine Fuertes2, Anna Bergström3, Olena Gruzieva3, Erik Melen4, Dietrich Berdel5, Joachim Heinrich6, Sibylle Koletzko7, Iana Markevych6, Marie Standl8, Dorothea Sugiri9, Lourdes Cirugeda2, Marisa Estarlich10, Ana Fernández-Somoano11, Amparo Ferrero10, Jesus Ibarlueza12, Aitana Lertxundi13, Adonina Tardón11, Jordi Sunyer14, Josep M Anto14. 1. ISGlobal, Barcelona Institute for Global Health - Campus MAR, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. Electronic address: christina.tischer@isglobal.org. 2. ISGlobal, Barcelona Institute for Global Health - Campus MAR, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. 3. Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Stockholm County Council, Sweden. 4. Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Stockholm County Council, Sweden; Sachs' Children's Hospital, Södersjukhuset, Stockholm, Sweden. 5. Research Institute, Department of Pediatrics, Marien-Hospital Wesel, Wesel, Germany. 6. Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich (LMU), Munich, Germany; Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany. 7. Division of Paediatric Gastroenterology and Hepatology, Dr. von Hauner Children's Hospital Munich, Ludwig-Maximilians-University of Munich, Germany. 8. Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany. 9. IUF - Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany. 10. CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; FISABIO-Universitat de València-Universitat Jaume I Joint Research Unit, Valencia, Spain. 11. CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; IUOPA-Preventive Medicine and Public Health Area, Department of Medicine, University of Oviedo, Asturias, Spain. 12. CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Health Research Institute, BIODONOSTIA, San Sebastian, Spain; Subdireccion de Salud Publica de Gipuzkoa, San Sebastian, Spain; University of Basque Country, UPV/EH, Leioa, Spain. 13. Health Research Institute, BIODONOSTIA, San Sebastian, Spain; University of Basque Country, UPV/EH, Leioa, Spain. 14. ISGlobal, Barcelona Institute for Global Health - Campus MAR, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
Abstract
OBJECTIVE: We integratively assessed the effect of different indoor and outdoor environmental exposures early in life on respiratory and allergic health conditions among children from (sub-) urban areas. METHODS: This study included children participating in four ongoing European birth cohorts located in three different geographical regions: INMA (Spain), LISAplus (Germany), GINIplus (Germany) and BAMSE (Sweden). Wheezing, bronchitis, asthma and allergic rhinitis throughout childhood were assessed using parental-completed questionnaires. We designed "environmental scores" corresponding to different indoor, green- and grey-related exposures (main analysis, a-priori-approach). Cohort-specific associations between these environmental scores and the respiratory health outcomes were assessed using random-effects meta-analyses. In addition, a factor analysis was performed based on the same exposure information used to develop the environmental scores (confirmatory analysis, data-driven-approach). RESULTS: A higher early exposure to the indoor environmental score increased the risk for wheezing and bronchitis within the first year of life (combined adjusted odds ratio: 1.20 [95% confidence interval: 1.13-1.27] and 1.28 [1.18-1.39], respectively). In contrast, there was an inverse association with allergic rhinitis between 6 and 8 years (0.85 [0.79-0.92]). There were no statistically significant associations for the outdoor related environmental scores in relation to any of the health outcomes tested. The factor analysis conducted confirmed these trends. CONCLUSION: Although a higher exposure to indoor related exposure through occupants was associated with an increased risk for wheezing and bronchitis within the 1st year, it might serve as a preventive mechanism against later childhood allergic respiratory outcomes in urbanized environments through enhanced shared contact with microbial agents.
OBJECTIVE: We integratively assessed the effect of different indoor and outdoor environmental exposures early in life on respiratory and allergic health conditions among children from (sub-) urban areas. METHODS: This study included children participating in four ongoing European birth cohorts located in three different geographical regions: INMA (Spain), LISAplus (Germany), GINIplus (Germany) and BAMSE (Sweden). Wheezing, bronchitis, asthma and allergic rhinitis throughout childhood were assessed using parental-completed questionnaires. We designed "environmental scores" corresponding to different indoor, green- and grey-related exposures (main analysis, a-priori-approach). Cohort-specific associations between these environmental scores and the respiratory health outcomes were assessed using random-effects meta-analyses. In addition, a factor analysis was performed based on the same exposure information used to develop the environmental scores (confirmatory analysis, data-driven-approach). RESULTS: A higher early exposure to the indoor environmental score increased the risk for wheezing and bronchitis within the first year of life (combined adjusted odds ratio: 1.20 [95% confidence interval: 1.13-1.27] and 1.28 [1.18-1.39], respectively). In contrast, there was an inverse association with allergic rhinitis between 6 and 8 years (0.85 [0.79-0.92]). There were no statistically significant associations for the outdoor related environmental scores in relation to any of the health outcomes tested. The factor analysis conducted confirmed these trends. CONCLUSION: Although a higher exposure to indoor related exposure through occupants was associated with an increased risk for wheezing and bronchitis within the 1st year, it might serve as a preventive mechanism against later childhood allergic respiratory outcomes in urbanized environments through enhanced shared contact with microbial agents.
Authors: Kim Hartley; Patrick H Ryan; Gordon L Gillespie; Joseph Perazzo; J Michael Wright; Glenn E Rice; Geoffrey H Donovan; Rebecca Gernes; Gurjit K Khurana Hershey; Grace LeMasters; Cole Brokamp Journal: Environ Health Date: 2022-05-12 Impact factor: 7.123