Modelling the effects of low indoor temperatures on the lung function of children with asthma.
BACKGROUND
While many epidemiological studies have shown that low outdoor temperatures are associated with increased rates of hospitalisation and mortality (especially for respiratory or cardiovascular disease), very few studies have looked at the association between indoor temperatures and health. Such studies are clearly warranted, as people have greater exposure to the indoor environment than the outdoor environment.


OBJECTIVE
To examine the relationship between various metrics of indoor temperature and lung function in children with asthma. Our specific research questions were: (1) In which room of the home is temperature most strongly associated with lung function? (2) Which exposure metric best describes the relationship between indoor temperature and lung function? (3) Over what lag/time period does indoor air temperature affect lung function most strongly?


METHODS
The Heating Housing and Health Study was a randomised controlled trial that investigated the effect of installing heaters in the homes of children with asthma. This study collected measurements of lung function (daily) and indoor temperature (hourly). Lung function and indoor temperature were measured for 309 children over 12 049 child-days. Statistical models were fitted to identify the best measures and metrics.


RESULTS
The strongest association with lung function was found for the severity of exposure to low bedroom temperatures averaged over the preceding periods of 0-7 to 0-12 days. A 1°C increase in temperature was associated with an average increase of 0.010, 0.008, 10.06, 12.06, in our four measures of lung function (peak expiratory flow rate (PEFR) morning, PEFR evening, forced expiratory volume in 1 s (FEV1) morning and FEV1 evening).


CONCLUSIONS
Indoor temperatures have a small, but significant, association with short-term variations in the lung function of children with asthma.
He Kainga Oranga/Housing and Health Research Programme, Department of Public Health, University of Otago, , Wellington, New Zealand.
Nevil
N
Pierse
Richard
R
Arnold
Michael
M
Keall
Philippa
P
Howden-Chapman
Julian
J
Crane
Malcolm
M
Cunningham
D000293:Adolescent; D016902:Air Pollution, Indoor / Q000009:adverse effects; D001249:Asthma / Q000503:physiopathology / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006361:Heating / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010366:Peak Expiratory Flow Rate / Q000502:physiology; D012129:Respiratory Function Tests / Q000379:methods*; D013696:Temperature
ASTHMA; Environmental epidemiology; TEMPERATURE