Gas cooking is associated with small reductions in lung function in children.

Inconsistent effects of gas cooking on lung function have been reported. In a previous study from Austria, we demonstrated a significant, though small, reduction of lung function parameters in children living in homes with gas stoves. We used a larger international database to check if this finding can be generalised. To study the relative impact of cooking with gas on lung function parameters of primary school children in a wide range of geographical settings, we analysed flow and volume data of approximately 24,000 children (aged 6-12 yrs) from nine countries in Europe and North America. Exposure information was obtained by comparable questionnaires and spirometry according to an American Thoracic Society/European Respiratory Society protocol. Linear regressions were used, controlling for individual risk factors and study area. Heterogeneity between study-specific results and mean effects were estimated using meta-analytical tools. On average, gas cooking reduced lung function parameters. Overall effects were small (-0.1-0.7%) and only significant for forced vital capacity and forced expiratory volume in 1 s. There was some indication that allergic children were more affected by gas cooking. Under current housing conditions, gas cooking is associated with only small reductions in lung function.

Exposure to indoor mould and children's respiratory health in the PATY study.

BACKGROUND: Living in a damp or mouldy home reportedly damages children's respiratory health, yet mould appears not to be a prominent risk factor in the public's perception. Analyses of data on over 58,000 children from the Pollution and the Young (PATY) study are presented. In this collaboration, researchers from 12 cross-sectional studies pooled their data to assess the effects of air quality on a spectrum of children's respiratory disorders. METHOD: Original studies were conducted in Russia, North America and 10 countries in Eastern and Western Europe. Pooled analyses were restricted to children aged 6-12 years. Associations between visible mould reported in the household and a spectrum of eight respiratory and allergic symptoms were estimated within each study. Logistic regressions were used, controlling for individual risk factors and for study area. Heterogeneity between study-specific results and mean effects (allowing for heterogeneity) were estimated using meta-analysis. RESULTS: Visible mould was reported by 13.9% of respondents in Russia, increasing to 39.1% in North America. Positive associations between exposure to mould and children's respiratory health were seen with considerable consistency across studies and across outcomes. Confounder-adjusted combined ORs ranged from 1.30 (95% CI 1.22 to 1.39) for "nocturnal cough" to 1.50 (1.31 to 1.73) for "morning cough". Evidence of stronger effects in more crowded households was statistically significant for only asthma and sensitivity to inhaled allergens. No consistent interactions between mould and age, sex or parental smoking were found. CONCLUSION: Indoor mould exposure was consistently associated with adverse respiratory health outcomes in children living in these diverse countries.

Parental education and children's respiratory and allergic symptoms in the Pollution and the Young (PATY) study.

Inequalities in health between socio-economic groups are a major public health concern. The current authors studied associations between parental socio-economic status (SES) and children's respiratory and allergic symptoms in 13 diverse countries, including the Russian Federation, North America (Canada and the USA), and countries across Eastern and Western Europe. Data of 57,000 children aged 6-12 yrs, originating from eight cross-sectional studies, were analysed. SES was defined by parental education. Respiratory and allergic symptoms were defined by parental questionnaire reports. Multiple logistic regressions showed that low parental education was associated with a decreased risk of inhalant allergy and itchy rash in school children. Furthermore, low parental education was associated with an increased prevalence of wheeze and nocturnal dry cough. No clear association was found between parental education and prevalence of doctor-diagnosed asthma and bronchitis. Part of the difference between socio-economic groups with regard to their children's symptoms was explained by established risk factors, such as parental allergy, smoking during pregnancy, pet ownership, crowding, mould/moisture in the home, use of gas for cooking, and air pollution (particulate matter with a diameter of <10 microm). However, differences remained after adjusting for these variables. Children's health was associated with parental education. The association could not fully be explained by established risk factors.

Risks of different self-approach to health in an industrial city population.

INTRODUCTION: The results of a number of epidemiological studies found relationship between low socio-economic status (SES) and worse health status. OBJECTIVES: The goal of the study is the evaluation of the health status in inhabitants of an industrial city, their different approach to health and preventive measures in relation with lifestyle factors and socio-economic status (SES). METHODS: A structured questionnaire was elaborated, distributed to a random sample of some 3,000 aged 25-70 and collected by postal delivery. RESULTS: A total of 634 completed questionnaires were analysed. The subjective health status was reported as good in 75% of respondents; it was positively correlated with education (p < 0.001), negatively with age; worse subjective health was significantly more reported in people economically non-active (p < 0.001). More than a half of the study sample suffered a serious chronic disease, significantly more in men (p < 0.01), in the less educated (p < 0.001), and the prevalence increased with age (p < 0.001). The health status improved with the level of education and economic situation and worsened with age. A better health status was identified in women and economically active people. Women more frequently took care about their limit of weight (mostly for esthetical reasons), use more medicaments than men, they were more interested in protective health information (p < 0.01). The use of medicaments was reported significantly less in economically active respondents than in non-active. About half of respondents regularly underwent preventive medical examinations at their practitioner (significantly more men--p < 0.05, economically active people--p < 0.001, and married--p < 0.01). Diseased respondents in the sample were significantly more discontent, more often in a lack of psychological well-being and more passive in comparison with the group of healthy respondents. Contrary to prediction the behaviour of ill individuals was less risky as compared with healthy people. CONCLUSIONS: A significant relationship between the groups of healthy and ill respondents was found in respect to sex, age and all the SES factors (education, economic activity and economical situation of family) except for marital status and density of housing. The health status improved with the level of education and economic situation and worsened with age. A better health status was identified in women and economically active people.

