Asthma‐related outcomes associated with indoor air pollutants among schoolchildren from four informal settlements in two municipalities in the Western Cape Province of South Africa

Olaniyan, Toyib; Dalvie, Mohamed Aqiel; Röösli, Martin; Naidoo, Rajen N.; Künzli, Nino; Hoogh, Kees de; Parker, B.; Leaner, Joy; Jeebhay, Mohamed F.

doi:10.1111/ina.12511

Cited by 24 publications

(28 citation statements)

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“…In primary school children from Viseu, Portugal, Martins et al [22] reported a slightly lower active wheezing prevalence (11.7%) when compared with that of the present study. Also for primary school children (aged 7-9 years old) from two municipalities in Western Cape Province, South Africa, Olaniyan et al [8] reported a slightly lower prevalence of active wheezing (12.9%) than in the present study. In another study in Portugal, Branco et al [12] reported an active wheezing prevalence of 17.1% for children with less than 5 years old attending nursery schools in Porto and Bragança districts, which was very similar to the prevalence calculated in the present study.…”

Section: Study Site and Populationcontrasting

confidence: 71%

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Children’s Exposure to Indoor Air in Schools: Impact on Wheezing

Sá

Branco

Alvim-Ferraz

et al. 2019

WIT Transactions on Ecology and the Environment

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Wheezing is a common symptom in childhood and has been associated with air pollution. Children spend a large part of their time in school, this being the most important indoor environment apart from home. However, studies on the impact of children's indoor air pollution exposure at schools on respiratory health are scarce. Thus, this study aimed to assess the impact of children's exposure to indoor air pollution in a total of five urban nursery and primary schools on active wheezing. Multivariate logistic regression models were used to estimate the associations, adjusted for sex, age group (pre-school/primary school) and parental history of asthma. A microenvironmental modelling approach was used to estimate indoor air pollution exposure to each of the pollutants exceeding legislation limit values (CO2, formaldehyde and PM2.5), as the sum of the product of time spent by the child in different indoor school microenvironments and the time-averaged concentration measured in each microenvironment. Measurements were performed in 11 classrooms, two bedrooms and two canteens in Porto, Portugal. A total of 164 completed parent-reported questionnaires derived from the International Study of Asthma and Allergies in Childhood allowed to identify active wheezing (at least one wheeze episode in the previous 12 months) in 16.5% of the studied children. Although not statistically significant, the studied children's exposure to indoor air pollution in nursery and primary schools seemed to be associated with an increase in the odds of having active wheezing especially for PM2.5 (OR = 1.57, p-value = 0.675). These results highlight the importance of applying indoor air pollution mitigation measures in nursery and primary schools. The impacts of those measures, on both indoor air quality and children's respiratory health, should be evaluated in future studies.

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Section: Study Site and Populationcontrasting

confidence: 71%

“…Existing literature focused on the association between children's exposure to indoor air pollutants and respiratory health is also limited, and mostly focusing on asthma, thus neglecting childhood wheezing although it is more common and easier to diagnose [8]- [13].…”

Section: Introductionmentioning

confidence: 99%

Children’s Exposure to Indoor Air in Schools: Impact on Wheezing

Sá

Branco

Alvim-Ferraz

et al. 2019

WIT Transactions on Ecology and the Environment

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“…The high rates of severe symptoms seen in low-income countries are concerning, and likely reflect multiple challenges within healthcare systems, which are better equipped to manage acute episodes relating to infectious diseases, rather than chronic non-communicable conditions. In keeping with this, recent research from Nigeria and South Africa has reported high rates of under-diagnosed and untreated asthma in schoolchildren 35 36…”

Section: Discussionmentioning

confidence: 75%

Lung health and exposure to air pollution in Malawian children (CAPS): a cross-sectional study

