Chinese Science Bulletin

, Volume 58, Issue 34, pp 4230–4236 | Cite as

Home risk factors for childhood pneumonia in Nanjing, China

  • XiaoHong Zheng
  • Hua Qian
  • YiLi Zhao
  • HongPing Shen
  • ZhuoHui Zhao
  • YueXia Sun
  • Jan Sundell
Open Access
Article Special Topic China, Children, Homes, Health


Pneumonia is a major cause of childhood morbidity in China. Many studies of rural areas have found an association between pneumonia and air pollution from burning of bio-mass. The present study is of children living in urban, modern homes without burning of bio-mass. In order to investigate potential home risk factors associated with children’s pneumonia, China Child Home Health (CCHH) questionnaires were randomly distributed to parents of 6461 children in 23 kindergartens in all 11 districts of Nanjing, covering urban, suburban, and industrial areas. The 4014 valid questionnaires (response rate 65.7%) were returned and have been analyzed. The lifetime incidence of pneumonia in Nanjing children 1–8 years old is 26.7%. The incidence of croup, asthma and frequent common colds was strongly associated with pneumonia, as was a history of allergies in the family, and persons other than parents (for example grandparents or nanny) taking care of the child. Several home environmental factors, namely, dampness, lack of ventilation, using coal or natural gas (electricity as reference) for cooking, new furniture, and “modern” floor and wall covering materials were also significantly associated with pneumonia. The indoor environment typical of modern apartments in China was a risk factor for pneumonia among children.


ventilation dampness life style pneumonia 

Supplementary material

11434_2013_5686_MOESM1_ESM.pdf (292 kb)
Supplementary material, approximately 292 KB.


