Study: Risk factors in indoor environment of modern apartments related to pneumonia among children

Childhood pneumonia is the leading causes of death among children in China and worldwide. Using coal or wood as cooking fuel in rural area was considered as major cause of Pneumonia. However, the incidence of childhood pneumonia is still high in urban modern cities. Which home risk factors affect the incidence of childhood pneumonia in modern urban apartment? Professor Hua QIAN and his group from School of Energy and Environment, Southeast University set out to research this problem. A recent study found that the risk factors in indoor environment typical of modern apartments in China related to pneumonia among children. Their work, entitled "Home risk factors for childhood pneumonia in Nanjing, China", was published in CHINESE SCIENCE Bulletin.2013.

The study is part of the China, Child, Home, and Health (CCHH) project, which is investigating associations between home indoor environmental factors and children's health. This is a population-based cross-sectional study. The survey was performed and completed from December 2010 to March 2011 in Nanjing. Twenty-three kindergartens were randomly selected in the 11 districts. No kindergartens were selected in the 2 counties. Total 6461 questionnaires were distributed and 4014 properly filled-out questionnaires were returned, giving a response rate of 65.7%. The response rate was 61.8%, 68.4% and 82.0% for kindergartens in urban, suburban, and industrial areas respectively.

Statistical analysis was conducted using SPSS for Windows. Binary logistic models were used to test associations between home environmental exposure, building characteristics, life style and the risk of pneumonia infections. For those factors that reached significance in binary analysis, a multivariate logistic model was applied to calculate adjusted odds ratios for pneumonia infections. Step forward elimination techniques were used in the multivariate logistic regression model.

This study investigated the association between childhood pneumonia and indoor environment factors in modern homes. The pneumonia incidence is found to be high in Nanjing. Lack of ventilation, gas as cooking fuel, dampness, new furniture, "modern" floor and wall covering materials showed significant associations with the incidence of pneumonia. Other factors such as family allergy, child care by non-parents, other respiratory diseases were also reported to be associated with pneumonia. In summary, modern life style and home environment play an important role in developing pneumonia infections among children in Nanjing.