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Wang, J., Zhao, Z., Zhang, Y., Li, B., Huang, C., Zhang, X., . . . Norbäck, D. (2019). Asthma, allergic rhinitis and eczema among parents of preschool children in relation to climate, and dampness and mold in dwellings in China. Environment International, 130, Article ID 104910.
Open this publication in new window or tab >>Asthma, allergic rhinitis and eczema among parents of preschool children in relation to climate, and dampness and mold in dwellings in China
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2019 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 130, article id 104910Article in journal (Refereed) Published
Abstract [en]

The main aim was to study associations between asthma, allergic rhinitis and eczema among adults across China and dampness and mold at home. Young adults (N = 40,279) in eight cities in China answered a questionnaire in 2010-2012 (response rate 75.0%). Data on asthma, allergic rhinitis, eczema and the home environment was assessed by the questionnaire. Climate data was obtained from China Meteorological Administration and the website of Weather Underground. Health associations were analyzed by two-level logistic regression models, adjusting for covariates. Totally 1.6% had asthma, 6.6% allergic rhinitis and 2.2% eczema. Mold odor was associated with asthma (OR = 1.90) and allergic rhinitis (OR = 1.25-1.44). Window pane condensation in winter was associated with asthma (OR = 1.39), allergic rhinitis (OR = 1.26-1.58) and eczema (OR = 1.36-1.77). Presence of mold spots or damp stains was related to asthma (OR = 1.58-2.49), allergic rhinitis (OR = 1.35-1.76) and eczema (OR = 1.47-1.70). Water damage was related to asthma (OR = 1.69-1.82), allergic rhinitis (OR = 1.40-1.45) and eczema (OR = 1.44-1.96). Damp bed clothing was related to asthma (OR = 1.23), allergic rhinitis (OR = 1.23) and eczema (OR = 1.35). A higher dampness score was associated with increased odds ratios for diseases. Those living in older buildings had more asthma (OR = 1.39-1.76) and allergic rhinitis (OR = 1.16-1.21). Those living in suburban or rural areas had less asthma, allergic rhinitis and eczema as compared to those living in urban areas (OR values from 0.24 to 0.66). Stronger health associations with dampness and mold were found in southern China and in newer buildings (constructed after 2005). In conclusion, dampness and mold at home can be risk factors for asthma, allergic rhinitis and eczema among adults in China. Living in older buildings can be risk factors for asthma or allergic rhinitis while living in less urbanized areas can be protective.

Place, publisher, year, edition, pages
PERGAMON-ELSEVIER SCIENCE LTD, 2019
Keywords
Asthma, Allergic rhinitis, Eczema, Dampness, Mold, Climate
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-392122 (URN)10.1016/j.envint.2019.104910 (DOI)000477934800019 ()31226554 (PubMedID)
Funder
Swedish Research Council, 2017-05845AFA Insurance, 467801100
Available from: 2019-09-03 Created: 2019-09-03 Last updated: 2019-09-03Bibliographically approved
Lu, C., Cao, L., Norbäck, D., Li, Y., Chen, J. & Deng, Q. (2019). Combined effects of traffic air pollution and home environmental factors on preterm birth in China. Ecotoxicology and Environmental Safety, 184, Article ID 109639.
Open this publication in new window or tab >>Combined effects of traffic air pollution and home environmental factors on preterm birth in China
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2019 (English)In: Ecotoxicology and Environmental Safety, ISSN 0147-6513, E-ISSN 1090-2414, Vol. 184, article id 109639Article in journal (Refereed) Published
Abstract [en]

Background: Although mounting evidence have linked traffic-related air pollution (TRAP) with increased risk of preterm birth (PTB), whether it can interact with indoor environmental factors remains unknown, and its window(s) susceptibility at the stage of gestation is unclear.

Objective: To explore PTB risk for prenatal exposure to traffic-related air pollution and home environmental factors during pregnancy, so as to identify critical window(s) in the combined effect of traffic air pollution and main home environmental factor(s) on PTB development.

Methods: A retrospective cohort study of 3,509 preschool children was performed in Changsha, China during 2011-2012. The PTB prevalence was reported by the parents based on a questionnaire. We estimated each mother's exposure to traffic-related air pollutant NO2 in different windows of gestation, including conception month, three trimesters, birth month, and whole gestation. Maternal exposure to home environmental factors was considered by renovation (new furniture/redecoration) in pregnancy, and mold/damp stains and window condensation during perinatal period. Associations of PTB with both ambient NO2 and home environmental factors, and their interactions on PTB were evaluated by logistic regression models using odds ratio (OR) with 95% confidence interval (CI).

