Protection from sun exposure in US white children ages 6 months to 11 years

OBJECTIVES: To estimate the prevalence of protection from sun exposure among US white children ages 6 months to 11 years. METHODS: During the summer of 1998, using telephone directory lists supplemented by random-digit dialing, the authors surveyed parents living in the contiguous United States. They calculated weighted prevalence estimates for protection methods and conducted logistic regression analyses to determine parent and child characteristics predictive of protection behaviors. RESULTS: Parents of 1,055 white children were interviewed. Children spent a median of 20 hours per week outdoors during the summer, of which 10 hours were at school. Sunscreen (61.8%, 95% confidence interval [CI] 57%, 66%) and shade (26.5%, 95% CI 22%, 31%) were the most frequently reported protection methods. Parents reported higher rates of protection for younger children and children who sunburn easily. CONCLUSIONS: Parents report that a large proportion of white children is protected from sun exposure by one or more methods. Health care providers and educators might encourage the use of all methods of protection, not just sunscreen use, and educate older children to protect themselves from the sun.     

Infant sleeping environment and asthma at 7 years: a prospective cohort study

OBJECTIVES: We investigated the role of infant bedding items, as part of a composite bedding environment, in the development of childhood wheezing. METHODS: This prospective cohort investigation involved 863 children who participated in an infant survey in 1988 and an asthma study in Tasmania, Australia, in 1995. The derived 3 composite infant bedding categories corresponded to increasing numbers of house dust mite (HDM)-rich bedding items used. Outcomes measured included recent and frequent wheezing. RESULTS: Composite infant bedding used was associated with recent wheezing. Effects increased at increasing levels of HDM-rich bedding items used. Effects were further enhanced by home environmental factors of bedroom heating, recent bedroom painting, and absence of bedroom carpeting. When any 2 or more of these environmental factors were present, a strong dose-response relationship was evident. CONCLUSIONS: Our results show that bedding exposures in infancy are prospectively associated with childhood wheezing and that home environmental conditions may modify this association.     

The relation of breastfeeding and body mass index to asthma and atopy in children: a prospective cohort study to age 6 years

OBJECTIVES: We investigated the relationship between breastfeeding, asthma and atopy, and child body mass index (BMI). METHODS: From a prospective birth cohort (n = 2860) in Perth, Western Australia, 2195 children were followed up to age 6 years. Asthma was defined as doctor-diagnosed asthma and wheeze in the last year, and atopy was determined by skin prick test of 1596 children. Breastfeeding, BMI, asthma, and atopy were regressed allowing for confounders and the propensity score for overweight. RESULTS: Using fractional polynomials, we found no association between breastfeeding and overweight. Less exclusive breastfeeding was associated with increased asthma and atopy, and BMI increased with asthma. CONCLUSIONS: Less exclusive breastfeeding leads to increases in child asthma and atopy and a higher BMI is a risk factor for asthma.     

Formaldehyde exposure and asthma in children: a systematic review

Despite multiple published studies regarding the association between formaldehyde exposure and childhood asthma, a consistent association has not been identified. Here we report the results of a systematic review of published literature in order to provide a more comprehensive picture of this relationship. After a literature search, we identified seven studies providing quantitative results regarding the association between formaldehyde exposure and asthma in children. Studies were heterogeneous with respect to the definition of asthma. For each study, an odds ratio (OR) and 95% confidence interval (CI) for asthma were abstracted from published results or calculated based on the data provided. We used fixed- and random-effects models to calculate pooled ORs and 95% CIs; measures of heterogeneity were also calculated. A fixed-effects model produced an OR of 1.03 (95% CI, 1.021.04), and random effects model produced an OR of 1.17 (95% CI, 1.011.36), both reflecting an increase of 10 mg/m3 of formaldehyde. Both the Q and I2 statistics indicated a moderate amount of heterogeneity. Results indicate a positive association between formaldehyde exposure and childhood asthma. Given the largely cross-sectional nature of the studies underlying this meta-analysis, further well-designed prospective epidemiologic studies are needed.     

