Atopic dermatitis and indoor use of energy sources in cooking and heating appliances

BMC Public Health

María Morales-Suárez-Varela^1,13  Alberto Arnedo-Pena^1,12  Francisco Guillén-Grima⁹  Antonio Martínez-Gimeno¹  Carlos González-Díaz⁷  Carlos Díaz-Vazquez⁶  Rosa María Busquets-Monge⁴  Alfredo Blanco-Quiros^1,11  José Batlles-Garrido⁸  Izaskun Miner-Canflanca^1,10  Ángel López-Silvarrey-Varela⁵  Agustín Llopis-González^1,13  Luís García-Marcos²  Ana M Vicedo-Cabrera³ 

[1] Department of Paediatric Pneumo-Allergy, 12 de Octubre Children’s Hospital, Madrid, Spain;Pulmology and Allergy Units, Virgen de la Arrixaca Children’s University Hospital, Murcia, Spain;Unit of Public Health, Hygiene and Environmental care, Department of Preventive Medicine, University of Valencia, Valencia, Spain;Department of Paediatrics, del Mar Hospital, Barcelona, Spain;Foundation María José Jove, A Coruña, Madrid, Spain;Health Centre of Moreda, Health Service of Principado de Asturias, Madrid, Spain;Department of Paediatrics, Basurto Hospital, Bilbao, Spain;Department of Paediatrics, Torrecárdenas Hospital, Almería, Spain;Section of Epidemiology, Centre of Public Health, Regional Ministry of Health, Castellón, Castellón, Spain;Department of Paediatrics, Donostia Hospital, San Sebastián, Spain;Department of Paediatrics, University of Valladolid, Valladolid, Spain;Department of Health Sciences, Public University of Navarre, Navarre, Spain;CIBER - Epidemiology and Public Health, Madrid, Spain

关键词: Children;    Indoor;    Biomass;    Gas;    Electricity;    Atopic dermatitis;   

Others  :  1162947
DOI  :  10.1186/1471-2458-12-890

 received in 2012-02-29, accepted in 2012-10-12,  发布年份 2012

【 摘 要 】

Background

Atopic dermatitis (AD) prevalence has considerably increased worldwide in recent years. Studying indoor environments is particularly relevant, especially in industrialised countries where many people spend 80% of their time at home, particularly children. This study is aimed to identify the potential association between AD and the energy source (biomass, gas and electricity) used for cooking and domestic heating in a Spanish schoolchildren population.

Methods

As part of the ISAAC (International Study of Asthma and Allergies in Childhood) phase III study, a cross-sectional population-based survey was conducted with 21,355 6-to-7-year-old children from 8 Spanish ISAAC centres. AD prevalence, environmental risk factors and the use of domestic heating/cooking devices were assessed using the validated ISAAC questionnaire. Crude and adjusted odds ratios (cOR, aOR) and 95% confidence intervals (CIs) were obtained. A logistic regression analysis was performed (Chi-square test, p-value < 0.05).

Results

It was found that the use of biomass systems gave the highest cORs, but only electric cookers showed a significant cOR of 1.14 (95% CI: 1.01-1.27). When the geographical area and the mother’s educational level were included in the logistic model, the obtained aOR values differed moderately from the initial cORs. Electric heating was the only type which obtained a significant aOR (1.13; 95% CI: 1.00-1.27). Finally, the model with all selected confounding variables (sex, BMI, number of siblings, mother’s educational level, smoking habits of parents, truck traffic and geographical area), showed aOR values which were very similar to those obtained in the previous adjusted logistic analysis. None of the results was statistically significant, but the use of electric heating showed an aOR close to significance (1.14; 95% CI: 0.99-1.31).

Conclusion

In our study population, no statistically significant associations were found between the type of indoor energy sources used and the presence of AD.