Results: Traffic air pollutant NO2 exposure in utero was significantly associated with PTB, with adjusted odds ratio (OR) (95% CI) of 1.41 (1.00-1.98) for an IQR increase in NO2 exposure during whole pregnancy, particularly in the conception month and 1st trimester. We further found a positive relationship between perinatal exposure to mold/damp stains in the homes and PTB, OR (95% CI) = 1.73 (1.04-2.90). Especially, we detected a significant interaction between outdoor NO2 and indoor mold/damp stains on PTB risk. Male and female foetus were respectively more susceptible to perinatal mold/dampness at home and outdoor NO2 exposure in early gestation.

Conclusion: Our finding indicates that both outdoor traffic air pollutant and indoor mold/dampness play key roles in PTB development, and their interaction effect in early pregnancy significantly increases PTB risk.

Place, publisher, year, edition, pages
ACADEMIC PRESS INC ELSEVIER SCIENCE, 2019
Keywords
Preterm birth, Pregnancy, Traffic-related air pollution, Indoor environmental factors, Interaction effect, Cohort study
National Category
Obstetrics, Gynecology and Reproductive Medicine Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-396424 (URN)10.1016/j.ecoenv.2019.109639 (DOI)000489085200062 ()31525560 (PubMedID)
Available from: 2019-11-06 Created: 2019-11-06 Last updated: 2019-11-06Bibliographically approved
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
Wang, J., Pindus, M., Janson, C., Sigsgaard, T., Kim, J.-L., Holm, M., . . . Norbäck, D. (2019). Dampness, mould, onset and remission of adult respiratory symptoms, asthma and rhinitis. European Respiratory Journal, 53(5), Article ID 1801921.
Open this publication in new window or tab >>Dampness, mould, onset and remission of adult respiratory symptoms, asthma and rhinitis
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2019 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 53, no 5, article id 1801921Article in journal (Refereed) Published
Abstract [en]

Study question: Is dampness and indoor mould associated with onset and remission of respiratory symptoms, asthma and rhinitis among adults?

Materials and methods: Associations between dampness, mould and mould odour at home and at work and respiratory health were investigated in a cohort of 11 506 adults from Iceland, Norway, Sweden, Denmark and Estonia. They answered a questionnaire at baseline and 10 years later, with questions on respiratory health, home and work environment.

Results: Baseline water damage, floor dampness, mould and mould odour at home were associated with onset of respiratory symptoms and asthma (OR 1.23-2.24). Dampness at home during follow-up was associated with onset of respiratory symptoms, asthma and rhinitis (OR 1.21-1.52). Dampness at work during follow-up was associated with onset of respiratory symptoms, asthma and rhinitis (OR 1.31-1.50). Combined dampness at home and at work increased the risk of onset of respiratory symptoms and rhinitis. Dampness and mould at home and at work decreased remission of respiratory symptoms and rhinitis.

The answer to the question: Dampness and mould at home and at work can increase onset of respiratory symptoms, asthma and rhinitis, and decrease remission.

Place, publisher, year, edition, pages
EUROPEAN RESPIRATORY SOC JOURNALS LTD, 2019
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-387961 (URN)10.1183/13993003.01921-2018 (DOI)000470244000010 ()30880288 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and WelfareSwedish Heart Lung FoundationVårdal FoundationThe Research Council of Norway
Available from: 2019-06-27 Created: 2019-06-27 Last updated: 2019-06-27Bibliographically approved
Olivieri, M., Murgia, N., Carsin, A.-E., Heinrich, J., Benke, G., Bono, R., . . . Verlato, G. (2019). Effects of smoking bans on passive smoking exposure at work and at home: The European Community respiratory health survey. Indoor Air, 29(4), 670-679
Open this publication in new window or tab >>Effects of smoking bans on passive smoking exposure at work and at home: The European Community respiratory health survey
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2019 (English)In: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 29, no 4, p. 670-679Article in journal (Refereed) Published
Abstract [en]