Polycyclic aromatic hydrocarbon exposure and wheeze in a cohort of children with asthma in Fresno, CA

Polycyclic aromatic hydrocarbons (PAHs) are found widely in the ambient air and result from combustion of various fuels and industrial processes. PAHs have been associated with adverse human health effects such as cognitive development, childhood IQ, and respiratory health. The Fresno Asthmatic Children's Environment Study enrolled 315 children aged 6-11 years with asthma in Fresno, CA and followed the cohort from 2000 to 2008. Subjects were evaluated for asthma symptoms in up to three 14-day panels per year. Detailed ambient pollutant concentrations were collected from a central site and outdoor pollutants were measured at 83 homes for at least one 5-day period. Measurements of particle-bound PAHs were used with land-use regression models to estimate individual exposures to PAHs with 4-, 5-, or 6-member rings (PAH456) and phenanthrene for the cohort (approximately 22,000 individual daily estimates). We used a cross-validation-based algorithm for model fitting and a generalized estimated equation approach to account for repeated measures. Multiple lags and moving averages of PAH exposure were associated with increased wheeze for each of the three types of PAH exposure estimates. The odds ratios for asthmatics exposed to PAHs (ng/m(3)) ranged from 1.01 (95% CI, 1.00-1.02) to 1.10 (95% CI, 1.04-1.17). This trend for increased wheeze persisted among all PAHs measured. Phenanthrene was found to have a higher relative impact on wheeze. These data provide further evidence that PAHs contribute to asthma morbidity.     

Maternal mental health and childrearing context in the development of children at 6, 18 and 36 months: a Taiwan birth cohort pilot study

Background This study investigated a possible pathway of the childrearing context and maternal mental health at 6 months, and how these factors influence children's development at 6, 18 and 36 months. Methods Using random sampling, 2048 children and mothers were selected. The mother's health status was evaluated using the Taiwanese version of the 36‐Item Short Form Health Survey (SF‐36), and infant development was assessed using the high reliable Taiwan birth cohort study instrument. All data were collected using parental self‐report, and were analysed using multiple linear regression analysis and further pathway using structural equation modelling. Results This study showed that 12 factors effected children's development at 6 months, and some dissipated with growth. Of these, maternal education had an enduring effect on different domains of child development, and this effect intensified as the child grew older. Children who grew up in a family with more siblings would show a delay in language development at 6 months; they have a delay in motor and social development at 18 and 36 months. Additionally, maternal mental health effected the children's fine motor development at 6 months. However, this effect disappeared at 18 months, and influenced children's social development at 36 months. Conclusions This study demonstrated that the development of children at as young as 6 months is affected by various factors. These factors may dissipate, continue to influence child development up to 3 years of age, turn from being disadvantageous to beneficial, or affect different domains of child development. Also, parental self‐report instrument might be has its limitation and could be contributed by several confounding factors. Thus, continuous longitudinal follow‐up on changes in maternal conditions, family factors, and environmental factors is vital to understand how these early infantile factors affect each other and influence the developmental trajectories of children into early childhood.     

Breastfeeding, weight gain in infancy, and overweight at seven years of age: the prevention and incidence of asthma and mite allergy birth cohort study

Compared with nonbreastfed children, breastfed children tend to have a lower body mass index (BMI) at about 1 year of age. How the BMI of breastfed children develops after the first year when this difference in BMI at 1 year of age is considered is not clear. The authors studied the association between breastfeeding and BMI development from 1 to 7 years of age independently of BMI at 1 year of age. Longitudinal BMI data reported by parents of 2,347 Dutch children born in 1996-1997 who participated in the Prevention and Incidence of Asthma and Mite Allergy birth cohort study were collected. Linear regression and mixed-effects models were used for data analyses. Mean BMI at 1 year of age was 17.2 kg/m(2) (standard deviation, 1.4). Compared with nonbreastfed children, children breastfed for >16 weeks had a lower BMI at 1 year of age, after adjustment for confounders (beta = -0.22, 95% confidence interval: -0.39, -0.06). The association between breastfeeding and BMI between 1 and 7 years of age was negligible, while a high BMI at 1 year of age was strongly associated with a high BMI between 1 and 7 years of age in the same model. These findings suggest that the lower BMI and lower risk of overweight among breastfed children later in life are already achieved at 1 year of age.     