【 授权许可】

   
2012 Vicedo-Cabrera et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Asher MI, Montefort S, Björkstén B, Lai CK, Strachan DP, Weiland SK, Williams H, ISAAC Phase Three Study Group: Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC phases One and three repeat multicountry cross-sectional surveys. Lancet 2006, 368(9537):733-743.
• [2]Torres-Borrego J, Molina-Terán AB, Montes-Mendoza C: Prevalence and associated factors of allergic rhinitis and atopic dermatitis in children. Allergol Immunopathol (Madr) 2008, 36(2):90-100.
• [3]Asher MI, Stewart AW, Mallol J, Montefort S, Lai CK, Aït-Khaled N, Odhiambo J, ISAAC Phase One Study Group: Which population level environmental factors are associated with asthma, rhinoconjunctivitis and eczema? Review of the ecological analyses of ISAAC phase One. Respir Res 2010, 21:11-18.
• [4]Howden-Chapman P, Pierse N, Nicholls S, Gillespie-Bennett J, Viggers H, Cunningham M, Phipps R, Boulic M, Fjällström P, Free S, Chapman R, Lloyd B, Wickens K, Shields D, Baker M, Cunningham C, Woodward A, Bullen C, Crane J: Effects of improved home heating on asthma in community dwelling children: randomised controlled trial. BMJ 2008, 337:a1411.
• [5]Qian Z, He Q, Kong L, Xu F, Wei F, Chapman RS, Chen W, Edwards RD, Bascom R: Respiratory responses to diverse indoor combustion air pollution sources. Indoor Air 2007, 17(2):135-142.
• [6]Venn AJ, Yemaneberhan H, Bekele Z, Lewis SA, Parry E, Britton J: Increased risk of allergy associated with the use of kerosene fuel in the home. Am J Respir Crit Care Med 2001, 164(9):1660-1664.
• [7]Morales-Suárez-Varela M, Garcia-Marcos L, Kogan MD, Llopis González A, Martínez Gimeno A, Aguinaga Ontoso I, González Díaz C, Arnedo Peña A, Domínguez Aurrecoechea B, Busquets Monge RM, Blanco Quirós A, Batlles Garrido J, Miner Canflanca I, López-Silvarrey Várela A, Gimeno Clemente N: Parents’ smoking habit and prevalence of atopic eczema in 6-7 and 13-14 year-old schoolchildren in Spain. ISAAC phase III. Allergol Immunopathol (Madr) 2008, 36(6):336-342.
• [8]Nel AE, Diaz-Sanchez D, Ng D, Hiura T, Saxon A: Enhancement of allergic inflammation by the interaction between diesel exhaust particles and the immune system. J Allergy Clin Immunol 1998, 102:539-554.
• [9]Ponsonby AL, Dwyer T, Kemp A, Couper D, Cochrane J, Carmichael A: A prospective study of the association between home gas appliance use during infancy and subsequent dust mite sensitization and lung function in childhood. Clin Exp Allergy 2001, 31(10):1544-1552.
• [10]Choi H, Schmidbauer N, Sundell J, Hasselgren M, Spengler J, Bornehag CG: Common household chemicals and the allergy risks in pre-school age children. PLoS One 2010, 5(10):e13423. 18
• [11]Huss-Marp J, Eberlein-König B, Breuer K, Mair S, Ansel A, Darsow U, Krämer U, Mayer E, Ring J, Behrendt H: Influence of short-term exposure to airborne Der p 1 and volatile organic compounds on skin barrier function and dermal blood flow in patients with atopic eczema and healthy individuals. Clin Exp Allergy 2006, 36(3):338-345.
• [12]Willers SM, Brunekreef B, Oldenwening M, Smit HA, Kerkhof M, Vries H: Gas cooking, kitchen ventilation, and exposure to combustion products. Indoor Air 2006, 16(1):65-73.
• [13]Fullerton DG, Bruce N, Gordon SB: Indoor air pollution from biomass fuel smoke is a major health concern in the developing world. Trans R Soc Trop Med Hyg 2008, 102(9):843-851.
• [14]Kumar R, Nagar JK, Raj N, Kumar P, Kushwah AS, Meena M, Gaur SN: Impact of domestic air pollution from cooking fuel on respiratory allergies in children in India. Asian Pac J Allergy Immunol 2008, 26(4):213-222.
• [15]Wilkinson P, Smith KR, Beevers S, Tonne C, Oreszczyn T: Energy, energy efficiency, and the built environment. Lancet 2007, 370(9593):1175-1187.
