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Environmental risk factors for respiratory infection and wheeze in young children: A multicentre birth cohort study
Tom Ruffles1,2, Sarah K Inglis3, Anjum Memon4
1Academic Department of Paediatrics, Royal Alexandra Children's Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK.
Insights
Environmental factors significantly impact young children's respiratory health. Daycare attendance and home dampness increase infection risks, while breastfeeding offers protection, highlighting the need for public health interventions.
Area of Science:
- Pediatric Environmental Health
- Respiratory Medicine
- Epidemiology
Background:
- Respiratory infections and wheeze are common in young children, leading to significant healthcare utilization.
- Understanding environmental influences is crucial for mitigating childhood respiratory illnesses.
Purpose of the Study:
- To investigate the association between various environmental factors and respiratory infections/symptoms in early childhood.
- To identify key risk and protective factors for common childhood respiratory conditions.
Main Methods:
- Prospective birth cohort study (GO-CHILD) with 1344 children followed to 24 months.
- Assessment of environmental factors including daycare, breastfeeding, siblings, home dampness, environmental tobacco smoke (ETS), and traffic density.
- Data collection via postal questionnaires, analyzed using log binomial and ordered logistic regression.
Main Results:
- Daycare attendance linked to increased odds of pneumonia, bronchiolitis, and otitis media.
- Breastfeeding beyond 6 months associated with reduced odds of bronchiolitis and otitis media.
- Home dampness and ETS exposure correlated with increased respiratory symptoms and healthcare visits.
Conclusions:
- Environmental exposures play a significant role in the variability of childhood respiratory infections and symptoms.
- Further large-scale studies are needed to inform public health policies aimed at reducing the burden of pediatric respiratory diseases.
Introduction:
Respiratory infections and wheeze have a considerable impact on the health of young children and consume significant healthcare resources. We aimed to evaluate the effect of environmental factors on respiratory infections and symptoms in early childhood.
Methods:
Environmental risk factors including: daycare attendance; breastfeeding; siblings; damp within the home; environmental tobacco smoke (ETS); child's bedroom flooring; animal exposure; road traffic density around child's home; and solid fuel pollution within home were assessed in children recruited to the GO-CHILD multicentre prospective birth cohort study. Follow-up information on respiratory infections (bronchiolitis, pneumonia, otitis media and cold or flu), wheeze and cough symptoms, healthcare utilisation and medication prescription was collected by postal questionnaires at 12 and 24 months. Log binomial and ordered logistic regression models were fitted to the data.
Results:
Follow-up was obtained on 1344 children. Daycare was associated with increased odds of pneumonia (odds ratio [OR] = 2.39, 95% confidence interval [CI]: 1.04-5.49), bronchiolitis (OR = 1.40, 1.02-1.90), otitis media (OR = 1.68, 1.32-2.14) and emergency department attendance for wheeze (RR = 1.81, 1.17-2.80). Breastfeeding beyond 6 months was associated with a reduced odds of bronchiolitis (OR = 0.55, 0.39-0.77) and otitis media (OR = 0.75, 0.59-0.99). Siblings at home was associated with an increased odds of bronchiolitis (OR = 1.65, 1.18-2.32) and risk of reliever inhaler prescription (RR = 1.37, 1.02-1.85). Visible damp was associated with an increased odds of wheeze (OR = 1.85, 1.11-3.19), and risk of reliever inhaler (RR = 1.73, 1.04-2.89) and inhaled corticosteroid prescription (RR = 2.61, 1.03-6.59). ETS exposure was associated with an increased odds of primary care attendance for cough or wheeze (OR = 1.52, 1.11-2.08). Dense traffic around the child's home was associated with an increased odds of bronchiolitis (OR = 1.32, 1.08-2.29).
Conclusion:
Environmental factors likely influence the wide variation in infection frequency and symptoms observed in early childhood. Larger population studies are necessary to further inform and guide public health policy to decrease the burden of respiratory infections and wheeze in young children.
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