Association between indoor environment and risk of asthma in Chinese children: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

WANG Shuomin , HU Yifan , ZHOU Bingxian , FAN Shiheng , WU Qisheng ,  ZHANG Jing

International School of Public Health and One Health, Hainan Medical University, Haikou 571199, P. R. China;

Corresponding?author：

ZHANG Jing, Email: zhangjing@hainmc.edu.cn

Keywords：

Asthma; Children; China; Influencing factors; Systematic review; Meta-analysis

DOI：

10.7507/1672-2531.202112121

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the indoor influencing factors of asthma in Chinese children. Methods The CNKI, WanFang Data, VIP, PubMed, Cochrane Library, and ScienceDirect databases were electronically searched to collect cross-sectional studies on the indoor influencing factors of asthma in Chinese children from inception to November 2021. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies; then, meta-analysis was performed using Stata 16.0 software. Results A total of 29 cross-sectional studies were included, and 11 influencing factors were analyzed by meta-analysis. The results of the meta-analysis showed that redecoration (OR=1.57, 95%CI 1.37 to 1.79, P<0.01), environmental tobacco smoke (OR=1.59, 95%CI 1.34 to 1.88, P<0.01), cooking oil fume (OR=1.98, 95%CI 1.20 to 3.25, P<0.01), mold and water damage (OR=1.49, 95%CI 1.09 to 2.02, P<0.01), mold (OR=2.01, 95%CI 1.40 to 2.90, P<0.01), water damage (OR=1.72, 95%CI 1.44 to 2.06, P<0.01), moldy odor (OR=1.38, 95%CI 1.22 to 1.56, P<0.01), indoor humidity (OR=1.50, 95%CI 1.18 to 1.91, P<0.01), furry pets (OR=1.55, 95%CI 1.39 to 1.72, P<0.01) and cockroach (OR=1.63, 95%CI 1.24 to 2.14, P<0.01) were risk factors for asthma in Chinese children, while burning incense had no association with the occurrence of asthma in children. Conclusion Current evidence indicates that redecoration, environmental tobacco smoke, cooking oil fume, mold and water damage, mold, water damage, moldy odor, indoor humidity, furry pets, and cockroaches are influencing factors of asthma in Chinese children. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.

Citation： WANG Shuomin, HU Yifan, ZHOU Bingxian, FAN Shiheng, WU Qisheng, ZHANG Jing. Association between indoor environment and risk of asthma in Chinese children: a systematic review. Chinese Journal of Evidence-Based Medicine, 2023, 23(3): 327-333. doi: 10.7507/1672-2531.202112121 Copy

