The impact of poor housing and indoor air quality on respiratory health in children

Innovations in Air Quality Monitoring: Sensors, IoT and Future Research

Recently, Air Quality Monitoring (AQM) has gained significant R&D attention from academia and industries, leading to advanced sensor-enabled IoT solutions. Literature highlights the use of nanomaterials in sensor design, emphasising miniaturisation, enhanced calibration, and low voltage, room-temperature operation. Significant efforts are aimed at improving sensitivity, selectivity, and stability, while addressing challenges like high power consumption and drift. The integration of sensors with IoT technology is driving the development of accurate, scalable, and real-time AQM systems. This paper provides technical insights into recent AQM advancements, focusing on air pollutants, sensor technologies, IoT frameworks, performance evaluation, and future research directions. It presents a detailed analysis of air quality composition and potential air pollutants. Relevant sensors are examined in terms of design, materials and methodologies for pollutant monitoring. A critical review of IoT frameworks for AQM is conducted, highlighting their strengths and weaknesses. As a technical contribution, an experimental performance evaluation of three commercially available AQM systems in the UK is discussed, with a comparative and critical analysis of the results. Lastly, future research directions are also explored with a focus on AQM sensor design and IoT framework development.

Socioeconomic determinants of outcomes in childhood asthma

Asthma is the commonest chronic condition of childhood. Children with asthma in the UK have the worst outcomes across Europe and other high-income countries. There are significant socioeconomic inequalities that impact the prevalence and outcomes of asthma (emergency healthcare utilisation, hospitalisation, critical care admission, mortality and quality of life). In this review we discuss these inequalities and the underlying mechanistic links, using the UK as an example of how poverty in a high-income country results in inequality in asthma outcomes. These inequalities and underlying mechanisms need to be understood by clinicians, policymakers and wider stakeholders to be redressed such that avoidable harm and asthma deaths in children can be prevented.

Spatial autocorrelation with environmental factors related to tuberculosis prevalence in Nepal, 2020-2023

BACKGROUND

Despite global efforts to reduce tuberculosis (TB) incidence, Nepal remains burdened by approximately 70,000 new cases annually, with an incidence rate of 229 per 100,000 people in 2022. This study investigated the geographic patterns of TB notifications in Nepal from fiscal year 2020 to 2023, focusing on environmental determinants such as land surface temperature (LST), urbanization, precipitation and cropland coverage.

METHODS

This study examined the spatial association between environmental factors and TB prevalence in Nepal at the district level, utilizing Geographic Information System (GIS) techniques, bivariate Local Indicators of Spatial Association (LISA) and spatial regression analyses. The tuberculosis prevalence data were obtained from the National Tuberculosis Control Center (NTCC) Nepal for the fiscal years (FY) 2020-2023.

RESULTS

Over the three fiscal years, high TB prevalence consistently clustered in districts such as Banke, Parsa, and Rautahat, while low prevalence areas included Mustang and Kaski. Significant positive spatial autocorrelation was found between environmental factors and TB prevalence. Moran's I values were as follows: for LST (day), 0.379, 0.424, and 0.423; for LST (night), 0.383, 0.420, and 0.425; for cropland coverage, 0.325, 0.339, and 0.373; for urbanization, 0.197, 0.245, and 0.246; and for precipitation, 0.222, 0.349, and 0.104 across FY 2020-2021, FY 2021-2022 and FY 2022-2023, respectively. Regression analyses, including Ordinary Least Squares (OLS), Spatial Lag Model (SLM), and Spatial Error Model (SEM), demonstrated that Land Surface Temperature Night (LSTN), urbanization, and precipitation significantly influenced TB prevalence, explaining up to 72.1% of the variance in FY 2021-2022 (R2: 0.721).

CONCLUSIONS

Environmental factors significantly influence the spatial distribution of TB in Nepal. This underscores the importance of integrating disease management strategies with environmental health policies in effectively addressing TB prevalence.

ERS Congress 2024: highlights from the Paediatrics Assembly

At #ERSCongress 2024, experts highlighted the need to address healthcare disparities, prevent disease progression and assess the value of AI-driven care to improve outcomes in paediatric respiratory health https://bit.ly/40944lv.

