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Fulltext Do indoor environments influence asthma and asthma-related symptoms among adults in homes?: a review of the literature

Jie Y, Ismail NH, Jie X, Isa ZM

J Formos Med Assoc, 2011 Sep;110(9):555-63.
PMID: 21930065 DOI: 10.1016/j.jfma.2011.07.003

This review summarizes the results of epidemiological studies focusing on the detrimental effects of home environmental factors on asthma morbidity in adults. We reviewed the literature on indoor air quality (IAQ), physical and sociodemographic factors, and asthma morbidity in homes, and identified commonly reported asthma, allergic, and respiratory symptoms involving the home environment. Reported IAQ and asthma morbidity data strongly indicated positive associations between indoor air pollution and adverse health effects in most studies. Indoor factors most consistently associated with asthma and asthma-related symptoms in adults included fuel combustion, mold growth, and environmental tobacco smoke. Environmental exposure may increase an adult's risk of developing asthma and also may increase the risk of asthma exacerbations. Evaluation of present IAQ levels, exposure characteristics, and the role of exposure to these factors in relation to asthma morbidity is important for improving our understanding, identifying the burden, and for developing and implementing interventions aimed at reducing asthma morbidity.

Matched MeSH terms: Air Pollution, Indoor/adverse effects*
Fulltext "Care and feeding": the Asian environmental tobacco smoke consultants programme

Assunta M, Fields N, Knight J, Chapman S

Tob Control, 2004 Dec;13 Suppl 2:ii4-12.
PMID: 15564219

STUDY OBJECTIVE: To review the tobacco industry's Asian environmental tobacco smoke (ETS) consultants programme, focusing on three key nations: China, Hong Kong, and Malaysia.
METHODS: Systematic keyword and opportunistic website searches of formerly private internal industry documents.
MAIN RESULTS: The release of the 1986 US Surgeon General's report on second hand smoke provoked tobacco companies to prepare for a major threat to their industry. Asian programme activities included conducting national/international symposiums, consultant "road shows" and extensive lobbying and media activities. The industry exploited confounding factors said to be unique to Asian societies such as diet, culture and urban pollution to downplay the health risks of ETS. The industry consultants were said to be "..prepared to do the kinds of things they were recruited to do".
CONCLUSIONS: The programme was successful in blurring the science on ETS and keeping the controversy alive both nationally and internationally. For the duration of the project, it also successfully dissuaded national policy makers from instituting comprehensive bans on smoking in public places.

Matched MeSH terms: Air Pollution, Indoor/adverse effects
Radiological impacts of the amang processing industry on neighbouring residents

Ismail B, Redzuwan Y, Chua RS, Shafiee W

Appl Radiat Isot, 2001 Mar;54(3):393-7.
PMID: 11214872

The processing of amang (one of a number of tin-tailing products) for its valuable minerals has associated with the radiological and environmental problems. The processing and stockpiling of amang and ilmenite in open-air spaces, subject as it is to environmental influences, gives rise to a potential for affecting residents in adjacent area. A case study was carried out in a residential area neighbouring a typical amang plant to investigate the radiological impact to the residents. The average Effective Dose rates, calculated based on the contributions of Effective Dose rates from inhaled suspended radioactive dust, radon-thoron and their progeny, and external gamma radiation, were determined for selected houses. Results show that the occupants of those houses received Effective Dose rate, which cannot be differentiated from background. The major contributor to the average Effective Dose rate came from external radiation sources. Inhaled radon and its progeny was the second major contributor.

Matched MeSH terms: Air Pollution, Indoor/adverse effects
Fulltext Prevalence of Penicillium specific Ig E level and allergy symptoms among office workers in a selected company in Bangi, Malaysia

Goh JC, Juliana J, Malina O, Ngah ZU, Norhafizalena O

Trop Biomed, 2007 Jun;24(1):37-46.
PMID: 17568376 MyJurnal

Indoor fungal reservoirs, particularly airborne Penicillium species, were identified throughout the ventilation system of the building and dissemination of fungi from those reservoirs was found to be occurring all the time. The objectives of this study were to determine the association between air concentration of indoor mould (Penicillium) and allergy symptoms among office workers. The study design used in this research was a cross-sectional study. Risk factors were identified through the questionnaire survey. Office workers were selected based on the proximity of their workstations to the microbiological air sampler used for the mould sampling. Results from the current study suggests that individual susceptibility of exposed subjects might be influenced by several factors associated with mould exposure; for example, inhaled mycotoxins or volatile organic compounds, which may, in some complex way, affect the immune response. This study provides the much needed preliminary baseline data for developing guidelines with validated findings that will be of use for policy decisions in Malaysia regarding indoor air quality. Results from this study are recommended for use in planning and implementing control measures in order to reduce the exposure to indoor mould and promote healthy working environment among the workers.

