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Indoor Environmental Factors and Chronic Diseases in Swedish Pre-School Children: Risk factors and methodological issues investigated in a longitudinal study on airway diseases and autism spectrum disorder
Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Asthma and allergies have increased considerably during the past 40-50 years. Along with this increase, a heightened awareness regarding different neuro-developmental disorders such as autism spectrum disorder has occurred and it has been proposed that such disorders are also on the increase. It has been suggested that environmental factors, especially in the indoor environments, may be associated with the increase in these disorder, especially among children, who spend more than 90% of their time indoors.

The aim of this thesis has been to investigate certain environmental factors in homes and their impact on children’s health, in terms of asthma, rhinitis, eczema as well as autism spectrum disorders, and to identify certain methodological difficulties in epidemiological investigations.

We found that the mean incidence rate per year for doctor diagnosed asthma was in the range of 0.6-2.4% and for incidence of rhinitis 1.1-3.7%. The incidence rate of eczema ever was 2.7%. These results showed that when using a cohort established after birth the estimated incidence rates are strongly dependent of how the baseline population’s health and how the studied health outcome at follow up is defined.

Our results showed that the associations between parental reported moisture problems in the home and asthma in children that were revealed in cross-sectional analyses decreased or disappeared when longitudinal data were used on the same data set. Our results therefore indicate that associations between parental reported moisture problems and asthma from cross-sectional questionnaire studies should be interpreted with caution due to the risk for reporting bias.

Our results show that children who were living in homes with PVC-flooring in the bedroom in early childhood were more likely to develop asthma during the following 5-year period when compared with children living in homes without such flooring material. A similar association could be seen for children with autism spectrum disorder, where PVC-flooring in early childhood was associated with more reports of autism spectrum disorder five years later. These results indicate that building materials including suspected endocrine disrupting chemicals such as phthalates might be of importance for the development of these chronic diseases. Further studies are needed to explore the early life exposure and the mechanisms and contribution of phthalates for the development of chronic diseases.

Place, publisher, year, edition, pages
Karlstad: Karlstad University , 2010. , p. 81
Series
Karlstad University Studies, ISSN 1403-8099 ; 2010:32
Keyword [en]
asthma, rhinitis, eczema, autism spectrum disorder, indoor environment, moisture related problems, chemical exposure, methodological issues
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public Health Science
Identifiers
URN: urn:nbn:se:kau:diva-6485ISBN: 978-91-7063-324-9 (print)OAI: oai:DiVA.org:kau-6485DiVA, id: diva2:358591
Public defence
2010-12-10, Fryxellsalen, 1B 306, Karlstads universitet, Karlstad, 13:00 (Swedish)
Opponent
Supervisors
Note
Appendix A (en undersökning) och Appendix B (en undersökning)finns i den tryckta versionen av avhandlingenAvailable from: 2010-11-08 Created: 2010-10-20 Last updated: 2011-10-31Bibliographically approved
List of papers
1. Incidence rates of asthma, rhinitis and eczema symptoms and influential factors in young children in Sweden
Open this publication in new window or tab >>Incidence rates of asthma, rhinitis and eczema symptoms and influential factors in young children in Sweden
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2008 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 97, no 9, p. 1210-1215Article in journal (Refereed) Published
Abstract [en]

Aim: To estimate the incidence rates for asthma, rhinitis and eczema symptoms and to investigate the importance of different influential factors for the incidence of these symptoms. Methods: The Dampness in Building and Health study commenced in the year 2000 in Värmland, Sweden with a parental questionnaire based on an ISAAC protocol to all children in the age of 1–6 years. Five years later a follow-up questionnaire was sent to the children that were 1–3 years at baseline. In total, 4779 children (response rate = 73%) participated in both surveys and constitute the study population in this cohort study. Results: The 5-year incidence of doctor-diagnosed asthma was 4.9% (95% CI 4.3–5.3), rhinitis was 5.7% (5.0–6.4) and eczema was 13.4% (12.3–14.5). However, incidence rates strongly depend on the health status of the baseline population. Risk factors for incident asthma were male gender and short period of breast-feeding. Allergic symptoms in parents were also a strong risk factor for incident asthma, as well as for rhinitis and eczema. Conclusion: When comparing incident rates of asthma between different studies it is important to realize that different definitions of the healthy baseline population will give rise to different incident rates.

Keyword
Baseline group, Children, Incidence, Influential factors
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public Health Science
Identifiers
urn:nbn:se:kau:diva-6610 (URN)10.1111/j.1651-2227.2008.00910.x (DOI)
Available from: 2010-11-25 Created: 2010-11-24 Last updated: 2017-12-12Bibliographically approved
2. Can we trust cross-sectional studies when studying the risk of moisture related problems indoor for asthma in children?
Open this publication in new window or tab >>Can we trust cross-sectional studies when studying the risk of moisture related problems indoor for asthma in children?
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2011 (English)In: International Journal of Environmental Health Research, ISSN 0960-3123, E-ISSN 1369-1619, Vol. 21, no 4, p. 237-247Article in journal (Refereed) Published
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public Health Science
Identifiers
urn:nbn:se:kau:diva-6615 (URN)10.1080/09603123.2010.533368 (DOI)000299646100001 ()
Available from: 2010-11-25 Created: 2010-11-25 Last updated: 2017-12-12Bibliographically approved
3. PVC - as flooring material - and its association with incident asthma in a Swedish child cohort study
Open this publication in new window or tab >>PVC - as flooring material - and its association with incident asthma in a Swedish child cohort study
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2010 (English)In: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 20, no 6, p. 494-501Article in journal (Refereed) Published
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public Health Science
Identifiers
urn:nbn:se:kau:diva-6618 (URN)10.1111/j.1600-0668.2010.00671.x (DOI)000284171900006 ()21070375 (PubMedID)
Available from: 2010-11-25 Created: 2010-11-25 Last updated: 2017-12-12Bibliographically approved
4. Associations between indoor environmental factors and parental-reported autistic spectrum disorders in children 6-9 years of age
Open this publication in new window or tab >>Associations between indoor environmental factors and parental-reported autistic spectrum disorders in children 6-9 years of age
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2009 (English)In: Neurotoxicology, ISSN 0161-813X, E-ISSN 1872-9711, no 30, p. 822-831Article in journal (Refereed) Published
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public Health Science
Identifiers
urn:nbn:se:kau:diva-6619 (URN)10.1016/j.neuro.2009.01.011 (DOI)
Available from: 2010-11-25 Created: 2010-11-25 Last updated: 2017-12-12Bibliographically approved

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