Study on Health Effects of Indoor Air Pollution in China

1. Study on Health Effects of Indoor Air Pollution in China Presented by Pan Xiao-chuan et al. Dept. of Occupational and Environmental Health Peking University School of Public Health Workshop in Oslo, Oct.17-19, 2004

2. Introduction • The indoor air quality is concerned more and more by the government and the public in China nowadays and the health effects of indoor air pollution are becoming a serious challenge in both urban and rural areas of China. In order to further study the health effects of indoor air pollution and population exposure to them, it is very important for us to know clearly what the key pollutants is in the urban and rural areas of China.

4. Key Indoor Air Pollutants • from housing fitment and decoration: • Formaldehyde • Benzene, toluene and xylene • Ammonia • VOCs • Radon and dust mite

5. Key Indoor Air Pollutants • From fuel combustion: • Particular Matter • SO2 • CO • Environmental Tobacco Smoke (ETS)

6. Part one: The Indoor Air Quality and Health Effects from Housing Fitment/Decoration in China

7. Approaches • Indoor air monitoring: the average level of ammonia, formaldehyde, total volatile organic compounds (TVOC), house dust mites, moulds and other allergens in 400-1400 households in 6 provinces of China, which measured by the standard procedure and methods in 2001-2002. • Case-control epidemiologic studies: asthma, leukemia andallergic rhinitis.

8. Results

12. Fig.4 the average level of indoor air formaldehyde in 3 cities in summer

14. Fig. 6 The level of the indoor air ammoniain summer(mg/m3)

15. Fig. 7 the level of indoor air TVOC in 4 cities in winter(mg/m3)

16. Fig. 8 the average level of indoor air TVOC in 4 cities in winter

17. Fig. 9 the level of indoor air TVOC in 4 cities in summer(mg/m3)

18. Fig. 10 The average level of indoor air 17 VOCs Compounds in winter and summer

19. Tab.11 Level of the allergen from dust mite, bacteria and epiphyte in the office buildings

20. epidemiological study

21. Indoor environmental risk factors for allergic asthma in adults — a case-control study Yue Wei, Pan Xiao-chuan et al. Peking University School of Public health

22. 1.Background • Allergic asthma is a kind of common disease. In recent years, it has an obviously increasing trend in our China. The prevalence in our China is about 1%，in adults is about 0.5%. • To the epidemiological study about the adults’ allergic asthma, many researches have been done in foreign countries in recent 20 years. While in China, few researches have been reported, especially the researches between the adults’ allergic asthma and indoor environmental risk factors. • This study is to investigate the risk factors of adults’ allergic asthma or its onset, especially the indoor environmental risk factors. It is also one of the key research subjects in our China.

23. 2. Methods: • case-control study: • Questionnaire by face to face interview • Formaldehyde, NO2 and dust mite measure Asthma patients in adults from the Peking University affiliated Renmin Hospital. 102 cases Age: 20～70y Gender: no limited Ratio 1：4 Healthy residents from Beijing Xicheng district which is near the Renmin hospital. They all have no allergic or respiratory diseases. 394 controls

24. 3.Results:Tab.1 Single risk factors analysis of the allergic asthma in adults

25. Tab.2 Multiple risk factors logistic analysis of the allergic asthma in adults SAS stepwise Sle＝0.10,Sls＝0.10.

26. Table3 Correlative analysis between the different concentration of the indoor formaldehyde and allergic asthma in adults *: P value < 0.01 # the adjusted factors: age, sex, cigarette smoking, family history of the chronic bronchitis or asthma

27. 4.Conclusion & Indication： • There were 6 risk factors correlated with the allergic • asthma in adults in our study: • Vocational exposure to dust • Housing type • Drying Bedding in the sunshine • Floor type of the living room • Cooking oil smoke contamination indoors • Family history of the chronic bronchitis or asthma • It indicated that the adults’ allergic asthma is a kind of complicated disease caused by genetic and environmental multiple factors. Meanwhile, there is concentration-response relationship between the indoor air formaldehyde level and the adults’ allergic asthma.

28. Ａ case-control study of the risk factors for adult leukemia DING Wen-qing, BAO li , HUANG xiao-jun, PAN Xiao-chuan. Peaking University School of Public Health and Second Hospital

29. Introduction • With the increasing of the living standards of the residents, the problems caused by the indoor air pollution have been the hotspot in China recently. In recent years, the incidence of leukemia has the increasing tendency , some reports says it is probably related with the indoor decoration of the house. The purpose of this study was to ascertain primarily the relationship between the indoor decoration and other suspicious risk factors related with adult leukemia.