• [16]Hanifin JM, Rajka G: Diagnostic features of atopic eczema. Acta Dermatol Venereol (Stockh) 1980, 92:44-47.
• [17]Eichenfield LF, Hanifin JM, Luger TA, Stevens SR, Pride HB: Consensus conference on pediatric atopic dermatitis. J Am Acad Dermatol 2003, 49(6):1088-1095.
• [18]Cole TJ, Bellizzi MC, Flegal KM, Dietz WH: Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000, 320(7244):1240-1243.
• [19]Platts-Mills TA: How environment affects patients with allergic disease: indoor allergens and asthma. Ann Allergy 1994, 72(4):381-384.
• [20]Padhi BK, Padhy PK: Domestic fuels, indoor air pollution, and children’s health. Ann N Y Acad Sci 2008, 1140:209-217.
• [21]Wichmann J, Wolvaardt JE, Maritz C, Voyi KV: Association between children’s household living conditions and eczema in the Polokwane area, South Africa. Health Place 2008, 14(2):323-335.
• [22]Zhang JJ, Smith KR: Household air pollution from coal and biomass fuels in China: measurements, health impacts, and interventions. Environ Health Perspect 2007, 115(6):848-855.
• [23]Development of WHO Guidelines for Indoor Air Qualityhttp://www.euro.who.int/__data/assets/pdf_file/0007/78613/AIQIAQ_mtgrep_Bonn_Oct06.pdf webcite
• [24]WHO Fuel for life. Household Energy and healthhttp://www.who.int/indoorair/publications/fuelforlife.pdf webcite
• [25]Di Giampaolo L, Di Donato A, Antonucci A, Paiardini G, Travaglini P, Spagnoli G, Magrini A, Reale M, Dadorante V, Iannaccone U, Di Sciascio MB, Di Gioacchino M, Boscolo P: Follow up study on the immune response to low frequency electromagnetic fields in men and women working in a museum. Int J Immunopathol Pharmacol 2006, 19(4 Suppl):37-42.
• [26]Gangi S, Johansson O: A theoretical model based upon mast cells and histamine to explain the recently proclaimed sensitivity to electric and/or magnetic fields in humans. Med Hypotheses 2000, 54(4):663-671.
• [27]Harris JM, Williams HC, White C, Moffat S, Mills P, Newman Taylor AJ, Cullinan P: Early allergen exposure and atopic eczema. Br J Dermatol 2007, 156(4):698-704.
• [28]Hesselmar B, Aberg B, Eriksson B, Aberg N: Allergic rhinoconjunctivitis, eczema, and sensitization in two areas with differing climates. Pediatr Allergy Immunol 2001, 12(4):208-215.
• [29]Ashida Y, Denda M: Dry environment increases mast cell number and histamine content in dermis in hairless mice. Br J Dermatol 2003, 149(2):240-247.
• [30]Ellingson AR, LeDoux RA, Vedanthan PK, Weber RW: The prevalence of dermatophagoides mite allergen in Colorado homes utilizing central evaporative coolers. J Allergy Clin Immunol 1995, 96(4):473-479.
• [31]Spertini F, Berney M, Foradini F, Roulet CA: Major mite allergen Der f 1 concentration is reduced in buildings with improved energy performance. Allergy 2010, 65(5):623-629.
• [32]Langan SM, Flohr C, Williams HC: The role of furry pets in eczema: a systematic review. Arch Dermatol 2007, 143(12):1570-1577.
• [33]Miyake Y, Ohya Y, Tanaka K, Yokoyama T, Sasaki S, Fukushima W, Ohfuji S, Saito K, Kiyohara C, Hirota Y, Osaka Maternal and Child Health Study Group: Home environment and suspected atopic eczema in Japanese infants: the Osaka maternal and child health study. Pediatr Allergy Immunol 2007, 18(5):425-432.
• [34]Suárez-Varela MM, Garcia-Marcos L, Kogan MD, Ferreira JC, Martínez Gimeno A, Aguinaga Ontoso I, González Díaz C, Arnedo Pena A, Domínguez Aurrecoechea B, Busquets Monge RM, Blanco Quiros A, Batlles Garrido J, García De Andoain N, Varela AL, García Merino A, Gimeno Clemente N, Llopis González A: Diet and prevalence of atopic eczema in 6 to 7-year-old schoolchildren in Spain: ISAAC phase III. J Investig Allergol Clin Immunol 2010, 20(6):469-475.