Association between indoor renovation activities and eczema in early childhood

doi:10.1016/j.ijheh.2006.01.003

International Journal of Hygiene and Environmental Health

Volume 209, Issue 3, 16 May 2006, Pages 241-247

https://doi.org/10.1016/j.ijheh.2006.01.003 Get rights and content

Abstract

Background

Other factors besides a genetic disposition seem to play a role in the development of allergic disorders. Exposure to risk factors such as indoor air pollution is becoming increasingly interesting, especially during early childhood.

Methods

Within an epidemiological study (LISS: Leipzig infection, allergy and airway diseases study among school starters, involving 2536 children, birth cohort 1991/92, carried out in 1997/98) the effect of indoor exposure on physician-confirmed eczema and allergic symptoms has been investigated. The exposure situation has been characterized on hand of the redecoration activities (painting, floor covering and new furniture) before birth and in the first years of life.

Results

Highly exposed children showed a significant effect on allergic disorders. The lifetime prevalences without any vs. all three redecoration activities were for allergic symptoms 9.3% vs. 17.2% and for eczema 11.5% vs. 20.4%. Adjusted for confounders, the redecoration associated burden led to odds ratios of 1.8 (95% CI: 1.3–2.6) for allergic symptoms and 1.9 (95% CI: 1.4–2.7) for eczema.

Conclusion

Exposure emissions due to redecoration activities seem to be associated with the risk of eczema and allergic symptoms. Thus, prevention of allergic disorders should include the avoidance of such activities around birth and in the first year of life.

Introduction

Besides a genetic predisposition and the controversially discussed hygiene hypothesis (Strachan, 1989, Strachan, 2000), other factors influence the development of allergies in early childhood: food, pollens, etc., and as lately described also indoor chemical pollutants, particularly volatile organic compounds (VOCs) (Herbarth and Rehwagen, 1998; Wolkoff and Nielsen, 2001). Important VOC sources are, e.g., smoking and emissions from building materials and furnishings (Samet et al., 1987, Samet et al., 1988; Cooke 1991). During and following home renovation activities, e.g., painting and/or floor covering, indoor exposure levels can be high. These exposure situations have been found to affect inflammatory processes as well as allergic disorders (Harving et al., 1991; Koren et al., 1992; Ware et al., 1993; Norback et al., 1995; Wieslander et al., 1997; Diez et al., 2000). Moreover, it remains largely unclear whether a time window exists within which the organism may be especially sensitive to these specific environmental influences. Several studies have investigated the existence of a time period and whether varying factors of influence early in a child's life does lead to an increased incidence of sensitization later in life, including whether prenatal exposure via the mother may have an impact on the offspring. Until now these investigations have been restricted to environmental factors which are able to cause allergies directly above all to allergen exposure (Warner, 1999; Warner and Warner, 2000; Warner et al., 2000). The effect of possibly indirectly affecting factors—trigger factors—is to a great extent unknown except for smoking. First attempts to clear up the role of indoor chemicals is given by Diez et al. (2000) but restricted to risk groups.

The present study is intended not only to contribute to the debate of the extent of chemical noxes being involved in triggering allergen-induced processes but also address the question of timing by examining the influences of pre- and postnatal exposure due to renovation activities.

Section snippets

Study population

The presented investigation is based on the data of an epidemiologic cross-sectional study (LISS study—Leipzig infection, allergy and airway diseases study among school starters). The LISS study was carried out during the fall and winter 1997–1998 (birth cohort 1991/92) and included all children of the City of Leipzig and its surrounding county ( $n = 3919$ ) eligible to enter first grade in the fall of 1998 (Table 1). Participation was on a voluntary basis, requiring an informed written consent by

Results

At time of investigation (mean age of children 6.3±0.6 years) (Table 1), lifetime prevalences were 16.9% for eczema and 12.7% for allergic symptom manifestation. They are shown in Table 2 together with the frequencies of pertinent study parameters.

The control group has been selected considering all families who have not carried out any redecoration activities neither around birth nor afterwards in later life time. This concerns 537 study participants (21.2% of the study population). Table 3

Discussion

This study suggests an influence of residential renovation on allergic disorders. The chemical indoor exposure levels seem to play an important role because of the frequency of renovations which were carried out in the investigated households. Of all parents in this study 78.8% had redecorated their apartment before birth or in early life of the children, 36.9% had carried out all three activities (painting, floor covering and new furniture) (Table 3), 28.5% of them before birth and in the

Acknowledgements and grant information

The study was supported by the BMBF—Federal Ministry of Education and Research of Germany, the UFZ—Centre for Environmental Research Leipzig-Halle and the State Ministry of Family and Health of Saxony.

The authors wish to thank the children and their parents as well as the staff of the local public health departments for their excellent cooperation in carrying out the field study. We are also indebted to our co-workers of the LISS study team for the field work in the schools.

