Skip to main content

Advertisement

SpringerLink
Log in

A Multiple Indicators Multiple Cause (MIMIC) Model of Respiratory Health and Household Factors in Chinese Children: The Seven Northeastern Cities (SNEC) Study

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

In China, with the rapid economic development and improvement of living standards over the past few decades, the household living environment has shifted dramatically. The aim of the present study is to assess the impact of home environment factors on respiratory symptoms and asthma in Chinese children. Investigators analyzed data collected in the 25 districts from the seven Northeastern cities to examine health effects on respiratory symptoms and asthma in 31,049 children aged 2–14 years. Factor analysis was used to reduce 33 children’s lifestyle and household variables to six new ‘factor’ variables. The multiple indicators multiple causes approach was used to examine the relationship between indoor air pollution and respiratory health status, controlling for covariates. Factor analyses generated six factor variables of potential household risk factors from an original list of 33 variables. The respiratory symptoms and asthma were significantly associated with the recent home renovation factor (estimate = 0.076, p < 0.001), pet ownership factor (estimate = 0.095, p < 0.001), environmental tobacco smoke (ETS) exposure factor (estimate = 0.181, p < 0.001) and PVC-flooring factor (estimate = 0.031, p = 0.007). Home ventilation factor was not related to any respiratory condition (estimate = 0.028, p = 0.074). Independent respiratory health effects existed for multiple household environmental factors recent home renovation, pet ownership, ETS, and PVC-flooring.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Björkstén, B., Clayton, T., Ellwood, P., Stewart, A., Strachan, D., & ISAAC Phase III Study Group. (2008). Worldwide time trends for symptoms of rhinitis and conjunctivitis: Phase III of the International Study of Asthma and Allergies in Childhood. Pediatric Allergy and Immunology, 19, 110–124.

    Article  Google Scholar 

  2. Pearce, N., Aït-Khaled, N., Beasley, R., Mallol, J., Keil, U., Mitchell, E., et al. (2007). Worldwide trends in the prevalence of asthma symptoms: Phase III of the International Study of Asthma and Allergies in Childhood (ISAAC). Thorax, 62, 758–766.

    Article  Google Scholar 

  3. Asher, M. I., Stewart, A. W., Mallol, J., Montefort, S., Lai, C. K., Aït-Khaled, N., et al. (2010). Which population level environmental factors are associated with asthma, rhinoconjunctivitis and eczema? Review of the ecological analyses of ISAAC phase one. Respiratory Research, 11, 8.

    Article  Google Scholar 

  4. Crain, E. F., Walter, M., O’Connor, G. T., Mitchell, H., Gruchalla, R. S., Kattan, M., et al. (2002). Home and allergic characteristics of children with asthma in seven US urban communities and design of an environmental intervention: The Inner-City Asthma Study. Environmental Health Perspectives, 110, 939–945.

    Article  Google Scholar 

  5. Hunt, A., Crawford, J. A., Rosenbaum, P. F., & Abraham, J. L. (2011). Levels of household particulate matter and environmental tobacco smoke exposure in the first year of life for a cohort at risk for asthma in urban Syracuse, NY. Environment International, 37, 1196–1205.

    Article  CAS  Google Scholar 

  6. Karvonen, A. M., Hyvärinen, A., Roponen, M., Hoffmann, M., Korppi, M., Remes, S., et al. (2009). Confirmed moisture damage at home, respiratory symptoms and atopy in early life: A birth-cohort study. Pediatrics, 124, e329–e338.

    Article  Google Scholar 

  7. McConnell, R., Islam, T., Shankardass, K., Jerrett, M., Lurmann, F., Gilliland, F., et al. (2010). Childhood incident asthma and traffic-related air pollution at home and school. Environmental Health Perspectives, 118, 1021–1026.

