Mini-symposium: Pollutants and respiratory health in childrenIndoor air quality and respiratory health of children
Section snippets
Why indoor air pollution?
Outdoor air pollution has long been considered a considerable risk for human health, particularly since major air pollution events such as the London smog of the early 1950s. Although outdoor air pollution, particularly pollution associated with vehicle exhausts, remains a concern,2 there has been a growing recognition that IAP is of equal or greater significance to human health.3 Reasons for this include: the amount of time people spend indoors; the wide and varied range of indoor emission
IAP and children's respiratory health
Important indoor pollutants were identified in Table 1. Each of these has been associated with adverse respiratory health in children, although in many cases the data remain equivocal. Although indoor biological pollutants are an important contributor to respiratory disease in children,14 the remainder of this review will focus on the more ubiquitous chemical pollutants in homes.
Does IAP cause asthma?
Indoor allergens are considered by some, but not all, to be an important cause of asthma and allergy in children.14 In contrast, indoor chemical air pollutants are considered more likely to be, at worst, a trigger for asthmatic symptoms. A causative role for IAP in asthma is difficult to demonstrate, however, evidence is emerging that suggests some air pollutants may indeed contribute to the development of asthma and other allergic diseases in children. For example, exposure of pregnant women
Conclusion
In 2000, the US Institute of Medicine published a book on asthma and indoor air exposures,61 which concluded that for asthma exacerbations there was: sufficient evidence of a causal relationship with ETS; sufficient evidence of an association with NO2; and suggestive evidence of an association with formaldehyde. For asthma initiation, the authors concluded that there was no evidence of a causal relationship with any of the chemical pollutants although there was suggestive evidence of an
Final remarks
Children spend the majority of their time indoors at home and this is unlikely to change in the near future. Homes are still built to reduce air ‘leakage’ and increase energy efficiency. Again this remains a dominant factor in building design. The exchange between indoor and outdoor air, therefore, relies on the opening of external windows and doors. However, there is an increased reliance on mechanical means to control indoor climate, reducing the need for active ventilation. Some form of
References (65)
- et al.
Changing concepts of allergic disease: the attempt to keep up with real changes in lifestyles
J Allergy Clin Immunol
(1996) - et al.
The assessment of personal exposure to nitrogen dioxide in epidemiological studies
Atmos Environ
(1990) Something old, something new: indoor endotoxin, allergens and asthma
Paediatr Respir Rev
(2004)- et al.
Comparison of health of occupants and characteristics of houses among control homes and homes insulated with urea formaldehyde foam I
Methodology Environ Res
(1988) - et al.
Chronic respiratory effects of indoor formaldehyde exposure
Environ Res
(1990) - et al.
IPEADAM study: indoor endotoxin exposure, family status, and some housing characteristics in English children
J Allergy Clin Immunol
(2006) - et al.
Volatile organic compounds and indoor air
J Allergy Clin Immunol
(1994) - et al.
Effects of indoor painting and smoking on airway symptoms in atopy risk children in the first year of life results of the LARS-study. Leipzig Allergy High-Risk Children Study
Int J Hyg Environ Health
(2000) - et al.
Association between indoor renovation activities and eczema in early childhood
Int J Hyg Environ Health
(2006) - et al.
Polycyclic aromatic hydrocarbons, environmental tobacco smoke, and respiratory symptoms in an inner-city birth cohort
Chest
(2004)