Objective

We integratively assessed the effect of different indoor and outdoor environmental exposures early in life on respiratory and allergic health conditions among children from (sub-) urban areas.

Methods

This study included children participating in four ongoing European birth cohorts located in three different geographical regions: INMA (Spain), LISAplus (Germany), GINIplus (Germany) and BAMSE (Sweden). Wheezing, bronchitis, asthma and allergic rhinitis throughout childhood were assessed using parental-completed questionnaires. We designed “environmental scores” corresponding to different indoor, green- and grey-related exposures (main analysis, a-priori-approach). Cohort-specific associations between these environmental scores and the respiratory health outcomes were assessed using random-effects meta-analyses. In addition, a factor analysis was performed based on the same exposure information used to develop the environmental scores (confirmatory analysis, data-driven-approach).

Results

A higher early exposure to the indoor environmental score increased the risk for wheezing and bronchitis within the first year of life (combined adjusted odds ratio: 1.20 [95% confidence interval: 1.13–1.27] and 1.28 [1.18–1.39], respectively). In contrast, there was an inverse association with allergic rhinitis between 6 and 8 years (0.85 [0.79–0.92]). There were no statistically significant associations for the outdoor related environmental scores in relation to any of the health outcomes tested. The factor analysis conducted confirmed these trends.

Conclusion

Although a higher exposure to indoor related exposure through occupants was associated with an increased risk for wheezing and bronchitis within the 1st year, it might serve as a preventive mechanism against later childhood allergic respiratory outcomes in urbanized environments through enhanced shared contact with microbial agents.

中文翻译：

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城市养育与儿童呼吸道和过敏性疾病：多国整体研究

客观的

我们综合评估了生活中不同的室内和室外环境暴露对（亚）城市地区儿童呼吸道和过敏性健康状况的影响。

方法

这项研究包括参与三个不同地理区域的四个正在进行的欧洲出生队列的儿童：INMA（西班牙），LISAplus（德国），GINIplus（德国）和BAMSE（瑞典）。使用父母填写的问卷评估了整个儿童时期的喘息，支气管炎，哮喘和过敏性鼻炎。我们设计了与不同的室内，绿色和灰色相关的暴露量相对应的“环境评分”（主要分析，先验方法）。使用随机效应荟萃分析评估了这些环境评分与呼吸健康结果之间的特定人群关联。此外，基于用于得出环境评分的相同暴露信息（确认分析，数据驱动方法）进行了因子分析。

结果

较高的室内环境分数早期暴露会增加出生后第一年内发生喘息和支气管炎的风险（组合调整后的优势比：1.20 [95％置信区间：1.13-1.27]和1.28 [1.18-1.39]）。相反，过敏性鼻炎在6至8岁之间呈负相关（0.85 [0.79–0.92]）。没有任何与户外健康相关的环境评分与任何健康结果相关的统计显着性关联。进行的因素分析证实了这些趋势。

结论

尽管在第一年中，乘员对室内相关暴露的暴露量增加与喘息和支气管炎的风险增加有关，但它可能是通过与微生物制剂加强共享接触来预防城市化环境中儿童后期过敏性呼吸道结局的预防机制。