Contribution of indoor and outdoor environments to PM2.5 personal exposure of children--VESTA study

Several studies among adult populations showed that an array of outdoor and indoor sources of particles emissions contributed to personal exposures to atmospheric particles, with tobacco smoke playing a prominent role (J. Expo. Anal. Environ. Epidemiol. 6 (1996) 57, Environ. Int. 24 (1998) 405, Arch. Environ. Health 54 (1999) 95). The Vesta study was carried out to assess the role of exposure to traffic emissions in the development of childhood asthma. In this paper, we present data on 68 children aged 8-14 years, living in the metropolitan areas of Paris (n = 30), Grenoble (n = 15) and Toulouse (n = 23), France, who continuously carried, over 48 h, a rucksack that contained an active PM2.5 sampler. Data about home indoor sources were collected by questionnaires. In parallel, daily concentrations of PM10 in ambient air were monitored by local air quality networks. The contribution of indoor and outdoor factors to personal exposures was assessed using multiple linear regression models. Average personal exposure across all children was 23.7 microg/m3 (S.D. = 19.0 microg/m3), with local means ranging from 18.2 to 29.4 microg/m3. The final model explains 36% of the total between-subjects variance, with environmental tobacco smoke contributing for more than a third to this variability; presence of pets at home, proximity of the home to urban traffic emissions, and concomitant PM10 ambient air concentrations were the other main determinants of personal exposure.     

Associations between ventilation and children’s asthma and allergy in naturally ventilated Chinese homes

Building ventilation is important for occupants’ health. There are few studies of associations between home ventilation and occupant's health in China. During 2013-2016, we measured ventilation in 399 homes in Tianjin and Cangzhou, China, and surveyed the health history of children. Ventilation rates were measured using mass balance of occupant generated CO₂. The associations of home ventilation with children's asthma and allergy were analyzed in different strata of time and space. A low bedroom ventilation at night was significantly associated with an increased proportion of rhinitis among children (rhinitis current, adjusted odds ratio (AOR): 1.59; 95% confidence interval (CI): 1.01-2.49; diagnosed rhinitis, AOR: 3.02 (1.16-7.89)). Our findings suggest a dose-response relationship between ventilation rate at night in children's bedrooms and rhinitis current. The night-time ventilation rate in bedrooms has a greater association with rhinitis than the whole home ventilation rate during daytime.     

Effects of environmental tobacco smoke on respiratory health of boys and girls from kindergarten: results from 15 districts of northern China

The effects of childhood environmental tobacco smoke (ETS) exposure on respiratory symptoms were investigated in 6053 kindergarten-aged children residing in 15 districts of northern China. Responses to a self-administered questionnaire completed by parents of children from 30 kindergartens were used to ascertain children with persistent cough, persistent phlegm, asthma symptom, current asthma, wheeze and wheeze without asthma. In first 2 years ETS exposure and current ETS exposure were associated with increased prevalence of persistent cough, persistent phlegm, wheeze and wheeze without asthma. Among boys, ETS exposure was associated with more respiratory symptoms and diseases than in girls. ETS exposure during pregnancy was associated with asthma symptom [odds ratio (OR), 3.00; 95% confidence interval (CI): 1.28-7.03], current asthma (OR, 3.38; 95% CI: 1.25-9.14), persistent cough (OR, 1.64; 95% CI: 1.13-2.37), persistent phlegm (OR, 1.74; 95% CI: 1.01-3.01), wheeze (OR, 1.75; 95% CI: 1.15-2.68), and wheeze without asthma (OR, 1.46; 95% CI: 1.01-2.37) only among boys. In boys, the adjusted ORs for increased risk of asthma symptom and current asthma for household exposures (> or =10 cigarettes smoked per day vs. none smoked) during workday were 2.04 (95% CI: 1.01-3.89) and 2.76 (95% CI: 1.06-9.58), respectively. We conclude that ETS exposure increases the occurrence of respiratory symptoms and diseases during childhood. Boys may be more susceptible to ETS than girls. PRACTICAL IMPLICATIONS: Environmental tobacco smoke (ETS) is a highly prevalent respiratory irritant. In agreement with previous cross-sectional studies, our study indicates that exposure to ETS may increase the occurrence of respiratory symptoms and diseases in children, and the association of ETS exposure and respiratory health of children increased in strength with number of cigarettes smoked inside the house per day during workday and day-off. Boys may be more susceptible to ETS than girls. These findings support the view that measures should be taken to reduce ETS exposure for children.     

