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.	全国儿科哮喘协作组. 2000年与1990年儿童支气管哮喘患病率的调查比较. 中华结核和呼吸杂志, 2004, 27(2): 112-116.
3.	张安慧, 王幼玲, 赵洋, 等. 芜湖市城区学龄前儿童过敏性疾病的现况调查. 现代预防医学, 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, 刘茜, 等. 乌鲁木齐学龄前儿童哮喘和喘息样呼吸困难情况及其影响因素分析. 中国公共卫生, 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.	Norbäck 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.	赵玉洁, 马兰, 滕增光, 等. 武汉市室内环境与6~8岁学龄儿童哮喘相关症状相关性分析. 环境与健康杂志, 2020, 37(7): 635-638.
14.	郭艳, 张浩玲, 何伦发, 等. 室内家居环境对儿童青少年呼吸系统健康影响. 中国公共卫生, 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.	Norbäck 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.	张浩玲, 郭艳, 何伦发, 等. 中山市居室内被动吸烟对儿童哮喘及哮喘样症状的影响. 环境与健康杂志, 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, 赵卓慧. 乌鲁木齐市住宅室内潮湿表征与儿童哮喘及过敏性疾病的相关性. 环境与职业医学, 2015, 32(2): 97-103.
23.	杜向阳. 父母居室内吸烟对儿童呼吸系统疾病和症状的影响研究. 环境与健康杂志, 2015, 32(6): 501-504.
24.	王芳, 李蓓, 王敏. 宜昌市儿童哮喘的危险因素分析. 中国儿童保健杂志, 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.	刘炜, 黄晨, 胡宇, 等. 室内环境烟草烟雾与学龄前儿童呼吸道症状的关联性. 科学通报, 2013, 58(25): 2535-2541.
28.	张铭, 周鄂生, 叶新, 等. 武汉地区室内环境质量与儿童哮喘和过敏性鼻炎患病率的关系. 科学通报, 2013, 58(25): 2559-2564.
29.	王晗, 李百战, 阳琴, 等. 重庆地区住宅室内潮湿问题和儿童哮喘及过敏性疾病的相关性分析: 横断面调查. 科学通报, 2013, 58(25): 2596-2604.
30.	周兰岛, 解继胜, 董光辉, 等. 百色市室内环境污染对儿童哮喘及哮喘样症状影响的流行病学调查. 中国卫生统计, 2013, 30(3): 354-356.
31.	吴金贵, 庄祖嘉, 钮春瑾, 等. 室内环境因素对儿童青少年呼吸道疾病影响的横断面研究. 中国预防医学杂志, 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, Röder 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.	张涛. 儿童肺炎流行特征、病原体诊断方法评价和肺炎链球菌多重PCR分型方法研究. 上海: 复旦大学, 2010.
40.	徐幽琼, Ignatius TS, 林捷, 等. 不同食用油和烹调方式的油烟成分分析. 中国卫生检验杂志, 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, 何万清, 等. 北京市典型餐饮企业VOCs排放特征研究. 环境科学, 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. 全国儿科哮喘协作组. 2000年与1990年儿童支气管哮喘患病率的调查比较. 中华结核和呼吸杂志, 2004, 27(2): 112-116.
3. 张安慧, 王幼玲, 赵洋, 等. 芜湖市城区学龄前儿童过敏性疾病的现况调查. 现代预防医学, 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, 刘茜, 等. 乌鲁木齐学龄前儿童哮喘和喘息样呼吸困难情况及其影响因素分析. 中国公共卫生, 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. Norbäck 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. 赵玉洁, 马兰, 滕增光, 等. 武汉市室内环境与6~8岁学龄儿童哮喘相关症状相关性分析. 环境与健康杂志, 2020, 37(7): 635-638.
14. 郭艳, 张浩玲, 何伦发, 等. 室内家居环境对儿童青少年呼吸系统健康影响. 中国公共卫生, 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. Norbäck 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. 张浩玲, 郭艳, 何伦发, 等. 中山市居室内被动吸烟对儿童哮喘及哮喘样症状的影响. 环境与健康杂志, 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, 赵卓慧. 乌鲁木齐市住宅室内潮湿表征与儿童哮喘及过敏性疾病的相关性. 环境与职业医学, 2015, 32(2): 97-103.
23. 杜向阳. 父母居室内吸烟对儿童呼吸系统疾病和症状的影响研究. 环境与健康杂志, 2015, 32(6): 501-504.
24. 王芳, 李蓓, 王敏. 宜昌市儿童哮喘的危险因素分析. 中国儿童保健杂志, 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. 刘炜, 黄晨, 胡宇, 等. 室内环境烟草烟雾与学龄前儿童呼吸道症状的关联性. 科学通报, 2013, 58(25): 2535-2541.
28. 张铭, 周鄂生, 叶新, 等. 武汉地区室内环境质量与儿童哮喘和过敏性鼻炎患病率的关系. 科学通报, 2013, 58(25): 2559-2564.
29. 王晗, 李百战, 阳琴, 等. 重庆地区住宅室内潮湿问题和儿童哮喘及过敏性疾病的相关性分析: 横断面调查. 科学通报, 2013, 58(25): 2596-2604.
30. 周兰岛, 解继胜, 董光辉, 等. 百色市室内环境污染对儿童哮喘及哮喘样症状影响的流行病学调查. 中国卫生统计, 2013, 30(3): 354-356.
31. 吴金贵, 庄祖嘉, 钮春瑾, 等. 室内环境因素对儿童青少年呼吸道疾病影响的横断面研究. 中国预防医学杂志, 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, Röder 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. 张涛. 儿童肺炎流行特征、病原体诊断方法评价和肺炎链球菌多重PCR分型方法研究. 上海: 复旦大学, 2010.
40. 徐幽琼, Ignatius TS, 林捷, 等. 不同食用油和烹调方式的油烟成分分析. 中国卫生检验杂志, 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, 何万清, 等. 北京市典型餐饮企业VOCs排放特征研究. 环境科学, 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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