Rylance

Nightingale

Naunje

et al. 2019

Thorax

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BackgroundNon-communicable lung disease and exposure to air pollution are major problems in sub-Saharan Africa. A high burden of chronic respiratory symptoms, spirometric abnormalities and air pollution exposures has been found in Malawian adults; whether the same would be true in children is unknown.MethodsThis cross-sectional study of children aged 6–8 years, in rural Malawi, included households from communities participating in the Cooking and Pneumonia Study (CAPS), a trial of cleaner-burning biomass-fuelled cookstoves. We assessed; chronic respiratory symptoms, anthropometry, spirometric abnormalities (using Global Lung Initiative equations) and personal carbon monoxide (CO) exposure. Prevalence estimates were calculated, and multivariable analyses were done.ResultsWe recruited 804 children (mean age 7.1 years, 51.9% female), including 476 (260 intervention; 216 control) from CAPS households. Chronic respiratory symptoms (mainly cough (8.0%) and wheeze (7.1%)) were reported by 16.6% of children. Average height-for-age and weight-for-age z-scores were −1.04 and −1.10, respectively. Spirometric abnormalities (7.1% low forced vital capacity (FVC); 6.3% obstruction) were seen in 13.0% of children. Maximum CO exposure and carboxyhaemoglobin levels (COHb) exceeded WHO guidelines in 50.1% and 68.5% of children, respectively. Children from CAPS intervention households had lower COHb (median 3.50% vs 4.85%, p=0.006) and higher FVC z-scores (−0.22 vs −0.44, p=0.05) than controls.ConclusionThe substantial burden of chronic respiratory symptoms, abnormal spirometry and air pollution exposures in children in rural Malawi is concerning; effective prevention and control strategies are needed. Our finding of potential benefit in CAPS intervention households calls for further research into clean-air interventions to maximise healthy lung development in children.

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“…Indoor or household air pollution is the result of the use of alternate and polluting fuels as a source of household energy for cooking and heating [ 14 ]. These include solid, biomass and fossil fuels [ 15 , 16 ] as well as kerosene (paraffin) [ 17 , 18 ]. Incomplete combustion often combined with inadequate ventilation of these polluting substances results in a large number of chemical compounds such as particulate matter (PM), sulphur dioxide, nitrogen dioxide, carbon monoxide (CO) and volatile organic compounds that are then inhaled [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Lung Health in Children in Sub-Saharan Africa: Addressing the Need for Cleaner Air

Masekela

Vanker

2020

IJERPH

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Air pollution is increasingly recognized as a global health emergency with its impacts being wide ranging, more so for low- and middle-income countries where both indoor and outdoor pollution levels are high. In Africa, more than 80% of children live in households which use unclean sources of energy. The effects of both indoor and outdoor pollution on lung health on children who are the most vulnerable to their effects range from acute lower respiratory tract infections to long-term chronic health effects. We reviewed the literature on the effects of air pollution in children in Sub-Saharan Africa from prenatal exposure, infancy and school-going children. Data from Sub-Saharan Africa on quantification of exposures both indoor and outdoor mainly utilizes modelling or self-reporting. Exposures to biomass not only increases the risk of acute respiratory tract infections in young children but also increases the risk of carriage of pathogenic bacteria in the upper respiratory tract. Although there is limited evidence of association between asthma and pollution in African children, airway hyper-responsiveness and lower lung function has been demonstrated in children with higher risk of exposure. Interventions at a policy level to both quantify the exposure levels at a population level are urgently needed to address the possible interventions to limit exposure and improve lung health in children in Sub-Saharan Africa.

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Asthma‐related outcomes associated with indoor air pollutants among schoolchildren from four informal settlements in two municipalities in the Western Cape Province of South Africa

Cited by 24 publications

References 50 publications

Children’s Exposure to Indoor Air in Schools: Impact on Wheezing

Children’s Exposure to Indoor Air in Schools: Impact on Wheezing

Lung health and exposure to air pollution in Malawian children (CAPS): a cross-sectional study

Lung Health in Children in Sub-Saharan Africa: Addressing the Need for Cleaner Air

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