  1. 1.
    Bryce J, Boschi-Pinto C, Shibuya K, et al. WHO estimates of the causes of death in children. Lancet, 2005, 365: 1147–1152CrossRefGoogle Scholar
  2. 2.
    Harris A M, Sempertegui F, Estrella B, et al. Air pollution and anemia as risk factors for pneumonia in Ecuadorian children: A retrospective cohort analysis. Environ Health-Glob, 2011, 10: 1–8CrossRefGoogle Scholar
  3. 3.
    Rudan I, Boschi-Pinto C, Biloglav Z, et al. Epidemiology and etiology of childhood pneumonia. Bull World Health Organ, 2008, 86: 408–416CrossRefGoogle Scholar
  4. 4.
    World Health Organization, UNICEF. Pneumonia: The forgotten killer of children. Geneva: World Health Organization, 2006Google Scholar
  5. 5.
    World Health Organization. Pneumococcal conjugate vaccine for childhood immunization-WHO position paper. Wkly Epidemiol Rec, 2007, 82: 93–104Google Scholar
  6. 6.
    2010 China Health Statistical Yearbook. Ministry of Health of the People’s Republic of China, 2010Google Scholar
  7. 7.
    He J, Gu D F, Wu X G, et al. Major causes of death among men and women in China. New Engl J Med, 2005, 353: 1124–1134CrossRefGoogle Scholar
  8. 8.
    Zhang T. Study on the epidemiology of children pneumonia, evaluation of the etiologic diagnosis method, and exploring multiplex PCR method for determining capsular serotypes of pneumococci (in Chinese). Doctoral Dissertation. Shanghai: Fudan University, 2010Google Scholar
  9. 9.
    Guan X, Silk B J, Li W, et al. Pneumonia incidence and mortality in Mainland China: Systematic review of Chinese and English literature, 1985–2008. PLoS One, 2010, 5: e11721CrossRefGoogle Scholar
  10. 10.
    Prayle A, Atkinson M, Smyth A. Pneumonia in the developed world. Paediatr Respir Rev, 2011, 12: 60–69CrossRefGoogle Scholar
  11. 11.
    Roxburgh C S, Youngson G G, Townend J A, et al. Trends in pneumonia and empyema in Scottish children in the past 25 years. Arch Dis Child, 2008, 93: 316–318CrossRefGoogle Scholar
  12. 12.
    Senstad A C, Suren P, Brauteset L, et al. Community-acquired pneumonia (CAP) in children in Oslo, Norway. Acta Paediatr, 2009, 98: 332–336CrossRefGoogle Scholar
  13. 13.
    Myles P R, Hubbard R B, Gibson J E, et al. Pneumonia mortality in a UK general practice population cohort. Eur J Public Health, 2009, 19: 521–526CrossRefGoogle Scholar
  14. 14.
    Myles P R, McKeever T M, Pogson Z, et al. The incidence of pneumonia using data from a computerized general practice database. Epidemiol Infect, 2009, 137: 709–716CrossRefGoogle Scholar
  15. 15.
    The Lancet. Indoor air pollution and acute respiratory infections in children. Lancet, 1992, 339: 396–398CrossRefGoogle Scholar
  16. 16.
    Smith K R, McCracken J P, Weber M W, et al. Effect of reduction in household air pollution on childhood pneumonia in Guatemala (RESPIRE): A randomised controlled trial. Lancet, 2011, 378: 1717–1726CrossRefGoogle Scholar
  17. 17.
    Dherani M, Pope D, Mascarenhas M, et al. Indoor air pollution from unprocessed solid fuel use and pneumonia risk in children aged under five years: A systematic review and meta-analysis. Bull World Health Organ, 2008, 86: 390–398CrossRefGoogle Scholar
  18. 18.
    Zhou Y. Seasonal analysis of the morbidity of pneumonia in children under 5 years of age in Guangzhou (in Chinese). Chin J Health Care, 2000, 8: 35–36Google Scholar
  19. 19.
    Samet J M, Dominici F, Curriero F C, et al. Fine particulate air pollution and mortality in 20 US Cities, 1987–1994. New Engl J Med, 2000, 343: 1742–1749CrossRefGoogle Scholar
  20. 20.
    Sun Y, Wang Z, Zhang Y, et al. In China, students in crowded dormitories with a low ventilation rate have more common colds: Evidence for airborne transmission. PLoS One, 2011, 6: e27140CrossRefGoogle Scholar
  21. 21.
    Sun Y, Zhang Y, Bao L, et al. Ventilation and dampness in dorms and their associations with allergy among college students in China: A case-control study. Indoor Air, 2011, 21: 277–283CrossRefGoogle Scholar
  22. 22.
    Naydenov K, Popov T, Mustakov T, et al. The association of pet keeping at home with symptoms in airways, nose and skin among Bulgarian children. Pediat Allerg Imm-UK, 2008, 19: 702–708CrossRefGoogle Scholar
  23. 23.
    Sun Y, Sundell J. Early daycare attendance increase the risk for respiratory infections and asthma of children. J Asthma, 2011, 48: 790–796CrossRefGoogle Scholar
  24. 24.
    Cheng P. Reducing Mortality rate of childhood pneumonia by ARI management (in Chinese). Jiangsu Journal of Preventive Medicine, 1996, 2: 48–49Google Scholar
  25. 25.
    Li Y, Leung G M, Tang J W, et al. Role of ventilation in airborne transmission of infectious agents in the built environment—A multidisciplinary systematic review. Indoor Air, 2007, 17: 2–18CrossRefGoogle Scholar

Copyright information

© The Author(s) 2013

Authors and Affiliations

  • XiaoHong Zheng
    • 1
  • Hua Qian
    • 1
  • YiLi Zhao
    • 1
  • HongPing Shen
    • 1
  • ZhuoHui Zhao
    • 2
  • YueXia Sun
    • 3
  • Jan Sundell
    • 1
    • 4
  1. 1.School of Energy and EnvironmentSoutheast UniversityNanjingChina
  2. 2.School of Public HealthFudan UniversityShanghaiChina
  3. 3.School of Environmental Science and EngineeringTianjin UniversityTianjinChina
  4. 4.Department of Building Science and TechnologyTsinghua UniversityBeijingChina

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