We studied indoor sources of indoor
particulate matter (PM), outdoor air pollution and
antibiotic use in relation to
asthma,
rhinitis and
eczema among pre-school children and investigated synergistic effects between PM and
antibiotics use. Children (3-6y) from randomly selected
day care centres in seven cities across China were included (n = 39,782). Data on ambient temperature and air pollution were collected from local monitoring stations. Data on indoor PM sources (ETS, burning of incense or mosquito coils and biomass for cooking),
antibiotics use and health (doctor diagnosed
asthma and
rhinitis, lifetime
eczema, current wheeze and current
rhinitis) were assessed by a parental questionnaire. Associations were calculated by multilevel logistic regression.
Asthma diagnosis was associated with outdoor temperature, NO2 and burning mosquito coils.
Rhinitis diagnosis was associated with NO2, ETS, gas cooking and burning biomass for cooking. Lifetime
eczema was associated with temperature, PM10, NO2, ETS, biomass cooking and burning mosquito coils. Burning incense was associated with current wheeze and current
rhinitis. Children using
antibiotics had more
asthma, wheeze,
rhinitis, and
eczema. Excluding children with
respiratory infections did not change associations with
antibiotics use.
Antibiotics use enhanced the effects of ETS and PM10 (a synergistic effect). In conclusion, a warmer climate, outdoor NO2 and PM10, ETS, gas cooking and burning biomass, incense and mosquito coils can increase the risk of
asthma, wheeze,
rhinitis and
eczema among pre-school children in China.
Antibiotics use is a risk factor for childhood
asthma, wheeze,
rhinitis and
eczema and ETS and outdoor PM10 can enhance the effect.