Abstract
Objectives
This study aimed to determine that home environmental factors were associated with atopic dermatitis in Japanese elementary school children.
Methods
In this cross-sectional study, a total of 4,254 children in 12 public elementary schools in Sapporo city in Hokkaido, Japan were examined. Atopic dermatitis was defined using the International Study of Asthma and Allergies in Childhood questionnaire. The questionnaires also contained 14 questions about the child’s home environment. To obtain multivariate-adjusted ORs for atopic dermatitis in relation to the home environment, we controlled for possible confounders including gender, school grade, parental history of allergies, number of siblings, and whether the child was firstborn. The study participants were then divided into two groups according to gender, and a stratified analysis was performed to obtain adjusted ORs for atopic dermatitis in relation to the home environment.
Results
The prevalence of atopic dermatitis in our sample was 16.7 %. Using fully adjusted models, the risk factors for atopic dermatitis were found to be the household use of a non-electric heating system without a ventilation duct to the outside (compared to the use of an electric heating system), having visible mould in the house, having a mouldy odour in the house, and condensation on the windowpanes in the house odds ratios (OR 1.25–1.54). In our stratified analysis, having visible mould and having a mouldy odour in the house were relevantly found to be risk factors for boys (OR 1.28–1.64). However, these associations were not found among girls.
Conclusions
To improve children’s health, further study is needed to corroborate the findings.
Similar content being viewed by others
References
Ahluwalia SK, Matsui EC (2011) The indoor environment and its effects on childhood asthma. Curr Opin Allergy Clin Immunol 11(2):137–143
Akdis CA, Akdis M, Bieber T, Bindslev-Jensen C, Boguniewicz M, Eigenmann P, Hamid Q, Kapp A, Leung DY, Lipozencic J, Luger TA, Muraro A, Novak N, Platts-Mills TA, Rosenwasser L, Scheynius A, Simons FE, Spergel J, Turjanmaa K, Wahn U, Weidinger S, Werfel T, Zuberbier T (2006) Diagnosis and treatment of atopic dermatitis in children and adults: European Academy of Allergology and Clinical Immunology/American Academy of Allergy, Asthma and Immunology/PRACTALL consensus report. Allergy 61(8):969–987
Al Shobaili HA (2010) The impact of childhood atopic dermatitis on the patients’ family. Pediatr Dermatol 27(6):618–623
Austin JB, Russell G (1997) Wheeze, cough, atopy, and indoor environment in the Scottish Highlands. Arch Dis Child 76(1):22–26
Baumer JH (2008) Atopic eczema in children, NICE. Arch Dis Child Educ Pract Ed 93(3):93–97
Bender BG, Leung SB, Leung DY (2003) Actigraphy assessment of sleep disturbance in patients with atopic dermatitis: an objective life quality measure. J Allergy Clin Immunol 111(3):598–602
Bender BG, Ballard R, Canono B, Murphy JR, Leung DY (2008) Disease severity, scratching, and sleep quality in patients with atopic dermatitis. J Am Acad Dermatol 58(3):415–420
Bornehag CG, Sundell J, Bonini S, Custovic A, Malmberg P, Skerfving S, Sigsgaard T, Verhoeff A (2004) Dampness in buildings as a risk factor for health effects, EUROEXPO: a multidisciplinary review of the literature (1998–2000) on dampness and mite exposure in buildings and health effects. Indoor Air 14(4):243–257
