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Asthma and Rhinitis among Adults in Sweden and China: Risk Factors in the Home Environment
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Description
Abstract [en]

The main aim of this thesis was to evaluate associations between selected home environment factors and asthma, rhinitis and respiratory symptoms among adults from Sweden, China and northern Europe. Two studies were performed in Sweden, one in China, and one longitudinal cohort study was performed in northern Europe. Dampness/mould was common, and was a main risk factor in all studies. Other risk factors for asthma symptoms in Sweden included window pane condensation in winter, multi-family buildings constructed from 1961-1975, rented apartments, environment tobacco smoke (ETS), and living in a colder climate zone. Higher ventilation flow in Sweden was associated with less asthma symptoms. Risk factors for rhinitis in Sweden included window pane condensation, a higher moisture load, concrete slab foundation constructed before 1991, multi-family buildings constructed from 1976-1985, rented apartments and living in densely populated areas. Risk factors for rhinitis in China included window pane condensation, recent redecoration, new furniture, presence of cockroaches, pet keeping, ETS and living near a main road or highway. Frequently cleaning of the home and putting beddings to sunshine were protective factors for rhinitis in China. Other risk factors for respiratory infections in Sweden included houses with a brick façade, window pane condensation, a higher moisture load, multi-family buildings constructed from 1976-1985, rented apartments and living in densely populated areas. Furthermore, dampness and mould, and mould odour were risk factors for onset of asthma and rhinitis in northern Europe. In conclusion, indoor dampness and mould can be a risk factor for asthma and rhinitis in Sweden, China and northern Europe. Certain construction years (1961-1985), ETS, recent redecoration, new furniture, living in urban areas and exposure to traffic air pollution can be risk factors for asthma, rhinitis or respiratory infections. A high ventilation flow and daily cleaning at home can be protective.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2018. , p. 80
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1467
Keywords [en]
Rhinitis, Asthma, Home, Dampness, Mould, Ventilation
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Occupational and Environmental Medicine
Identifiers
URN: urn:nbn:se:uu:diva-347698ISBN: 978-91-513-0347-5 (print)OAI: oai:DiVA.org:uu-347698DiVA, id: diva2:1195680
Public defence
2018-06-12, Konferensrummet, Arbets- och miljömedicin, Daghammarskjölds väg 60, Uppsala, 09:00 (English)
Opponent
Supervisors
Available from: 2018-05-21 Created: 2018-04-06 Last updated: 2018-05-21
List of papers
1. Rhinitis Symptoms and Asthma among Parents of Preschool Children in Relation to the Home Environment in Chongqing, China
Open this publication in new window or tab >>Rhinitis Symptoms and Asthma among Parents of Preschool Children in Relation to the Home Environment in Chongqing, China
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2014 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, no 4, p. e94731-Article in journal (Refereed) Published
Abstract [en]

Risk factors for rhinitis and asthma in the home environment were studied by a questionnaire survey. Parents of 4530 1-8 year old children (one parent per child) from randomly selected kindergartens in Chongqing, China participated. 70.4% were females; 47.1% had rhinitis symptoms in the last three months (current rhinitis, CR); 1.6% reported a history of allergic asthma (AA); 2.7% reported a history of allergic rhinitis (AR); 16.4% were current smokers; 50.8% males and 2.4% females were current smokers. Stuffy odor, unpleasant odor, tobacco smoke odor and dry air were associated with CR (adjustment for gender, current smoking and other perceptions of odor or humidity). Associations between home environment and CR, AR, and AA were studied by multiple logistic regression analyses, adjusting for gender, current smoking and other significant home factors. Living near a main road or highway was a risk factor for both CR (OR(95% CI): 1.31(1.13,1.52)) and AR (OR(95% CI): 2.44(1.48,4.03)). Other risk factors for CR included living in rural areas (OR(95% CI): 1.43(1.10,1.85)), new furniture (OR(95% CI): 1.28(1.11,1.49)), water damage (OR(95% CI): 1.68(1.29,2.18)), cockroaches (OR(95% CI): 1.46(1.23,1.73)), and keeping pets (OR(95% CI): 1.24(1.04,1.49)). Other risk factors for AR included redecoration (OR(95% CI): 2.14(1.34,3.41)), mold spots (OR(95% CI): 2.23(1.06,4.68)), window pane condensation (OR(95% CI): 2.04(1.28,3.26)). Water damage was the only home factor associated with AA (2.56(1.34,4.86)). Frequently put bedding to sunshine was protective for CR (OR(95% CI): 0.79(0.68,0.92); cleaning every day was protective for AR (OR(95% CI): 0.40(0.22,0.71)). In conclusion, parents' CR and AR were related to a number of factors of the home environment.