    Article  CAS  Google Scholar 

  8. Morgan, W. J., Crain, E. F., Gruchalla, R. S., O’Connor, G. T., Kattan, M., Evans, R., I. I. I., et al. (2004). Results of a home-based environmental intervention among urban children with asthma. New England Journal of Medicine, 351, 1068–1080.

    Article  CAS  Google Scholar 

  9. Tischer, C. G., Hohmann, C., Thiering, E., Herbarth, O., Müller, A., Henderson, J., et al. (2011). Meta-analysis of mould and dampness exposure on asthma and allergy in eight European birth cohorts: An ENRIECO initiative. Allergy, 66, 1570–1576.

    Article  CAS  Google Scholar 

  10. Dong, G. H., Chen, T., Liu, M. M., Wang, D., Ma, Y. N., Ren, W. H., et al. (2011). Gender difference for effects of compound-air pollution on respiratory symptoms in children: Results from 25 districts of Northeast China. PLoS ONE, 6(8), e20827.

    PubMed  PubMed Central  Google Scholar 

  11. Zhang, J. J., Hu, W., Wei, F., Wu, G., Korn, L. R., & Chapman, R. S. (2002). Children’s respiratory morbidity prevalence in relation to air pollution in four Chinese cities. Environmental Health Perspectives, 110, 961–967.

    Article  CAS  Google Scholar 

  12. Baker, R. J., Hertz-Picciotto, L., Dostal, M., Keller, J. A., Nozicka, J., Kotesovec, F., et al. (2006). Coal home heating and environmental tobacco smoke in relation to lower respiratory illness in Czech children, from birth to 3 years of age. Environmental Health Perspectives, 114, 1126–1132.

    Article  CAS  Google Scholar 

  13. Salo, P. M., Xia, J., Johnson, C. A., Li, Y., Kissling, G. E., Avol, E. L., et al. (2004). Respiratory symptoms in relation to residential coal burning and environmental tobacco smoke among early adolescents in Wuhan, China: A cross-sectional study. Environmental Health, 3, 14.

    Article  Google Scholar 

  14. Cunningham, J., Dockery, D. W., Gold, D. R., & Speizer, F. E. (1995). Racial differences in the association between maternal smoking during pregnancy and lung function in children. American Journal of Respiratory and Critical Care Medicine, 152, 565–569.

    Article  CAS  Google Scholar 

  15. Forsberg, B., Pekkanen, J., Clench-Aas, J., Martensson, M. B., Stjernberg, N., Bartonova, A., et al. (1997). Childhood asthma in four regions in Scandinavia: Risk factors and avoidance effects. International Journal of Epidemiology, 26, 610–619.

    Article  CAS  Google Scholar 

  16. Gilliland, F. D., Li, Y. F., & Peters, J. M. (2001). Effects of maternal smoking during pregnancy and environmental tobacco smoke on asthma and wheezing in children. American Journal of Respiratory and Critical Care Medicine, 163, 429–436.

    Article  CAS  Google Scholar 

  17. Keil, T., Lau, S., Roll, S., Grüber, C., Nickel, R., Niggemann, B., et al. (2009). Maternal smoking increases risk of allergic sensitization and wheezing only in children with allergic predisposition: Longitudinal analysis from birth to 10 years. Allergy, 64, 445–451.

    Article  CAS  Google Scholar 

  18. Stein, R. T., Holberg, C. J., Sherrill, D., Wright, A. L., Morgan, W. J., Taussig, L., et al. (1999). Influence of parental smoking on respiratory symptoms during the first decade of life: The Tucson Children’s Respiratory Study. American Journal of Epidemiology, 149, 1030–1037.

    Article  CAS  Google Scholar 

  19. Apelberg, B. J., Aoki, Y., & Jaakkola, J. J. (2001). Systematic review: Exposure to pets and risk of asthma and asthma-like symptoms. Journal of Allergy and Clinical Immunology, 107, 455–460.

    Article  CAS  Google Scholar 

  20. Bufford, J. D., & Gern, J. E. (2007). Early exposure to pets: Good or bad? Current Allergy and Asthma Reports, 7, 375–382.

