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Zhang, X., Norbäck, D., Fan, Q., Bai, X., Li, T., Zhang, Y., . . . Wang, J. (2019). Dampness and mold in homes across China: Associations with rhinitis, ocular, throat and dermal symptoms, headache and fatigue among adults. Indoor Air, 29(1), 30-42
Open this publication in new window or tab >>Dampness and mold in homes across China: Associations with rhinitis, ocular, throat and dermal symptoms, headache and fatigue among adults
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2019 (English)In: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 29, no 1, p. 30-42Article in journal (Refereed) Published
Abstract [en]

We studied dampness and mold in China in relation to rhinitis, ocular, throat and dermal symptoms, headache and fatigue. A questionnaire study was performed in six cities including 36 541 randomized parents of young children. Seven self-reported signs of dampness were evaluated. Multilevel logistic regression models were used to calculate odds ratios (ORs). Totally, 3.1% had weekly rhinitis, 2.8% eye, 4.1% throat and 4.8% skin symptoms, 3.0% headache and 13.9% fatigue. Overall, 6.3% of the homes had mold, 11.1% damp stains, 35.3% damp bed clothing, 12.8% water damage, 45.4% window pane condensation, 11.1% mold odor, and 37.5% humid air. All dampness signs were associated with symptoms (ORs from 1.2 to 4.6; P < 0.001), including rhinitis (ORs from 1.4 to 3.2; P < 0.001), and ORs increased by number of dampness signs. The strongest associations were for mold odor (ORs from 2.3 to 4.6) and humid air (ORs from 2.8 to 4.8). Associations were stronger among men and stronger in Beijing as compared to south China. In conclusion, dampness and mold are common in Chinese homes and associated with rhinitis and ocular, throat and dermal symptoms, headache and fatigue. Men can be more sensitive to dampness and health effects of dampness can be stronger in northern China.

Place, publisher, year, edition, pages
WILEY, 2019
Keywords
dampness, home environment, mold odor, rhinitis, sick building syndrome, water damage
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:uu:diva-372871 (URN)10.1111/ina.12517 (DOI)000453742000004 ()30379348 (PubMedID)
Funder
Swedish Research Council Formas, 348-2011-7402
Note

De två första författarna delar förstaförfattarskapet.

Available from: 2019-01-10 Created: 2019-01-10 Last updated: 2019-01-10Bibliographically approved
Liu, W., Huang, C., Li, B., Zhao, Z., Yang, X., Deng, Q., . . . Zhang, Y. (2019). Household renovation before and during pregnancy in relation to preterm birth and low birthweight in China. Indoor Air, 29(2), 202-214
Open this publication in new window or tab >>Household renovation before and during pregnancy in relation to preterm birth and low birthweight in China
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2019 (English)In: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 29, no 2, p. 202-214Article in journal (Refereed) Published
Abstract [en]

From October 2010 to April 2012, we conducted a cross-sectional study of associations between household environments and childhood health among preschool children in eight Chinese cities. Here, we analyze associations of early household renovation with preterm birth (PTB), low birthweight (LBW), term low birthweight (Term-LBW), and small for gestational age (SGA). Parents responded to questions about household renovation and their children's gestational age and birthweight. In the multivariate logistic regression analyses, household renovation in the year before pregnancy was significantly associated with LBW (sample size: N = 25 813; adjusted odds ratio (OR) with 95% confidence intervals (CIs): 1.23, 1.01-1.50) and Term-LBW (N = 24 823; 1.29, 1.01-1.67). Household renovation during pregnancy was significantly associated with PTB (N = 25 202; 1.28, 1.01-1.69). These significant associations were also found in the two-level (city-child) logistic regression analyses and in the sensitivity analyses among 21 009 children with complete data in all studied variates. Stronger associations were found in certain subgroups. Our findings indicate that household renovation within one year before pregnancy might be a risk factor for LBW and Term-LBW, while household renovation during pregnancy could be a risk factor for PTB.