The effect of ventilation strategies of child care centers on indoor air quality and respiratory health of children in Singapore

This paper reports the effects of ventilation strategies on indoor air quality (IAQ) and respiratory health of children within 104 child care centers (CCCs) in a hot and humid climate. The CCCs were categorized by ventilation strategies: natural (NV), air-conditioned and mechanically ventilated (ACMV), air-conditioned using split units (AC), and hybrid (NV and AC operated intermittently). The concentration levels of IAQ parameters in NV CCCs are characterized by the influence of the outdoors and good dilution of indoor pollutants. The lower ventilation rates in air-conditioned CCCs result in higher concentrations of occupant-related pollutants but lower outdoor pollutant ingress. This study also revealed lower prevalence for most asthma and allergy, and respiratory symptoms in children attending NV CCCs. In multivariate analyses controlled for the effects of confounders, the risk of current rhinitis among children is significantly higher if they attend mechanically ventilated CCCs compared to NV CCCs. Air-conditioned CCCs were also associated with higher adjusted prevalence ratio of severe phlegm and cough symptoms and lower respiratory illness. Finally, children attending CCCs with hybrid ventilation are at high risk for almost all the respiratory symptoms studied. PRACTICAL IMPLICATIONS: This large field study indicates that different ventilation strategies employed by child care centers can cause significant variations in the indoor air quality and prevalence of asthma, allergies and respiratory symptoms of attending children. The higher prevalence rates of allergic and respiratory symptoms among young children, whose immune system is still under-developed, in child care centers, whether fully or partially air-conditioned, suggest that ventilation and plausible growth and propagation mechanisms of allergens and infectious agents be further investigated.     

PVC--as flooring material--and its association with incident asthma in a Swedish child cohort study

The Dampness in Buildings and Health study (DBH) started in the year 2000 in V?rmland, Sweden, with a baseline questionnaire sent to all children (n = 14,077) aged 1-6. Five years later, a follow-up questionnaire was sent to the children who were 1-3 years at baseline. A total of 4779 children participated in both the baseline and the follow-up studies and constitute the study population in this cohort study. The aim of this study was to examine the association between exposure to PVC-flooring in the child's and parent's bedroom in homes of children aged 1-3 and the incidence of asthma, rhinitis, and eczema during the following 5-year period. Adjusted analyses showed that the incidence of asthma among children was associated with PVC-flooring in the child's bedroom (AOR 1.52; 95% CI 0.99-2.35) and in the parent's bedroom (1.46; 0.96-2.23). The found risks were on borderline of significance and should therefore be interpreted with caution. There was further a positive relationship between the number of rooms with PVC-flooring and the cumulative incidence of asthma. PVC-flooring was found to be a stronger risk factor for incident asthma in multifamily homes when compared with single-family houses and in smoking families compared with non-smoking families and in women. PRACTICAL IMPLICATIONS: These longitudinal data from the DBH study found an association between the presence of PVC-flooring in the home and incident asthma in children. However, earlier results from the DBH study have shown that PVC-flooring is one important source for phthalates in indoor dust, and exposure to such phthalates was found to be associated with asthma and allergy among children. This emphasizes the need for prospective studies that focus on the importance of prenatal and neonatal exposure to phthalates in the development of asthma and allergy in children.     

Association between ventilation rates in 390 Swedish homes and allergic symptoms in children

The aim of the study was to test the hypothesis that a low-ventilation rate in homes is associated with an increased prevalence of asthma and allergic symptoms among children. A total of 198 cases (with at least two of three symptoms: wheezing, rhinitis, eczema) and 202 healthy controls, living in 390 homes, were examined by physicians. Ventilation rates were measured by a passive tracer gas method, and inspections were carried out in the homes. About 60% of the multi-family houses and about 80% of the single-family houses did not fulfill the minimum requirement regarding ventilation rate in the Swedish building code (0.5 air changes per hour, ach). Cases had significantly lower ventilation rates than controls and a dose-response relationship was indicated. PRACTICAL IMPLICATIONS: A low-ventilation rate of homes may be a risk factor for allergies among children. Families with allergic children should be given the advice to have good ventilation in the home. In investigations, of associations between environmental factors and allergies, the air change rate in homes has to be considered.     

