| Objective:Over the past few decades,asthma and allergic disease prevalence have been increasing in our country,environmental exposure is thought to be caused by the upward trend of the most important factor,but epidemiological evidence was limited about the relationship between indoor and outdoor home environment and family lifestyle in Liaoning province.In this study,a cross-sectional survey was conducted in Fuxin city,Liaoning province,to obtain the prevalence and epidemiological characteristics of childhood asthma and allergic diseases in Fuxin city,Liaoning province,and to explore indoor and outdoor household environmental factors and family lifestyle risk factors related to childhood asthma and allergic diseases in Liaoning province,to provide theoretical basis for the proposal of prevention and control measures.Methods:A cross-sectional study was conducted in this study,children under the age of14 were selected as the study subjects.A stratified cluster sampling method was used to sample the study population in Liaoning province from March to December in 2015.According to inclusion criteria:1.Voluntary project investigation;2.Age≤14 years old;3.Non-floating population,permanent residents of the area（those who have lived in the community for 6 months or more in the past 12 months）,taking children in Liaoning as the research object.Randomly in the form of a questionnaire survey to participate in school students’questionnaires,the final effective recovery rate of questionnaire was99.6%.Through the questionnaire,the information of children’s family indoor environmental factors,outdoor environmental factors and family living habits,as well as the prevalence of children’s asthma and allergic diseases were obtained.Multivariate regression analysis was used to establish different models according to different adjustment factors,and statistical correlation analysis was conducted between many factors in the family and children’s asthma,allergic rhinitis,eczema,and other diseases,and the odds ratios（OR values）and 95%confidence intervals（95%CIs）were calculated to obtain the risk factors related to children’s asthma,allergic rhinitis,and eczema.Results:A total of 3,276 children were eventually included in the study,ranging in age from 1 to 14 years.The incidence of allergic eczema diagnosed was the highest among allergic diseases,with a prevalence of 39.85%;the prevalence of diagnosed hay fever or allergic rhinitis was 5.01%and the prevalence of asthma was about 3.29%.There are more indoor environmental factors associated with diagnosed asthma and allergic diseases among children,which are related to the exposure time.After adjusting the covariates,interior decoration and furniture purchases at different stages of child growth have different effects on asthma and allergic diseases,new furniture purchases within a year before pregnancy increases the risk of allergic eczema（OR=2.09,95%CI:1.72-2.54）and asthma（OR=1.78,95%CI:1.11-2.84）in children,new furniture during purchases during pregnancy and after pregnancy significantly increases the risk of allergic eczema in children（P<0.05）;Decoration in the first year of pregnancy will have a negative impact on children’s allergic rhinitis and asthma,which will increase the risk of diseases by about 80%,decorating at age of 0-1 will increase the risk of more than 1 times of allergic eczema and asthma,home renovations after the age of 1 can significantly increase risk of hay fever or allergic rhinitis（OR=1.88,95%CI:1.16-3.06）;There is a strong association between indoor damp factors and asthma and allergic diseases in children,and there is a significant correlation between the birth of the child and the existing damp index and the occurrence of the disease.The presence of indoor mildew spots and wet stains,as well as the presence of indoor mildew odor,were significantly correlated with the diagnosis of asthma and allergic diseases in children,with OR values greater than 2,and the presence of indoor window water condensation at birth was statistically significant for the increased risk of allergic eczema and asthma（P<0.05）,when indoor wet factors are accumulated at birth,the risk of asthma and allergic diseases is significantly increased,and the trend of increased risk is statistically significant with the increase of exposure index(P trend<0.001);Among the existing humidity factors,indoor moldy odor is still a risk factor for hay fever or allergic rhinitis in children,with an OR value of 1.82（95%CI:1.02-3.25）.Childhood asthma is also significantly correlated with indoor moldy odor and window water condensation,with an OR value of3.20 and 1.73,respectively,the accumulation of existing indoor humidity factors significantly increased the risk of asthma and allergic eczema in children,and with the increase of exposure indicators,the trend of increased risk was statistically significant(all P trend<0.001),while the effect on hay fever or allergic rhinitis in children was not significant;Indoor perceived drying is a negative impact on children allergic eczema and asthma as well;The other important allergens in indoor environments were indoor mice and cockroaches,when more than two pests were reported indoors,the risk of allergic eczema（OR=1.60,95%CI:1.21-2.12）and asthma（OR=3.11,95%CI:1.31-7.40）was significantly increased in children,with a significant dose-response relationship(P trend<0.001).An important finding among the outdoor factors was that the risk of asthma,allergic eczema,and allergic rhinitis was significantly increased when the children’s residence was within 50 meters of major traffic arteries and within 500 meters of factories or smokestacks（P<0.05）.Moreover,the closer the children were to these sources of pollution,the higher the risk of asthma and allergic eczema was,and the increasing trend was statistically significant（P trend<0.01）.Among family habits,we found a strong association between childhood asthma and exposure to tobacco smoke.Maternal smoking during pregnancy（OR=4.05,95%CI:1.77-9.27）and passive smoking（OR=2.29,95%CI:1.43-3.69）increased the risk of asthma in children by more than2-4fold.Having smoking in the home at the age of 0-2 also increased the risk of asthma in children（OR=1.74,95%CI:1.07-2.81）,the risk of allergic eczema,asthma and suspected allergic symptoms in children increased with the accumulation of tobacco smoke exposure factors,showing a significant dose-response relationship(P trend<0.001);Besides,having a pet during pregnancy more than doubled the risk of asthma in children;Different from other factors,good air drying habits significantly reduced the risk of asthma in children.The OR value of occasional air drying of bedding was 0.38,and that of regular air drying of bedding was 0.20.In addition,frequent air drying of bedding significantly reduced the risk of allergic eczema in children（OR=0.70,95%CI:0.50-0.99）.Conclusions:In addition to genetic factors,childhood asthma and allergic diseases are influenced by indoor and outdoor environmental factors as well as a variety of factors in family habits.Indoor environmental conditions play an important role in the development of childhood asthma and allergic diseases.Home decoration and furniture purchases and indoor exposure to perceived humidity and dryness are associated with asthma and allergic disease.And different exposure times will have different effects on different diseases.When the accumulation of moisture-related factors and related factors increases,the risk of asthma and allergic diseases in children will increase to different degrees.In addition,indoor pests such as cockroaches and mice were found to be important factors affecting asthma and allergic diseases in children.Living near major highways,factories or smokestacks increases the risk of asthma and related allergies in children.Indoor exposure to tobacco smoke during different periods of children’s growth increases the risk of childhood asthma,and the cumulative increase of tobacco smoke exposure factors has a significant dose-response relationship with childhood asthma and allergic diseases.In addition,regular drying of bedding and good window ventilation can effectively reduce the risk of asthma and allergic diseases in children.The in-depth study on the influence of family factors on childhood asthma and allergies is of great significance for evaluating the pros and cons of indoor and outdoor environments,changing family living habits,and preventing and controlling diseases. |
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