Indoor environment and respiratory symptoms in children living in the Dutch–German borderland
ABSTRACT ObjectiveTo investigate the relation between indoor environmental risk factors and respiratory symptoms in 7–8-year-old children living in the Dutch–German borderland.MethodsA nested case-control study was conducted among children participating in a large longitudinal study on respiratory health. Parents of all 781 children with respiratory complaints and an equal number of randomly selected controls were asked to complete a questionnaire, including questions on indoor environment.ResultsThe parents of 1191 children (76.2%) participated. Past exposure to environmental (OR=2.73, 95% CI 1.14–6.67) as well as in utero exposure (OR=2.28, 95% CI 1.15–4.53) to tobacco smoke, use of an unvented geyser for water heating (OR=3.01, 95% CI 1.21–7.56), long-term exposure to dampness (OR=2.98, 95% CI 1.10–8.28) or pets (OR=2.18, 95% CI 1.39–3.42) increased the risk of asthmatic symptoms in 7–8-year-old children. A middle or low socio-economic status also increased the risk of asthmatic symptoms. An inverse association with asthmatic symptoms was seen for wall-to-wall carpeting (OR=0.57, 95% CI 0.33–0.95) and insulation measures (OR=0.46, 95% CI 0.25–0.83). Except for the presence of an unvented geyser, these environmental risk factors also presented a risk for coughing symptoms in children.ConclusionThis study showed an increased risk of respiratory symptoms in children exposed to several indoor environmental risk factors.
Article: Age-specific long-term course of IgG antibodies to pertussis toxin after symptomatic infection with Bordetella pertussis.[show abstract] [hide abstract]
ABSTRACT: To investigate the possible dependence on age of the rate of decline of IgG antibodies to pertussis toxin (IgG-PT) after natural infection with Bordetella pertussis we measured IgG-PT in follow-up sera of 121 patients (age 0-94 years) obtained after 123 episodes of B. pertussis infection. For analysis we applied a dynamic model for the inactivation of B. pertussis by the immune system. There were no significant differences in rise, peak and decline of IgG-PT between different age groups, although there was a tendency for a more rapid increase, a higher peak and a faster decline with increasing age. The IgG-PT cut-off of 100 U/ml for serodiagnosis of pertussis appeared valid in all age groups. A decline of IgG-PT to < 10 U/ml was associated with increased risk of re-infection with B. pertussis.Epidemiology and Infection 09/2005; 133(4):737-48. · 2.84 Impact Factor
[show abstract] [hide abstract]
ABSTRACT: The presented cross-sectional study, comprised a group of 1,130 children from 13-15 years of age living in Upper Silesia, Poland, was undertaken to ascertain the role of environmental factors in the development of adverse respiratory health outcomes. To estimate the prevalence of these effects, the ISAAC questionnaire supplemented by questions related to risk factors was used. Bronchial asthma was identified in 4.5% of the children, asthma diagnosed by physicians in 8.7%, and prevalence of wheezing in the previous 12 months in 12.6%. The highest probability of wheezing was found in children with maternal genetic propensity (such as asthma, allergy), exposed to maternal smoking, or was connected with household risk factors such as the presence of dampness/mould or living in 50-year-old building. Female gender and attendance at nursery school were shown to be protective factors against wheezing. The probability of asthma was nearly twice as high in children residing in damp/mouldy dwellings, heated by coal-fired furnaces and living in the immediate vicinity of a road with heavy traffic. This study revealed that exposure to indoor (tobacco smoke, coal stove emission, mould or dampness in dwelling) and outdoor (traffic pollution) air contaminants are major environmental factors responsible for adverse respiratory health effects in children.Annals of agricultural and environmental medicine: AAEM 12/2010; 17(2):221-9. · 2.31 Impact Factor
Article: Residential Dampness and Molds and the Risk of Developing Asthma: A Systematic Review and Meta-Analysis.[show abstract] [hide abstract]
ABSTRACT: CONTEXT: Studies from different geographical regions have assessed the relations between indoor dampness and mold problems and the risk of asthma, but the evidence has been inconclusive. OBJECTIVE: To assess the relations between indicators of indoor dampness and mold problems and the risk of developing new asthma, and to investigate whether such relations differ according to the type of exposure. DATA SOURCES: A systematic literature search of PubMed database from 1990 through March 2012 and the reference lists of recent reviews and of relevant articles identified in our search. STUDY SELECTION: Cohort/longitudinal and incident case-control studies assessing the relation between mold/dampness and new asthma were included. DATA EXTRACTION: Three authors independently evaluated eligible articles and extracted relevant information using a structured form. SYNTHESIS: SIXTEEN STUDIES WERE INCLUDED: 11 cohort and 5 incident case-control studies. The summary effect estimates (EE) based on the highest and lowest estimates for the relation between any exposure and onset of asthma were 1.50 (95% confidence interval [CI] 1.25-1.80, random-effects model, Q-statistic 38.74 (16), P = 0.001) and 1.31 (95% CI 1.09-1.58, random-effects model, Q-statistic 40.08 (16), P = 0.000), respectively. The summary effect estimates were significantly elevated for dampness (fixed-effects model: EE 1.33, 95% CI 1.12-1.56, Q-statistic 8.22 (9), P = 0.413), visible mold (random-effects model; EE 1.29, 95% CI 1.04-1.60, 30.30 (12), P = 0.001), and mold odor (random-effects model; EE 1.73, 95% CI 1.19-2.50, Q-statistics 14.85 (8), P = 0.038), but not for water damage (fixed-effects model; EE 1.12, 95% CI 0.98-1.27). Heterogeneity was observed in the study-specific effect estimates. CONCLUSION: The evidence indicates that dampness and molds in the home are determinants of developing asthma. The association of the presence of visible mold and especially mold odor to the risk of asthma points towards mold-related causal agents.PLoS ONE 01/2012; 7(11):e47526. · 4.09 Impact Factor