Associations between indoor environment in residential buildings in wet and dry seasons and health of students in upper northern Thailand

We performed a repeated questionnaire study on home environment and health (six medical symptoms) in 1159 junior high school students (age 12.8 ± 0.7 years) in upper northern Thailand in wet and dry seasons. Data on outdoor temperature, relative humidity (RH), and air pollution were collected from nearest monitoring station. Odds ratios (OR) were calculated by multi-level logistic regression. Most common symptoms were rhinitis (62.5%), headache (49.8%), throat (42.8%), and ocular symptoms (42.5%). Ocular symptoms were more common at lower RH and rhinitis more common in dry season. Water leakage (28.2%), indoor mold (7.1%), mold odor (4.1%), and windowpane condensation (13.6%) were associated with all six symptoms (ORs: 1.3–3.5). Other risk factors included cat keeping, environmental tobacco smoke (ETS), other odor than mold odor, gas cooking, and cooking with biomass fire. Biomass burning inside and outside the home for other reasons than cooking was associated with all six symptoms (ORs: 1.5–2.6). Associations between home environment exposure and rhinitis were stronger in wet season. In conclusion, dampness-related exposure, windowpane condensation, cat keeping, ETS, gas cooking, and biomass burning can impair adolescent health in upper northern Thailand. In subtropical areas, environmental health effects should be investigated in wet and dry seasons.     

Allergens in indoor air: environmental assessment and health effects

It has been suggested that the increase in morbidity and mortality for asthma and allergies, may also be due to an increase in exposure to allergens in the modern indoor environment. Indoor allergen exposure is recognised as the most important risk factor for asthma in children. House dust mites, pets, insects, plants, moulds and chemical agents in the indoor environment are important causes of allergic diseases. House dust mites and their debris and excrements that contain the allergens are normally found in the home in beds, mattresses, pillows, carpets and furniture stuffing, but they have also been found in office environments. Domestic animals such as cats, dogs, birds and rodents may cause allergic asthma and rhinoconjunctivitis. The exposure usually occurs in homes, but also in schools and kindergartens where domestic animals are kept as pets or for education; moreover, cat and dog owners can bring allergens to public areas in their clothes. Allergy to natural rubber latex has become an important occupational health concern in recent years, particularly among healthcare workers; when powdered gloves are worn or changed, latex particles get into the air and workers are exposed to latex aerosolised antigens. To assess the environmental risk to allergen exposure or to verify if there is a causal relationship between the immunologic findings in a patient and his/her environmental exposure, sampling from the suspected environment may be necessary.     

Current asthma and respiratory symptoms among pupils in relation to dietary factors and allergens in the school environment

The aim was to study asthma and allergy in relation to diet and the school environment. Pupils (5-14 years) in eight schools received a questionnaire, 1014 participated (68%). Settled dust was collected on ALK-filters and analyzed for allergens from cat (Fel d 1), dog (Can f 1), horse (Equ cx), house dust mites (Der p 1, Der f 1), and cockroach (Bla g 1) by ELISA. In total, 6.8% reported cat allergy, 4.8% dog allergy, 7.7% doctor's diagnosed asthma and 5.9% current asthma, and 7.8% reported wheeze. Current asthma was less common among those consuming more fresh milk (P < 0.05) and fish (P < 0.01). Poly-unsaturated fatty acids was associated with more wheeze (P < 0.05), olive oil was associated with less doctors' diagnosed asthma (P < 0.05). Totally, 74% of the classrooms had mean CO(2) <1000 ppm. The median concentration per gram dust was 860 ng/g Fel d 1, 750 ng/g Can f 1 and 954 U/g Equ cx. Horse allergen was associated with more wheeze (P < 0.05), daytime breathlessness (P < 0.05), current asthma (P < 0.05) and atopic sensitization (P < 0.05). Dog allergen was associated with wheeze (P < 0.05) and daytime breathlessness (P < 0.05). The associations between allergens and respiratory symptoms were more pronounced among those consuming margarine, not consuming butter, and with a low intake of milk. In conclusion, cat, dog and horse allergens in schools could be a risk factor for asthma and atopic sensitization, and dietary factors may interact with the allergen exposure. PRACTICAL IMPLICATIONS: Previous school studies performed by us in mid-Sweden, showed that most classrooms did not fulfill the ventilation standards. In this study, most of the classrooms fulfilled the ventilation standard, but despite that had widespread allergen contamination. Most previous studies have focused on cat allergen, but our study has shown that also dog and horse allergens can be risk factors for asthma and allergy in schools. As allergens are transported from other environments, mainly the home environment, the main prevention should be to minimize transfer of allergens. This could be achieved by reducing contacts with furry pets and horses, or using different clothes at home and at school (e.g. school uniforms). Increased cleaning in the schools may reduce allergen levels, but the efficiency of this measure must be evaluated in further intervention studies. Finally, our study supports the view that dietary habits among pupils should not be neglected and interaction between dietary factors and indoor allergen exposure needs to be further investigated.     

