Review Article

Sources of Indoor Air Pollution and Respiratory Health in Preschool Children

Table 4

Studies analyzing the relation between chemical compound sources in the home and respiratory health in children under 5 years of age.

Location
Year
Author
DesignSample population:
Age
Number of cases
Disease studiedExposureControl variablesResults: adjusted OR/RR (IC 95%)
Case definitionInformation sourceSource of chemical productsEvaluationLevels (% exposure)

Studies conducted in Europe

Oslo, Norway
1999
Jaakkola et al. [27]
Case-control nested in a birth cohort2 first years of life
251 pairs
Case: 2 episodes of bronchial obstruction or 1 episode 4 weeks- Q, at birth and at 6, 12, 18, and 24 months.
- Reports from the family physician
- Medical registers
Floor and wall covering materialsHome visit with systematic inspectionFloors
PVC:
Ca 72%,
Co 59%
Carpeting
Ca 39%,
Co 46%
Walls
Paper with PVC
Ca 32% Co 34%
Cloth wallpaper
Ca 31%,
Co 22%
- Atopy in parents
- Problems with humidity and other variables related to the surface covering materials used in the home
- Passive exposure to tobacco smoke
- Siblings
- Day care, breastfeeding, sex
Floors:
- PVC in 1 or more rooms: 1.89 (1.14–3.14)
- Carpeting in 1 or more rooms: 0.74 (0.48–1.13)
Wall coverings:
- Paper with PVC in 1 or more rooms: 0.72 (0.42–1.22)
- Cloth wallpaper in 1 or more rooms: 1.58 (0.98–2.54)

Oslo, Norway
1999
Oie et al. [28]
Paired case-control within a birth cohort2 first years of life
- 304 pairs
- Study of ventilation carried out for 172 pairs
Case: 2 episodes of bronchial obstruction or 1 episode 4 weeksQ: at birth and at 6, 12, 18, and 24 months.
Reports from the family physician
Medical registers
Textile or plastic indoor surfaces
Ventilation of the home
Q, home visit with systematic inspection and measurement of ventilation37% of the homes were insufficiently ventilated- History of atopy in parents
- Problems with humidity
- Passive exposure to tobacco smoke
- Siblings, breastfeeding, daycare at age one, sex
Cloth wallpaper
All children: 1.7 (0.94–2.93)
Depending on the ventilation of the home:
- Low: 3.7 (0.62–21,53)
- High: 1.7 (0.72–3.94)
- Index of exposure to plastics:
All: 2.9 (1.54–5.49)
Depending on the ventilation of the home:
- Low: 12.6 (1.00–159)
- High: 2.6 (1.02–6.58)

Espoo, (Helsinki) Finland
2000
Jaakkola et al. [29]
Transversal1–7 years
n: 2568
- Current asthma
- Allergic rhinitis
- Persistent wheezing
- Persistent cough
- Persistent phlegm
- Congestion/nasal secretions
- Respiratory infections
QPlastic wall coveringsQPlastic wall coverings in 2.8% of the homes- Parents’ education, a sole caregiver
- Presence of pets with fur or feathers, mold, and humidity
- Passive exposure to tobacco smoke,
- Daycare outside the home, sex, age
Persistent wheezing: 3.42 (1.13–10.36)
Persistent cough: 2.41 (1.04–5.63)
Persistent phlegm: 2.76 (1.03–7.41)
For the rest of the indicators, the results were not statistically significant

Leizpig, Germany
2000
Diez et al. [30]
Birth cohort
(high risk: premature or with risk factors for allergies)
Follow-up:
Check up at 6 weeks
(n: 339)
At l year (310)
Respiratory infections
(6 weeks)
Wheezing
(1 year)
Q (parents)
Clinical check up
Redecorating during pregnancyQRedecorating in 67% of the homes:
37% new carpeting
17% new adhesive carpeting
48% new paint
52% new furniture
- Heating, gas for cooking
- Size of home
- Pets
OR
- Respiratory infections in children at 6 weeks of age:
Redecorating: 5.6 (1.3–24.0)
- Wheezing in children 1 year of age:
Redecorating: 1.9 (1.1–3.5)

Leizpig, Germany
2003
Diez et al. [31]
Birth cohort (high risk)First 2 years of life
n: 186
Respiratory symptoms: wheezing, panting, obstructive bronchitis (excluding laryngitis)Q (parents)Redecorating in the homeQDuring pregnancy: 66%
During the first year: 19%
During the second year: 19%
- Atopy in parents,
- Humidity, pets
- Tobacco smoke
- IgE, birth weight, sex
OR
- During the first year:
Obstructive bronchitis: 4.1 (1.4–11.9)
Wheezing: 2.4 (0.7–8.6)
- During the second year:
Obstructive bronchitis: 4.1 (1.4–12.9)
Wheezing: 3.0 (1.0–9.1)

Stockholm
2004
Emenius et al. [32]
Paired case-control from the BAMSE cohortFrom birth to the age of 2
181 cases
359 controls
paired by age
Recurrent wheezingQ (parents)Having painted the home/child’s room in the year prior to the child’s birth or during the first year of life.
Ventilation in the home
Q, home visit with systematic inspection and measurement of ventilationPainting the house but not the child’s room:
Cases (16.6%)
Controls (20.9%)
Painting the child’s room:
Cases (40.9%)
Controls (30.6%)
- Maternal age, parents’ medical history (asthma, allergies), maternal smoking
- Age of building
- Breastfeeding
Painting the house but not the child’s room:
1.1 (0.7–1.9)
Painting the child’s room:
1.7 (1.1–2.6)
The amount of ventilation did not modify the correlation

Q: questionnaire