Effect of indoor air quality of day care centers in children with different predisposition for asthma

Abstract

To cite this article: Carreiro-Martins P, Papoila AL, Caires I, Azevedo S, Cano MM, Virella D, Leiria-Pinto P, Teixeira JP, Rosado-Pinto J, Annesi-Maesano I, Neuparth N.Effect of indoor air quality of day care centers in children with different predisposition for asthma. Abstract Background: Scarce information is available about the relationships between indoor air quality (IAQ) at day care centers (DCC), the estimated predisposition for asthma, and the actual wheezing susceptibility. Methods: In the Phase II of ENVIRH study, 19 DCC were recruited after cluster analysis. Children were evaluated firstly using the ISAAC questionnaire and later by a follow-up questionnaire about recent wheezing. A positive asthma predictive index (API) was considered as predisposition for asthma. Every DCC was audited for IAQ and monitored for chemical and biologic contaminants. Results: We included 1191 children, with a median age of 43 (P 25 -P 75 : 25-58) months. Considering the overall sample, in the first questionnaire, associations were found between CO 2 concentration (increments of 200 ppm) and diagnosis of asthma (OR: 1.10; 95% CI: 1.00-1.20). Each increment of 100 lg/m 3 of total volatile organic

Indoor allergen exposure and asthma outcomes

“…Permaul et al [16] noted mouse allergen to be present in high levels in inner-city schools due to infestation within the schools and not passive transfer from students’ homes [22]. For younger children, exposure to dust mites and molds in day care centers was associated with wheezing [23]. Likewise, researchers in Denmark found that high classroom dampness was associated with increased wheezing and decreased spirometry in exposed students [24].…”

Evaluation of Low-Cost Mitigation Measures Implemented to Improve Air Quality in Nursery and Primary Schools

“…In order to improve IAQ, several IAP mitigation measures were identified, based on the literature [8,12,18,19,20,21,22,23,24,25,26,27,28,29,30,31,38,39] and grouped hierarchically in 5 different types, from the less to the most expensive and complex: Type I—raising awareness; Type II—behavioural changes; Type III—changes in products/materials and places of activities; Type IV—technical and technological changes; Type V—structural changes. Detailed description of those measures can be consulted in Table S1 (Supplementary Materials).…”

“…Among indoor environments, nursery and primary schools need a special attention because children spend more time there than in any other indoor environment besides home. Moreover, several studies have recognized a relationship between indoor air quality (IAQ) and adverse health effects on children, namely respiratory illness and poor cognitive performance [5,7,8,9,10,11,12,13]. …”

“…After observing high concentrations of indoor air pollutants, mainly particulate matter (PM), carbon dioxide (CO 2 ) and volatile organic compounds (VOC), several studies concluded that there is a pressing need to implement strategies to improve IAQ, through the implementation of measures to mitigate indoor air pollution (IAP): (i) the change of some behavioural habits, promoting efficient ventilation [8,12,18,19,20,21,22,23,24,25,26,27,28,29,30,31]; (ii) the improvement of cleaning actions [19,21,22,23,27,29,31,32,33]; (iii) the replacement of carpets and carpeted floors by smooth panels [27,33]; (iv) the adequacy of occupational density and promotion of more class breaks and outdoor activities [12,27,32]; and (v) structural measures such as the installation of air purifiers [33], the replacement of building materials, furniture and windows [25,34] and the replacement of the heating system [26]. …”

On early metabolite exposure influencing asthma outcome, the risk of hymenoptera allergy in a birth cohort, and improvement of food allergy management at school

“…The authors found an association between phthalate exposure and probable asthma, opening more research opportunities notably in defining the role of metabolite exposure on development of sensitization as well as allergic asthma. A study published earlier in PAI had also highlighted the influence of metabolic compounds on asthma, and it has been shown that metabolic compounds are only one part of a much more larger set of environmental exposures with a possible influence on respiratory health . Asthma is a complex disease, with its pathogenesis being largely influenced by environmental exposure before birth, as well as at various ages in childhood .…”