National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-228494 (URN)10.1371/journal.pone.0094731 (DOI)000336970400086 ()
Available from: 2014-07-15 Created: 2014-07-15 Last updated: 2018-04-06Bibliographically approved
2. Rhinitis, Asthma and Respiratory Infections among Adults in Relation to the Home Environment in Multi-Family Buildings in Sweden
Open this publication in new window or tab >>Rhinitis, Asthma and Respiratory Infections among Adults in Relation to the Home Environment in Multi-Family Buildings in Sweden
2014 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, no 8, p. e105125-Article in journal (Refereed) Published
Abstract [en]

Risk factors for rhinitis, asthma and respiratory infections in the home environment were studied by a questionnaire survey. Totally 5775 occupants (>= 18 years old) from a stratified random sample of multi-family buildings in Sweden participated (46%). 51.0% had rhinitis in the last 3 months (current rhinitis); 11.5% doctor diagnosed asthma; 46.4% respiratory infections in the last 3 months and 11.9% antibiotic medication for respiratory infections in the last 12 months. Associations between home environment and health were analyzed by multiple logistic regression, controlling for gender, age and smoking and mutual adjustment. Buildings constructed during 1960-1975 were risk factors for day time breathlessness (OR = 1.53, 95%CI 1.03-2.29). And those constructed during 1976-1985 had more current rhinitis (OR = 1.43, 95%CI 1.12-1.84) and respiratory infections (OR = 1.46, 95%CI 1.21-1.78). Cities with higher population density had more current rhinitis (p = 0.008) and respiratory infections (p<0.001). Rented apartments had more current rhinitis (OR = 1.23, 95%CI 1.07-1.40), wheeze (OR = 1.20, 95%CI 1.02-1.41), day time breathlessness (OR = 1.31, 95%CI 1.04-1.66) and respiratory infections (OR = 1.13, 95%CI 1.01-1.26). Living in colder parts of the country was a risk factor for wheeze (p = 0.03) and night time breathlessness (p = 0.002). Building dampness was a risk factor for wheeze (OR = 1.42, 95%CI 1.08-1.86) and day time breathlessness (OR = 1.57, 95%CI 1.09-2.27). Building dampness was a risk factor for health among those below 66 years old. Odor at home was a risk factor for doctor diagnosed asthma (OR = 1.49, 95%CI 1.08-2.06) and current asthma (OR = 1.52, 95%CI 1.03-2.24). Environmental tobacco smoke (ETS) was a risk factor for current asthma (OR = 1.53, 95%CI 1.09-2.16). Window pane condensation was a risk factor for antibiotic medication for respiratory infections (OR = 1.41, 95%CI 1.10-1.82). In conclusion, rhinitis, asthma and respiratory infections were related to a number of factors in the home environment. Certain building years (1961-1985), building dampness, window pane condensation and odor in the dwelling may be risk factors.

National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:uu:diva-232599 (URN)10.1371/journal.pone.0105125 (DOI)000340742100066 ()
Available from: 2014-09-24 Created: 2014-09-22 Last updated: 2018-04-06Bibliographically approved
3. Current wheeze, asthma, respiratory infections, and rhinitis among adults in relation to inspection data and indoor measurements in single-family houses in Sweden - The BETSI study
Open this publication in new window or tab >>Current wheeze, asthma, respiratory infections, and rhinitis among adults in relation to inspection data and indoor measurements in single-family houses in Sweden - The BETSI study
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2017 (English)In: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 27, no 4, p. 725-736Article in journal (Refereed) Published
Abstract [en]

In the Swedish Building Energy, Technical Status and Indoor environment study, a total of 1160 adults from 605 single-family houses answered a questionnaire on respiratory health. Building inspectors investigated the homes and measured temperature, air humidity, air exchange rate, and wood moisture content (in attic and crawl space). Moisture load was calculated as the difference between indoor and outdoor absolute humidity. Totally, 7.3% were smokers, 8.7% had doctor' diagnosed asthma, 11.2% current wheeze, and 9.5% current asthma symptoms. Totally, 50.3% had respiratory infections and 26.0% rhinitis. The mean air exchange rate was 0.36/h, and the mean moisture load 1.70g/m(3). Damp foundation (OR=1.79, 95% CI 1.16-2.78) was positively associated while floor constructions with crawl space (OR=0.49, 95% CI 0.29-0.84) was negatively associated with wheeze. Concrete slabs with overlying insulation (OR=2.21, 95% CI 1.24-3.92) and brick facade (OR=1.71, 95% CI 1.07-2.73) were associated with rhinitis. Moisture load was associated with respiratory infections (OR=1.21 per 1g/m(3), 95% CI 1.04-1.40) and rhinitis (OR=1.36 per 1g/m(3), 95% CI 1.02-1.83). Air exchange rate was associated with current asthma symptoms (OR=0.85 per 0.1/h, 95% CI 0.73-0.99). Living in homes with damp foundation, concrete slabs with overlying insulation, brick facade, low ventilation flow, and high moisture load are risk factors for asthma, rhinitis, and respiratory infections.

Place, publisher, year, edition, pages
WILEY, 2017
Keywords
asthma, building dampness, indoor environment, mold, rhinitis, ventilation flow
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-328991 (URN)10.1111/ina.12363 (DOI)000403895400003 ()28005296 (PubMedID)
Funder
National Board of Housing, Building and Planning, 2012-1104
Available from: 2017-09-08 Created: 2017-09-08 Last updated: 2018-04-06Bibliographically approved
4. Adult onset and remission of respiratory symptoms, asthma and rhinitis in relation to dampness, mould and mould odour: the RHINE cohort
Open this publication in new window or tab >>Adult onset and remission of respiratory symptoms, asthma and rhinitis in relation to dampness, mould and mould odour: the RHINE cohort
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(English)In: Article in journal (Other academic) Submitted
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-347692 (URN)
Available from: 2018-04-06 Created: 2018-04-06 Last updated: 2018-04-06

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