Indoor Environmental Risk Factors for Respiratory Health in Children

Abstract The indoor environment of 80 houses in the Latrobe Valley, Victoria, Australia was assessed during six visits performed bi-monthly over a period of one year. Children between 7 and 14 years of age residing in the houses were included, resulting in 148 study children, 53 of whom were asthmatic. A respiratory health questionnaire was completed and skin prick tests performed. Significant risk factors for asthma were: exposure to a gas stove (OR=3.15, 95% CI 1.28-7.72), and indoor pets (OR = 2.68, 95% CI 1.07-6.70). Exposure to airborne Aspergillus spores (+10 CFU/m³, OR=1.51, 95% CI 1.05-2.18) was a risk factor for atopy, while exposure to a gas stove (OR=2.32, 95% CI 1.04-5.18) was a risk factor for respiratory symptoms. In conclusion, exposure to gas stoves, fungal spores and pets in the home were identified as statistically significant risk factors for respiratory health in children.     

Breastfeeding modifies the effects of environment tobacco smoke exposure on respiratory diseases and symptoms in Chinese children: the Seven Northeast Cities Study

To evaluate the potential effect of interaction between breastfeeding and environmental tobacco smoke (ETS) exposure on respiratory health, we studied 31 049 children (aged 2–14 years) from 25 districts of seven cities in northeast China. Parents of the children completed standardized questionnaires that characterized the children's histories of respiratory symptoms and illness, feeding methods, ETS exposure, and other associated risk factors. Breastfeeding was defined as having been mainly breastfed for 3 months or more. The results showed that the association of ETS exposure with childhood respiratory conditions/diseases was modified by breastfeeding, and the association for nonbreastfed children was stronger than that for breastfed children. In particular, for nonbreastfed children, the odds ratios (ORs) for the effect of current ETS exposure asthma was 1.71 (95% CI: 1.43–2.05); however, the OR for breastfed children was 1.33 (95% CI: 1.20–1.48), indicating that the interactions between breastfeeding and current ETS exposure on asthma were statistically significant (P = 0.019). When stratified by school (kindergarten vs. elementary school), breastfeeding was more protective for asthma‐related symptoms among children from kindergarten. In conclusion, this study shows that breastfeeding is associated with smaller associations between ETS exposure and respiratory conditions in children, suggesting that breastfeeding reduces susceptibility to the respiratory effects of ETS.     

Biomarkers of exposure to passive smoking of school children: frequency and determinants

This study aims to assess the extent of children' exposure to ETS and quantify potential determinants. A total of 2767 children aged 5-14 years participated in an environmental survey in East Germany in 1998-1999 (participation rate 75.9%). A subgroup of 979 children between the ages of 11 and 14 years with complete data on nicotine and cotinine in urine were selected for this analysis. This study population consisted of 73 self-reported smokers (7.5%), 793 non-smokers (81%) and 113 children with missing data on smoking status (11.5%). Nicotine and cotinine concentrations in spontaneous urine sample were determined by high-performance liquid chromatography methods with ultraviolet-detection and corrected for creatinine. Approximately 40% of self-reported non-smokers were exposed to environmental tobacco smoke (ETS) at home. Non-smoking children exposed to parental tobacco smoke at home compared with not exposed showed in average higher nicotine and cotinine concentration (geometric mean 4.7 microg/l vs. 1.4 microg/l and 8.1 microg/l vs. 2.7 microg/l) and the adjusted odds ratio (OR) for detectable biomarkers ranged between 17 and 22. There were increased rates of detectable biomarkers in urine with increasing numbers of smoked cigarettes in the household (adjusted OR increased from 8 to 54). Maternal smoking showed a stronger effect than paternal smoking. Furthermore, low parental education, cold season, height of dwelling (相似文献   