Matched MeSH terms: Air Pollution, Indoor/adverse effects*
Fulltext Indoor air quality and respiratory health among malay preschool children in Selangor

Rawi NA, Jalaludin J, Chua PC

Biomed Res Int, 2015;2015:248178.
PMID: 25984527 DOI: 10.1155/2015/248178

Indoor air quality (IAQ) has been the object of several studies due to its adverse health effects on children. Methods. A cross-sectional comparative study was carried out among Malay children in Balakong (2 studied preschools) and Bangi (2 comparative preschools), Selangor, with the aims of determining IAQ and its association with respiratory health. 61 and 50 children aged 5-6 years were selected as studied and comparative groups. A questionnaire was used to obtain an exposure history and respiratory symptoms. Lung function test was carried out. IAQ parameters obtained include indoor concentration of particulate matter (PM), volatile organic compounds (VOCs), carbon monoxide (CO), carbon dioxide (CO2), temperature, air velocity (AV), and relative humidity. Results. There was a significant difference between IAQ in studied and comparative preschools for all parameters measured (P < 0.001) except for CO2 and AV. Studied preschools had higher PM and CO concentration. FVC, FEV1, FVC% and FEV1% predicted values were significantly lower among studied group. Exposures to PM, VOCs, and CO were associated with wheezing. Conclusion. The finding concluded that exposures to poor IAQ might increase the risk of getting lung function abnormality and respiratory problems among study respondents.

Matched MeSH terms: Air Pollution, Indoor/adverse effects*
Indoor air pollution and asthma in hospitalized children in a tropical environment

Azizi BHO, Zulkifli HI, Kasim S

J Asthma, 1995;32(6):413-8.
PMID: 7592244 DOI: 10.3109/02770909409077752

We performed a hospital-based study to examine a hypothesis that indoor air pollution was associated with acute asthma in young children living in Kuala Lumpur City. A total of 158 children aged 1 month to 5 years hospitalized for the first time for asthma were recruited as cases. Controls were 201 children of the same age group who were hospitalized for causes other than a respiratory illness. Information was obtained from mothers using a standardized questionnaire. Univariate analysis identified two indoor pollution variables as significant factors. Sharing a bedroom with an adult smoker and exposure to mosquito coil smoke at least three nights in a week were both associated with increased risk for asthma. Logistic regression analysis confirmed that sharing a bedroom with an adult smoker (OR = 1.91, 95% CI 1.13, 3.21) and exposure to mosquito coil smoke (OR = 1.73, 95% CI 1.02, 2.93) were independent risk factors. Other factors independently associated with acute asthma were previous history of allergy, history of asthma in first-degree relatives, low birth weight, and the presence of a coughing sibling. There was no association between asthma and exposure to kerosene stove, wood stove, aerosol mosquito repellent, type of housing, or crowding. We conclude that indoor air pollution is an avoidable factor in the increasing morbidity due to asthma in children in a tropical environment.

Matched MeSH terms: Air Pollution, Indoor/adverse effects*
Fractional exhaled nitric oxide (FeNO) among school children in Java and Sumatra, Indonesia: associations with respiratory symptoms, house dust mite sensitization and the home environment

Norbäck D, Hashim JH, Hashim Z, Jalaludin J, Ismail R, Wieslander G, et al.

J Asthma, 2024 Dec;61(12):1772-1780.
PMID: 39066997 DOI: 10.1080/02770903.2024.2383627

OBJECTIVE: To study associations between fractional exhaled nitric oxide (FeNO) and asthma, airway symptoms, sensitization to common allergens, outdoor pollution and home environment among 380 students in eight junior high schools in two areas in Indonesia.
METHODS: Data on health and home were collected by a face-to face interview before measuring FeNO and performing skin prick test against common allergens. Exploratory linear mixed and logistic regression models were employed.
RESULTS: Geometric mean of FeNO was 17.8 ppb (GSD 2.09) and 139 students (36.6%) had elevated FeNO (>20 ppb). In total, 107 students (28.2%) were sensitized to house dust mite (HDM) (Der p1 or Der f1), 4 (1.1%) to cat and 3 (0.8%) to mold (Cladosporium or Alternaria). Moreover, 20 students (5.3%) had diagnosed asthma, 38 (10.0%) had current wheeze, and 107 (28.2%) had current rhinitis. HDM sensitization, diagnosed asthma, current wheeze, and current rhinitis were associated with FeNO. In total, 281 students (73.9%) had mold or dampness, 232 (61.1%) had environmental tobacco smoke (ETS) and 43 (11.3%) had other odor at home. Indoor mold or dampness and other odor at home were associated with FeNO. ETS was negatively associated with FeNO.
CONCLUSION: HDM sensitization and elevated FeNO can be common among children in this part of Indonesia. The high prevalence of elevated FeNO indicate that undiagnosed childhood asthma is common. Dampness, mold and odor at home can be associated with increased FeNO while ETS can be associated with decreased FeNO.