Place, publisher, year, edition, pages
WILEY, 2019
Keywords
China, home renovation, low birthweight, prenatal exposure, preterm birth
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-379573 (URN)10.1111/ina.12534 (DOI)000459637200005 ()30597644 (PubMedID)
Available from: 2019-04-11 Created: 2019-04-11 Last updated: 2019-04-11Bibliographically approved
Norbäck, D., Lu, C., Zhang, Y., Li, B., Zhao, Z., Huang, C., . . . Deng, Q. (2019). Onset and remission of childhood wheeze and rhinitis across China: Associations with early life indoor and outdoor air pollution. Environment International, 123, 61-69
Open this publication in new window or tab >>Onset and remission of childhood wheeze and rhinitis across China: Associations with early life indoor and outdoor air pollution
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2019 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 123, p. 61-69Article in journal (Refereed) Published
Abstract [en]

Objective: Few longitudinal studies exist on childhood exposure to indoor and outdoor air pollution and respiratory illness in China. We studied associations between indoor and outdoor environment and prevalence, onset and remission of wheeze and rhinitis among children across China.

Methods: Children (3-6 y) were recruited from randomized day care centres in six cities. The main data analysis was restricted to children not moving since birth (N = 17,679). Data on wheeze, rhinitis and the home environment were assessed by a parental questionnaire. Prevalence in the first two years of life (baseline) and the last year (follow-up) was used to calculate onset and remission. Outdoor PM2.5, PM10, and NO2 at the day care centre were modelled from monitoring station data. Associations were calculated by multilevel logistic regression.

Results: Prenatal NO2 was associated with decreased remission of wheeze and increased prevalence and increased onset of rhinitis. Prenatal PM2.5 was associated with increased prevalence of wheeze. Postnatal NO2 and postnatal PM10 were associated with increased prevalence and lower remission of wheeze and rhinitis. Mould, window pane condensation, renovation and cockroaches at home were associated with increased prevalence and increased onset of wheeze and rhinitis. Gas cooking was associated with increased onset of rhinitis. Children of mothers with industrial work had more wheeze.

Conclusions: Outdoor PM2.5, PM10 and NO2 can increase childhood wheeze and rhinitis. Dampness and mould can increase onset and decrease remission. Crowdedness, cockroaches at home and emissions from new building materials and gas cooking can be risk factors for wheeze and rhinitis.

Keywords
Asthma, Rhinitis, Dampness, PM2.5, Traffic-related air pollution (TRAP), Renovation
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:uu:diva-375805 (URN)10.1016/j.envint.2018.11.033 (DOI)000455532500008 ()30496983 (PubMedID)
Funder
Swedish Research Council
Note

De 2 första författarna delar förstaförfattarskapet.

Available from: 2019-02-13 Created: 2019-02-13 Last updated: 2019-02-13Bibliographically approved
Norbäck, D., Lu, C., Zhang, Y., Li, B., Zhao, Z., Huang, C., . . . Deng, Q. (2019). Sources of indoor particulate matter (PM) and outdoor air pollution in China in relation to asthma, wheeze, rhinitis and eczema among pre-school children: Synergistic effects between antibiotics use and PM10 and second hand smoke. Environment International, 125, 252-260
Open this publication in new window or tab >>Sources of indoor particulate matter (PM) and outdoor air pollution in China in relation to asthma, wheeze, rhinitis and eczema among pre-school children: Synergistic effects between antibiotics use and PM10 and second hand smoke
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2019 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 125, p. 252-260Article in journal (Refereed) Published
Abstract [en]

We studied indoor sources of indoor particulate matter (PM), outdoor air pollution and antibiotic use in relation to asthma, rhinitis and eczema among pre-school children and investigated synergistic effects between PM and antibiotics use. Children (3-6y) from randomly selected day care centres in seven cities across China were included (n = 39,782). Data on ambient temperature and air pollution were collected from local monitoring stations. Data on indoor PM sources (ETS, burning of incense or mosquito coils and biomass for cooking), antibiotics use and health (doctor diagnosed asthma and rhinitis, lifetime eczema, current wheeze and current rhinitis) were assessed by a parental questionnaire. Associations were calculated by multilevel logistic regression. Asthma diagnosis was associated with outdoor temperature, NO2 and burning mosquito coils. Rhinitis diagnosis was associated with NO2, ETS, gas cooking and burning biomass for cooking. Lifetime eczema was associated with temperature, PM10, NO2, ETS, biomass cooking and burning mosquito coils. Burning incense was associated with current wheeze and current rhinitis. Children using antibiotics had more asthma, wheeze, rhinitis, and eczema. Excluding children with respiratory infections did not change associations with antibiotics use. Antibiotics use enhanced the effects of ETS and PM10 (a synergistic effect). In conclusion, a warmer climate, outdoor NO2 and PM10, ETS, gas cooking and burning biomass, incense and mosquito coils can increase the risk of asthma, wheeze, rhinitis and eczema among pre-school children in China. Antibiotics use is a risk factor for childhood asthma, wheeze, rhinitis and eczema and ETS and outdoor PM10 can enhance the effect.