Particle concentrations and effectiveness of free-standing air filters in bedrooms of children with asthma in Detroit,Michigan

Asthma can be exacerbated by environmental factors including airborne particulate matter (PM) and environmental tobacco smoke (ETS). We report on a study designed to characterize PM levels and the effectiveness of filters on pollutant exposures of children with asthma. 126 households with an asthmatic child in Detroit, Michigan, were recruited and randomized into control or treatment groups. Both groups received asthma education; the latter also received a free-standing high efficiency air filter placed in the child’s bedroom. Information regarding the home, emission sources, and occupant activities was obtained using surveys administered to the child’s caregiver and a household inspection. Over a one week period, we measured PM, carbon dioxide (CO₂), environmental tobacco smoke (ETS) tracers, and air exchange rates (AERs). Filters were installed at midweek. Before filter installation, PM concentrations averaged 28 μg m⁻³, number concentrations averaged 70,777 and 1471 L⁻¹ in 0.3–1.0 and 1–5 μm size ranges, respectively, and the median CO₂ concentration was 1018 ppm. ETS tracers were detected in 23 of 38 homes where smoking was unrestricted and occupants included smokers and, when detected, PM concentrations were elevated by an average of 15 μg m⁻³. Filter use reduced PM concentrations by an average of 69–80%. Simulation models representing location conditions show that filter air flow, room volume and AERs are the key parameters affecting PM removal, however, filters can achieve substantial removal in even "worst" case applications. While PM levels in homes with asthmatic children can be high, levels can be dramatically reduced using filters.     

Home dampness,childhood asthma,hay fever,and airway symptoms in Shanghai,China: associations,dose‐response relationships,and lifestyle's influences

Numerous studies of associations between dampness and respiratory diseases have been conducted, but their implications remain inconclusive. In this study of 13,335 parent‐reported questionnaires (response rate: 85.3%), we analyzed associations between home dampness and asthma and related symptoms in 4‐ to 6‐year‐old children in a cross‐sectional study of Shanghai. Indicators of home dampness were strongly and significantly associated with dry cough, wheeze, and rhinitis symptoms. In the current residence, children with visible mold spots (VMS) exposure had 32% higher risk of asthma (adjusted OR, 95% CI: 1.32, 1.07–1.64); damp clothing and/or bedding (frequently) was strongly associated with dry cough (1.78, 1.37–2.30); condensation on windows was strongly associated with hay fever (1.60, 1.27–2.01). In the early‐life residence, VMS or damp stains (frequently) were strongly associated with dry cough (2.20, 1.55–3.11) and rhinitis ever (1.57, 1.11–2.21). Associations between dampness and diseases among children with or without family history of atopy were similar. The total number of dampness indicators had strong dose‐response relationships with investigated health outcomes. Actions, including opening windows of the child's room at night and cleaning the child's room frequently, could potentially mitigate 25% of home VMS, thereby preventing more than 1.5% of attributable risk of the studied symptoms.     

Risk Factors Indoors and Prevalences of Childhood Respiratory Health in Four Countries in Western and Central Europe

Abstract The prevalence of respiratory symptoms and risk factors were gathered in four study centres in Western and Central Europe as part of an EU-funded multi-centre study addressing the use of small area methods in air pollution epidemiology (SAVI-AH). The study was carried out in Prague (CZ), Poznan (PL), Huddersfield (UK) and Amsterdam (NL). Prevalences of respiratory symptoms and risk factors between the centres were compared, and associations between risk factors and respiratory symptoms were calculated. Respiratory health was assessed by a self-administered questionnaire, distributed among parents or guardians of schoolchildren between the age of 7 and 11 years. Life-time wheezing and attacks of shortness of breath showed highest prevalences in Huddersfield (30% and 14%, respectively); usual cough showed highest prevalence in Poznan (27%). Differences in prevalence between the centres were found for the potential determinants “age” (due to different age ranges), “gas cooking” (highest in Amsterdam and Poznan), gas/coal heating (lowest in Central European centres), home dampness (highest in Western European centres), disturbance by traffic (highest in urban centres), maternal smoking (highest in Central European centres), family history (highest in Huddersfield) and education (highest in Huddersfield). The prevalence of pets in the home differed only slightly between the study centres. Of the potential deteminants studied, gender, family history of allergic diseases, dampness of the home and, to a lesser extent, passive smoking were important risk factors for life-time prevalence of respiratory symptoms in schoolchildren.     

