The prevalence and risk factors of hoarseness among pupils in elementary schools in the South of Finland.

Purpose: Hoarseness and voice problems are one of the chronic conditions experienced by children. The aim of this study was to investigate the prevalence of hoarseness, possible risk factors and effects of the remediation of school buildings to the prevalence of hoarseness among school children.Methods: The material was gathered from all the schools in a large city in the south of Finland and the collection method used was an e-mail survey sent to the parents of the pupils and a simultaneous survey sent to the personnel in the schools.Results: All 51 schools participated, and 5889 pupils returned the questionnaire (39%). The exposure data was obtained from two building experts who knew the repair history of the schools. A subjective estimation of the quality of the indoor air was obtained from teachers and the parents. The overall prevalence of hoarseness among pupils was 6.3%; prevalence being higher in unrepaired school buildings than in schools in a good condition or buildings with a thorough remediation. Hoarseness was associated with asthma and allergies, several respiratory symptoms, and respiratory infections. Exposure to tobacco smoke increased the risk, and consumption of caffeine containing drinks seemed to reduce the risk. Noise, stuffiness of the indoor air and microbial smells correlated strongly with the occurrence of hoarseness in a logistic regression model when controlled for age, gender, asthma, passive smoking, and caffeine consumption.Conclusions: We recommend renovations in school buildings with the aim of providing better acoustics, sufficient ventilation, and a reduction in exposure to moisture damage microbes.

Hoarseness Among Young Children in Day-Care Centers.

BACKGROUND: Chronic respiratory symptoms among toddlers are assumed to be due to allergies and common respiratory infections. Because symptoms and respiratory disease in this age group often continue on to school age and later life, it is important to know the possible risk factors for prevention of the chronic hoarseness. AIM: We aimed to determine the current prevalence of hoarseness and other chronic respiratory symptoms among toddlers and young children. Another aim was to examine the risk factors for hoarseness in the building environments of day-care centers (DCC). MATERIAL: An electronic symptom survey was sent to all parents of children in day-care centers of a large city in southern Finland. In all, 3721 individuals completed the questionnaire (38%), 53.4% were the parents of boys and 46.6% girls. RESULTS: The prevalence of hoarseness was 5.6%. The boy's parents reported hoarseness more often than the girls, but no significant difference was observed. Risk factors for hoarseness in a built environment in this age group were noise, visible dust and dirt, mold and a cellar like odor, a sewer smell, other unpleasant smells, stuffiness of the indoor air, a too high or too low temperatures, a cold floor, insufficient ventilation, the age of the DCC building, and wood as the bearing construction of the building. The lifestyle factors that correlated with the prevalence of hoarseness were the amount of time spent outdoors; however, passive smoking, the number of siblings and pets at home did not correlate with hoarseness. Hoarseness was significantly correlated with other chronic respiratory symptoms such as rhinitis, coughs, eye irritation, tiredness, headaches, and stomach problems and also with the regular or periodic use of medication. Hoarseness was also significantly correlated with asthma and allergic rhinitis and also with repeated infections, such as a common cold, cold with a fever, laryngitis, otitis media and acute bronchitis, but not with tonsillitis or pneumonia. When potential confounders had been controlled for with a logistic regression model, the following risk factors in the built environment remained statistically significant: noise, high room temperature, insufficient ventilation and the stuffiness of the indoor air, a solvent odor, wood as the bearing construction and the age of the building. CONCLUSIONS: We conclude that in day-care centers, buildings should be maintained, cleaned and ventilated properly. Concrete and brick used in the construction were protective compared with wood. The acoustic environment should be planned to reduce noise indoors and solvent based chemicals should be avoided. Neither having pets at home or the number of siblings were risk factors, but they were also not found to be protective in this material. All measures that reduce the occurrence of respiratory infections probably also reduce chronic voice problems.

The associations of indoor environment and psychosocial factors on the subjective evaluation of Indoor Air Quality among lower secondary school students: a multilevel analysis.

Subjective evaluation of Indoor Air Quality (subjective IAQ) reflects both building-related and psychosocial factors, but their associations have rarely been studied other than on the individual level in occupational settings and their interactions have not been assessed. Therefore, we studied whether schools' observed indoor air problems and psychosocial factors are associated with subjective IAQ and their potential interactions. The analysis was performed with a nationwide sample (N = 195 schools/26946 students) using multilevel modeling. Two datasets were merged: (i) survey data from students, including information on schools' psychosocial environment and subjective IAQ, and (ii) data from school principals, including information on observed indoor air problems. On the student level, school-related stress, poor teacher-student relationship, and whether the student did not easily receive help from school personnel, were significantly associated with poor subjective IAQ. On the school level, observed indoor air problem (standardized ß = -0.43) and poor teacher-student relationship (standardized ß = -0.22) were significant predictors of poor subjective IAQ. In addition, school-related stress was associated with poor subjective IAQ, but only in schools without observed indoor air problem (standardized ß = -0.44).

Umbilical artery pH values at birth and risk of asthma at 5 to 6 years of age.

