title: Effect of indoor air quality of day care centers in children with different predisposition for asthma.
abstract: Scarce information is available about the relationships between indoor air quality (IAQ) at day care centers (DCC), the estimated predisposition for asthma, and the actual wheezing susceptibility.
  
  
  
  In the Phase II of ENVIRH study, 19 DCC were recruited after cluster analysis. Children were evaluated firstly using the ISAAC questionnaire and later by a follow-up questionnaire about recent wheezing. A positive asthma predictive index (API) was considered as predisposition for asthma. Every DCC was audited for IAQ and monitored for chemical and biologic contaminants.
  
  
  
  We included 1191 children, with a median age of 43 (P25 -P75 : 25-58) months. Considering the overall sample, in the first questionnaire, associations were found between CO2 concentration (increments of 200 ppm) and diagnosis of asthma (OR: 1.10; 95% CI: 1.00-1.20). Each increment of 100 μg/m(3) of total volatile organic compounds (TVOC) and 1 μg of Der p1/g of dust were associated with wheezing in the previous 12 months (OR: 1.06; 95% CI: 1.01-1.11 and OR: 1.06; 95% CI: 0.99-1.12, respectively). In the follow-up questionnaire, TVOC were again associated with wheezing (OR: 1.05; 95% CI: 1.00-1.11). Children exposed to fungal concentration above the 75th percentile had also higher odds of wheezing at follow-up. TVOC were associated with wheezing in children with either negative or positive API.
  
  
  
  IAQ in DCC seems to be associated with wheezing, in children with and without predisposition for asthma.
authors.affiliation: CEDOC, Respiratory Research Group, Nova Medical School, Campo dos Mártires da Pátria, Lisbon, Portugal.|Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal.|Epidemiology and Statistics Analisys Unit, Research Centre, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal.
authors.forename: Pedro
authors.identifier: 0000-0002-4129-133X
authors.initials: P
authors.lastname: Carreiro-Martins
authors.affiliation: Epidemiology and Statistics Analisys Unit, Research Centre, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal.|CEAUL, Department of Biostatistic and Informatics, Nova Medical School, Campo dos Mártires da Pátria, 130, 1169-056, Lisbon, Portugal.
authors.forename: Ana Luisa
authors.initials: AL
authors.lastname: Papoila
authors.affiliation: CEDOC, Respiratory Research Group, Nova Medical School, Campo dos Mártires da Pátria, Lisbon, Portugal.
authors.forename: Iolanda
authors.initials: I
authors.lastname: Caires
authors.affiliation: National Laboratory for Civil Engineering, Lisbon, Portugal.
authors.forename: Susana
authors.initials: S
authors.lastname: Azevedo
authors.affiliation: Environmental Health Department, National Health Institute Doutor Ricardo Jorge - Lisboa, Lisbon, Portugal.
authors.forename: Maria Manuela
authors.initials: MM
authors.lastname: Cano
authors.affiliation: Epidemiology and Statistics Analisys Unit, Research Centre, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal.
authors.forename: Daniel
authors.initials: D
authors.lastname: Virella
authors.affiliation: CEDOC, Respiratory Research Group, Nova Medical School, Campo dos Mártires da Pátria, Lisbon, Portugal.|Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal.
authors.forename: Paula
authors.initials: P
authors.lastname: Leiria-Pinto
authors.affiliation: Environmental Health Department, National Health Institute Doutor Ricardo Jorge - Porto, Oporto, Portugal.|Institute of Public Health (ISPUP), University of Porto, Oporto, Portugal.
authors.forename: João Paulo
authors.initials: JP
authors.lastname: Teixeira
authors.affiliation: Hospital da Luz, Lisbon, Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Rosado-Pinto
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Epidemiology of Allergic and Respiratory diseases department (EPAR), Medical School Saint-Antoine, F75012 Paris, France.
authors.forename: Isabella
authors.initials: I
authors.lastname: Annesi-Maesano
authors.affiliation: CEDOC, Respiratory Research Group, Nova Medical School, Campo dos Mártires da Pátria, Lisbon, Portugal.|Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal.
authors.forename: Nuno
authors.initials: N
authors.lastname: Neuparth
mesh_terms: D016902:Air Pollution, Indoor / Q000009:adverse effects* / Q000032:analysis; D001249:Asthma / Q000209:etiology*; D002656:Child Day Care Centers; D002675:Child, Preschool; D004198:Disease Susceptibility; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012135:Respiratory Sounds / Q000209:etiology*; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: asthma; asthma predictive index; day care center; indoor air quality; volatile organic compounds; wheezing