    Article  Google Scholar 

  21. Ownby, D. R., Johnson, C. C., & Peterson, E. L. (2002). Exposure to dogs and cats in the first year of life and risk of allergic sensitization at 6 to 7 years of age. Journal of the American Medical Association, 288, 963–972.

    Article  Google Scholar 

  22. Burke, H., Leonardi-Bee, J., Hashim, A., Pine-Abata, H., Chen, Y., Cook, D. G., et al. (2012). Prenatal and passive smoke exposure and incidence of asthma and wheeze: Systematic review and meta-analysis. Pediatrics, 129, 735–744.

    Article  Google Scholar 

  23. Diette, G. B., Accinelli, R. A., Balmes, J. R., Buist, A. S., Checkley, W., Garbe, P., et al. (2012). Obstructive lung disease and exposure to burning biomass fuel in the indoor environment. Glob Heart., 7, 265–270.

    Article  Google Scholar 

  24. Svanes, C., Sunyer, J., Plana, E., Dharmage, S., Heinrich, J., Jarvis, D., et al. (2010). Early life origins of chronic obstructive pulmonary disease. Thorax, 65, 14–20.

    Article  CAS  Google Scholar 

  25. Dherani, M., Pope, D., Mascarenhas, M., Smith, K. R., Weber, M., & Bruce, N. (2008). Indoor air pollution from unprocessed solid fuel use and pneumonia risk in children aged under five years: A systematic review and meta-analysis. Bulletin of the World Health Organization, 86, 390–398C.

    Article  Google Scholar 

  26. Raw, G. J., Coward, S. K., Brown, V. M., & Crump, D. R. (2004). Exposure to air pollutants in English homes. Journal of Exposure Analysis and Environmental Epidemiology, 1, S85–S94.

    Article  Google Scholar 

  27. Jaakkola, J. J., Parise, H., Kislitsin, V., Lebedeva, N. I., & Spengler, J. D. (2004). Asthma, wheezing, and allergies in Russian schoolchildren in relation to new surface materials in the home. American Journal of Public Health, 94, 560–562.

    Article  Google Scholar 

  28. Jaakkola, J. J., Ieromnimon, A., & Jaakkola, M. S. (2006). Interior surface materials and asthma in adults: A population-based incident case-control study. American Journal of Epidemiology, 164, 742–749.

    Article  Google Scholar 

  29. Jaakkola, J. J., Oie, L., Nafstad, P., Botten, G., Samuelsen, S. O., & Magnus, P. (1999). Interior surface materials in the home and development of bronchial obstruction in young children in Oslo, Norway. American Journal of Public Health, 89, 188–192.

    Article  CAS  Google Scholar 

  30. Larsson, M., Hägerhed-Engman, L., Kolarik, B., James, P., Lundin, F., Janson, S., et al. (2010). PVC—As flooring material—And its association with incident asthma in a Swedish child cohort study. Indoor Air, 20, 494–501.

    Article  CAS  Google Scholar 

  31. Aiken Morgan, A. T., Marsiske, M., Dzierzewski, J. M., Jones, R. N., Whitfield, K. E., Johnson, K. E., et al. (2010). Race-related cognitive test bias in the active study: A mimic model approach. Experimental Aging Research, 36, 426–452.

    Article  Google Scholar 

  32. Mast, B. T. (2004). Cerebrovascular disease and late-life depression: A latent-variable analysis of depressive symptoms after stroke. American Journal of Geriatric Psychiatry, 12, 315–322.

    Article  Google Scholar 

  33. Ríos-Bedoya, C. F., Pomerleau, C. S., Neuman, R. J., & Pomerleau, O. F. (2009). Using MIMIC models to examine the relationship between current smoking and early smoking experiences. Nicotine & Tobacco Research, 11, 1035–1041.

    Article  Google Scholar 

  34. State Environmental Protection Administration of China (SEPA). (1992). Standardized environmental monitoring and analysis methods. Beijing, China: SEPA.