A nationwide study of indoor and outdoor environments in allergen avoidance and conventional daycare centers in Sweden

Sweden has had specialized 'allergen avoidance daycare centers' (AADC) since 1979. The aim was to compare AADC with ordinary daycare centers (ODC). Through contacts with municipalities and hospitals, 72 AADC were identified. For each AADC, the two nearest ODCs served as controls. A questionnaire was sent to the local directors of the 216 daycare centers (531 sections), 83% responded. A total of 39% of the ODCs had ever had dampness/molds, 12% were near (<500 m) stables/farms, 23% were closer than 50 m to a heavy trafficked road, and 13% were exposed to wood smoke in winter. Only 11% of the AADCs had any child with furred pets at home, while 97% of the ODCs had children with furred pets. Bans on smoking at home and on perfumes were more common at the AADCs (P = 0.001). Fewer AADCs had PVC floors (OR = 0.53; P = 0.01), dampness/molds (OR = 0.55; P = 0.04), shelves (OR 3.03; P = 0.001), curtains (OR = 1.67; P = 0.047), and flowers (OR = 0.03; P < 0.001), while more had daily floor cleaning (OR = 19.9; P = 0.004), weekly wiping of furniture (OR = 11.0; P = 0.001), and washing of pillows/mattresses (OR = 2.74; P = 0.005) and curtains (OR = 9.07; P = 0.001). In conclusion, allergy avoidance daycare centers differ from other daycare centers, and may have better indoor environments. PRACTICAL IMPLICATIONS: There is a need to improve the indoor environments of daycare centers, including reduction of building dampness and molds. Allergen avoidance daycare centers (AADC) in Sweden differ from ordinary daycare centers in many respects, with fewer indoor and building factors related to dust, allergens and irritants. This shows that the indoor environments of daycare centers can be improved. Data suggest that AADC may have lower levels of pet allergens, and this is beneficial for children with pet allergy. The effects of these improvements on indoor exposures and health of the children need to be further evaluated.     

The Acute Effect of Environmental Tobacco Smoke Exposure on Asthmatics: Studies with a Dynamic Challenge Chamber

Abstract To determine the acute effects of environmental tobacco smoke on respiratory tract lung function, 130 asthmatics and 28 non-asthmatics were exposed up to 4 hours to side stream environmental tobacco smoke (SS-ETS) in a dynamic challenge chamber. The vast majority of the subjects exposed to SS-ETS reported upper respiratory and ocular irritant symptoms; the prevalence of these symptoms was not significantly associated with any particular study groups analyzed, or with the self-perception of tobacco smoke allergy by the study subject. All 28 SS-ETS-exposed non-asthmatics had no significant change in lung function, while 26/130 asthmatics demonstrated a significant drop in pulmonary function (FEV₁≥20% decline), generally within 90 to 240 minutes after start of exposure. Classical late phase bronchoconstriction was not observed up to 24 hours following the challenge. Six/26 reactors had a significant drop in lung function following a sham control challenge, indicating that 20/130 asthmatics had a specific bronchoconstrictive response to SS-ETS. Responses to diminishing levels of SS-ETS demonstrated that some asthmatics can react to levels as low as 0.0128 cigarette – min/m³ (comparable to ETS levels in the homes of many smokers).     

