Parental stress and air pollution increase childhood asthma in China

Qihong Deng; Linjing Deng; Chan Lu; Yuguo Li; Dan Norbäck

doi:10.1016/j.envres.2018.04.003

Parental stress and air pollution increase childhood asthma in China

Environ Res. 2018 Aug:165:23-31. doi: 10.1016/j.envres.2018.04.003. Epub 2018 Apr 11.

Authors

Qihong Deng¹, Linjing Deng², Chan Lu², Yuguo Li³, Dan Norbäck⁴

Affiliations

¹ School of Energy Science and Engineering, Central South University, Changsha, Hunan, China; XiangYa School of Public Health, Central South University, Changsha, Hunan, China. Electronic address: qhdeng@csu.edu.cn.
² School of Energy Science and Engineering, Central South University, Changsha, Hunan, China.
³ Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, China.
⁴ School of Energy Science and Engineering, Central South University, Changsha, Hunan, China; Department of Medical Sciences/Occupational & Environmental Medicine, Uppsala University, Uppsala, Sweden.

PMID: 29655040
DOI: 10.1016/j.envres.2018.04.003

Abstract

Background: Although air pollution and social stress may independently increase childhood asthma, little is known on their synergistic effect on asthma, particularly in China with high levels of stress and air pollution.

Objectives: To examine associations between exposure to a combination of parental stress and air pollution and asthma prevalence in children.

Methods: We conducted a cohort study of 2406 preschool children in Changsha (2011-2012). A questionnaire was used to collect children's lifetime prevalence of asthma and their parental stress. Parental socioeconomic and psychosocial stresses were respectively defined in terms of housing size and difficulty concentrating. Children's exposure to ambient air pollutants was estimated using concentrations measured at monitoring stations. Associations between exposure to parental stress and air pollution and childhood asthma were estimated by multiple logistic regression models using odds ratio (OR) and 95% confidence interval (CI).

Results: Life time prevalence of asthma in preschool children (6.7%) was significantly associated with parental socioeconomic and psychosocial stresses with OR (95% CI) respectively 1.48 (1.02-2.16) and 1.64 (1.00-2.71). Asthma was also associated with exposure to air pollutants, with adjusted OR (95% CI) during prenatal and postnatal periods respectively 1.43 (1.10-1.86) and 1.35 (1.02-1.79) for SO₂ and 1.61 (1.19-2.18) and 1.76 (1.19-2.61) for NO₂. The association with air pollution was significant only in children exposed to high parental stress, the association with parental stress was significant only in children exposed to high air pollution, and the association was the strongest in children exposed to a combination of parental stress and air pollution. Sensitivity analysis showed that the synergistic effects of parental stress and air pollution on childhood asthma were stronger in boys.

Conclusions: Parental stress and air pollution were synergistically associated with increased childhood asthma, indicating a common biological effect of parental stress and air pollution during both prenatal and postnatal periods.

Keywords: Air pollution; Childhood asthma; China; Psychosocial stress; Social environment; Socioeconomic stress.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Air Pollution* / statistics & numerical data
Asthma* / epidemiology
Child
Child, Preschool
China
Cohort Studies
Environmental Exposure
Female
Humans
Male
Particulate Matter
Pregnancy
Psychology
Socioeconomic Factors
Stress, Psychological* / epidemiology
Surveys and Questionnaires

Substances

Particulate Matter