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A nationwide study of indoor and outdoor environments in allergen avoidance and conventional daycare centers in Sweden
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Allmänpediatrisk forksning/Nordvall)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. (Arbets- och miljömedicin. Eva Vingård)
2006 (English)In: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 16, no 3, 227-35 p.Article in journal (Refereed) Published
Abstract [en]

Sweden has had specialized 'allergen avoidance daycare centers' (AADC) since 1979. The aim was to compare AADC with ordinary daycare centers (ODC). Through contacts with municipalities and hospitals, 72 AADC were identified. For each AADC, the two nearest ODCs served as controls. A questionnaire was sent to the local directors of the 216 daycare centers (531 sections), 83% responded. A total of 39% of the ODCs had ever had dampness/molds, 12% were near (<500 m) stables/farms, 23% were closer than 50 m to a heavy trafficked road, and 13% were exposed to wood smoke in winter. Only 11% of the AADCs had any child with furred pets at home, while 97% of the ODCs had children with furred pets. Bans on smoking at home and on perfumes were more common at the AADCs (P = 0.001). Fewer AADCs had PVC floors (OR = 0.53; P = 0.01), dampness/molds (OR = 0.55; P = 0.04), shelves (OR 3.03; P = 0.001), curtains (OR = 1.67; P = 0.047), and flowers (OR = 0.03; P < 0.001), while more had daily floor cleaning (OR = 19.9; P = 0.004), weekly wiping of furniture (OR = 11.0; P = 0.001), and washing of pillows/mattresses (OR = 2.74; P = 0.005) and curtains (OR = 9.07; P = 0.001). In conclusion, allergy avoidance daycare centers differ from other daycare centers, and may have better indoor environments. PRACTICAL IMPLICATIONS: There is a need to improve the indoor environments of daycare centers, including reduction of building dampness and molds. Allergen avoidance daycare centers (AADC) in Sweden differ from ordinary daycare centers in many respects, with fewer indoor and building factors related to dust, allergens and irritants. This shows that the indoor environments of daycare centers can be improved. Data suggest that AADC may have lower levels of pet allergens, and this is beneficial for children with pet allergy. The effects of these improvements on indoor exposures and health of the children need to be further evaluated.

Place, publisher, year, edition, pages
2006. Vol. 16, no 3, 227-35 p.
Keyword [en]
Air Pollutants, Air Pollution; Indoor/*analysis, Allergens/*analysis, Animals, Antigens; Dermatophagoides/analysis, Cats, Child Day Care Centers, Child; Preschool, Cockroaches, Dogs, Dust/analysis, Environmental Monitoring, Facility Design and Construction, Humans, Questionnaires, Sick Building Syndrome, Sweden, Ventilation
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-81290DOI: 10.1111/j.1600-0668.2005.00420.xPubMedID: 16683941OAI: oai:DiVA.org:uu-81290DiVA: diva2:109205
Available from: 2008-06-25 Created: 2008-06-25 Last updated: 2011-08-15Bibliographically approved
In thesis
1. A Nationwide Study of Asthma and Allergy in Swedish Preschool Children: with Special Reference to Environment, Daycare, Prevalence, Co-ocurrence and Incidence
Open this publication in new window or tab >>A Nationwide Study of Asthma and Allergy in Swedish Preschool Children: with Special Reference to Environment, Daycare, Prevalence, Co-ocurrence and Incidence
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The aim of this project was to study the age and sex specific occurrence of atopic and non-atopic asthma and other atopic manifestations in a nationwide sample of Swedish pre-school children.

Methods: All 70 allergen avoidance day-care centres (AADC) with 84 sections and 140 matched ordinary day-care centres with 440 sections in 62 municipalities across Sweden were sampled. In 2000 the staff at each section responded to a questionnaire on indoor and outdoor environment at the section. In 2002 parents of 5,886 children attending the AADCs and ODCs responded to a postal questionnaire regarding symptoms indicating prevalent asthma, allergic rhinitis, eczema, and food, furred pet and pollen allergy and other data in their children. In 2007, parents of 4255 children responded to an almost identical follow-up questionnaire.

Results: The AADCs had far more strict rules than ODCs on furred pets and smoking at home and on perfume use, and the indoor environment was better, owing to better cleaning. The age specific asthma prevalence was curvilinear with a peak at age 3 of 11.4% among boys and 9.8% among girls. In addition the prevalence increased by municipality population density, a proxy for degree of urbanisation. There was a highly significant co-occurrence between all asthma-atopic manifestations, but there was no evidence of ordered sequence of manifestation onset. The asthma incidence was highly dependent on presence or absence of co-occurrence variables. Given the variable mix in the present study population, the annual asthma incidence ranged from 0.6% to 1.2%.

Conclusions: AADCs had more strict rules and a better indoor environment than ODCs. The asthma prevalence was affected by age, sex and degree of urbanisation. There was close co-occurrence between all asthma and atopic manifestations but no evidence of ordered sequence of onsets. The annual asthma incidence was strongly dependent of co-occurrence conditions.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2010. 69 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 542
Keyword
Asthma, rhinitis, eczema, allergy, indoor environment, daycare centre, prevalence, incidence epidemiology
National Category
Family Medicine
Research subject
Family Medicine
Identifiers
urn:nbn:se:uu:diva-121426 (URN)978-91-554-7759-2 (ISBN)
Public defence
2010-05-07, Brömssalen, ingång 11, Länssjukhuset, Gävle, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2010-04-16 Created: 2010-03-23 Last updated: 2010-05-10

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Bröms, KristinaSvärdsudd, Kurt FSundelin, ClaesNorbäck, Dan

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