Early-life exposure to household chemical products with relation to patterns of whistling and wheezing in children up to 5 years old and their association to asthma in school age

摘要

The prevalence of the asthmatic symptoms and asthma among children increases globally over the time. Few hypotheses about the causes of such increase have been proposed including the hygiene hypothesis saying that reduced exposure to pathogens in early childhood and increased exposure to anthropogenic irritants results in increased risk of whistling and wheezing symptoms in children. Evaluation of aspects related to asthmatic symptoms is of high importance in order to possibly reduce these inconvenient life obstacles. Of importance is to study the effects of such exposures longitudinally including many potential confounders. The Czech part of the European Longitudinal Study of Pregnancy and Childhood (ELSPAC) which was established in the early nineties in the Czech Republic with recruitment of thousands of families and follow up until the 19 years of children, has been used to evaluate the hypothesis. The Central European region is currently understudied and its results may support the results from other similar studies. Composite household chemical exposure scores have been used in line with sister study ALSPAC and they were standardized after and expressed as a z-score. Whistling and wheezing patterns were based on the reported onsets and their persistency or transiency from birth until five years of age. Social, medical and environmental factors were taken into account for analysis. Multivariable multinomial logistic regression analysis was performed using patterns of wheezing/whistling as a study outcome. We were able to determine the association between several whistling and wheezing childhood patterns and the frequent usage of household chemicals in the fully adjusted model, which supports the hygiene hypothesis. Moreover, the persistent and late onset patterns were highly significantly associated with the school age asthma. Acknowledgements: Supported by the Czech Ministry of Education, Youth, and Sports (LM2015051 and CZ.02.1.01/0.0/0.0/15_003/0000469).