1.	Masoli M, Fabian D, Holt S, et al. The global burden of asthma: executive summary of the GINA Dissemination Committee report. Allergy, 2004, 59(5): 469-478.
2.	全國兒科哮喘協作組. 2000年與1990年兒童支氣管哮喘患病率的調查比較. 中華結核和呼吸雜志, 2004, 27(2): 112-116.
3.	張安慧, 王幼玲, 趙洋, 等. 蕪湖市城區學齡前兒童過敏性疾病的現況調查. 現代預防醫學, 2016, 43(21): 3896-3898.
4.	Serebrisky D, Wiznia A. Pediatric asthma: a global epidemic. Ann Glob Health, 2019, 85(1): 6.
5.	Tiotiu AI, Novakova P, Nedeva D, et al. Impact of air pollution on asthma outcomes. Int J Environ Res Public Health, 2020, 17(17): 6212.
6.	Bray NW, Smart RR, Jakobi JM, et al. Exercise prescription to reverse frailty. Appl Physiol Nutr Metab, 2016, 41(10): 1112-1116.
7.	王婷婷, 史浩楠, 劉茜, 等. 烏魯木齊學齡前兒童哮喘和喘息樣呼吸困難情況及其影響因素分析. 中國公共衛生, 2021, 37(2): 260-264.
8.	Hu YB, Chen YT, Liu SJ, et al. Increasing prevalence and influencing factors of childhood asthma: a cross-sectional study in Shanghai, China. World J Pediatr, 2021, 17(4): 419-428.
9.	Norb?ck D, Zhang X, Tian L, et al. Prenatal and perinatal home environment and reported onset of wheeze, rhinitis and eczema symptoms in preschool children in Northern China. Sci Total Environ, 2021, 774: 145700.
10.	Ellie AS, Sun Y, Hou J, et al. Prevalence of childhood asthma and allergies and their associations with perinatal exposure to home environmental factors: a cross-sectional study in Tianjin, China. Int J Environ Res Public Health, 2021, 18(8): 4131.
11.	Ren X, Liu Y, Hu L, et al. Associations between home renovation and asthma, allergic rhinitis, and eczema among preschool children in Wuhan, China. Int J Environ Health Res, 2021: 1-11.
12.	Huang CF, Chie WC, Wang IJ. Effect of environmental exposures on allergen sensitization and the development of childhood allergic diseases: a large-scale population-based study. World Allergy Organ J, 2021, 14(1): 100495.
13.	趙玉潔, 馬蘭, 滕增光, 等. 武漢市室內環境與6~8歲學齡兒童哮喘相關癥狀相關性分析. 環境與健康雜志, 2020, 37(7): 635-638.
14.	郭艷, 張浩玲, 何倫發, 等. 室內家居環境對兒童青少年呼吸系統健康影響. 中國公共衛生, 2020, 36(1): 56-59.
15.	Li W, Liu Q, Chen Y, et al. Effects of indoor environment and lifestyle on respiratory health of children in Chongqing, China. J Thorac Dis, 2020, 12(10): 6327-6341.
16.	Lin J, Lin W, Yin Z, et al. Respiratory health effects of residential individual and cumulative risk factors in children living in two cities of the Pearl River Delta Region, China. J Thorac Dis, 2020, 12(10): 6342-6355.
17.	Norb?ck D, Lu C, Wang J, et al. Asthma and rhinitis among Chinese children - Indoor and outdoor air pollution and indicators of socioeconomic status (SES). Environ Int, 2018, 115: 1-8.
18.	Luo S, Sun Y, Hou J, et al. Pet keeping in childhood and asthma and allergy among children in Tianjin area, China. PLoS One, 2018, 13(5): e0197274.
19.	Zhang J, Sun C, Liu W, et al. Associations of household renovation materials and periods with childhood asthma, in China: a retrospective cohort study. Environ Int, 2018, 113: 240-248.
20.	張浩玲, 郭艷, 何倫發, 等. 中山市居室內被動吸煙對兒童哮喘及哮喘樣癥狀的影響. 環境與健康雜志, 2018, 35(3): 217-220.
21.	Qian H, Zheng X, Zhang M, et al. Associations between parents' perceived air quality in homes and health among children in Nanjing, China. PLoS One, 2016, 11(5): e0155742.
22.	林之靖, 王婷婷, 趙卓慧. 烏魯木齊市住宅室內潮濕表征與兒童哮喘及過敏性疾病的相關性. 環境與職業醫學, 2015, 32(2): 97-103.
