Yang Zhuge1, Hua Qian2, Xiaohong Zheng1, Chen Huang3, Yinping Zhang4, Min Zhang1, Baizhan Li5, Zhuohui Zhao6, Qihong Deng7, Xu Yang8, Yuexia Sun9, Tingting Wang10, Xin Zhang11, Jan Sundell4. 1. School of Energy and Environment, Southeast University, Nanjing, China. 2. School of Energy and Environment, Southeast University, Nanjing, China. Electronic address: qianh@seu.edu.cn. 3. School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China. 4. Beijing Key Lab of Indoor Air Quality Evaluation and Control, Tsinghua University, Beijing, China. 5. Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Chongqing University, Chongqing, China. 6. School of Public Health, Fudan University, Shanghai, China. 7. School of Energy Science and Engineering, Central South University, Changsha, Hunan, China. 8. College of Life Science, Central China Normal University, Wuhan, China. 9. School of Environmental Science and Engineering, Tianjin University, Tianjin, China. 10. School of Public Health, Xinjiang Medical University, Urumqi, China. 11. Institute of Environmental Science, Shanxi University, Taiyuan, China.
Abstract
BACKGROUND: Children's pneumonia is a heavy health burden. Few studies have been carried out on residential risk factors for pneumonia in children. Potential risks associated with dwelling characteristics are still unknown. METHODS: A cross-sectional study was conducted among children in 8 cities in China during 2010-2011 and 41,176 valid data on children aged 3-8 years old were used in this analysis. To obtain the lifetime-ever incidence of pneumonia in children and identify associations between pneumonia and residential risk factors, chi-square analysis and logistic regression methods were employed. Adjusted odds ratios were used as measures of effect with a 95% confidence interval. Confounding variables in the regression model include children's gender, birthweight, breastfeeding duration, parental smoking and family history of atopy. RESULTS: The average lifetime-ever incidence of childhood pneumonia was 32.3%. Urban children (33.6%) had more pneumonia than suburban (29.9%) and rural children (24.9%). More residential risk factors were found in urban-dwellings. Boys, low birthweight (<2500 g), breastfeeding duration <6 months, family allergic history, and exposure to parental smoking were found to be associated with higher pneumonia lifetime-ever incidences. Various indicators of dampness, including visible mold spots, damp stains, water damage, water condensation, damp clothing or bedding and mold odor, were also positively associated with pneumonia. Pneumonia incidence increased as the number of dampness indicators increased. Both natural gas and solid cooking fuels were positively associated with pneumonia compared with electricity. Compared with cement, construction materials including synthetic fiber, laminated wood, real wood, paint, emulsion paint and wall paper were positively associated with pneumonia. Daily living habits such as putting bedding to sunshine frequently and cleaning the child's bedroom every day could be effective preventive strategies. A dose-response relationship between the number of residential risk factors and pneumonia was observed when the risk factors number ranged from 7 to 11. Residences with more risk factors had higher lifetime-ever pneumonia odds ratios. CONCLUSIONS: Indoor environmental factors including dampness, use of solid fuels or natural gas for cooking and use of new construction materials are risk factors for childhood pneumonia. This study gives evidence for the importance of home environment exposures in the occurrence of childhood pneumonia. Actions against the residential risk factors described in this study may help to prevent pneumonia in children.
BACKGROUND:Children's pneumonia is a heavy health burden. Few studies have been carried out on residential risk factors for pneumonia in children. Potential risks associated with dwelling characteristics are still unknown. METHODS: A cross-sectional study was conducted among children in 8 cities in China during 2010-2011 and 41,176 valid data on children aged 3-8 years old were used in this analysis. To obtain the lifetime-ever incidence of pneumonia in children and identify associations between pneumonia and residential risk factors, chi-square analysis and logistic regression methods were employed. Adjusted odds ratios were used as measures of effect with a 95% confidence interval. Confounding variables in the regression model include children's gender, birthweight, breastfeeding duration, parental smoking and family history of atopy. RESULTS: The average lifetime-ever incidence of childhood pneumonia was 32.3%. Urban children (33.6%) had more pneumonia than suburban (29.9%) and rural children (24.9%). More residential risk factors were found in urban-dwellings. Boys, low birthweight (<2500 g), breastfeeding duration <6 months, family allergic history, and exposure to parental smoking were found to be associated with higher pneumonia lifetime-ever incidences. Various indicators of dampness, including visible mold spots, damp stains, water damage, water condensation, damp clothing or bedding and mold odor, were also positively associated with pneumonia. Pneumonia incidence increased as the number of dampness indicators increased. Both natural gas and solid cooking fuels were positively associated with pneumonia compared with electricity. Compared with cement, construction materials including synthetic fiber, laminated wood, real wood, paint, emulsion paint and wall paper were positively associated with pneumonia. Daily living habits such as putting bedding to sunshine frequently and cleaning the child's bedroom every day could be effective preventive strategies. A dose-response relationship between the number of residential risk factors and pneumonia was observed when the risk factors number ranged from 7 to 11. Residences with more risk factors had higher lifetime-ever pneumonia odds ratios. CONCLUSIONS: Indoor environmental factors including dampness, use of solid fuels or natural gas for cooking and use of new construction materials are risk factors for childhood pneumonia. This study gives evidence for the importance of home environment exposures in the occurrence of childhood pneumonia. Actions against the residential risk factors described in this study may help to prevent pneumonia in children.