Household cleaning agents impact on pediatric asthma: a systematic review and meta-analysis

BACKGROUND

Household cleaning agents promote hygiene along with causing respiratory effects, especially pediatric asthma. This systematic review quantified the association between exposure to household cleaning agents and pediatric asthma.

METHOD

Five databases were searched. Data were analyzed qualitatively and quantitatively. RevMan 5.4 calculated odds ratios (OR) with 95% confidence intervals (CI), and a funnel plot assessed publication bias. The Mixed Methods Appraisal Tool (MMAT) and GRADE framework assessed methodological quality and certainty respectively.

RESULTS

Sixteen studies met the eligibility criteria. Meta-analysis showed a significant association between the use of household cleaning agents and pediatric asthma (OR 2.90 (95% CI: 2.13-3.95; p < 0.01, I2 = 98%). Exposure stages also showed significant (p < 0.01) association with household cleaning agents (OR 2.92 (95% CI: 2.12-4.03, I2 = 98%). No publication bias or high risk of bias was found.

CONCLUSION

A strong association between exposure to household cleaning agents and an increased risk of pediatric asthma was found. .

Patterns and trends in burden of asthma and its attributable risk factors from 1990 to 2021 among South Asian countries: a systematic analysis for the Global Burden of Disease Study 2021

OBJECTIVE

Asthma poses a significant health burden in South Asia, with increasing incidence and mortality despite a global decline in age-standardized prevalence rates. This study aims to analyze asthma trends from 1990 to 2021, focusing on prevalence, incidence, mortality, and disability-adjusted life years (DALYs) across South Asia. The study also assesses the impact of risk factors like high body mass index (BMI), smoking, and occupational exposures on asthma outcomes.

METHOD

We extracted asthma data from the Global Burden of Disease database for South Asia (1990-2021). Joinpoint regression analysis was used to assess temporal trends in asthma burden. Total Percentage change (TPC) in age-standardized rates of incidence, mortality, and DALYs were calculated. Data were stratified by gender, and the contribution of risk factors was evaluated.

RESULTS

Asthma-related mortality in South Asia decreased by 37%, from 27.78 per 100,000 (1990) to 17.54 per 100,000 (2021). The Maldives showed the most significant reduction in mortality (78.31%), while Bangladesh recorded a 47.44% reduction in prevalence and a 62.64% decrease in DALYs. High BMI, smoking, and environmental risks contributed significantly to DALYs, with environmental factors playing a major role in countries like Afghanistan (20.73%) and Bhutan (18.58%). Females, particularly those over 20, experienced higher asthma-related DALYs than males.

CONCLUSION

Asthma burden in South Asia has reduced over the past three decades, yet the absolute number of cases continues to rise, driven by population growth and environmental risk factors. Targeted interventions addressing risk factors and healthcare disparities are essential for further reducing asthma burden.

Factors associated with malaria infection in under-5 children in Papua Province, Indonesia: an observational study

BACKGROUND

Malaria remains a serious public health challenge in tropical and subtropical regions, including Indonesia. Children under 5 years old face particular risk of contracting malaria due to low immunity. We examined potential factors associated with malaria infection among under-5 children in Papua Province, Indonesia.

METHODS

The study utilized secondary data from Indonesia Basic Health Research 2018. Multistage random sampling was employed, from the province level to census blocks (CBs). In Papua Province, interviews were conducted in 928 CBs. All 2,745 under-5 children were selected. The dependent variable was laboratory-confirmed malaria positivity; independent factors included residential area, socioeconomic characteristics, and behaviors such as sleeping under an insecticide net impregnated ≤3 years ago and the use of ventilation barriers. We also examined the conditions of the bedroom, kitchen, and living room according to the frequency of window-opening, proportion of ventilation area to the floor, and radiance.

RESULTS

Not sleeping under an insecticide net impregnated within the last 3 years (adjusted odds ratio [aOR], 0.518; 95% confidence interval [CI], 0.391-0.685; p<0.001); having a kitchen without windows (aOR, 0.491; 95% CI, 0.285-0.844; p=0.01); rarely opening the living room window (aOR, 2.804; 95% CI, 1.232-6.383; p=0.01), and having a windowless living room (aOR, 3.027; 95% CI, 1.369-6.696; p=0.01) displayed significant relationships with malaria infection among under-5 children.