23.	杜向陽. 父母居室內吸煙對兒童呼吸系統疾病和癥狀的影響研究. 環境與健康雜志, 2015, 32(6): 501-504.
24.	王芳, 李蓓, 王敏. 宜昌市兒童哮喘的危險因素分析. 中國兒童保健雜志, 2014, 22(1): 28-30.
25.	Liu F, Zhao Y, Liu YQ, et al. Asthma and asthma related symptoms in 23326 Chinese children in relation to indoor and outdoor environmental factors: the Seven Northeastern Cities (SNEC) Study. Sci Total Environ, 2014, 497-498: 10-17.
26.	Hu Y, Liu W, Huang C, et al. Home dampness, childhood asthma, hay fever, and airway symptoms in Shanghai, China: associations, dose-response relationships, and lifestyle's influences. Indoor Air, 2014, 24(5): 450-463.
27.	劉煒, 黃晨, 胡宇, 等. 室內環境煙草煙霧與學齡前兒童呼吸道癥狀的關聯性. 科學通報, 2013, 58(25): 2535-2541.
28.	張銘, 周鄂生, 葉新, 等. 武漢地區室內環境質量與兒童哮喘和過敏性鼻炎患病率的關系. 科學通報, 2013, 58(25): 2559-2564.
29.	王晗, 李百戰, 陽琴, 等. 重慶地區住宅室內潮濕問題和兒童哮喘及過敏性疾病的相關性分析: 橫斷面調查. 科學通報, 2013, 58(25): 2596-2604.
30.	周蘭島, 解繼勝, 董光輝, 等. 百色市室內環境污染對兒童哮喘及哮喘樣癥狀影響的流行病學調查. 中國衛生統計, 2013, 30(3): 354-356.
31.	吳金貴, 莊祖嘉, 鈕春瑾, 等. 室內環境因素對兒童青少年呼吸道疾病影響的橫斷面研究. 中國預防醫學雜志, 2010, 11(5): 450-454.
32.	Dong GH, Ma YN, Ding HL, et al. Housing characteristics, home environmental factors and respiratory health in 3945 pre-school children in China. Int J Environ Health Res, 2008, 18(4): 267-282.
33.	Salo PM, Xia J, Johnson CA, et al. Indoor allergens, asthma, and asthma-related symptoms among adolescents in Wuhan, China. Ann Epidemiol, 2004, 14(8): 543-550.
34.	Wang TN, Ko YC, Chao YY, et al. Association between indoor and outdoor air pollution and adolescent asthma from 1995 to 1996 in Taiwan. Environ Res, 1999, 81(3): 239-247.
35.	Yang CY, Chiu JF, Cheng MF, et al. Effects of indoor environmental factors on respiratory health of children in a subtropical climate. Environ Res, 1997, 75(1): 49-55.
36.	Franck U, Weller A, R?der SW, et al. Prenatal VOC exposure and redecoration are related to wheezing in early infancy. Environ Int, 2014, 73: 393-401.
37.	Lam J, Koustas E, Sutton P, et al. Exposure to formaldehyde and asthma outcomes: a systematic review, meta-analysis, and economic assessment. PLoS One, 2021, 16(3): e0248258.
38.	Odebeatu CC, Taylor T, Fleming LE, et al. Phthalates and asthma in children and adults: US NHANES 2007-2012. Environ Sci Pollut Res Int, 2019, 26(27): 28256-28269.
39.	張濤. 兒童肺炎流行特征、病原體診斷方法評價和肺炎鏈球菌多重PCR分型方法研究. 上海: 復旦大學, 2010.
40.	徐幽瓊, Ignatius TS, 林捷, 等. 不同食用油和烹調方式的油煙成分分析. 中國衛生檢驗雜志, 2012, 22(10): 2271-2274, 2279.
41.	Peng CY, Lan CH, Lin PC, et al. Effects of cooking method, cooking oil, and food type on aldehyde emissions in cooking oil fumes. J Hazard Mater, 2017, 324(Pt B): 160-167.
42.	崔彤, 程婧晨, 何萬清, 等. 北京市典型餐飲企業VOCs排放特征研究. 環境科學, 2015, 36(5): 1523-1529.
43.	Leavy O. Asthma and allergy: diet and airway inflammation. Nat Rev Immunol, 2014, 14(2): 64-65.
44.	Wegienka G, Johnson CC, Zoratti E, et al. Racial differences in allergic sensitization: recent findings and future directions. Curr Allergy Asthma Rep, 2013, 13(3): 255-261.
45.	Pomés A, Glesner J, Calatroni A, et al. Cockroach allergen component analysis of children with or without asthma and rhinitis in an inner-city birth cohort. J Allergy Clin Immunol, 2019, 144(4): 935-944.
46.	Fang L, Wyon DP, Clausen G, et al. Impact of indoor air temperature and humidity in an office on perceived air quality, SBS symptoms and performance. Indoor Air, 2004, 14(Suppl 7): 74-81.