This longitudinal study investigated whether smoking bans influence passive smoking at work and/or at home in the same subjects. Passive smoking at work and/or at home was investigated in random population samples (European Community Respiratory Health Survey) in 1990-1995, with follow-up interviews in 1998-2003 and 2010-2014. National smoking bans were classified as partial (restricted to public workplaces) or global (extended to private workplaces). Multivariable analysis was accomplished by three-level logistic regression models, where level-1, level-2, and level-3 units were, respectively, questionnaire responses, subjects, and centers. Passive smoking at work was reported by 31.9% in 1990-1995, 17.5% in 1998-2003, and 2.5% in 2010-2014. Concurrently, passive smoking at home decreased from 28.9% to 18.2% and 8.8%. When controlling for sex, age, education, smoking status, and ECHRS wave, the odds of passive smoking at work was markedly reduced after global smoking bans (OR = 0.45, 95% CI 0.25-0.81), particularly among non-smokers, while the protective effect of global smoking bans on passive smoking at home was only detected in non-smokers. Smoking bans both in public and private workplaces were effective in reducing passive smoking at work in Europe. However, given the inefficacy of smoking bans in current smokers' dwellings, better strategies are needed to avoid smoking indoors.

Keywords
follow-up study, home environment, secondhand smoke, smoking restriction, social settings, workplace
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-388764 (URN)10.1111/ina.12556 (DOI)000471273100013 ()30963644 (PubMedID)
Available from: 2019-08-13 Created: 2019-08-13 Last updated: 2019-08-13Bibliographically approved
Norbäck, D. (2019). Elemental composition of ambient air particles in Taiyuan, China: evaluation of lifetime cancer and non-cancer risks. Human and Ecological Risk Assessment: An International Journal
Open this publication in new window or tab >>Elemental composition of ambient air particles in Taiyuan, China: evaluation of lifetime cancer and non-cancer risks
2019 (English)In: Human and Ecological Risk Assessment: An International JournalArticle in journal (Refereed) Published
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:uu:diva-400270 (URN)10.1080/10807039.2019.1579048 (DOI)
Available from: 2019-12-19 Created: 2019-12-19 Last updated: 2020-02-06Bibliographically approved
Ma'pol, A., Hashim, J. H., Norbäck, D., Weislander, G., Hashim, Z. & Isa, Z. M. (2019). FeNO level and allergy status among school children in Terengganu, Malaysia.. Journal of Asthma, 1-8
Open this publication in new window or tab >>FeNO level and allergy status among school children in Terengganu, Malaysia.
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2019 (English)In: Journal of Asthma, ISSN 0277-0903, E-ISSN 1532-4303, p. 1-8Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background: Almost one third of the world population suffers from allergic conditions. Respiratory symptoms are common in Malaysian children but there are few studies on fractional exhaled nitric oxide (FeNO), inclusive of field clinical test for asthma among children in Malaysia. The aim was to provide insight on factors related to level of FeNO among students in Terengganu, Malaysia. Methods: In total, 487 randomly selected students from eight secondary schools participated (13-14 years old). A Standardized questionnaire was used to obtained information on doctors' diagnosed asthma, current asthma and respiratory symptoms. FeNO measurement and skin prick test (SPT to common allergen) were conducted. Results: The geometric mean FeNO was 16.7 ppb. Totally, 38.4% of students had elevated FeNO level (>20 ppb) and 40.3% had had positive SPT to house dust mites allergens (HDM), Dermatophagoides pteronyssinus (Der p 1), Dermatophagoides farinae (Der f 1) or Felis domisticus (cat). Male gender, height, parental history of allergy, self-reported allergy, and atopy were associated with FeNO. In particular, a combination of sensitization to HDM or cat and elevated FeNO were associated with doctor-diagnosed asthma and self-reported allergy to food, pollen and cat. Conclusion: Asthma, respiratory symptoms and sensitization to HDM and cat are common among students and presence of elevated FeNO levels indicate ongoing airway inflammation.

Keywords
FeNO, Malaysia, Students, allergy, asthma
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:uu:diva-400266 (URN)10.1080/02770903.2019.1614614 (DOI)31155989 (PubMedID)
Available from: 2019-12-19 Created: 2019-12-19 Last updated: 2020-02-06Bibliographically approved
Norbäck, D., Zhang, X., Fan, Q., Zhang, Z., Zhang, Y., Li, B., . . . Wang, J. (2019). Home environment and health: Domestic risk factors for rhinitis, throat symptoms and non-respiratory symptoms among adults across China. Science of the Total Environment, 681, 320-330
Open this publication in new window or tab >>Home environment and health: Domestic risk factors for rhinitis, throat symptoms and non-respiratory symptoms among adults across China
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2019 (English)In: Science of the Total Environment, ISSN 0048-9697, E-ISSN 1879-1026, Vol. 681, p. 320-330Article in journal (Refereed) Published
Abstract [en]