Obesity prognosis: a longitudinal study of children from the age of 6 months to 9 years

The development of body fatness and leanness is examined in an ongoing prospective nutrition and growth study. Individual skinfold thicknesses, relative weights, weight gains, activity levels, and caloric intakes were examined at seven ages between 6 months and 9 years. Changes in body fatness in this group of children provide evidence that the obese infant usually does not become the obese child. Weight gain in infancy is also a poor predictor of 9-year old obesity. Changes from obese to non-obese or lean are often not linear. There is evidence that impending or actual obesity begins at ages 6 to 9 years with some predictability provided as early as age 2 years for girls, age 3 years for boys.     

Neurodevelopmental outcomes of Seychellois children from the pilot cohort at 108 months following prenatal exposure to methylmercury from a maternal fish diet

The Seychelles Child Development Study has been unable to confirm any relationship between maternal exposure to MeHg during pregnancy and adverse developmental outcomes. In this report, 87 children from a pilot cohort were evaluated at 9 years of age. Each child was given a battery testing specific cognitive, visual motor, and motor skills using standardized psychometric and neuro-psychological tests. The results indicated no adverse association between maternal MeHg exposure and any developmental outcome measure. For three endpoints (Boston Naming Test and two tests of visual motor coordination), enhanced performance in males was associated with increasing prenatal MeHg exposure. A secondary analysis including both prenatal MeHg and postnatal MeHg exposure was done even though we lacked postnatal hair for about 35% of the cohort. The results of the secondary analysis mirrored the outcomes of the primary analysis regarding prenatal exposure but were less robust. The results of this study are consistent with earlier findings from the 66-month evaluations of the SCDS Main cohort. Since MeHg is neurotoxic, this effect is likely due to other factors associated with consumption of fish.     

Prenatal exposure to perfluorooctanoate and risk of overweight at 20 years of age: a prospective cohort study

Background: Perfluoroalkyl acids are persistent compounds used in various industrial -applications. Of these compounds, perfluorooctanoate (PFOA) is currently detected in humans worldwide. A recent study on low-dose developmental exposure to PFOA in mice reported increased weight and elevated biomarkers of adiposity in postpubertal female offspring.Objective: We examined whether the findings of increased weight in postpubertal female mice could be replicated in humans.Methods: A prospective cohort of 665 Danish pregnant women was recruited in 1988–1989 with offspring follow-up at 20 years. PFOA was measured in serum from gestational week 30. Offspring body mass index (BMI) and waist circumference were recorded at follow-up (n = 665), and biomarkers of adiposity were quantified in a subset (n = 422) of participants.Results: After adjusting for covariates, including maternal pre-pregnancy BMI, smoking, education, and birth weight, in utero exposure to PFOA was positively associated with anthropometry at 20 years in female but not male offspring. Adjusted relative risks comparing the highest with lowest quartile (median: 5.8 vs. 2.3 ng/mL) of maternal PFOA concentration were 3.1 [95% confidence interval (CI): 1.4, 6.9] for overweight or obese (BMI ≥ 25 kg/m²) and 3.0 (95% CI: 1.3, 6.8) for waist circumference > 88 cm among female offspring. This corresponded to estimated increases of 1.6 kg/m² (95% CI: 0.6, 2.6) and 4.3 cm (95% CI: 1.4, 7.3) in average BMI and waist circumference, respectively. In addition, maternal PFOA concentrations were positively associated with serum insulin and leptin levels and inversely associated with adiponectin levels in female offspring. Similar associations were observed for males, although point estimates were less precise because of fewer observations. Maternal perfluorooctane sulfonate (PFOS), perfluorooctane sulfonamide (PFOSA), and perfluorononanoate (PFNA) concentrations were not independently associated with offspring anthropometry at 20 years.Conclusions: Our findings on the effects of low-dose developmental exposures to PFOA are in line with experimental results suggesting obesogenic effects in female offspring at 20 years of age.     