1. Masoli M, Fabian D, Holt S, et al. The global burden of asthma: executive summary of the GINA Dissemination Committee report. Allergy, 2004, 59(5): 469-478.
2. 全國兒科哮喘協作組. 2000年與1990年兒童支氣管哮喘患病率的調查比較. 中華結核和呼吸雜志, 2004, 27(2): 112-116.
3. 張安慧, 王幼玲, 趙洋, 等. 蕪湖市城區學齡前兒童過敏性疾病的現況調查. 現代預防醫學, 2016, 43(21): 3896-3898.
4. Serebrisky D, Wiznia A. Pediatric asthma: a global epidemic. Ann Glob Health, 2019, 85(1): 6.
5. Tiotiu AI, Novakova P, Nedeva D, et al. Impact of air pollution on asthma outcomes. Int J Environ Res Public Health, 2020, 17(17): 6212.
6. Bray NW, Smart RR, Jakobi JM, et al. Exercise prescription to reverse frailty. Appl Physiol Nutr Metab, 2016, 41(10): 1112-1116.
7. 王婷婷, 史浩楠, 劉茜, 等. 烏魯木齊學齡前兒童哮喘和喘息樣呼吸困難情況及其影響因素分析. 中國公共衛生, 2021, 37(2): 260-264.
8. Hu YB, Chen YT, Liu SJ, et al. Increasing prevalence and influencing factors of childhood asthma: a cross-sectional study in Shanghai, China. World J Pediatr, 2021, 17(4): 419-428.
9. Norb?ck D, Zhang X, Tian L, et al. Prenatal and perinatal home environment and reported onset of wheeze, rhinitis and eczema symptoms in preschool children in Northern China. Sci Total Environ, 2021, 774: 145700.
10. Ellie AS, Sun Y, Hou J, et al. Prevalence of childhood asthma and allergies and their associations with perinatal exposure to home environmental factors: a cross-sectional study in Tianjin, China. Int J Environ Res Public Health, 2021, 18(8): 4131.
11. Ren X, Liu Y, Hu L, et al. Associations between home renovation and asthma, allergic rhinitis, and eczema among preschool children in Wuhan, China. Int J Environ Health Res, 2021: 1-11.
12. Huang CF, Chie WC, Wang IJ. Effect of environmental exposures on allergen sensitization and the development of childhood allergic diseases: a large-scale population-based study. World Allergy Organ J, 2021, 14(1): 100495.
13. 趙玉潔, 馬蘭, 滕增光, 等. 武漢市室內環境與6~8歲學齡兒童哮喘相關癥狀相關性分析. 環境與健康雜志, 2020, 37(7): 635-638.
14. 郭艷, 張浩玲, 何倫發, 等. 室內家居環境對兒童青少年呼吸系統健康影響. 中國公共衛生, 2020, 36(1): 56-59.
15. Li W, Liu Q, Chen Y, et al. Effects of indoor environment and lifestyle on respiratory health of children in Chongqing, China. J Thorac Dis, 2020, 12(10): 6327-6341.
16. Lin J, Lin W, Yin Z, et al. Respiratory health effects of residential individual and cumulative risk factors in children living in two cities of the Pearl River Delta Region, China. J Thorac Dis, 2020, 12(10): 6342-6355.
17. Norb?ck D, Lu C, Wang J, et al. Asthma and rhinitis among Chinese children - Indoor and outdoor air pollution and indicators of socioeconomic status (SES). Environ Int, 2018, 115: 1-8.
18. Luo S, Sun Y, Hou J, et al. Pet keeping in childhood and asthma and allergy among children in Tianjin area, China. PLoS One, 2018, 13(5): e0197274.
19. Zhang J, Sun C, Liu W, et al. Associations of household renovation materials and periods with childhood asthma, in China: a retrospective cohort study. Environ Int, 2018, 113: 240-248.
20. 張浩玲, 郭艷, 何倫發, 等. 中山市居室內被動吸煙對兒童哮喘及哮喘樣癥狀的影響. 環境與健康雜志, 2018, 35(3): 217-220.
21. Qian H, Zheng X, Zhang M, et al. Associations between parents' perceived air quality in homes and health among children in Nanjing, China. PLoS One, 2016, 11(5): e0155742.
22. 林之靖, 王婷婷, 趙卓慧. 烏魯木齊市住宅室內潮濕表征與兒童哮喘及過敏性疾病的相關性. 環境與職業醫學, 2015, 32(2): 97-103.
23. 杜向陽. 父母居室內吸煙對兒童呼吸系統疾病和癥狀的影響研究. 環境與健康雜志, 2015, 32(6): 501-504.
24. 王芳, 李蓓, 王敏. 宜昌市兒童哮喘的危險因素分析. 中國兒童保健雜志, 2014, 22(1): 28-30.
