Household environment, lifestyle behaviors, and dietary habits in relation to childhood atopic eczema in Shanghai, China.
OBJECTIVE
We aim to investigate associations of the child's individual characteristics, building characteristics, home environmental exposures, family lifestyle behaviors, and dietary habits on childhood eczema during lifetime-ever and in the last year before the survey.


METHODS
During April 2011-April 2012, we conducted a cross-sectional study and collected 13,335 parents-reported questionnaires of 4-6-year-old children from 72 kindergartens in Shanghai, China. Logistic regression model was used to investigate associations.


RESULTS
After adjusted for sex, age, family history of atopy, and questionnaire reporter, the factors which were strongly associated (increased odds >30% and p value <0.05) with lifetime-ever eczema included mother employed during pregnancy (adjusted OR 1.33), residence renovated during pregnancy (1.49) and in the child's first year of life (1.31), using laminate (1.58) and solid (1.42) wood as material of floor covering (compared to using cement), residence located in urban district (1.38), and dampness-related exposures in the early residence (mold spots/stains: 1.41; mold odor: 1.41) and in the current residence (water damage: 1.33; damp stains: 1.34; mold spots: 1.32; and windows pane condensation: 1.31). Parental smoking, pet-keeping, and incense-burning had no significant associations with childhood eczema. Similar associations were found for eczema in the last year before the survey. Families with sick children likely changed lifestyle behaviors and dietary habits.


CONCLUSIONS
Childhood eczema could be influenced by many household environmental and non-environmental factors. Exposures during early lifetime likely have greater impact on childhood eczema than current exposures. Associations of lifestyle behaviors and dietary habits with childhood eczema could be modified by family avoidance behaviors.
Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, 516 Jungong Road, Yangpu District, Shanghai, People's Republic of China.
Jiao
J
Cai
Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, 516 Jungong Road, Yangpu District, Shanghai, People's Republic of China.
Wei
W
Liu
Tongji Architectural Design (Group) Company Limited (TJAD), Shanghai, People's Republic of China.
Yu
Y
Hu
Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, 516 Jungong Road, Yangpu District, Shanghai, People's Republic of China.
Zhijun
Z
Zou
R&B Technology (Shanghai) Company Limited, Shanghai, People's Republic of China.
Li
L
Shen
Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, 516 Jungong Road, Yangpu District, Shanghai, People's Republic of China. hcyhyywj@163.com.
Chen
C
Huang
D002648:Child; D002675:Child, Preschool; D002681:China; D003430:Cross-Sectional Studies; D003876:Dermatitis, Atopic / Q000209:etiology*; D004777:Environment; D004781:Environmental Exposure / Q000009:adverse effects*; D005247:Feeding Behavior; D005260:Female; D006798:Housing; D006801:Humans; D006813:Humidity; D007223:Infant; D008019:Life Style; D016015:Logistic Models; D008297:Male; D012307:Risk Factors; D011795:Surveys and Questionnaires
Atopic eczema; Avoidance behaviors; Children; Home environment; Lifestyle behaviors