Onset and remission of eczema at pre-school age in relation to prenatal and postnatal air pollution and home environment across China

Chan Lu; Dan Norbäck; Yinping Zhang; Baizhan Li; Zhuohui Zhao; Chen Huang; Xin Zhang; Hua Qian; Yuexia Sun; Jan Sundell; Juan Wang; Wei Liu; Qihong Deng

doi:10.1016/j.scitotenv.2020.142467

Onset and remission of eczema at pre-school age in relation to prenatal and postnatal air pollution and home environment across China

Sci Total Environ. 2021 Feb 10;755(Pt 1):142467. doi: 10.1016/j.scitotenv.2020.142467. Epub 2020 Sep 24.

Authors

Chan Lu¹, Dan Norbäck², Yinping Zhang³, Baizhan Li⁴, Zhuohui Zhao⁵, Chen Huang⁶, Xin Zhang⁷, Hua Qian⁸, Yuexia Sun⁹, Jan Sundell¹⁰, Juan Wang¹¹, Wei Liu¹², Qihong Deng¹³

Affiliations

¹ XiangYa School of Public Health, Central South University, Changsha, Hunan, China.
² XiangYa School of Public Health, Central South University, Changsha, Hunan, China; School of Energy Science and Engineering, Central South University, Changsha, Hunan, China; Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Electronic address: dan.norback@medsci.uu.se.
³ School of Architecture, Tsinghua University, Beijing, China.
⁴ Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Chongqing University, Chongqing, China.
⁵ Department of Environmental Health, Fudan University, Shanghai, China.
⁶ School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China.
⁷ Institute of Environmental Science, Shanxi University, Taiyuan, China.
⁸ School of Energy & Environment, Southeast University, Nanjing, China.
⁹ School of Environmental Science and Engineering, Tianjin University, Tianjin, China.
¹⁰ XiangYa School of Public Health, Central South University, Changsha, Hunan, China; School of Environmental Science and Engineering, Tianjin University, Tianjin, China.
¹¹ Department of Medical Sciences, Uppsala University, Uppsala, Sweden; Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Chongqing University, Chongqing, China.
¹² School of Architecture, Tsinghua University, Beijing, China; Institute for Health and Environment, Chongqing University of Science and Technology, Chongqing, China.
¹³ XiangYa School of Public Health, Central South University, Changsha, Hunan, China; School of Energy Science and Engineering, Central South University, Changsha, Hunan, China. Electronic address: qhdeng@csu.edu.cn.

PMID: 33035972
DOI: 10.1016/j.scitotenv.2020.142467

Abstract

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.

Keywords: Dampness; Eczema; Farm exposure; Mould; NO(2); PM(10); Renovation.

MeSH terms

Air Pollutants* / adverse effects
Air Pollutants* / analysis
Air Pollution*
Air Pollution, Indoor* / analysis
Child
Child, Preschool
China / epidemiology
Cities
Cross-Sectional Studies
Eczema* / epidemiology
Environmental Exposure
Female
Humans
Pregnancy
Retrospective Studies

Substances

Air Pollutants