Household environmental factors and children’s respiratory health: comparison of two cross-sectional studies over 25 years in Wuhan, China

Abstract

Background: Over the recent decades, residential lifestyle and household environment have changed substantially with rapid development of industrialization and urbanization in China. Whether the prevalence of respiratory diseases changed is still lack of evidence. The objective of this study is to assess potential changes in children's respiratory disease prevalence and associated household environmental factors in Wuhan over a 25-year time interval. Methods: Two cross-sectional studies in the Period 1 (1993 to 1996) and Period 2 (2017 to 2018) were compared in this research. Elementary school children in period 1 (N=2,517) and in period 2 (N=3,152) were recruited in Wuhan, China. The respiratory health condition, home environmental factors, and family socioeconomic status of each subject were acquired through questionnaire survey using the same protocols in both periods. We used the Chi-square test to analyze the difference of household environmental factors (focused on three indoor air quality determinants) and children's respiratory health condition between two periods. Logistic regression models were used to assess the impacts of household environmental determinants on children's respiratory diseases and symptoms between the two studies, by adjusting a set of covariates. Results: The three indoor air quality determinants have reduced substantially in prevalence from period 1 to period 2: environment tobacco smoke (ETS) from 86.6% to 45.9%, household coal use from 47.6% to 4.9%, and kitchen smoke from 58.9% to 7.3%. The prevalence of certain respiratory symptoms in children significantly decreased, such as cough with colds (51.1% to 41.6%) and phlegm with colds (22.3% to 17.7%). The prevalence of asthma was 2.5% and 2.4% and that of bronchitis was 27.1% and 29.8% in both periods. Coal use was a risk factor for asthma in period 1 (OR =2.34, 95% CI: 1.30-4.23), while it was not significantly associated with prevalence of asthma in period 2 (OR =0.60, 95% CI: 0.08-4.51).Conclusions: Household indoor air quality determinants and respiratory health condition of children in Wuhan has been improved over the last 25 years. At present, kitchen smoke is an important factor affecting the prevalence of wheeze whatever child has a cold or not and reducing exposure to ETS could be beneficial to protect children to be less likely to develop bronchitis.

COVID-19 Mitigation in a K-12 School Setting: A Case Study of <em>Avenues: The World School </em>in<em> </em>New York City

“…While individual measures cannot be disaggregated and examined for efficacy, the combination of measures implemented at Avenues NYC during the pandemic can be associated with reduced case COVID-19 prevalence at this school but cannot be causally linked. Additionally, ongoing research indicates that improvement of IAQ could benefit students not only during an active pandemic but also reduce illness incidences year-round 12 due to the association of indoor air pollutants with poorer respiratory health outcomes in children [30][31][32][33] . Moreover, the school demonstrated success in the essential step of ensuring that open lines of communication were maintained with the school community, particularly parents, ensuring long-term buy-in on and compliance with the school's policies.…”

Domestic Environmental Factors Associated with Pediatric Snoring: A Scoping Review Protocol

“…It aims to identify and analyze any gaps in knowledge that are significant for future research. This review serves as a necessary step before conducting a systematic review and clinical studies 14,15 .…”

Asthma and Other Respiratory Diseases of Children in Relation to Personal Behavior, Household, Parental and Environmental Factors in West China

“…It is reported that the prevalence of asthma in children increased from 0.91% in 1990 to 2.12% in 2010 [ 7 ]. However, a study conducted in Lanzhou, China, has reported that the prevalence of asthma decreased from 3.2% in 1994–1995 to 1.5% in 2018 [ 8 ]; a contemporary study conducted in Wuhan, China, has indicated that the prevalence of asthma was 2.5% and 2.4% and that of bronchitis was 27.1% and 29.8%, in 1994–1995 and 2018, respectively [ 9 ]. It seems currently difficult to assess accurate trends in the prevalence of respiratory diseases among children in China, due to a lack of comprehensive investigations or follow-up studies and insufficient evidence, especially in economically underdeveloped areas.…”

“…The combustion of solid fuels (biomass and coal) for heating and cooking is the main source of indoor air pollution in central countries [ 12 ]. Ambient air pollution [ 13 ], household molds [ 8 ] and indoor solid fuel burning [ 9 ] are evidenced as having negative impacts on asthma outcomes. Existing studies documented that the household dampness and mold occurred in 1/4 of children’s houses in southern China, and the presence of dampness and mold at home was associated with an increased risk of developing asthma (OR = 1.31, 95% CI: 1.08–1.59) in children [ 14 , 15 ].…”

“…To date, the studies on respiratory diseases and their influencing factors are mostly focused on western countries, as well as mainland China in areas with developed economies or large population [ 9 , 10 , 11 , 12 , 13 , 14 , 15 ]; only a few studies have been conducted in areas that are economically underdeveloped or have a low population density [ 8 ]. This situation is neither conducive to rationally analyze the incidence of respiratory diseases nor beneficial to provide scientific evidence for reducing the risk of respiratory diseases.…”