CONCLUSION

Not using an insecticide-treated net impregnated ≤3 years ago, along with opening the living room window daily and having a kitchen without windows, appear preventive of malaria infection among under-5 children.

Risk Factors for Acute Rheumatic Disease: Exploring Factors at Individual and Collective Levels

Acute rheumatic fever (ARF) is a complex disease with several clinical manifestations. Its most significant long-term complication is valvular heart damage, commonly referred to as chronic rheumatic heart disease. The risk of ARF varies globally, with over 80% of cases occurring in low- and middle-income countries, highlighting the role of socioeconomic factors. A comprehensive understanding of the risk factors associated with ARF and its clinical, genetic, and sociodemographic mediators can help clinicians identify high-risk individuals, develop effective management strategies, enhance target screening and active case-finding initiatives, and ultimately improve patient outcomes. This review aimed to provide an overview of ARF and its global burden, focusing on the established and potential risk factors associated with its development.

Home and school pollutant exposure, respiratory outcomes, and influence of historical redlining

BACKGROUND

The discriminatory and racist policy of historical redlining in the United States during the 1930s played a role in perpetuating contemporary environmental health disparities.

OBJECTIVE

Our objectives were to determine associations between home and school pollutant exposure (fine particulate matter [PM2.5], NO2) and respiratory outcomes (Composite Asthma Severity Index, lung function) among school-aged children with asthma and examine whether associations differed between children who resided and/or attended school in historically redlined compared to non-redlined neighborhoods.

METHODS

Children ages 6 to 17 with moderate-to-severe asthma (N = 240) from 9 US cities were included. Combined home and school exposure to PM2.5 and NO2 was calculated based on geospatially assessed monthly averaged outdoor pollutant concentrations. Repeated measures of Composite Asthma Severity Index and lung function were collected.

RESULTS

Overall, 37.5% of children resided and/or attended schools in historically redlined neighborhoods. Children in historically redlined neighborhoods had greater exposure to NO2 (median: 15.4 vs 12.1 parts per billion) and closer distance to a highway (median: 0.86 vs 1.23 km), compared to those in non-redlined neighborhoods (P < .01). Overall, PM2.5 was not associated with asthma severity or lung function. However, among children in redlined neighborhoods, higher PM2.5 was associated with worse asthma severity (P < .005). No association was observed between pollutants and lung function or asthma severity among children in non-redlined neighborhoods (P > .005).

CONCLUSIONS

Our findings highlight the significance of historical redlining and current environmental health disparities among school-aged children with asthma, specifically, the environmental injustice of PM2.5 exposure and its associations with respiratory health.

Self-reported questionnaires to assess indoor home environmental exposures in asthma patients: a scoping review

BACKGROUND

The indoor home environment plays a crucial role in determining the outcome of respiratory diseases, including asthma. Researchers, clinicians, and patients would benefit from self-reported questionnaires to assess indoor home environmental exposures that may impact on respiratory health.

OBJECTIVE

To review self-reported instruments for assessing indoor home environmental exposures in asthma patients and to characterise their content, development, and psychometric properties.

DESIGN

A scoping review was conducted with content assessment.

METHODS

A literature search was conducted in Embase and PubMed using the key words housing quality, questionnaire and asthma and their index terms, covering articles published in English between January 2000 to July 2023. Articles in which questionnaires or single item questions were used to assess indoor home environmental exposures in asthma patients in middle- and high-income countries were included. We excluded articles in which the questionnaire required an interviewer or onsite observations and those conducted in low-income countries.

RESULTS

We screened 1584 articles to identify 44 studies containing self-reported questionnaires measuring indoor home environmental exposures. 36 studies (82%) were cross sectional, 35 (80%) had a sample size of greater than 1000 participants, and 29 (66%) were conducted in children. Most studies (86%, n = 38) had binary (yes/no) or multiple-choice responses. 25 studies (57%) included a recall period of 12 months. 32 studies (73%) had a response rate of greater than 50%. Dampness, biological exposures (e.g. mould), and second-hand tobacco smoke were the most assessed indoor home environmental exposures. Childhood asthma (54%, n = 24) and asthma symptoms (36%, n = 16) were the most examined asthma related outcomes. The exposure most associated with adverse asthma outcomes was exposure to damp (79%, n = 35). 13 studies (29%) had developed a self-reported instrument by adapting questions from previous studies and almost all instruments (n = 42 studies, 95%) had not been validated.