25. Liu F, Zhao Y, Liu YQ, et al. Asthma and asthma related symptoms in 23326 Chinese children in relation to indoor and outdoor environmental factors: the Seven Northeastern Cities (SNEC) Study. Sci Total Environ, 2014, 497-498: 10-17.
26. Hu Y, Liu W, Huang C, et al. Home dampness, childhood asthma, hay fever, and airway symptoms in Shanghai, China: associations, dose-response relationships, and lifestyle's influences. Indoor Air, 2014, 24(5): 450-463.
27. 劉煒, 黃晨, 胡宇, 等. 室內環境煙草煙霧與學齡前兒童呼吸道癥狀的關聯性. 科學通報, 2013, 58(25): 2535-2541.
28. 張銘, 周鄂生, 葉新, 等. 武漢地區室內環境質量與兒童哮喘和過敏性鼻炎患病率的關系. 科學通報, 2013, 58(25): 2559-2564.
29. 王晗, 李百戰, 陽琴, 等. 重慶地區住宅室內潮濕問題和兒童哮喘及過敏性疾病的相關性分析: 橫斷面調查. 科學通報, 2013, 58(25): 2596-2604.
30. 周蘭島, 解繼勝, 董光輝, 等. 百色市室內環境污染對兒童哮喘及哮喘樣癥狀影響的流行病學調查. 中國衛生統計, 2013, 30(3): 354-356.
31. 吳金貴, 莊祖嘉, 鈕春瑾, 等. 室內環境因素對兒童青少年呼吸道疾病影響的橫斷面研究. 中國預防醫學雜志, 2010, 11(5): 450-454.
32. Dong GH, Ma YN, Ding HL, et al. Housing characteristics, home environmental factors and respiratory health in 3945 pre-school children in China. Int J Environ Health Res, 2008, 18(4): 267-282.
33. Salo PM, Xia J, Johnson CA, et al. Indoor allergens, asthma, and asthma-related symptoms among adolescents in Wuhan, China. Ann Epidemiol, 2004, 14(8): 543-550.
34. Wang TN, Ko YC, Chao YY, et al. Association between indoor and outdoor air pollution and adolescent asthma from 1995 to 1996 in Taiwan. Environ Res, 1999, 81(3): 239-247.
35. Yang CY, Chiu JF, Cheng MF, et al. Effects of indoor environmental factors on respiratory health of children in a subtropical climate. Environ Res, 1997, 75(1): 49-55.
36. Franck U, Weller A, R?der SW, et al. Prenatal VOC exposure and redecoration are related to wheezing in early infancy. Environ Int, 2014, 73: 393-401.
37. Lam J, Koustas E, Sutton P, et al. Exposure to formaldehyde and asthma outcomes: a systematic review, meta-analysis, and economic assessment. PLoS One, 2021, 16(3): e0248258.
38. Odebeatu CC, Taylor T, Fleming LE, et al. Phthalates and asthma in children and adults: US NHANES 2007-2012. Environ Sci Pollut Res Int, 2019, 26(27): 28256-28269.
39. 張濤. 兒童肺炎流行特征、病原體診斷方法評價和肺炎鏈球菌多重PCR分型方法研究. 上海: 復旦大學, 2010.
40. 徐幽瓊, Ignatius TS, 林捷, 等. 不同食用油和烹調方式的油煙成分分析. 中國衛生檢驗雜志, 2012, 22(10): 2271-2274, 2279.
41. Peng CY, Lan CH, Lin PC, et al. Effects of cooking method, cooking oil, and food type on aldehyde emissions in cooking oil fumes. J Hazard Mater, 2017, 324(Pt B): 160-167.
42. 崔彤, 程婧晨, 何萬清, 等. 北京市典型餐飲企業VOCs排放特征研究. 環境科學, 2015, 36(5): 1523-1529.
43. Leavy O. Asthma and allergy: diet and airway inflammation. Nat Rev Immunol, 2014, 14(2): 64-65.
44. Wegienka G, Johnson CC, Zoratti E, et al. Racial differences in allergic sensitization: recent findings and future directions. Curr Allergy Asthma Rep, 2013, 13(3): 255-261.
45. Pomés A, Glesner J, Calatroni A, et al. Cockroach allergen component analysis of children with or without asthma and rhinitis in an inner-city birth cohort. J Allergy Clin Immunol, 2019, 144(4): 935-944.
46. Fang L, Wyon DP, Clausen G, et al. Impact of indoor air temperature and humidity in an office on perceived air quality, SBS symptoms and performance. Indoor Air, 2004, 14(Suppl 7): 74-81.

Chinese Journal of Evidence-Based Medicine

Association between indoor environment and risk of asthma in Chinese children: a systematic review

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