Bornehag CG, Sundell J, Hagerhed-Engman L, Sigsggard T, Janson S, Aberg N (2005) ‘Dampness’ at home and its association with airway, nose, and skin symptoms among 10,851 preschool children in Sweden: a cross-sectional study. Indoor Air 15(Suppl 10):48–55
Breuer K, Heratizadeh A, Wulf A, Baumann U, Constien A, Tetau D, Kapp A, Werfel T (2004) Late eczematous reactions to food in children with atopic dermatitis. Clin Exp Allergy 34(5):817–824
Chapman MD (2006) Challenges associated with indoor moulds: health effects, immune response and exposure assessment. Med Mycol 44:S29–S32
Chen W, Mempel M, Schober W, Behrendt H, Ring J (2008) Gender difference, sex hormones, and immediate type hypersensitivity reactions. Allergy 63(11):1418–1427
Eberlein-Konig B, Przybilla B, Kuhnl P, Pechak J, Gebefugi I, Kleinschmidt J, Ring J (1998) Influence of airborne nitrogen dioxide or formaldehyde on parameters of skin function and cellular activation in patients with atopic eczema and control subjects. J Allergy Clin Immunol 101(1 Pt 1):141–143
Eggleston PA (2003) Environmental control for fungal allergen exposure. Curr Allergy Asthma Rep 3(5):424–429
Fisk WJ, Eliseeva EA, Mendell MJ (2010) Association of residential dampness and mold with respiratory tract infections and bronchitis: a meta-analysis. Environ Health 9:72
Flohr C, Johansson SG, Wahlgren CF, Williams H (2004) How atopic is atopic dermatitis? J Allergy Clin Immunol 114(1):150–158
Fukuda M, Fukuda K, Shimizu T, Nobunaga M, Andersen EW, Byskov AG, Andersen CY (2011) Paternal smoking habits affect the reproductive life span of daughters. Fertil Steril 95(8):2542–2544
Govaere E, Van Gysel D, Massa G, Verhamme KM, Doli E, De Baets F (2007) The influence of age and gender on sensitization to aero-allergens. Pediatr Allergy Immunol 18(8):671–678
Green BJ, Mitakakis TZ, Tovey ER (2003) Allergen detection from 11 fungal species before and after germination. J Allergy Clin Immunol 111(2):285–289
Ibargoyen-Roteta N, Aguinaga-Ontoso I, Fernandez-Benitez M, Marin-Fernandez B, Guillen-Grima F, Serrano-Monzo I, Hermoso-de-mendoza J, Brun-Sandiumetge C, Ferrer-Nadal A, Irujo-Andueza A (2007) Role of the home environment in rhinoconjunctivitis and eczema in schoolchildren in Pamplona, Spain. J Investig Allergol Clin Immunol 17(3):137–144
Kanazawa A, Saijo Y, Tanaka M, Yoshimura T, Chikara H, Takigawa T, Morimoto K, Nakayama K, Shibata E, Kishi R (2010) Nationwide study of sick house syndrome: comparison of indoor environment of newly built dwellings between Sapporo city and Southern areas including those in Honshu and Kyushu. Nihon Eiseigaku Zasshi 65(3):447–458
Larsson M, Hagerhed-Engman L, Moniruzzaman S, Janson S, Sundell J, Bornehag CG (2011) Can we trust cross-sectional studies when studying the risk of moisture-related problems indoor for asthma in children? Int J Environ Health Res 21(4):237–247
Leung DY, Boguniewicz M, Howell MD, Nomura I, Hamid QA (2004) New insights into atopic dermatitis. J Clin Invest 113(5):651–657
Leung DYM, Eichenfield LF, Boguneiwicz M (2008) Atopic dermatitis. In: Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell D (eds) Fitzpatrick’s dermatology in general medicine, vol 1, 7th edn. The McGraw-Hill, USA, pp 146–158
McKenna SP, Whalley D, Dewar AL, Erdman RA, Kohlmann T, Niero M, Baro E, Cook SA, Crickx B, Frech F, van Assche D (2005) International development of the parents’ index of quality of life in atopic dermatitis (PIQoL-AD). Qual Life Res 14(1):231–241
Mitchell VL, Gershwin LJ (2007) Progesterone and environmental tobacco smoke act synergistically to exacerbate the development of allergic asthma in a mouse model. Clin Exp Allergy 37(2):276–286