National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-379020 (URN)10.1016/j.envint.2019.01.036 (DOI)000459005200027 ()30731375 (PubMedID)
Funder
Swedish Research Council, 2017-05845
Note

De 2 första författarna delar förstaförfattarskapet.

Available from: 2019-03-12 Created: 2019-03-12 Last updated: 2019-03-12Bibliographically approved
Zheng, X., Zhang, W., Lu, C., Norbäck, D. & Deng, Q. (2018). An epidemiological assessment of the effect of ambient temperature on the incidence of preterm births: Identifying windows of susceptibility during pregnancy. Journal of Thermal Biology, 74, 201-207
Open this publication in new window or tab >>An epidemiological assessment of the effect of ambient temperature on the incidence of preterm births: Identifying windows of susceptibility during pregnancy
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2018 (English)In: Journal of Thermal Biology, ISSN 0306-4565, E-ISSN 1879-0992, Vol. 74, p. 201-207Article in journal (Refereed) Published
Abstract [en]

It is well known that exposure to thermal stress during pregnancy can lead to an increased incidence of premature births. However, there is little known regarding window(s) of susceptibility during the course of a pregnancy. We attempted to identify possible windows of susceptibility in a cohort study of 3604 children in Changsha with a hot-summer and cold winter climatic characteristics. We examined the association between PTB and ambient temperature during different timing windows of pregnancy: conception month, three trimesters, birth month and entire pregnancy. We found a U-shaped relation between the prevalence of PTB and mean ambient temperature during pregnancy. Both high and low temperatures were associated with PTB risk, adjusted OR (95% CI) respectively 2.57 (1.98–3.33) and 2.39 (1.93–2.95) for 0.5 °C increase in high temperature range (>18.2°C) and 0.5°C decrease in low temperature range (< 18.2°C). Specifically, PTB was significantly associated with ambient temperature and extreme heat/cold days during conception month and the third trimester. Sensitivity analysis indicated that female fetus were more susceptible to the risk of ambient temperature. Our study indicates that the risk of preterm birth due to high or low temperature may exist early during the conception month.

Keywords
Preterm birth, Pregnancy, Ambient temperature, Cohort study, Extreme heat or cold days, Conception month
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-358202 (URN)10.1016/j.jtherbio.2018.04.001 (DOI)000436526200027 ()29801628 (PubMedID)
Available from: 2018-08-31 Created: 2018-08-31 Last updated: 2018-08-31Bibliographically approved
Norbäck, D., Lu, C., Wang, J., Zhang, Y., Li, B., Zhao, Z., . . . Deng, Q. (2018). Asthma and rhinitis among Chinese children - Indoor and outdoor air pollution and indicators of socioeconomic status (SES). Environment International, 115, 1-8
Open this publication in new window or tab >>Asthma and rhinitis among Chinese children - Indoor and outdoor air pollution and indicators of socioeconomic status (SES)
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2018 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 115, p. 1-8Article in journal (Refereed) Published
Abstract [en]

Background: Few data exist on asthma and rhinitis across China in relation to indoor and outdoor air pollution, climate and socioeconomic factors. The main aim was to study associations between asthma, rhinitis and current respiratory symptoms among pre-school children across China and selected indoor and outdoor exposure and indicators of socio-economic status (SES) in mutually adjusted models.

Methods: Chinese children (3-6 yr.) (n = 39,782) were recruited from randomly selected day care centres in seven cities in China. Data on asthma, respiratory symptoms, rhinitis, indoor and outdoor exposure at home and SES were assessed by a parentally administered questionnaire. Lifetime mean ambient temperature, PM10, NO2, and GDP per capita on city level were calculated.