    Google Scholar 

  35. Peters, J. M., Avol, E., Navidi, W., London, S. J., Gauderman, W. J., Lurmann, F., et al. (1999). A study of twelve Southern California communities with differing levels and types of air pollution. I. Prevalence of respiratory morbidity. American Journal of Respiratory and Critical Care Medicine, 159, 760–767.

    Article  CAS  Google Scholar 

  36. Cattell, R. B. (1966). The scree test for the number of factors. Multivariate Behavioral Research, 1, 245–276.

    Article  CAS  Google Scholar 

  37. Muthén, B., du Toit S. H. C., & Spisic, D. (1997). Robust inference using weighted least squares and quadratic estimating equations in latent variable modeling with categorical and continuous outcomes. Working Paper. http://WWW.gseis.ucla.edu/faculty/muthen/full_paper_list.htm.

  38. Brown, T. (2006). Confirmatory factor analysis for applied research. New York: Guildford.

    Google Scholar 

  39. Kachigan, S. K. (1991). Multivariate statistical analysis: A conceptual introduction. New York, NY: Radius Press.

    Google Scholar 

  40. Loehlin, J. C. (1987). Latent variable models, an introduction to factor, path, and structural analysis. Hillsdale, NJ: Lawrence Erlbaum Associates.

    Google Scholar 

  41. Muthén, L. K., & Muthén, B. O. (2009). Mplus user’s guide. Statistical analysis with latent variables (4th ed.). Los Angeles, CA: Muthen & Muthen.

    Google Scholar 

Download references

Acknowledgments

The authors acknowledge the cooperation of the seven cities, school principals, and the many teachers, students, and parents in Liaoning province. This work was supported by Grants from the China Environmental Protection Foundation (CEPF2008-123-1-5).

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, 110001, Liaoning Province, People’s Republic of China

    Guang-Hui Dong, Miao-Miao Liu & Da Wang

  2. Department of Occupational and Environmental Health, School of Public Health, China Medical University, Shenyang, 110001, Liaoning Province, People’s Republic of China

    Guang-Hui Dong, Miao-Miao Liu & Da Wang

  3. Department of Epidemiology, School of Public Health, Saint Louis University, Salus Center/Room 473, 3545 Lafayette Avenue, Saint Louis, MO, 63104, USA

    Zhengmin Qian, Edwin Trevathan, Erin Riley & Maayan Simckes

  4. Department of Biostatistics, School of Public Health, Saint Louis University, Saint Louis, MO, 63104, USA

    Qiang Fu & Jing Wang

  5. Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 510300, Guangdong Province, People’s Republic of China

    Wenjun Ma

  6. Department of Ambient Air Pollution Monitor, Shenyang Environmental Monitoring Center, Shenyang, 110014, Liaoning Province, People’s Republic of China

    Wan-Hui Ren

  7. Department of Environmental and Occupational Health, School of Public Health, Saint Louis University, Saint Louis, MO, 63104, USA

    Kee-Hean Ong

  8. Department of Epidemiology, School of Public Health, Louisiana State University, New Orleans, LA, 70112, USA

    Tekeda Freeman Ferguson

Authors
  1. Guang-Hui Dong
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zhengmin Qian
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Qiang Fu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jing Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Edwin Trevathan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Wenjun Ma
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Miao-Miao Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Da Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Wan-Hui Ren
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Kee-Hean Ong
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Tekeda Freeman Ferguson
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Erin Riley
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Maayan Simckes
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Zhengmin Qian.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dong, GH., Qian, Z., Fu, Q. et al. A Multiple Indicators Multiple Cause (MIMIC) Model of Respiratory Health and Household Factors in Chinese Children: The Seven Northeastern Cities (SNEC) Study. Matern Child Health J 18, 129–137 (2014). https://doi.org/10.1007/s10995-013-1245-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-013-1245-6

Keywords

Search

Navigation