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The previous studies reported inconsistent associations of early residential decoration with childhood allergies and respiratory diseases. In this study, we conducted a 10-year retrospective observational survey among preschoolers from three urban districts in Chongqing of China in 2010 and in 2019, to investigate the associations of the prenatal and postnatal residential decorations with the childhood asthma, allergic rhinitis, eczema, wheeze, rhinitis, and pneumonia. We collected data from 4976 to 3971 of 3-6-year-olds preschoolers in the 2010 and 2019 surveys, respectively. The results showed that proportions of prenatal and postnatal residential decorations in different durations in 2010 were significantly higher than in 2019 (4.1%–19.6% vs. 2.1–5.3%). Except for allergic rhinitis (6.1% vs. 9.5%), prevalences of the studied diseases in 2010 also were significantly higher than in 2019 (for example: asthma: 8.2% vs. 6.1%; wheeze: 17.1% vs. 7.7%; rhinitis: 40.6% vs. 24.0%). In the two-level (district-child) logistic regression analyses, surveys in both 2010 and 2019 revealed that residential renovation and buying new furniture in prenatal and postnatal periods consistently increased odds of most studied diseases (ranges of adjusted odds ratio (AOR): 1.31–1.86). The prenatal decoration exposures had stronger associations with childhood allergies and respiratory diseases than the postnatal decoration exposures. The early residential decoration activities had stronger associations with allergies and respiratory diseases among girls and preschoolers without history of family allergy. Our findings indicate that prenatal and postnatal household decoration behaviors are risk factors for childhood airway diseases and allergies. Girls and children without family history of allergy are vulnerability groups.
Prenatal and perinatal home environment and reported onset of wheeze, rhinitis and eczema symptoms in preschool children in Northern China
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Early life environment can affect asthma and allergies but few cohort studies on this issue are available from China. Our aim was to investigate reported onset of childhood wheeze, rhinitis and eczema symptoms in relation to prenatal, perinatal and postnatal home environment. Data on home environment and symptoms (ISAAC based questions) in first two years of life and in the past 12 months were reported by parents of the children (3–6 y) in a cross-sectional questionnaire survey in ten day care centers in Taiyuan, northern China (N = 3606). Changes of symptoms from the first 2 years of life to the past 12 months (recall period) were calculated retrospectively. Multilevel logistic regression analysis was applied. Reported onset of wheeze, rhinitis and eczema were 11.8%, 22.2% and 3.3%, respectively. Redecorating during pregnancy increased reported onset of rhinitis (OR = 2.29) and eczema (OR = 4.91). New furniture during pregnancy increased reported onset of rhinitis (OR = 1.47). Perinatal indoor mould increased reported onset of wheeze (OR = 1.51), rhinitis (OR = 1.65) and eczema (OR = 1.91). Perinatal mould odour increased reported onset of wheeze (OR = 1.85). Perinatal window pane condensation increased reported onset of wheeze (OR = 1.54) and rhinitis (OR = 1.24). Perinatal stuffy air and dry air in the home increased reported onset of all three symptoms (ORs 1.46–2.24). Dog keeping increased reported onset of wheeze (OR = 1.69) and eczema (OR = 2.13). Based on principal component analysis, four exposure scores were calculated (renovation, new furniture, mould and indoor air quality scores). Dose-response relationships were observed between these exposure scores and reported onset of symptoms. In conclusion, prenatal and postnatal exposure to emissions from renovation and new furniture can increase reported onset of childhood wheeze, rhinitis and eczema. Perinatal indoor mould, mould odour, condensation on window panes and impaired indoor air quality at home can be associated with reported development of wheeze, rhinitis and eczema in preschoolers in northern China.
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We investigated associations between prenatal and postnatal environmental factors and onset and remission of preschool childhood eczema across China. The study population was preschoolers in randomized day care centers in seven cities (N = 39,782). Data on eczema and prenatal and postnatal indoor and outdoor environment were obtained from a cross-sectional questionnaire sent to parents or other guardians. Reports on eczema in the first 2 years and in the past year was used to retrospectively calculate onset and remission (changes of reported eczema). Prenatal and postnatal outdoor temperature, NO₂ and PM₁₀ were modelled from official air pollution data. Associations were estimated by two-level logistic regression. Calculated onset rate was 3.2%/y and remission rate 29.2%/y. Exposure to NO₂ during pregnancy was associated with onset of eczema, similarly for all trimesters. Postnatal PM₁₀ and NO₂ were related to decreased remission. Postnatal outdoor temperature was associated with onset of eczema. Pre-natal and current redecoration or buying new furniture, and perinatal as well as current dampness and indoor mould, were associated with increased onset and decreased remission. Cockroaches in current home was another indoor risk factors. Prenatal exposure to farm environment and large family size were all negatively associated with eczema. In conclusion, a warmer climate and prenatal NO₂ can be associated with increased onset of eczema in Chinese preschoolers. Postnatal PM₁₀ and NO₂ can be associated with reduced remission. Perinatal and current dampness, indoor mould and cockroaches may increase onset and decrease remission. Exposure to chemical emissions from indoor materials after first year of life may increase onset. Prenatal exposure to farm environment and large family size could be protective.
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Evidence linking prenatal exposure to outdoor air pollution with eczema in early childhood is scare, and the role of components of air pollution and exposure timing remains unclear.
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Association between indoor renovation activities and eczema in early childhood

Abstract

Background

Methods

Results

Conclusion

Introduction

Section snippets

Study population

Results

Discussion

Acknowledgements and grant information

Int. J. Hyg. Environ. Health

Int. J. Hyg. Environ. Health

Int. J. Hyg. Environ. Health

Int. J. Hyg. Environ. Health

J. Allergy Clin. Immunol.

Ann. Allergy Asthma Immunol.

Atmos. Environ.

Atopic dermatitis in early infancy predicts allergic airway disease at 5 years

Clin. Exp. Allergy

Indoor air pollutants. A literature review

Rev. Environ. Health

Lung function and bronchial reactivity in asthmatics during exposure to volatile organic compounds

Am. Rev. Respir. Dis.

VOCs—investigation into outdoor and indoor exposure: initial results

Umweltmed. Forsch. Prax.

Effect of volatile organic compounds in- and outdoors on allergies

Epidemiologic risk analysis of environmental attributed exposure on airway diseases and allergies in children

Cent. Eur. J. Public Health