Dan Norbäck1, Chan Lu2, Yinping Zhang3, Baizhan Li4, Zhuohui Zhao5, Chen Huang6, Xin Zhang7, Hua Qian8, Yuexia Sun9, Jan Sundell9, Juan Wang10, Wei Liu3, Qihong Deng11. 1. School of Energy Science and Engineering, Central South University, Changsha, Hunan, China; Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Electronic address: dan.norback@medsci.uu.se. 2. School of Energy Science and Engineering, Central South University, Changsha, Hunan, China; XingYa School of Public Health, Central South University, Changsha, Hunan, China. 3. School of Architecture, Tsinghua University, Beijing, China. 4. Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Chongqing University, Chongqing, China. 5. Department of Environmental Health, Fudan University, Shanghai, China. 6. Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China. 7. Research Center for Environmental Science and Engineering, Shanxi University, Taiyuan, China. 8. School of Energy & Environment, Southeast University, Nanjing, China. 9. School of Environmental Science and Engineering, Tianjin University, Tianjin, China. 10. Department of Medical Sciences, Uppsala University, Uppsala, Sweden; Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Chongqing University, Chongqing, China. 11. School of Energy Science and Engineering, Central South University, Changsha, Hunan, China; XingYa School of Public Health, Central South University, Changsha, Hunan, China. Electronic address: qhdeng@csu.edu.cn.
Abstract
BACKGROUND: Biomass burning is associated with childhood pneumonia but few studies exist on other indoor factors. AIM: To study pneumonia in relation to pre-natal and post-natal exposure among children across China. METHODS: Children (3-6 y) (n = 39,782) from randomized day care centres in seven cities in China. Information on pneumonia and pre-natal and post-natal exposure to home environment factors were assessed by a parental questionnaire. Life-time outdoor temperature and GDP per capita were assessed on city level. Associations were calculated by multilevel logistic regression adjusting for fourteen co-variates. RESULTS: Totally 32.0% had ever had pneumonia diagnosed by a physician. Children of farmer mothers (OR = 0.65), with breastfeeding (OR = 0.91) and living in rural (OR = 0.85) or suburban (OR = 0.90) areas had less pneumonia. Buying new furniture one year before conception (OR = 1.11) and after first year of life (OR = 1.10) increased the risk. Redecoration one year before conception (OR = 1.20), during pregnancy (OR = 1.18) and after first year of life (OR = 1.17) increased pneumonia risk. Children with mould (OR = 1.17), window pane condensation (WPC) (OR = 1.20) and mould odour (OR = 1.15) at home at birth only had a higher risk of pneumonia. Similar associations were seen for dampness and mould in the current home. Children in the oldest and newest homes had less pneumonia. Cockroaches (OR = 1.08), mosquitos or flies in the current home (OR = 1.18), an exhaust fan in the bathroom (OR = 1.10) and higher economic development level, measured as GDP per capita on city level (OR 1.11 per 10,000 RMB/year) were associated with childhood pneumonia. CONCLUSIONS: Perinatal and postnatal exposure to mould, mould odour and window pane condensation at home can be early life risk factors for childhood pneumonia in China. Moreover, pre-natal and post-natal exposure to chemical emissions from new furniture and renovation could increase the risk of childhood pneumonia. Breastfeeding, farm exposure, and living in rural or suburban areas could be protective.
BACKGROUND: Biomass burning is associated with childhood pneumonia but few studies exist on other indoor factors. AIM: To study pneumonia in relation to pre-natal and post-natal exposure among children across China. METHODS:Children (3-6 y) (n = 39,782) from randomized day care centres in seven cities in China. Information on pneumonia and pre-natal and post-natal exposure to home environment factors were assessed by a parental questionnaire. Life-time outdoor temperature and GDP per capita were assessed on city level. Associations were calculated by multilevel logistic regression adjusting for fourteen co-variates. RESULTS: Totally 32.0% had ever had pneumonia diagnosed by a physician. Children of farmer mothers (OR = 0.65), with breastfeeding (OR = 0.91) and living in rural (OR = 0.85) or suburban (OR = 0.90) areas had less pneumonia. Buying new furniture one year before conception (OR = 1.11) and after first year of life (OR = 1.10) increased the risk. Redecoration one year before conception (OR = 1.20), during pregnancy (OR = 1.18) and after first year of life (OR = 1.17) increased pneumonia risk. Children with mould (OR = 1.17), window pane condensation (WPC) (OR = 1.20) and mould odour (OR = 1.15) at home at birth only had a higher risk of pneumonia. Similar associations were seen for dampness and mould in the current home. Children in the oldest and newest homes had less pneumonia. Cockroaches (OR = 1.08), mosquitos or flies in the current home (OR = 1.18), an exhaust fan in the bathroom (OR = 1.10) and higher economic development level, measured as GDP per capita on city level (OR 1.11 per 10,000 RMB/year) were associated with childhood pneumonia. CONCLUSIONS: Perinatal and postnatal exposure to mould, mould odour and window pane condensation at home can be early life risk factors for childhood pneumonia in China. Moreover, pre-natal and post-natal exposure to chemical emissions from new furniture and renovation could increase the risk of childhood pneumonia. Breastfeeding, farm exposure, and living in rural or suburban areas could be protective.