BACKGROUND: Intrapartum factors may have a role in the development of asthma and allergic diseases among offspring. OBJECTIVE: To investigate the association between umbilical arterial pH values at birth and asthma, allergic rhinitis, and atopic eczema in children. METHODS: We performed a case-control study of 222 asthmatic children and 183 control children aged 5 to 6 years with umbilical artery pH values recorded at birth. Associations were evaluated using logistic regression analysis. RESULTS: Asthmatic children had significantly lower umbilical artery pH values at birth than nonasthmatics, even after adjusting. Children who were born with pH values of 7.20-7.25 had a 2.62-fold (95% confidence interval [CI], 1.31-5.23) higher risk of asthma and children who were born with umbilical arterial pH values < or = 7.19 had a 3.22-fold (95% CI, 1.51-6.87) higher risk of asthma than children who were born with umbilical arterial pH values of 7.26-7.30. In contrast, children who were born with umbilical arterial pH values > or = 7.30 had a 0.41-fold lower risk of atopic eczema than children who were born with umbilical arterial pH values of 7.26-7.30. No such association was detected between umbilical artery pH values and allergic rhinitis. CONCLUSIONS: Stressful events at birth may play an important role in the development of asthma during early childhood. In contrast, higher umbilical arterial pH values were associated with a decreased risk of parent-reported atopic eczema at 5-6 years.

Moisture damage and childhood asthma: a population-based incident case-control study.

Most previous studies on the association between moisture damage and asthma have been cross-sectional and relied on self-reported exposure and health. The present authors studied the association by carrying out careful home inspections among new, clinically determined cases of asthma and controls. New cases of asthma aged 12-84 months (n = 121) were recruited prospectively and matched for year of birth, sex and living area with two randomly selected population controls (n = 241). Trained engineers visited all homes. Both cases and controls had lived >or=75% of their lifetime or the past 2 yrs in their current home. Risk of asthma increased with severity of moisture damage and presence of visible mould in the main living quarters but not in other areas of the house. Cases more often had damage in their bedroom. Associations were comparable for atopic and nonatopic asthma and for children aged >30 months or

Does the pill make a difference? Previous maternal use of contraceptive pills and allergic diseases among offspring.

BACKGROUND: Maternal use of oral contraceptive pills (OCPs) might increase the prevalence of allergic diseases among offspring. The aim of the study was to clarify if there are differences between OCP types in this association. METHODS: Primary outcomes were asthma, allergic rhinitis and atopic eczema among 1182 children (618 asthmatic and 564 controls) aged 5-6 years. RESULTS: Maternal previous use of desogestrel, gestodene or cyproterone acetate before pregnancy, each combined with ethinyloestradiol (EO), increased the risk of allergic rhinitis among offspring compared with those children whose mothers had not used OCPs (OR 1.67, 95% CI 1.07-2.59, P < 0.024), and this risk was increased mainly in those children with parental allergy (OR 1.78, 95% CI 1.11-2.86, P < 0.018), especially in boys (OR 2.12, 95% CI 1.17-3.84, P < 0.014). No associations were observed between maternal use of OCPs before pregnancy and asthma or atopic eczema among offspring. The association between the previous use of OCPs and allergic rhinitis was not mediated through maternal sex steroid levels during early pregnancy, but women who had used more androgenic types of progestin formulas had higher serum levels of progesterone during early pregnancy. CONCLUSION: Maternal previous use of desogestrel, gestodene or cyproterone acetate before pregnancy, each combined with EO, increased the risk of allergic rhinitis among offspring compared with those children whose mothers had not used OCPs and this risk was detected mainly in boys and in children with parental allergy.

Children's homes--determinants of moisture damage and asthma in Finnish residences.

UNLABELLED: Certain housing characteristics increase the risk for moisture damage, which has been associated with increased risk for asthma in children. Modeling moisture damage as a function of these characteristics could therefore provide a simple tool to estimate building-related risk for asthma. This study aimed to find out specific associations between asthma case-control status of children and moisture damage and housing characteristics. The data consisted of information on 121 asthmatic children and predominately two age-, gender- and place of residence-matched control children for every case, and information on moisture damage and housing characteristics in the homes of the children. In a previous study, we found a statistically significant association between moisture damage observations in main living areas and asthma in children. Using logistic regression, five models were formulated to predict moisture damage status of the homes and moisture damage status of living areas. The models were able to classify the damage status correctly in 65.0-87.7% of the homes (kappa values 0.10-0.47) as functions of housing characteristics. None of the models qualified as a significant determinant of the case-control status of the children. PRACTICAL IMPLICATIONS: It can be hypothesized that building-related risk for asthma could be roughly estimated using models predicting moisture damage status of buildings as a function of easily obtainable housing characteristics. The results of this study indicated that, with a moderate certainty, it is possible to model moisture damage status of buildings using housing characteristics. However, the models developed did not associate with asthma in children. In conclusion, it was not possible to estimate the risk for asthma by studying housing characteristics only, but detailed information on moisture damage (e.g. location of damage) was crucial for such estimation.