CONCLUSIONS

The scoping review did not identify a comprehensive, validated self-reported questionnaire for assessing indoor home environmental exposures in patients with asthma. There is need to develop and validate a robust but pragmatic self-reported instrument, incorporating the findings from this review.

Advocacy and Health Equity: The Role of the Pediatric Pulmonologist

Pediatric pulmonologists have the expertise to be advocates in many areas that affect the respiratory health of children. This article provides an overview of selected advocacy topics related to health equity and provides key examples that can improve child respiratory health in the clinical encounter and beyond.

Comprehensive analysis of classroom microclimate in context to health-related national and international indoor air quality standards

Indoor air quality (IAQ) and indoor air pollution are critical issues impacting urban environments, significantly affecting the quality of life. Nowadays, poor IAQ is linked to respiratory and cardiovascular diseases, allergic reactions, and cognitive impairments, particularly in settings like classrooms. Thus, this study investigates the impact of indoor environmental quality on student health in a university classroom over a year, using various sensors to measure 19 environmental parameters, including temperature, relative humidity, CO2, CO, volatile organic compounds (VOCs), particulate matter (PM), and other pollutants. Thus, the aim of the study is to analyze the implications of the indoor microclimate for the health of individuals working in the classroom, as well as its implications for educational outcomes. The data revealed frequent exceedances of international standards for formaldehyde (HCHO), VOC, PM2.5, NO, and NO2. HCHO and VOCs levels, often originating from building materials and classroom activities, were notably high. PM2.5 levels exceeded both annual and daily standards, while NO and NO2 levels, possibly influenced by inadequate ventilation, also surpassed recommended limits. Even though there were numerous exceedances of current international standards, the indoor microclimate quality index (IMQI) score indicated a generally good indoor environment, remaining mostly between 0 and 50 for this indicator. Additionally, analyses indicate a high probability that some indicators will exceed the current standards, and their values are expected to trend upwards in the future. The study highlighted the need for better ventilation and pollutant control in classrooms to ensure a healthy learning environment. Frequent exceedances of pollutant standards can suggest a significant impact on student health and academic performance. Thus, the present study underscored the importance of continuous monitoring and proactive measures to maintain optimal indoor air quality.

Ambient Air Pollution, Housing Context, and Birth Outcomes Among Wisconsin Mothers

OBJECTIVES

To assess the association between air pollution exposure and housing context during pregnancy and adverse birth outcomes.

METHODS

We linked air pollution data from the Environmental Protection Agency and housing data from the American Community Survey with birth records from Wisconsin counties over a 9-year period. We calculated average daily pregnancy exposure to fine particulate matter and ozone and modeled its relationship to preterm birth, low birthweight and NICU admission, adjusting for individual characteristics and housing context.

RESULTS

Ozone exposure and housing cost-burden had substantive and statistically significant negative associations with birthweight and gestational age, and positive associations with NICU admission, while a poor-quality housing environment had a significant negative effect on weeks of gestation. Fine particulate matter exposure had a negligible correlation with these outcomes.

CONCLUSIONS FOR PRACTICE

An additional tenth of one part-per-million daily average exposure to ozone is associated with a 33 g decrease in birthweight. This decrease in birthweight is about the same size as the association of gestational diabetes (32 g), larger than the association of chronic hypertension (22 g), and about 40% the size of the effect of smoking during pregnancy on birthweight (84 g). Given the magnitudes of the associations with atmospheric ozone and adverse birth outcomes, reducing atmospheric ozone should be a public health priority. Inclusion of controls for housing cost-burden and poor-quality housing reduces the magnitude of the association with mothers who identify as Black, suggesting the importance of these structural factors in understanding adverse birth outcomes by race.

Respiratory conditions and health symptoms associated with air pollution amongst children aged six years and below in Melusi Informal Settlement, Tshwane Metropolitan Municipality, South Africa: a cross-sectional study

BACKGROUND

Respiratory conditions and health symptoms associated with air pollution in children are a major public health concern, as their immune systems and lungs are not yet fully developed. This study aimed to assess self-reported respiratory conditions and health symptoms associated with air pollution sources amongst children aged six years and below in Melusi informal settlement, Tshwane Metropolitan Municipality, South Africa.