6月龄～6 岁儿童屈光筛查界值点的研究

目的 运用伟伦spot双目视力筛查仪对 6月龄～6 岁儿童进行屈光状态的筛查与分析,寻找各年龄组的屈光筛查界值点。方法 对2018年3—9 月来南京医科大学附属妇产医院门诊就诊的15 342例6月龄～6岁儿童使用伟伦spot双目视力筛查仪进行屈光筛查,按照年龄分组进行统计学描述与分析,寻找合适的界值点。结果 各年龄组等效球镜x-±2s 和柱镜P₉₅的界值点分别是6～12月龄-1.50 D～+2.00 D,2.75 D;1～3 岁-1.25 D～+1.75 D,2.00 D;3～6岁-0.75 D～+1.25 D,1.25 D。各个年龄段柱镜绝对值随年龄增加逐渐减小(H=739.449,P<0.05),等效球镜正视构成比逐渐增高(χ²＝585.048,P<0.01)。结论 6月龄～6 岁儿童屈光筛查结果的判断需结合儿童年龄特点,等效球镜数值偏离出x-±2s和柱镜绝对值度数偏离出P₉₅者应列为视力低常和弱视的可疑,给予恰当的转诊,完善进一步相关的眼科检查。     

Prenatal mercury exposure and child neurodevelopment outcomes at 18 months: Results from the Mediterranean PHIME cohort

Introduction

Neurotoxicity due to acute prenatal exposure to high-dose of mercury (Hg) is well documented. However, the effect of prenatal exposure to low Hg levels on child neurodevelopment and the question about “safety” of fish-eating during pregnancy remain controversial. International comparisons of Hg concentrations in mother-child biological samples and neurodevelopmental scores embedded in birth cohort studies may provide useful evidence to explore this issue.

Factors associated with sunburn in white children aged 6 months to 11 years

OBJECTIVE: To determine the sunburn experience and factors associated with sunburn among white children aged 6 months to 11 years. METHODS: Telephone interviews were conducted with parents and primary caretakers of children, selected by random, stratified sampling, in the contiguous United States in the summer of 1998. Information was gathered on demographic characteristics of parents and children, and children's sunburn experience during the past year, protection from sun exposure, and hours per week spent outdoors. The proportion of children experiencing sunburn in the past year was calculated. Multivariate logistic regression analyses were conducted to determine factors associated with sunburn. Information for 1052 white children was available for the analyses. RESULTS: An estimated 42.6% of U.S. white children experienced one or more sunburns within the past year (95% CI 38.2-47.0). Sunburn was less common among children who ever wore hats (adjusted OR 0.59, 95% CI 0.40-0.87) and more common among children who did not always wear sunscreen (OR for using sunscreen sometimes compared with always, 2.25; 95% CI 1.31-3. 86). Sunburn was also more common among children with sun-sensitive skin and older children. CONCLUSIONS: A large proportion of U.S. white children experience sunburns. Parents and children may benefit from education about protection from sun exposure.     

Health effects in children aged 3-6 years induced by environmental lead exposure

OBJECTIVES: To investigate the involvement of oxidative damage in lead-induced toxicity in children aged 3-6 years and to enlighten whether oxidative stress indicators are correlated with the known indices of lead toxicity. METHODS: Blood samples were collected from 408 subjects (217 boys and 191 girls) in the urban kindergartens. The age range of the subjects was 3-6 years. Blood lead levels (BLLs) were analyzed by flameless atomic absorption spectrophotometry. Activities of delta-aminolevulinic acid dehydratase (ALAD), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), and contents of glutathione (GSH) in erythrocyte and levels of plasma malondialdehyde (MDA) were analyzed spectrophotometrically in these children. RESULTS: Children with BLLs >or = 100 microg/L had significantly decreased erythrocyte ALAD activities and increased plasma MDA levels compared to the children with BLLs < 100 microg/L. No significant changes were observed in erythrocyte SOD and GSH-Px activities and GSH levels associated with elevated BLLs in these children. CONCLUSION: Present data indicate that oxidative damage could be induced by lead in children with BLLs > or = 100 microg/L, and this may partly be attributed to the inhibited ALAD activities. Statistically significant changes of oxidative stress parameters in preschool children while BLLs were more than 100 microg/L could be implicated that oxidative damage might contribute to lead-induced intellectual impairment.