Matched MeSH terms: Air Pollution, Indoor/adverse effects
Volatile organic compounds (VOC), formaldehyde and nitrogen dioxide (NO2) in schools in Johor Bahru, Malaysia: Associations with rhinitis, ocular, throat and dermal symptoms, headache and fatigue

Norbäck D, Hashim JH, Hashim Z, Ali F

Sci Total Environ, 2017 Aug 15;592:153-160.
PMID: 28319702 DOI: 10.1016/j.scitotenv.2017.02.215

This paper studied associations between volatile organic compounds (VOC), formaldehyde, nitrogen dioxide (NO2) and carbon dioxide (CO2) in schools in Malaysia and rhinitis, ocular, nasal and dermal symptoms, headache and fatigue among students. Pupils from eight randomly selected junior high schools in Johor Bahru, Malaysia (N=462), participated (96%). VOC, formaldehyde and NO2 were measured by diffusion sampling (one week) and VOC also by pumped air sampling during class. Associations were calculated by multi-level logistic regression adjusting for personal factors, the home environment and microbial compounds in the school dust. The prevalence of weekly rhinitis, ocular, throat and dermal symptoms were 18.8%, 11.6%, 15.6%, and 11.1%, respectively. Totally 20.6% had weekly headache and 22.1% fatigue. Indoor CO2 were low (range 380-690 ppm). Indoor median NO2 and formaldehyde concentrations over one week were 23μg/m3 and 2.0μg/m3, respectively. Median indoor concentration of toluene, ethylbenzene, xylene, and limonene over one week were 12.3, 1.6, 78.4 and 3.4μg/m3, respectively. For benzaldehyde, the mean indoor concentration was 2.0μg/m3 (median<1μg/m3). Median indoor levels during class of benzene and cyclohexane were 4.6 and 3.7μg/m3, respectively. NO2 was associated with ocular symptoms (p<0.001) and fatigue (p=0.01). Formaldehyde was associated with ocular (p=0.004), throat symptoms (p=0.006) and fatigue (p=0.001). Xylene was associated with fatigue (p<0.001) and benzaldehyde was associated with headache (p=0.03). In conclusion, xylene, benzaldehyde, formaldehyde and NO2 in schools can be risk factors for ocular and throat symptoms and fatigue among students in Malaysia. The indoor and outdoor levels of benzene were often higher than the EU standard of 5μg/m3.

Matched MeSH terms: Air Pollution, Indoor/adverse effects*
Fulltext Interleukin-6 via sputum induction as biomarker of inflammation for indoor particulate matter among primary school children in Klang Valley, Malaysia

Nazariah SS, Juliana J, Abdah MA

Glob J Health Sci, 2013 Jul;5(4):93-105.
PMID: 23777726 DOI: 10.5539/gjhs.v5n4p93

In the last few years, air within homes have been indicates by various and emerging body as more serious polluted than those outdoor. Prevalence of respiratory inflammation among school children aged 8 and 10 years old attending national primary schools in urban and rural area were conducted in Klang Valley. Two population studies drawn from the questionnaires were used to investigate the association between indoor particulate matter (PM2.5 & PM10) in a home environment and respiratory implication through the understanding of biological responses. Approximately 430 healthy school children of Standard 2 and Standard 5 were selected. Indication of respiratory symptoms using adaptation questionnaire from American Thoracic Society (1978). Sputum sample collection taken for biological analysis. IL-6 then was analyse by using ELISA techniques. Indoor PM2.5 and PM10 were measured using Dust Trak Aerosol Monitor. The mean concentration of PM2.5 (45.38 µg/m3) and PM10 (80.07 µg/m3) in urban home environment is significantly higher compared to those in rural residential area (p=0.001). Similar trend also shows by the prevalence of respiratory symptom. Association were found with PM2.5 and PM10 with the level of IL-6 among school children. A greater exposure to PM2.5 and PM10 are associated with higher expression of IL-6 level suggesting that the concentration of indoor particulate in urban density area significantly influence the health of children.

Matched MeSH terms: Air Pollution, Indoor/adverse effects*