METHODS

With a quantitative cross-sectional study design, parents/caregivers of children aged six years and below (n = 300) from eight Early Childhood Development Centres were invited to participate in the study. This study employed complete sampling, and data was collected using the modified International Study of Asthma and Allergies in Children. The chi-square and multiple logistic regression models were used to analyze data, with p < 0.05 in the adjusted odds ratios considered as being statistically significant.

RESULTS

Three models were run to examine the predictors of wheezing in the past 12 months, dry cough, and itchy-watery eyes. The model for asthma was excluded, as only seven participants reported having asthma. Wheeze in the past 12 months was associated with participants living in the area for more than three years (OR 2.96 95%CI: 1.011-8.674). Furthermore, having a dog in the house in the past 12 months was associated with wheeze in the past 12 months (OR 5.98 95%CI: 2.107-16.967). There was an association between duration of stay in a residence and dry cough prevalence (OR 5.63 95%CI: 2.175-14.584). Trucks always or frequently passing near homes was associated with itchy-watery eyes (OR 3.27 95%CI: 1.358-7.889). 59% (59%) of participants perceived the indoor air quality in their homes to be good, while 6% perceived it as poor. In contrast, 36% of participants perceived the outdoor air quality to be good, and 19.7% perceived it as poor.

CONCLUSION

The association between perceived air pollution exposure, self-reported respiratory conditions, and health symptoms amongst children is complex. Further research is required to better understand the multifaceted nature of air pollution and its impact on the health of children.

Near-fatal and fatal asthma and air pollution: are we missing an opportunity to ask key questions?

There is an increasing body of evidence supporting the link between asthma attacks and air pollution in children. To our knowledge, there has only been one reported case of a fatal asthma attack in a child associated with air pollution and this was in the UK. This article considers why there is a lack of evidence on fatal/near-fatal asthma and air pollution. We also explore three challenges. First, fatal and near-fatal asthma events are rare and not yet well understood. Second, measuring and interpreting personal exposure to air pollution with sufficient temporal and spatial detail are challenging to interpret in the context of individual fatal or near-fatal asthma attacks. Third, current studies are not designed to answer the question of whether or to what extent air pollution is associated with fatal/near-fatal asthma attacks in children. Conclusive evidence is not yet available and systems of data collection for both air pollution and fatal and near-fatal asthma attacks should be enhanced to ensure risk can be determined and impact minimised.

Enriched housing differentially alters allostatic load and cardiopulmonary responses to wildfire-related smoke in male and female mice

Living conditions are an important modifier of individual health outcomes and may lead to higher allostatic load (AL). However, housing-induced cardiovascular and immune effects contributing to altered environmental responsiveness remain understudied. This investigation was conducted to examine the influence of enriched (EH) versus depleted housing (DH) conditions on cardiopulmonary functions, systemic immune responses, and allostatic load in response to a single wildfire smoke (WS) exposure in mice. Male and female C57BL/6J mice were divided into EH or DH for 22 weeks, and cardiopulmonary assessments measured before and after exposures to either one-hr filtered air (FA) or flaming eucalyptus WS exposure. Male and female DH mice exhibited increased heart rate (HR) and left ventricular mass (LVM), as well as reduced stroke volume and end diastolic volume (EDV) one week following exposure to WS. Female DH mice displayed significantly elevated levels of IL-2, IL-17, corticosterone and hemoglobin A1c (HbA1c) following WS, while female in EH mice higher epinephrine levels were detected. Female mice exhibited higher AL than males with DH, which was potentiated post-WS exposure. Thus, DH increased susceptibility to extreme air pollution in a gender-dependent manner suggesting that living conditions need to be evaluated as a modifier of toxicological responses.

