Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY 12144, USA.
Department of Environmental Medicine, School of Medicine, New York University, New York, NY 12144, USA.
Sci Total Environ. 2021 May 20;770:144746. doi: 10.1016/j.scitotenv.2020.144746. Epub 2021 Jan 23.
Few studies have comprehensively assessed multiple environmental exposures affecting children's health. This study applied machine-learning methods to evaluate how indoor environmental conditions at home and school contribute to asthma and allergy-related symptoms.
We randomly selected 10 public schools representing different socioeconomic statuses in New York State (2017-2019) and distributed questionnaires to students to collect health status and home-and school-environmental exposures. Indoor air quality was measured at school, and ambient particle exposures (PM and components) were measured using real-time personal monitors for 48 h. We used random forest model to identify the most important risk factors for asthma and allergy-related symptoms, and decision tree for visualizing the inter-relationships among the multiple risk factors with the health outcomes.
The top contributing factors identified for asthma were family rhinitis history (relative importance: 10.40%), plant pollen trigger (5.48%); bedroom carpet (3.58%); environmental tobacco smoke (ETS) trigger symptom (2.98%); and ETS exposure (2.56%). For allergy-related symptoms, plant pollen trigger (10.88%), higher paternal education (7.33%), bedroom carpet (5.28%), family rhinitis history (4.78%), and higher maternal education (4.25%) were the strongest contributing factors. Conversely, primary heating with hot water radiator was negatively (-6.86%) associated with asthma symptoms. Younger children (<9 years old) with family history of rhinitis and carpeting in the bedroom were the prominent combined risk factors for asthma. Children jointly exposed to pollen, solvents, and carpeting in their home tended to have greater risks of allergy-related symptoms, even without family history of rhinitis.
Family rhinitis history, bedroom carpet, and pollen triggers were the most important risk factors for both asthma and allergy-related symptoms. Our new findings included that hot-water radiator was related to reduced asthma symptoms, and the combination of young age, rhinitis history, and bedroom carpeting was related to increased asthma symptoms. Further studies are needed to confirm our findings.
很少有研究全面评估影响儿童健康的多种环境暴露因素。本研究应用机器学习方法评估家庭和学校室内环境条件如何导致哮喘和过敏相关症状。
我们在纽约州随机选择了 10 所代表不同社会经济地位的公立学校（2017-2019 年），向学生发放问卷收集健康状况和家庭及学校环境暴露情况。在学校测量室内空气质量，并使用实时个人监测仪测量 48 小时环境颗粒物暴露（PM 及其成分）。我们使用随机森林模型确定哮喘和过敏相关症状的最重要危险因素，并使用决策树可视化多个危险因素与健康结果之间的相互关系。
确定的哮喘最重要影响因素为家族性鼻炎史（相对重要性：10.40%）、植物花粉触发（5.48%）、卧室地毯（3.58%）、环境烟草烟雾（ETS）触发症状（2.98%）和 ETS 暴露（2.56%）。对于过敏相关症状，植物花粉触发（10.88%）、父亲教育程度较高（7.33%）、卧室地毯（5.28%）、家族性鼻炎史（4.78%）和母亲教育程度较高（4.25%）是最强的影响因素。相反，主要使用热水散热器供暖与哮喘症状呈负相关（-6.86%）。有家族性鼻炎史和卧室地毯的年龄较小（<9 岁）的儿童是哮喘的突出综合危险因素。在家庭中同时暴露于花粉、溶剂和地毯的儿童患过敏相关症状的风险更大，即使没有家族性鼻炎史也是如此。
家族性鼻炎史、卧室地毯和花粉触发是哮喘和过敏相关症状的最重要危险因素。我们的新发现包括热水散热器与哮喘症状减少有关，以及年龄较小、鼻炎史和卧室地毯相结合与哮喘症状增加有关。需要进一步研究来证实我们的发现。