Namkung JH, Lee JE, Kim E, Park GT, Yang HS, Jang HY, Shin ES, Cho EY, Yang JM (2011) An association between IL-9 and IL-9 receptor gene polymorphisms and atopic dermatitis in a Korean population. J Dermatol Sci 62(1):16–21
Narita S, Goldblum RM, Watson CS, Brooks EG, Estes DM, Curran EM, Midoro-Horiuti T (2007) Environmental estrogens induce mast cell degranulation and enhance IgE-mediated release of allergic mediators. Environ Health Perspect 115(1):48–52
Nemoto-Hasebe I, Akiyama M, Nomura T, Sandilands A, McLean WH, Shimizu H (2009) FLG mutation p.Lys4021X in the C-terminal imperfect filaggrin repeat in Japanese patients with atopic eczema. Br J Dermatol 161(6):1387–1390
Nomura T, Sandilands A, Akiyama M, Liao H, Evans AT, Sakai K, Ota M, Sugiura H, Yamamoto K, Sato H, Palmer CN, Smith FJ, McLean WH, Shimizu H (2007) Unique mutations in the filaggrin gene in Japanese patients with ichthyosis vulgaris and atopic dermatitis. J Allergy Clin Immunol 119(2):434–440
Osawa R, Konno S, Akiyama M, Nemoto-Hasebe I, Nomura T, Nomura Y, Abe R, Sandilands A, McLean WH, Hizawa N, Nishimura M, Shimizu H (2010) Japanese-specific filaggrin gene mutations in Japanese patients suffering from atopic eczema and asthma. J Invest Dermatol 130(12):2834–2836
Osawa R, Akiyama M, Shimizu H (2011) Filaggrin gene defects and the risk of developing allergic disorders. Allergol Int 60(1):1–9
Ponsonby AL, Dwyer T, Kemp A, Couper D, Cochrane J, Carmichael A (2001) A prospective study of the association between home gas appliance use during infancy and subsequent dust mite sensitization and lung function in childhood. Clin Exp Allergy 31(10):1544–1552
Roll A, Cozzio A, Fischer B, Schmid-Grendelmeier P (2004) Microbial colonization and atopic dermatitis. Curr Opin Allergy Clin Immunol 4(5):373–378
Saeki H, Iizuka H, Mori Y, Akasaka T, Takagi H, Kitajima Y, Tezuka T, Tanaka T, Hide M, Yamamoto S, Hirose Y, Kodama H, Urabe K, Furue M, Kasagi F, Torii H, Nakamura K, Morita E, Tsunemi Y, Tamaki K (2005) Prevalence of atopic dermatitis in Japanese elementary schoolchildren. Br J Dermatol 152(1):110–114
Savilahti R, Uitti J, Roto P, Laippala P, Husman T (2001) Increased prevalence of atopy among children exposed to mold in a school building. Allergy 56(2):175–179
Schafer T, Vieluf D, Behrendt H, Kramer U, Ring J (1996) Atopic eczema and other manifestations of atopy: results of a study in East and West Germany. Allergy 51(8):532–539
Schafer T, Heinrich J, Wjst M, Krause C, Adam H, Ring J, Wichmann HE (1999) Indoor risk factors for atopic eczema in school children from East Germany. Environ Res 81(2):151–158
Schmitt J, Romanos M (2009) Lack of studies investigating the association of childhood eczema, sleeping problems, and attention-deficit/hyperactivity disorder. Pediatr Allergy Immunol 20(3):299–300
Schroeder JT, MacGlashan DW Jr, MacDonald SM, Kagey-Sobotka A, Lichtenstein LM (1997) Regulation of IgE-dependent IL-4 generation by human basophils treated with glucocorticoids. J Immunol 158(11):5448–5454
Shaw TE, Currie GP, Koudelka CW, Simpson EL (2011) Eczema prevalence in the United States: data from the 2003 national survey of children’s health. J Invest Dermatol 131(1):67–73
Smit LA, Bouzigon E, Bousquet J, Le Moual N, Nadif R, Pin I, Lathrop M, Demenais F, Kauffmann F, Siroux V (2011) Mold allergen sensitization in adult asthma according to integrin beta3 polymorphisms and toll-like receptor 2/+596 genotype. J Allergy Clin Immunol 128(1):185–191
