Urban upbringing and childhood respiratory and allergic conditions: A multi-country holistic study

作者：Tischer Christina; Dadvand Payam; Basagana Xavier; Fuertes Elaine; Bergstrom Anna; Gruzieva Olena; Melen Erik; Berdel Dietrich; Heinrich Joachim; Koletzko Sibylle; Markevych Iana; Standl Marie; Sugiri Dorothea; Cirugeda Lourdes; Estarlich Marisa; Fernandez Somoano Ana; Ferrero Amparo; Ibarlueza Jesus; Lertxundi Aitana; Tardon Adonina; Sunyer Jordi; Anto Josep M

来源：Environmental Research, 2018, 161: 276-283.

DOI：10.1016/j.envres.2017.11.013

• Indoor exposure
• Microbial load
• Green space
• Grey space
• Asthma
• Allergic rhinitis

Objective: We integratively assessed the effect of different indoor and outdoor environmental exposures early in life on respiratory and allergic health conditions among children from (sub-) urban areas.
Methods: This study included children participating in four ongoing European birth cohorts located in three different geographical regions: INMA (Spain), LISAplus (Germany), GINIplus (Germany) and BAMSE (Sweden). Wheezing, bronchitis, asthma and allergic rhinitis throughout childhood were assessed using parental-completed questionnaires. We designed "environmental scores" corresponding to different indoor, green- and grey-related exposures (main analysis, a-priori-approach). Cohort-specific associations between these environmental scores and the respiratory health outcomes were assessed using random-effects meta-analyses. In addition, a factor analysis was performed based on the same exposure information used to develop the environmental scores (confirmatory analysis, data-driven-approach).
Results: A higher early exposure to the indoor environmental score increased the risk for wheezing and bronchitis within the first year of life (combined adjusted odds ratio: 1.20 [95% confidence interval: 1.13-1.27] and 1.28 [1.18-1.39], respectively). In contrast, there was an inverse association with allergic rhinitis between 6 and 8 years (0.85 [0.79-0.92]). There were no statistically significant associations for the outdoor related environmental scores in relation to any of the health outcomes tested. The factor analysis conducted confirmed these trends.
Conclusion: Although a higher exposure to indoor related exposure through occupants was associated with anincreased risk for wheezing and bronchitis within the 1st year, it might serve as a preventive mechanism against later childhood allergic respiratory outcomes in urbanized environments through enhanced shared contact with microbial agents.

• 出版日期2018-2