Shaodan Huang1, Eric Garshick2, Louise B Weschler3, Chuan Hong4, Jing Li5, Linyan Li6, Fang Qu7, Dewen Gao8, Yanmin Zhou9, Jan Sundell10, Yinping Zhang11, Petros Koutrakis6. 1. Department of Building Science, Tsitnghua University, Beijing, 100084, China; Beijing Key Lab of Indoor Air Quality Evaluation and Control, Beijing, 100084, China; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, 02115, USA. 2. Pulmonary, Allergy, Sleep, and Critical Care Medicine Section, Medical Service, VA Boston Healthcare System, Boston, MA, 02132, USA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA. 3. Department of Building Science, Tsitnghua University, Beijing, 100084, China; 161 Richdale Road, Colts Neck, NJ, 07722, USA. 4. Department of Biomedical Informatics, Harvard Medical School, Boston, MA, 02115, USA. 5. Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, 02115, USA. Electronic address: jingli@hsph.harvard.edu.cn. 6. Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, 02115, USA. 7. Department of Building Science, Tsitnghua University, Beijing, 100084, China; China Meteorological Administration Training Centre, China Meteorological Administration, Beijing, 100081, China. 8. Beijing Key Lab of Indoor Air Quality Evaluation and Control, Beijing, 100084, China. 9. School of Architecture, Tsinghua University, Beijing, 100084, China; Beijing Key Lab of Indoor Air Quality Evaluation and Control, Beijing, 100084, China. 10. School of Environmental Science and Engineering, Tianjin University, Tianjing, 300072, China. 11. Department of Building Science, Tsitnghua University, Beijing, 100084, China; Beijing Key Lab of Indoor Air Quality Evaluation and Control, Beijing, 100084, China. Electronic address: zhangyp@mail.tsinghua.edu.cn.
Abstract
BACKGROUND: The prevalence of asthma and allergic diseases has increased rapidly in urban China since 2000. There has been limited study of associations between home environmental and lifestyle factors with asthma and symptoms of allergic disease in China. METHODS: In a cross-sectional analysis of 2214 children in Beijing, we applied a two-step hybrid Least Absolute Shrinkage and Selection Operator (LASSO) algorithm to identify environmental and lifestyle-related factors associated with asthma, rhinitis and wheeze from a wide range of candidates. We used group LASSO to select variables, using cross-validation as the criterion. Effect estimates were then calculated using adaptive LASSO. Model performance was assessed using Area Under the Curve (AUC) values. RESULTS: We found a number of environmental and lifestyle-related factors significantly associated with asthma, rhinitis or wheeze, which changed the probability of asthma, rhinitis or wheeze from -5.76% (95%CI: -7.74%, -3.79%) to 27.4% (95%CI: 16.6%, 38.3%). The three factors associated with the largest change in probability of asthma were short birth length, carpeted floor and paternal allergy; for rhinitis they were maternal smoking during pregnancy, paternal allergy and living close to industrial area; and for wheeze they were carpeted floor, short birth length and maternal allergy. Other home environmental risk factors identified were living close to a highway, industrial area or river, sharing bedroom, cooking with gas, furry pets, cockroaches, incense, printer/photocopier, TV, damp, and window condensation in winter. Lifestyle-related risk factors were child caretakers other than parents, and age<3 for the day-care. Other risk factors included use of antibiotics, and mother's occupation. Major protective factors for wheeze were living in a rural/suburban region, air conditioner use, and mother's occupation in healthcare. CONCLUSIONS: Our findings suggest that changes in lifestyle and indoor environments associated with the urbanization and industrialization of China are associated with asthma, rhinitis, and wheeze in children.
BACKGROUND: The prevalence of asthma and allergic diseases has increased rapidly in urban China since 2000. There has been limited study of associations between home environmental and lifestyle factors with asthma and symptoms of allergic disease in China. METHODS: In a cross-sectional analysis of 2214 children in Beijing, we applied a two-step hybrid Least Absolute Shrinkage and Selection Operator (LASSO) algorithm to identify environmental and lifestyle-related factors associated with asthma, rhinitis and wheeze from a wide range of candidates. We used group LASSO to select variables, using cross-validation as the criterion. Effect estimates were then calculated using adaptive LASSO. Model performance was assessed using Area Under the Curve (AUC) values. RESULTS: We found a number of environmental and lifestyle-related factors significantly associated with asthma, rhinitis or wheeze, which changed the probability of asthma, rhinitis or wheeze from -5.76% (95%CI: -7.74%, -3.79%) to 27.4% (95%CI: 16.6%, 38.3%). The three factors associated with the largest change in probability of asthma were short birth length, carpeted floor and paternal allergy; for rhinitis they were maternal smoking during pregnancy, paternal allergy and living close to industrial area; and for wheeze they were carpeted floor, short birth length and maternal allergy. Other home environmental risk factors identified were living close to a highway, industrial area or river, sharing bedroom, cooking with gas, furry pets, cockroaches, incense, printer/photocopier, TV, damp, and window condensation in winter. Lifestyle-related risk factors were child caretakers other than parents, and age<3 for the day-care. Other risk factors included use of antibiotics, and mother's occupation. Major protective factors for wheeze were living in a rural/suburban region, air conditioner use, and mother's occupation in healthcare. CONCLUSIONS: Our findings suggest that changes in lifestyle and indoor environments associated with the urbanization and industrialization of China are associated with asthma, rhinitis, and wheeze in children.
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