Song S, Lee K, Lee YM, Lee JH, Lee SI, Yu SD, Paek D (2011) Acute health effects of urban fine and ultrafine particles on children with atopic dermatitis. Environ Res 111(3):394–399
Sudo N, Yu XN, Kubo C (2001) Dehydroepiandrosterone attenuates the spontaneous elevation of serum IgE level in NC/Nga mice. Immunol Lett 79(3):177–179
Tabata N, Tagami H, Terui T (1997) Dehydroepiandrosterone may be one of the regulators of cytokine production in atopic dermatitis. Arch Dermatol Res 289(7):410–414
Takeda M, Saijo Y, Yuasa M, Kanazawa A, Araki A, Kishi R (2009) Relationship between sick building syndrome and indoor environmental factors in newly built Japanese dwellings. Int Arch Occup Environ Health 82(5):583–593
The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee (1998) Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. Lancet 351(9111):1225–1232
Torres-Borrego J, Molina-Teran AB, Montes-Mendoza C (2008) Prevalence and associated factors of allergic rhinitis and atopic dermatitis in children. Allergol Immunopathol (Madr) 36(2):90–100
Werner S, Buser K, Kapp A, Werfel T (2002) The incidence of atopic dermatitis in school entrants is associated with individual life-style factors but not with local environmental factors in Hannover, Germany. Br J Dermatol 147(1):95–104
Williams H, Robertson C, Stewart A, Ait-Khaled N, Anabwani G, Anderson R, Asher I, Beasley R, Bjorksten B, Burr M, Clayton T, Crane J, Ellwood P, Keil U, Lai C, Mallol J, Martinez F, Mitchell E, Montefort S, Pearce N, Shah J, Sibbald B, Strachan D, von Mutius E, Weiland SK (1999) Worldwide variations in the prevalence of symptoms of atopic eczema in the International Study of Asthma and Allergies in Childhood. J Allergy Clin Immunol 103(1 Pt 1):125–138
Wu KG, Li TH, Chen CJ, Cheng HI, Wang TY (2011) Correlations of serum Interleukin-16, total IgE, eosinophil cationic protein and total eosinophil counts with disease activity in children with atopic dermatitis. Int J Immunopathol Pharmacol 24(1):15–23
Yamatomo T, Okano M, Ono T, Nakayama E, Yoshino T, Satoskar AR, Harn DA Jr, Nishizaki K (2001) Sex-related differences in the initiation of allergic rhinitis in mice. Allergy 56(6):525–531
Yanagi T, Akiyama M, Nishihara H, Ishikawa J, Sakai K, Miyamura Y, Naoe A, Kitahara T, Tanaka S, Shimizu H (2010) Self-improvement of keratinocyte differentiation defects during skin maturation in ABCA12-deficient harlequin ichthyosis model mice. Am J Pathol 177(1):106–118
Yang CY, Cheng MF, Hsieh YL (2000) Effects of indoor environmental factors on risk for atopic eczema in a subtropical area. J Toxicol Environ Health A 61(4):245–253
Acknowledgments
We thank all participants and the public elementary schools in Sapporo city for their assistance. This study was conducted with support from the Ministry of Health, Labour and Welfare, Health and Labour Sciences Research Grant, Japan (H20-Research on Community Health Crisis Management-Ippan-009) and the Environment Research and Technology Development Fund (C-1151) from the Japan Ministry of Environment.
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ukawa, S., Araki, A., Kanazawa, A. et al. The relationship between atopic dermatitis and indoor environmental factors: a cross-sectional study among Japanese elementary school children. Int Arch Occup Environ Health 86, 777–787 (2013). https://doi.org/10.1007/s00420-012-0814-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00420-012-0814-0