Assessing the health consequences of indoor air pollution from biomass fuel combustion on pediatric populations in rural communities of Pakistan

Indoor air pollution arising from burning of biomass fuels poses a significant threat to child health in rural areas of Pakistan. This cross-sectional study aimed to assess health implications associated with indoor air pollution resulting from biomass burning among children under 12 years of age in rural Punjab. A questionnaire-based survey was conducted in six randomly selected rural districts of Punjab, characterized by their primary reliance on biomass fuels. The findings revealed that several characteristics, such as monthly household income, number of living rooms, secondary use of solid fuels, kitchen type, type of cooking stove, and presence of child in the kitchen with their mother, exhibited significant associations (p < 0.05) with negative health impacts among children. Reported health effects among the children included coughing (18.7%), watery eyes (17.7%), eye irritation (12.3%), runny nose (11.8%), breathing difficulties (8.5%), phlegm (38%), headache (25%), nausea (20.1%), dizziness (6.7%), asthma (6.4%), tuberculosis (1.8%), and pneumonia (1.5%).

A Comprehensive Look at the Development of Asthma in Children

Asthma, a prevalent chronic respiratory condition affecting millions of children globally, presents a significant health challenge. This review critically examines the developmental pathways of asthma in children, focusing on genetic, environmental, and early-life determinants. Specifically, we explore the impact of prenatal and postnatal factors such as maternal smoking, nutrition, respiratory infections, and allergen exposure on asthma development. Our analysis highlights the intricate interplay of these influences and their contribution to childhood asthma. Moreover, we emphasize targeted strategies and interventions to mitigate its burden, including genetic counseling for at-risk families, environmental modifications to reduce triggers, and early-life immunomodulation. By delving into these preventive measures and interventions, our review aims to provide actionable insights for healthcare professionals in developing tailored strategies to address the complexities of childhood asthma. In summary, this article offers a detailed examination of asthma development in children, aiming to enhance understanding and inform efforts to reduce its burden through targeted interventions.

Social determinants of respiratory health from birth: still of concern in the 21st century?

Respiratory symptoms are ubiquitous in children and, even though they may be the harbinger of poor long-term outcomes, are often trivialised. Adverse exposures pre-conception, antenatally and in early childhood have lifetime impacts on respiratory health. For the most part, lung function tracks from the pre-school years at least into late middle age, and airflow obstruction is associated not merely with poor respiratory outcomes but also early all-cause morbidity and mortality. Much would be preventable if social determinants of adverse outcomes were to be addressed. This review presents the perspectives of paediatricians from many different contexts, both high and low income, including Europe, the Americas, Australasia, India, Africa and China. It should be noted that there are islands of poverty within even the highest income settings and, conversely, opulent areas in even the most deprived countries. The heaviest burden of any adverse effects falls on those of the lowest socioeconomic status. Themes include passive exposure to tobacco smoke and indoor and outdoor pollution, across the entire developmental course, and lack of access even to simple affordable medications, let alone the new biologicals. Commonly, disease outcomes are worse in resource-poor areas. Both within and between countries there are avoidable gross disparities in outcomes. Climate change is also bearing down hardest on the poorest children. This review highlights the need for vigorous advocacy for children to improve lifelong health. It also highlights that there are ongoing culturally sensitive interventions to address social determinants of disease which are already benefiting children.

Impact of climate change on paediatric respiratory health: pollutants and aeroallergens

Paediatric populations are particularly vulnerable to respiratory diseases caused and exacerbated by aeroallergens, pollutants and infectious agents. Worsening climate change is expected to increase the prevalence of pollutants and aeroallergens while amplifying disease severity and causing disproportionate effects in under-resourced areas. The purpose of this narrative review is to summarise the role of anthropogenic climate change in the literature examining the future impact of aeroallergens, pollutants and infectious agents on paediatric respiratory diseases with a focus on equitable disease mitigation. The aeroallergens selected for discussion include pollen, dust mites and mould as these are prevalent triggers of paediatric asthma worldwide. Human rhinovirus and respiratory syncytial virus are key viruses interacting with climate change and pollution and are primary causal agents of viral respiratory disease. Within this review, we present the propensity for aeroallergens, climate change and pollution to synergistically exacerbate paediatric respiratory disease and outline measures that can ameliorate the expected increase in morbidity and severity of disease through a health equity lens. We support shifting from fossil fuels to renewable energy worldwide, across sectors, as a primary means of reducing increases in morbidity.

Inadequate Social Housing and Health: The Case of Oliver Bond House, The Liberties, Dublin

Background

Inadequate housing is an important social justice issue that adversely affects health.