Nasal hyperreactivity in allergic and non-allergic rhinitis: a potential risk factor for non-specific building-related illness

Self-reported non-allergic nasal symptom triggers in non-allergic ('vasomotor') rhinitis overlap with commonly identified environmental exposures in non-specific building-related illness. These include extremes of temperature and humidity, cleaning products, fragrances, and tobacco smoke. Some individuals with allergic rhinitis also report non-allergic triggers. We wished to explore the phenotypic overlap between allergic and non-allergic rhinitis by ascertaining self-reported non-allergic nasal symptom triggers among allergic rhinitics. Sixty subjects without work-related respiratory exposures or symptoms, aged 19-68 years, stratified by age, gender and (skin test-proven) allergic rhinitis status, were queried with regard to self-reported non-allergic nasal symptom triggers (aggregate score 0-8). In this sample, the number of self-reported non-allergic triggers was bimodal, with peaks at 1 and 5. Forty-two percent of seasonal allergic rhinitic subjects reported more than three non-allergic triggers, compared with only 3% of non-allergic non-rhinitics (P < 0.01). Subjects over 35 years were more likely to report one or more non-allergic triggers, particularly tobacco smoke (P < 0.05). Allergic rhinitics reported more non-allergic symptom triggers than did non-allergic, non-rhinitics. As indexed by self-reported reactivity to non-specific physical and chemical triggers, both non-allergic rhinitics and a subset of allergic rhinitics may constitute susceptible populations for non-specific building-related illness. PRACTICAL IMPLICATIONS: Judging by self-report, a substantial subset of individuals with allergic rhinitis--along with all individuals with nonallergic rhinitis (by definition)--are hyperreactive to non-allergic triggers. There is overlap between these triggers (elicited in the process of obtaining a clinical diagnosis) and environmental characteristics associated with 'problem buildings.' Since individuals with self-identified rhinitis report an excess of symptoms in most epidemiologic studies of problem buildings (even in the absence of unusual aeroallergen levels), rhintics may be acting as a 'sentinel' subgroup when indoor air quality is suboptimal. Together, non-allergic rhinitics plus allergic rhinitics with prominent non-allergic triggers, are thought to constitute approximately one-sixth of the US population.     

RACIAL,ECONOMIC, AND INSTITUTIONAL DIFFERENCES IN HOME MORTGAGE LOANS: St. Joseph County,Indiana

ABSTRACT: Numerous studies have documented racial and economic disparities in the home mortgage market. Almost all of these have been done in large urban areas, many of which have long histories of racial conflict and discrimination. Further, little attention has been paid to institutional disparities, i.e., the ways in which mortgage lenders differ among themselves in their community reinvestment performance. In this study, we profile the home mortgage lending of several institutions doing business in the medium-sized urban area of St. Joseph County, Indiana. We find tremendous differences between lenders, suggesting that bank practices and policies exert a great impact on how well low income and minority neighborhoods and individuals are served. Lender characteristics, such as the legal structure of the institution (e.g., commercial bank, credit union, savings and loan), branch locations, and other factors are associated with these disparities. We conclude by suggesting that several heretofore ignored variables need closer examination.     

Onset and remission of rhinitis among students in relation to the home and school environment—A cohort study from Northern China

Few prospective studies exist on indoor and outdoor air pollution in relation to adolescent rhinitis. We studied associations between onset and remission of rhinitis among junior high school students in relation to the home and school environment. A 2‐year questionnaire cohort study was performed among 1325 students (11‐15 years) in eight schools in Taiyuan, Northern China. Climate and air pollution were measured by direct reading instruments and passive samplers inside and outside the schools at baseline. Associations were calculated by multilevel logistic regression. Two‐year onset of rhinitis and weekly rhinitis were 26.7% and 13.1%, respectively. RH (P < 0.001), CO₂ (P < 0.01) and PM₁₀ (P < 0.01) in the classrooms, PM₁₀ (P < 0.01) and NO₂ (P < 0.05) outside the schools, and redecoration (OR = 2.25) and dampness/indoor mold at home (OR = 2.04) were associated with onset of weekly rhinitis. RH (P < 0.05) and CO₂ (P < 0.05) in the classroom and dampness/indoor mold (OR = 0.67) and environmental tobacco smoke (ETS) at home (OR = 0.63) reduced remission of rhinitis. In conclusion, dampness/mold and chemical emissions from new materials at home can increase onset of rhinitis and ETS and dampness/mold can reduce the remission. PM₁₀, RH, CO₂, and NO₂ at school can increase the onset, and RH and CO₂ can reduce the remission of rhinitis.