Environmental Medicine Integrating a Missing Element into Medical Education (1995) / Chapter Skim
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Case Study 54: Childhood Asthma and Indoor Enviromental Risk Factors
Case Study 54: Childhood Asthma and Indoor Enviromental Risk Factors
Pages 893-903
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From page 893... ...
A 20% feasibility subsample was chosen to wear a nitrogen dioxide monitoring badge during a 24-hour period. Multiple conditional logistic regression analysis showed that after personal susceptibility factors were controlled for, the following were independent risk factors for asthma: the mother's heavy smoking (odds ratio (OR)
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From page 894... ...
In rural areas surrounding the city, a postal code area indicates a region served by the post office or the postal branch. Controls were chosen from computerized family allowance files for the target region.
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From page 895... ...
The first category was personal susceptibility factors, family history of asthma, and past infectious diseases: the chills allergies, e.g., to food or clothing; parental and sibling asthma; and history of eczema, pneumonia, and tonsillectomy. The second category, environmental exposures in the home of a chemical nature, included maternal and paternal smoking; other smokers in the home; exposure to gas cooking appliances, kerosene space heaters, insulation material, and a fireplace or wood stove; and year of home construction.
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From page 896... ...
, each adjusted for the other, were independent risk factors for asthma. The percentages of parents and siblings with asthma and the prevalence of past infectious diseases for cases and controls are shown in table 1, along with matched odds ratios adjusted for child allergies and eczema.
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From page 897... ...
0 24.5 39.2 1.00 >0.5 to '10 18.0 43.0 0.75 0.29-1.93 >10 to <15 13.1 10.1 2.51 0.75-8.35 >15 44.2 7.5 10.54 3.48-31.89 Gas cooking appliance 6.6 5.2 1.33 0.68-2.58 Kerosene space heater 2.0 2.8 0.67 0.27-1.64 Mineral wool insulations 86.6 80.1 1.67 0.98-2.85 Urea formaldehyde foam insulations 2.2 1.9 1.26 0.31-5.17 Fireplace 21 .4 24.3 0.82 0.58-1 .17 Wood stove 16.6 17.7 0.91 0.62-1.32 Year of construction of first home inhabited by the child After t970 versus before 53.4 45.4 1.48 1.10-1.99 After 1980 versus before 20.7 14.0 1.54 1.04-2.29 Electric heating system 86.2 75.9 2.02 1.38-2.94 Central humidifier 8.5 11.8 0.67 0.42-1.07 Central air purifier 14.9 15.6 0.99 0.58-1.69 Central air conditioning 6.7 9.4 0.68 0.41-1.13 Humidifier in child's room 67.6 55.8 1.73 1.28-2.34 WalLt~wall carpets 56.5 55.3 1.03 0.71-1.50 Dampness on windows 63.6 67.9 0.85 0.58-1.26 Occupant density <1 person/ room 77.9 81.6 0.79 0.55-1.1 2 Pets 43.7 43.5 1.05 0.79-1.38 * Factors are defined as yes versus no if not otherwise specified.
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From page 898... ...
, whereas the presence of central air conditioning was a protective factor, likewise marginally significant tp c 0.08~. Multivanate unconditional logistic regression was camed out for the 140 subjects who had nitrogen dioxide measurements; the analysis included nitrogen dioxide and the variables retained in the final conditional model.
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From page 899... ...
for the analysis of risk factors among 457 cases diagnosed with asthma and 457 controls matched for age and area of residence, Montreal, Quebec, Canada, 1988-1990 Factort Odds 95°/° Child is allergic Child had eczema Asthma in father Asthma in siblings Child had pneumonia Child had tonsillectomy Mother smoking (cigarettes/day) >0 to <20 versus 0 1.16 >20 versus 0 Other smokers in the home 1.82 Humidifier in child's 2.77 room 1.89 Electnc heating sys tem 2.27 Central air conditioning 0.56 Mother has university education 1.60 No breast feeding 1.47 2.52 1.68 2.39 2.26 3.12 1 .50~.21 1.01 -2.81 1 .1 3-5.04 1 .19-4.29 1 .92-5.09 2.83 0.92-8.71 0.77-1 .76 1 .35-5.66 0.98-3.38 1 .30-2.74 1.41 -3.65 0.29-1 .08 0.96-2.67 1 .02-2.13 *
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From page 900... ...
Although an electric heating system was never found to be significant in any of the few studies that have considered it as a potential risk factor for childhood asthma (21, ENVIRONMENTAL MEDICINE
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From page 901... ...
901 In conclusion, this incident density casecontrol study showed that even after accounting for personal susceptibility, family history, past infections, and factors related to the indoor environment contribute significantly to the incidence of asthma. For future studies to have a greater impact on public health, it will be necessary to assess exposure-response relations and to relate findings to suggested protective standards.
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From page 902... ...
Risk factors for childhood respiratory diseases: the effect of host factors and home environmental exposures. Am Rev Respir Dis 1983;128:1038-43.
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From page 903... ...
Roberge D, et al. The changing frequency of childhood asthma.
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