RESUMO
We conducted a cross-sectional study to investigate the associations between recent home renovation exposure and lung function in children. We randomly recruited 7326 school children residing in 24 districts from seven cities in northeastern China. We collected information about home renovations from parents using a questionnaire and lung function measurements from children using spirometer recordings gathered by trained professionals and expressed as the forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), maximal mid-expiratory flow (MMEF), and peak expiratory flow (PEF). We identified higher odds of diminished lung function among these with home renovation in the previous 2 years compared to those without home renovation in the previous 2 years, for FVC (odds ratios [ORs] = 1.84 [95%CI: 1.58, 2.15]; FEV1: ORs = 2.82 [95%CI: 2.36, 3.36]; PEF: ORs = 1.51 [95%CI: 1.24, 1.83]; and MMEF: ORs = 1.90 [95%CI: 1.60, 2.24]). The associations were stronger among children exposed to new polyvinyl chloride (PVC) flooring compared to children exposed to other surface materials. Our results were consistent throughout the analysis of each type of renovation materials. In conclusion, recent home renovation exposure was associated with poor lung function among children. Strategies to protect home owners and their families from respiratory hazards during and after renovation are required.
Assuntos
Poluentes Atmosféricos/efeitos adversos , Poluição do Ar em Ambientes Fechados/efeitos adversos , Materiais de Construção/efeitos adversos , Exposição Ambiental/efeitos adversos , Pulmão/fisiopatologia , Poluentes Atmosféricos/análise , Poluição do Ar em Ambientes Fechados/análise , Criança , China , Cidades , Materiais de Construção/análise , Estudos Transversais , Exposição Ambiental/análise , Feminino , Pisos e Cobertura de Pisos , Volume Expiratório Forçado , Habitação , Humanos , Masculino , Pico do Fluxo Expiratório , Cloreto de Polivinila/efeitos adversos , Cloreto de Polivinila/análise , Testes de Função Respiratória , Espirometria , Capacidade VitalRESUMO
Continuing its path of Medicaid program innovation, Oregon recently embarked on a major reform that gives regional coordinated care organizations (CCOs) global budgets and accountability for the physical, behavioral, and dental care of the state's Medicaid beneficiaries (Howard et al. 2014). There are some who maintain that the state's bold reform initiative is overly aggressive in scope and unrealistically optimistic in schedule and may prove to be a costly debacle to the state of Oregon. We argue that the Oregon CCO model is not only bold in its aims and timetable but also realistically achievable.