Methods

Drawing on an extended ethnography case study, this paper presents the results of a resident-led survey to highlight the health consequences of inadequate social housing, as residents wait for a 'fair regeneration' of their social housing 'flats' estate within a gentrifying inner-city Dublin neighbourhood.

Results

Four key concerns were identified by residents as part of this analysis: (1) substandard housing conditions which are physically harmful to health; (2) the emotional toll of an unsafe social environment; (3) lack of child friendly and community green spaces; and (4) constrained mobility due to inaccessible housing design.

Conclusions

The results highlight the urgent need to place greater priority on the maintenance of the existing social housing stock and demonstrate the need for public housing policies that recognize the quality and quantity of adequate housing provision, where care is at the heart of housing policies. The paper also presents a novel 'City of Care' framework, following the need to develop an ethics of care within cities where public health, community wellbeing, solidarity, residents' empowerment, and social justice principles are at the forefront. Given that housing is an essential contributor to good health, it is now time for a joint public housing and public health agenda to create healthier homes by confronting the everyday impact of inadequate housing to tackle social inequalities more broadly.

Hispanic Housing Disparities and its relationship with asthma.. [DOI: 10.21203/rs.3.rs-3997553/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Introduction. Asthma is a chronic relapsing condition whose successful treatment is impacted by the spacing between exacerbations. Still, such spacing may not be optimal when the built environment enhances the risk for increased frequency and severity of symptoms. Objective. In this study, we analyzed the relationship between the severity and frequency of asthma symptoms in a sample of children and the built environment in which they lived. Materials and methods. Our study is based on a cross-sectional analytical study involving 353 individuals, their parents, and their homes. The descriptive statistics reported include frequencies and percentages for multinominal variables and explore the associations between severe presentation and each symptom using logistic regression modeling conducted using Stata 14. Results. Most participants reported low-income levels and lived in houses owned and inhabited by a single family. We also found that houses located near agricultural fields and conditions inside the house, including moisture, stuffed toys, and having pets inside the room, were associated with the onset of asthma symptomatology. Conclusions. The built environment is relevant to children with asthma, particularly those with an allergenic component. Families living near agricultural fields must be aware of an increased risk of the onset of severe symptoms and that having pets in the room was correlated with higher levels of symptom onset, including negative impacts on sleep quality. The presence of indoor furniture, carpets, curtains, and any other objects that accumulate dust may exacerbate symptoms, as those elements favor an increase in the concentration of allergens inside the house.

Cutaneous Redox Senescence

Our current understanding of skin cell senescence involves the role of environmental stressors (UV, O3, cigarette smoke, particulate matter, etc.), lifestyle (diet, exercise, etc.) as well as genetic factors (metabolic changes, hormonal, etc.). The common mechanism of action of these stressors is the disturbance of cellular redox balance characterized by increased free radicals and reactive oxygen species (ROS), and when these overload the intrinsic antioxidant defense system, it can lead to an oxidative stress cellular condition. The main redox mechanisms that activate cellular senescence in the skin involve (1) the oxidative damage of telomeres causing their shortening; (2) the oxidation of proteomes and DNA damage; (3) an a in lysosomal mass through the increased activity of resident enzymes such as senescence-associated β-galactosidase (SA-β-gal) as well as other proteins that are products of lysosomal activity; (4) and the increased expression of SASP, in particular pro-inflammatory cytokines transcriptionally regulated by NF-κB. However, the main targets of ROS on the skin are the proteome (oxi-proteome), followed by telomeres, nucleic acids (DNAs), lipids, proteins, and cytoplasmic organelles. As a result, cell cycle arrest pathways, lipid peroxidation, increased lysosomal content and dysfunctional mitochondria, and SASP synthesis occur. Furthermore, oxidative stress in skin cells increases the activity of p16INK4A and p53 as inhibitors of Rb and CDks, which are important for maintaining the cell cycle. p53 also promotes the inactivation of mTOR-mediated autophagic and apoptotic pathways, leading to senescence. However, these markers alone cannot establish the state of cellular senescence, and multiple analyses are encouraged for confirmation. An updated and more comprehensive approach to investigating skin senescence should include further assays of ox-inflammatory molecular pathways that can consolidate the understanding of cutaneous redox senescence.