Results: Totally 7.4% had ever doctors' diagnosed (DD) asthma and 8.7% DD-rhinitis, 19.7% had current wheeze, 45.0% rhinitis and 16.9% cough. DD-asthma was associated with ambient temperature (OR = 1.15, 95% CI 1.11-1.20 per degrees C), NO2 (OR = 1.16, 95% CI 1.02-1.33 per 10 mu g/m(3)), indoor mould/dampness (OR = 1.25, 95% CI 1.13-1.39) and living near major roads (OR = 1.13, 95% CI 1.02-1.25). DD-rhinitis was associated with ambient temperature (OR= 1.07, 95% CI 1.05-1.10 per degrees C), NO2 (OR= 1.20, 95% CI 1.09-1.32 per 10 mu g/m(3)), GDP (OR= 1.03, 95% CI 1.01-1.06 per 10,000 RenMinBi/year), indoor mould/dampness (OR= 1.23, 95% CI 1.11-1.35), passive smoking (OR= 1.11, 95% CI 1.01-1.21), and living near major roads (OR= 1.14, 95% CI 1.03-1.25). Children in suburban or rural areas, in larger families (>= 5 persons) and with prenatal farm exposure had less DD-asthma and DD-rhinitis.

Conclusions: Economic development level of the city, higher SES, ambient temperature, NO2, PM10, traffic air pollution and mould/dampness can be risk factors for asthma and rhinitis and respiratory symptoms among preschool children in China. Breastfeeding, large family size and early-life farm exposure could be protective factors.

Place, publisher, year, edition, pages
PERGAMON-ELSEVIER SCIENCE LTD, 2018
National Category
Respiratory Medicine and Allergy Occupational Health and Environmental Health
Identifiers
urn:nbn:se:uu:diva-356620 (URN)10.1016/j.envint.2018.02.023 (DOI)000432523500001 ()29529393 (PubMedID)
Available from: 2018-08-20 Created: 2018-08-20 Last updated: 2018-08-20Bibliographically approved
Svanes, Ø., Bertelsen, R. J., Lygre, S. H. L., Carsin, A. E., Anto, J. M., Forsberg, B., . . . Svanes, C. (2018). Cleaning at Home and at Work in Relation to Lung Function Decline and Airway Obstruction. American Journal of Respiratory and Critical Care Medicine, 197(9), 1157-1163
Open this publication in new window or tab >>Cleaning at Home and at Work in Relation to Lung Function Decline and Airway Obstruction
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2018 (English)In: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 197, no 9, p. 1157-1163Article in journal (Refereed) Published
Abstract [en]

Rationale: Cleaning tasks may imply exposure to chemical agents with potential harmful effects to the respiratory system, and increased risk of asthma and respiratory symptoms among professional cleaners and in persons cleaning at home has been reported. Long-term consequences of cleaning agents on respiratory health are, however, not well described.

Objectives: This study aimed to investigate long-term effects of occupational cleaning and cleaning at home on lung function decline and airway obstruction.

Methods: The European Community Respiratory Health Survey (ECRHS) investigated a multicenter population-based cohort at three time points over 20 years. A total of 6,235 participants with at least one lung function measurement from 22 study centers, who in ECRHS II responded to questionnaire modules concerning cleaning activities between ECRHS I and ECRHS II, were included. The data were analyzed with mixed linear models adjusting for potential confounders.

Measurements and Main Results: As compared with women not engaged in cleaning (ΔFEV1 = −18.5 ml/yr), FEV1 declined more rapidly in women responsible for cleaning at home (−22.1; P = 0.01) and occupational cleaners (−22.4; P = 0.03). The same was found for decline in FVC (ΔFVC = −8.8 ml/yr; −13.1, P = 0.02; and −15.9, P = 0.002; respectively). Both cleaning sprays and other cleaning agents were associated with accelerated FEV1 decline (−22.0, P = 0.04; and −22.9, P = 0.004; respectively). Cleaning was not significantly associated with lung function decline in men or with FEV1/FVC decline or airway obstruction.

Conclusions: Women cleaning at home or working as occupational cleaners had accelerated decline in lung function, suggesting that exposures related to cleaning activities may constitute a risk to long-term respiratory health.

Keywords
occupational medicine, spirometry, lung diseases
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-356082 (URN)10.1164/rccm.201706-1311OC (DOI)000431196700015 ()29451393 (PubMedID)
Funder
EU, Horizon 2020, 633212
Available from: 2018-07-13 Created: 2018-07-13 Last updated: 2018-07-13Bibliographically approved
Erbas, B., Knudsen, T. M., Janson, C., Nilsen, R. M., Accordini, S., Benediktdottir, B., . . . Svanes, C. (2018). Critical age windows in the impact of lifetime smoking exposure on respiratory symptoms and disease among ever smokers. Environmental Research, 164, 241-247
Open this publication in new window or tab >>Critical age windows in the impact of lifetime smoking exposure on respiratory symptoms and disease among ever smokers
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2018 (English)In: Environmental Research, ISSN 0013-9351, E-ISSN 1096-0953, Vol. 164, p. 241-247Article in journal (Refereed) Published
Abstract [en]

