Childhood Acute Respiratory Infections and Household Environment in an Eastern Indonesian Urban Setting

Abstract

This pilot study evaluated the potential effect of household environmental factors such as income, maternal characteristics, and indoor air pollution on children’s respiratory status in an Eastern Indonesian community. Household data were collected from cross-sectional (n = 461 participants) and preliminary childhood case-control surveys (pneumonia cases = 31 diagnosed within three months at a local health clinic; controls = 30). Particulate matter (PM2.5 and PM10) was measured in living rooms, kitchens, children’s bedrooms, and outside areas in close proximity once during the case-control household interviews (55 homes) and once per hour from 6 a.m. to midnight in 11 homes. The household survey showed that children were 1.98 times (p = 0.02) more likely to have coughing symptoms indicating respiratory infection, if mothers were not the primary caregivers. More children exhibited coughing if they were not exclusively breastfed (OR = 2.18; p = 0.06) or there was a possibility that their mothers were exposed to environmental tobacco smoke during pregnancy (OR = 2.05; p = 0.08). This study suggests that household incomes and mother’s education have an indirect effect on childhood pneumonia and respiratory illness. The concentrations of PM2.5 and PM10 ranged from 0.5 to 35.7 µg/m3 and 7.7 to 575.7 µg/m3, respectively, based on grab samples. PM was significantly different between the case and control groups (p < 0.01). The study also suggests that ambient air may dilute indoor pollution, but also introduces pollution into the home from the community environment. Effective intervention programs need to be developed that consider multiple direct and indirect risk factors to protect children.

The association between environmental tobacco smoke exposure and childhood respiratory disease: a review

“…A high incidence of pneumonia (0.27 episodes per child-year (95% CI 0.23–0.32)) was reported in infants in the Drakenstein Child Health study, an African birth cohort study; maternal smoking was strongly associated with pneumonia (OR 2.36, 95% CI 1.45–3.82) [39]. Studies from Nepal and Indonesia confirm a similar risk [40,41], and in a large questionnaire-based study from Taiwan, prenatal ETS exposure or maternal smoking were significant risk factors for infantile pneumonia [42]. A Vietnamese study of almost 25,000 children less than 5 years of age found that household ETS exposure to be independently associated with hospitalization for pneumonia (adjusted OR 1.55, 95% CI 1.25–1.92) [43].…”

Open Burning of Household Solid Waste and Child Respiratory Health: Evidence From Indonesia

“…Furthermore, burning household solid waste emanates many harmful particulates which pollutes the air (Gullett et al, 2010;Hoornweg, D., & Bhada-Tata, 2012;Li, Lei, Bei, & Molina, 2012;Ochoa et al, 2012;Vergara & Tchobanoglous, 2012). Many studies have shown evidence on the deleterious health effects of the pollution emanated from burning solid waste on morbidity and mortality (Burnley, 2014;Kodros, Wiedinmyer, Ford, Cucinotta, & Gan, 2016;Lelieveld, Evans, Fnais, Giannadaki, & Pozzer, 2015;Schwartz, Bind, & Koutrakis, 2017;Shibata, Wilson, Watson, Leduc, & Meng, 2014).…”

“…Moreover, the scale of the health effects of burning household solid waste in the open could be massive given the fact that Indonesia is the fourth most populated country in the world, with population over 255 million in 2015 based on the latest Intercensal Population Census (Badan Pusat Statistik, 2016) What is worrying is that exposure to particulate matter (PM), one of the pollutants resulted from burning solid waste, adversely affect the respiratory health of children (Shibata et al, 2014). Given the issues above, it is interesting and imperative to know whether exposure to pollution from burning household solid waste in the open affect respiratory health of children.…”

The impact of airborne particulate matter on pediatric hospital admissions for pneumonia among children in Jinan, China: A case-crossover study

“…Globally, pneumonia accounts for 15% of all deaths in children less than 5 years of age and was the largest infectious cause of death in children in 2015 (Shibata et al, 2014). Many studies have demonstrated associations between selected air pollutants and adverse health effects in children in the aspects of childhood hospital admissions (Barnett et al, 2005), school absences (Hales et al, 2016), physician visits for upper and lower respiratory illness (Aguilera et al, 2005), and deficits in lung function growth rates (den Dekker et al, 2016).…”