Department of Civil Engineering, International Centre for Indoor Environment and Energy, Technical University of Denmark, Lyngby, Denmark.
Indoor Air. 2012 Dec;22(6):467-75. doi: 10.1111/j.1600-0668.2012.00777.x. Epub 2012 Mar 31.
The principle objective of the Danish research program 'Indoor Environment and Children's Health' (IECH) was to explore associations between various exposures that children experience in their indoor environments (specifically their homes and daycare centers) and their well-being and health. The targeted health endpoints were allergy, asthma, and certain respiratory symptoms. The study was designed with two stages. In the first stage, a questionnaire survey was distributed to more than 17,000 families with children between the ages of 1 and 5. The questionnaire focused on the children's health and the environments within the homes they inhabited and daycare facilities they attended. More than 11,000 questionnaires were returned. In the second stage, a subsample of 500 children was selected for more detailed studies, including an extensive set of measurements in their homes and daycare centers and a clinical examination; all clinical examinations were carried out by the same physician. In this study, the methods used for data collection within the IECH research program are presented and discussed. Furthermore, initial findings are presented regarding descriptors of the study population and selected characteristics of the children's dwellings and daycare centers.
This study outlines methods that might be followed by future investigators conducting large-scale field studies of potential connections between various indoor environmental factors and selected health endpoints. Of particular note are (i) the two-stage design - a broad questionnaire-based survey followed by a more intensive set of measurements among a subset of participants who have been selected based on their responses to the questionnaire; (ii) the case-base approach utilized in the stage 2 in contrast to the more commonly used case-control approach; (iii) the inclusion of the children's daycare environment when conducting intensive sampling to more fully capture the children's total indoor exposure; and (iv) all clinical examinations conducted by the same physician. We recognize that future investigators are unlikely to fully duplicate the methods outlined in this study, but we hope that it provides a useful starting point in terms of factors that might be considered when designing such a study.
丹麦研究计划“室内环境与儿童健康”（IECH）的主要目标是探索儿童在其室内环境（特别是家庭和日托中心）中所经历的各种暴露与其健康之间的关联。目标健康终点是过敏、哮喘和某些呼吸道症状。该研究设计分为两个阶段。在第一阶段，向 17000 多个 1 至 5 岁儿童的家庭分发了一份问卷。该问卷侧重于儿童健康以及他们居住的家庭和日托设施的环境。超过 11000 份问卷被收回。在第二阶段，选择了 500 名儿童的样本进行更详细的研究，包括在家庭和日托中心进行广泛的测量和临床检查；所有临床检查均由同一位医生进行。在本研究中，介绍并讨论了 IECH 研究计划中用于数据收集的方法。此外，还介绍了有关研究人群描述符以及儿童住所和日托中心的选定特征的初步发现。
本研究概述了未来的研究人员可能遵循的方法，以进行各种室内环境因素与选定健康终点之间潜在联系的大规模现场研究。特别值得注意的是：（i）两阶段设计 - 在基于问卷的广泛调查之后，根据对问卷的回答选择的参与者子集进行更深入的测量；（ii）在第二阶段中使用的基于病例的方法与更常用的病例对照方法相反；（iii）在进行密集采样时纳入儿童日托环境，以更全面地捕捉儿童的总室内暴露；（iv）所有临床检查均由同一位医生进行。我们认识到，未来的研究人员不太可能完全复制本研究中概述的方法，但希望它能为设计此类研究时应考虑的因素提供一个有用的起点。