Evaluation of the response of a questionnaire study by using the GIS and standard statistical methods.

This study is a part of a larger project Nr. NJ 6139-3 funded by the Grant Agency of the Czech Ministry of Health. The aim of the paper was to analyse the response rate using standard statistical methods and the Geographical Information System (GIS); to indicate differences in the response by sex, age, education, and employment; to determine the breakpoint for the collection of questionnaires according to which we can estimate the total response rate; to indicate whether the study sample was representative enough to generalize the project results. The additional aim of the paper was to collect those background literary sources dealing with the response rate as a methodological paradigm. The statistical and GIS analysis were based on comparison of the total population data (Census 2001), the study sample and the sample of the completed questionnaires data in the 23 districts of the city of Ostrava. The information from the data collection was derived from the date of receipt for each questionnaire. The literature sources were obtained from the Internet--in total 228 papers from the period since 1986 to the present have been checked. The main results of this study are: the GIS analysis was confirmed in all stages by standard statistical methods--it can therefore be used as a valid tool for quick orientation in data and for the comparison of a study sample with the general population; we did not find significant differences in the course of the collection of the questionnaires between sex, age, education, and the employment of respondents; it can be seen that the breakpoint according to which we can estimate the total response rate, is the 10th day after the questionnaires are distributed by post (75% of the questionnaires collected); our sample is representative enough from the geographical point of view. More detailed information about the whole project and results already published or presented are available on the following web site: www.zuova.cz/projekty/ses/php.

Perceptual differences regarding health and environmental problems and their remedies in two states of the former Czechoslovakia.

In the framework of the Central European Study on Air pollution and Respiratory Health (CESAR), a risk perception and risk communication study was carried out in a total of 25 areas in Bulgaria, the Czech Republic, Hungary, Poland, Romania and the Slovak Republic. This paper is focused on the differences of perception between the Czech (CR) and the Slovak Republic (SR), and the other involved countries. The analysis is based on the data of a structured risk perception questionnaire survey of a random population sample. 6,043 completed questionnaires were collected from the total number of 14,400 distributed ones in 25 areas of the 6 countries. The risk perception was different in the CR and the SR, mainly concerning local environment and health of children in the CR and drug abuse including alcohol consumption and AIDS in the SR. In both countries environmental and health problems were seen as important, but the perceived responsibility for finding a solution was placed with different kinds of institutions.

Nutrition and respiratory health in children in six Central and Eastern European countries.

BACKGROUND: The results of studies on the effect of nutrition on respiratory diseases are inconsistent. The role of nutrition in children's respiratory health was therefore analysed within the cross sectional Central European Study on Air Pollution and Respiratory Health (CESAR). METHOD: A total of 20 271 children aged 7-11 were surveyed in six European countries. Respiratory health and food intake were assessed using questionnaires. Associations between four symptoms and nutritional factors were evaluated using logistic regression, controlling for area plus other potential confounders. RESULTS: All symptoms showed initial associations with nutritional factors. Low consumption of fish and of summer and winter fruit were the most consistent predictors. In a fully adjusted model low fish intake remained a significant independent predictor of persistent cough (OR=1.18; 95% CI 1.04 to 1.34), wheeze ever (OR=1.14; 95% CI 1.03 to 1.25) and current wheeze (OR=1.21; 95% CI 1.06 to 1.39) and a weaker predictor of winter cough (OR=1.10; 95% CI 0.99 to 1.23). Low summer fruit intake was a predictor of winter cough (OR=1.40; 95% CI 1.10 to 1.79) and persistent cough (OR=1.35; 95% CI 1.01 to 1.82). Low winter fruit intake was associated with winter cough (OR=1.28; 95% CI 1.09 to 1.51). Associations between symptoms and vegetable intake were inconsistent. Low summer intake was significantly associated with winter cough (OR=1.23; 95% CI 1.03 to 1.47) but, overall, winter intake had inverse associations with both coughs. Associations between winter vegetable intake and wheeze varied considerably between countries. CONCLUSION: A number of associations were found between respiratory symptoms and low intake of fish, fruit and vegetables in children. Low fish intake was the most consistent predictor of poor respiratory health. Fruit and vegetable intake showed stronger associations with cough than with wheeze.