Background: Despite extensive knowledge of smoking effects on respiratory disease, there is no study including all age windows of exposure among ever smokers. The objective of this study was to assess the effects from smoking exposure in utero, early childhood, adolescence and adulthood on respiratory health outcomes in adult male and female ever smokers. Methods: Respiratory health outcomes were assessed in 10,610 participants of the European Community Respiratory Health Survey (ECRHS) I who reported a history of ever smoking by questionnaire. The associations of maternal smoking in utero, maternal smoking during childhood, age of smoking debut and pack-years of smoking with respiratory symptoms, obstructive diseases and bronchial hyperreactivity were analysed using generalized linear regression, non-linearity between age of smoking debut and outcomes were assessed by Generalized additive mixed models. Results: Respiratory symptoms and asthma were more frequent in adults if their mother smoked during pregnancy, and, in men, also if mother smoked in childhood. Wheeze and >= 3 respiratory symptoms declined with later smoking debut among women [<= 10 years: OR = 3.51, 95% CI 1.26, 9.73; 11-12 years: 1.57[1.01-2.44]; 13-15 years: 1.11[0.94-1.32] and <= 10 years: 3.74[1.56-8.83]; 11-12 years: 1.76[1.19-2.56]; 13-15 years: 1.12[0.94-1.35], respectively]. Effects of increasing number of packyears were pronounced in women (Chronic Obstructive Pulmonary Disease (COPD): OR/10 packyears women: 1.33 [1.18, 1.50], men: 1.14 [1.04, 1.26] P-interaction = 0.01). Conclusions: Among ever smokers, smoking exposure in each stage of the lifespan show persistent harmful effects for adult respiratory health, while women appeared to be more vulnerable to an early age of smoking debut and amount of smoking in adulthood.

Place, publisher, year, edition, pages
ACADEMIC PRESS INC ELSEVIER SCIENCE, 2018
Keywords
Cigarette smoking, Lung function, Asthma, Respiratory symptoms, ECRHS
National Category
Respiratory Medicine and Allergy Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-356376 (URN)10.1016/j.envres.2018.02.028 (DOI)000431387100031 ()29522998 (PubMedID)
Available from: 2018-08-15 Created: 2018-08-15 Last updated: 2018-08-15Bibliographically approved
Norbäck, D., Lu, C., Wang, J., Zhang, Y., Li, B., Zhao, Z., . . . Deng, Q. (2018). Doctor diagnosed asthma and wheeze among Chinese pre-school children in relation to indoor and outdoor air pollution and urbanization. Paper presented at 28th International Congress of the European-Respiratory-Society (ERS), SEP 15-19, 2018, Paris, FRANCE. European Respiratory Journal, 52
Open this publication in new window or tab >>Doctor diagnosed asthma and wheeze among Chinese pre-school children in relation to indoor and outdoor air pollution and urbanization
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2018 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 52Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
EUROPEAN RESPIRATORY SOC JOURNALS LTD, 2018
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-376278 (URN)10.1183/13993003.congress-2018.PA5065 (DOI)000455567107010 ()
Conference
28th International Congress of the European-Respiratory-Society (ERS), SEP 15-19, 2018, Paris, FRANCE
Note

Supplement: 62

Meeting Abstract: PA5065

Available from: 2019-02-04 Created: 2019-02-04 Last updated: 2019-02-04Bibliographically approved
Shi, W., Liu, C., Norbäck, D., Deng, Q., Huang, C., Qian, H., . . . Zhao, Z. (2018). Effects of fine particulate matter and its constituents on childhood pneumonia: a cross-sectional study in six Chinese cities. Paper presented at Lancet-CAMS Health Summit, OCT 27-28, 2018, Beijing, China. The Lancet, 392, 79-79
Open this publication in new window or tab >>Effects of fine particulate matter and its constituents on childhood pneumonia: a cross-sectional study in six Chinese cities
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2018 (English)In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 392, p. 79-79Article in journal, Meeting abstract (Other academic) Published
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-373083 (URN)000452900100080 ()
Conference
Lancet-CAMS Health Summit, OCT 27-28, 2018, Beijing, China
Available from: 2019-01-11 Created: 2019-01-11 Last updated: 2019-01-11Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-5174-6668

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