Few studies exist from China on associations between home environment and adult health. We studied associations between home environment factors (other than dampness and mould) and rhinitis, throat and dermal symptoms and headache and fatigue among young parents in six cities across China (N = 36,541). They were recruited as parents from day care centers selected randomly and answered a questionnaire on medical symptoms and the home environment. Odds ratios (OR) were calculated by multilevel logistic regression adjusting for gender, atopy, smoking, home size and dampness/mould. Overall, 4.8% had skin symptoms 3.1% rhinitis, 2.8% eye, 4.1% throat symptoms, 3.0% headache and 13.9% had fatigue (all as weekly symptoms). Redecoration was associated with rhinitis, eye and skin symptoms, headache and fatigue. New furniture was associated with eye, throat and skin symptoms and fatigue. Gas cooking was associated with eye and throat symptoms, headache and fatigue. Biomass cooking was associated with eye and throat symptoms and headache. Burning incense was associated with eye, throat and skin symptoms, headache and fatigue. Presence of cockroaches and mosquitos or flies was associated with all six symptoms. Rats or mice were associated with eye and dermal symptoms. Cat keeping was associated with eye symptoms while dog keepers had less fatigue. Living near major roads was associated with rhinitis, eye, throat and skin symptoms and fatigue. Daily cleaning, a mechanical ventilation system in the kitchen or in the bathroom, living in older buildings and living in less urbanized areas were protective factors. In conclusion, urbanization, traffic exhaust, indoor emissions from redecoration and new furniture, gas cooking and air pollution from burning incense and biomass may cause dermal and mucosal symptoms, headache and fatigue among adults in China. Indoor animals (cats, mice/rats, cockroaches) were other risk factors. Daily cleaning, mechanical ventilation and living in older buildings can be protective. 

Place, publisher, year, edition, pages
ELSEVIER SCIENCE BV, 2019
Keywords
Home environment, Sick Building Syndrome (SBS), Air pollution, Redecoration, Incense burning, Cockroaches
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:uu:diva-387712 (URN)10.1016/j.scitotenv.2019.05.084 (DOI)000469847200030 ()31121396 (PubMedID)
Funder
Swedish Research Council Formas, 348-2011-7402Swedish Research Council, 2017-05845
Available from: 2019-06-26 Created: 2019-06-26 Last updated: 2019-12-19Bibliographically approved
Cai, J., Li, B., Yu, W., Wang, H., Du, C., Zhang, Y., . . . Sundell, J. (2019). Household dampness-related exposures in relation to childhood asthma and rhinitis in China: A multicentre observational study. Environment International, 126, 735-746
Open this publication in new window or tab >>Household dampness-related exposures in relation to childhood asthma and rhinitis in China: A multicentre observational study
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2019 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 126, p. 735-746Article in journal (Refereed) Published
Abstract [en]

During 2010-2012, we conducted an observational study on household environment and health outcomes among 40,010 preschool children from seven cities of China. Here we examined associations of six dampness-related indicators (visible mold spots, visible damp stains, damp clothing and/or bedding, water damage, condensation on windowpane, moldy odor) in the current residence and three dampness-related indicators (visible mold spots, condensation on windowpane, moldy odor) in the early residence with childhood asthma and rhinitis. In the multi-level logistic regression analyses, visible mold spots and visible damp stains in the current residence were significantly associated with the increased odds of doctor-diagnosed asthma and allergic rhinitis during lifetime-ever (adjusted odd ratios (AORs) range: 1.18-1.35). All dampness-related indicators were significantly associated with increased odds of wheeze and rhinitis during lifetime-ever and in the past 12 months (AORs range: 1.16-2.64). The cumulative numbers of damp indicators had positively dose-response relationships with the increased odds of the studied diseases. These associations for wheeze and rhinitis were similar between northern children and southern children. Similar results were found in the sensitive analyses among children without a family history of allergies and among children without asthma and allergic rhinitis. For 3-6 years-old children in mainland of China in 2011, we speculated that about 90,000 (2.02%) children with asthma and about 59,000 (1.09%) children with allergic rhinitis could be attributable to exposing to visible mold spots in the current residence. Our results suggested that early and lifetime exposures to household dampness indicators are risk factors for childhood asthma and rhinitis.

Keywords
Home, Dampness, Asthma, Rhinitis, Children, China
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-382244 (URN)10.1016/j.envint.2019.03.013 (DOI)000462597500082 ()30878869 (PubMedID)
Available from: 2019-05-15 Created: 2019-05-15 Last updated: 2019-05-15Bibliographically 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
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ORCID iD: ORCID iD iconorcid.org/0000-0002-5174-6668

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