30. Methods A total of 127 cases (age 15-75 years old) of Adult leukemia survivors were interviewed with health questionnaire by face to face,which included general conditions, living environment, harmful materials contact, living style, disease and family history ,etc. The conditional Logistic regression model in univariate and multivariate analysis were used to seek the key risk factors, specially for adult leukemia.

31. Result In the single factor analysis,14 of 98 indexes were obviously significant<0.05)

32. Tab. The Single Factor Analysis

33. Variables P value OR value 8. Having factory nearby house 0.020 0.292 (<500meters) 9. Using the cosmetic often 0.050 0.437 10. Using perfume often 0.020 0.400 11. Cigarette smoking 0.002 4.420 12. Milk drinking frequently 0.009 0.530 13. Over intake of salt 0.005 0.436 14. Number of cigarette smoking 0.004 3.452

34. the multi-factor stepwise regression analysis • There were 4 variables significantly associated with adult leukemia (P<0.05)

35. Conclusion • It is suggested that the degree of the indoor decoration might be one of risk factors for adult leukemia.

36. The Correlative relations between Indoor Air pollution and allergic rhinitis--a pilot case-control study Liu Ying, Pan Xiao-chuan et al. Peking University School of public health

37. Methods • we chose 95 patients and 45 controls to perform case-control study. Patients were selected from Peking University affiliated hospitals, where they had been diagnosed as allergic rhinitis. Controls are patients from the same hospital but not suffer from allergic rhinitis. Block-paired design of Logistic regression was utilized to conduct multi-factor analysis. We use SPSS 11.0 to do the statistics.

38. results

39. Tab.3:the results of multi-factors analysis

40. Tab. Distribution of the Cooking oils in the subjects • P=0.008, OR value=12.918( Logistic Regression) The results suggests that use of salad oil may cause the increase of the prevalence rate of allergic rhinitis.

41. The Indoor Air Quality and Health Effects from Fuel Combustion in China 1999-2004

42. INDOOR AIR POLLUTION AND RESPIRATORY HEALTH OF THE PEOPLES IN BEIJING:A COMMUNITY-BASED STUDY Dept. of Occupational and Environmental Health, Peking University School of Public Health, Beijing 100083, P.R. China Xiao-chuan Pan, et.al.

43. INTRODUCTION • In recent years the housing of Beijing peoples have been improved enormously with the fast development of the economy as well as living level. A lot of the new fitments, soft furnishings, fitted carpets and mechanical air ventilation systems are now introduced into more and more households in Beijing, especially in urban areas. • How about indoor air quality caused by them?

44. METHODS • Participants: About 270 households, living in 3 communities of urban area were selected randomly for indoor air monitoring, about 3000 individuals aged from 18 – 65 yr. from the study households and their neighbors were interviewed by questionnaire for their respiratory health. • The mass concentration of particles smaller than 10μm/2.5μm in diameter（PM10/PM2.5）and sulphur dioxide (SO2) was measured in the bedroom and kitchen of the study households in real time twice a day for two weeks, respectively in winter and summer.

45. METHODS 2 • Health:The health questionnaire was based on that of the British Medical Respiratory Committee and revised according to the different status in Beijing. It consisted of age, gender, education, occupation, and general health status, living habits, exposure to indoor microenvironment factors, cooking, and smoking, respiratory symptoms and other daily activities. The trained students of a medical college conducted the health survey with the questionnaire by face-to-face interview.

46. METHODS 3 • Determination and Data analysis: The determination of levels of PM10, PM2.5 and SO2 was taken with standardized procedures. The t-test and X-square test were used for estimates of variances of the pollutants level. Effect size of various factors for respiratory symptoms and lung function were estimated with two models. First, is a linear model with an ordinary least-squares regression of symptoms rates. We accounted for clustering of observations in units of Household. Second, we used a logistic probability model y=F (X×β+u): y, X, andβare defined as in the linear model; F=cumulative logistic distribution, F (z)=exp (z) divided by [1+exp (z)].

47. RESULTS

48. B: bedroom, K: kitchen. the same as below

49. Fig.2: The Indoor Air PM2.5 Level among Three Districts in Beijing(mcg/m3)

50. Fig3: The Indoor Air SO2 Level among Three Districts in Beijing(mcg/m3)