Psychosocial factors and indoor environmental quality in respiratory symptom reports of pupils : a cross-sectional study in Finnish schools

Objectives Poor indoor environmental quality (IEQ) in schools is related to higher respiratory symptoms of pupils, but little is known about the importance of other factors. This study examined the associations between different psychosocial factors and other pupils’ individual and allergic characteristics, beyond school IEQ, and reporting of respiratory symptoms in pupil-administered and parent-administered questionnaires. Setting All primary and secondary schools in two areas of Helsinki, Finland. Participants Primary school pupils (grade 3–6, n=8775, 99 school buildings) and secondary school pupils (grade 7–9, n=3410, 30 school buildings) reported their respiratory symptoms, as well as psychosocial factors and individual characteristics. Parents of primary school pupils (grade 1–6, n=3540, 88 school buildings) also filled in questionnaires, but the response rate was low (20% in 2017 and 13% in 2018). Main outcome measure Respiratory symptoms were reported in relation to the school environment and in general (without such relation) by pupils or parents. Results Worry about IEQ and low school satisfaction, and asthma and hay fever were related to higher reporting of respiratory symptoms in three samples. The variance between schools in respiratory symptoms was low (intraclass correlation=0.6%–2.4%). Psychosocial factors, especially worry about school’s IEQ, explained more of the variance between schools in symptoms than IEQ among secondary school pupils and parents, but not among primary school pupils for symptoms in general. Worry about IEQ also modified the associations between IEQ and respiratory symptoms, but only in parental reports. Conclusion In addition to IEQ, psychosocial factors and pupils’ individual and allergic characteristics were related to higher reporting of respiratory symptoms in all three samples. Psychosocial factors explained more variance between schools than IEQ, although it was 2.4% at most. Other factors beyond IEQ should be considered when interpreting symptom reporting in indoor air questionnaires.Peer reviewe

Associations between indoor environmental quality in schools and symptom reporting in pupil-administered questionnaires

Peer reviewe

Associations between indoor environmental quality in schools and symptom reporting in pupil-administered questionnaires

Peer reviewe

Baltic herring as nutrition – Risk-benefit analysis

Tämän tutkimuksen tarkoitus oli selvittää, onko silakansyönnistä enemmän terveyshyötyä kuin -haittaa Suomessa ja millainen tilanne on eri ikäryhmissä. Aiemmat hyöty-riskiarviot ovat osoittaneet, että kalansyönti on yleensä terveellisempää kuin sen syömättä jättäminen. Tämä johtuu erityisesti kalan terveellisistä omega-3-rasvahapoista. Kuitenkin iso osa hyödyistä tulee aikuisille, joilla on suurentunut sydäntautiriski, ja osa mahdollisista haitoista tulee lapsille hammasvaurioiden ja muiden kehityshäiriöiden riskinä. Eviran toimeksiantona, yhteistyössä THL:n kanssa on vuoden 2014 aikana tehty hyöty-haitta-analyysi, jossa on tarkasteltu nimenomaan eri ikäryhmiä erikseen nykyisen kalankäytön mukaan. Tulokset perustuvat Taloustutkimuksen tekemän kyselyn aineistoon vuodelta 2013, jonka pohjalta on tehty varsinainen terveysvaikutusten tarkastelu. Tulokset ilmaistiin käyttäen haittapainotettuja elinvuosia (Disability Adjusted Life Year DALY) eli yksi DALY vastaa yhtä menetettyä tervettä elinvuotta. Hyödyllisistä ravintoaineista raportissa tarkasteltiin omega-3-rasvahappoja, eikosapentaeenihappoa (EPA) ja dokosaheksaeenihappoa (DHA) sekä D-vitamiinia. Silakassa esiintyvistä terveydelle haitallisista ympäristömyrkyistä tarkasteltiin dioksiineihin luettavia yhdisteitä, joihin kuuluvat polyklooratut dibentso-p-dioksiinit ja polyklooratut furaanit sekä dioksiininkaltaiset polyklooratut bifenyylit (PCB:t). Tulosten mukaan silakansyönti aiheuttaa Suomessa noin 11 (95 % luottamusväli LV 0 – 54) DALY kehityshäiriöistä (hammasvaurio) johtuvaa haittapainotettua elinvuotta (DALY), jotka kaikki kohdistuvat lapsiin äidin välityksellä raskausajan ja imetyksen kautta. Lisäksi silakansyönti aiheuttaa noin 12 (95 % LV 1.7 – 56) DALY dioksiinien aiheuttaman syöpäriskin kautta koko väestössä. Yli 50-vuotiailla naisilla ja varsinkin miehillä silakansyönnin terveyshyödyt ovat selkeästi suuremmat kuin terveyshaitat. Suurimmat terveyshyödyt saadaan sydäntautia ja sydänkuolleisuutta vähentävästä vaikutuksesta, noin -688 (95 % LV -2126 – -41) DALY/vuosi. Tulosten mukaan silakan syönti on vähentynyt väestössä niin paljon, että nykyiset suomalaiset kalan yleiset syöntisuositukset ovat riittävät suojaamaan väestöä dioksiinien ja dioksiinien kaltaisten yhdisteiden aiheuttamilta terveyshaitoilta. Hyöty-haitta-analyysissä tulisi kuitenkin tulevaisuudessa arvioida myös muiden rasvaisten kalojen keräämien ympäristömyrkkyjen kumulatiivisia terveysvaikutuksia ja yleisten syöntisuositusten riittävyyttä.Syftet med denna undersökning var att utreda om konsumtion av strömming från Östersjön ger mer hälsofördelar än hälsoskador i Finland och hurdant läget i olika ålderskategorier är. Tidigare nytta/riskvärderingar har visat att det i allmänhet är hälsosammare att äta fisk än att låta bli att göra det. Det beror särskilt på de hälsosamma omega-3-fettsyrorna i fisken. En stor del av fördelarna tillkommer ändå vuxna personer med förhöjd risk för hjärtsjukdomar och en stor del av skadorna tillkommer barn i form av risk för skador på tänderna och andra utvecklingsstörningar. På uppdrag från Evira och i samarbete med THL har under året 2014 gjorts en nytta/riskanalys, där man uttryckligen granskat olika ålderskategorier skilt för sig i ljuset av den nuvarande konsumtionen av strömming. Resultaten bygger på ett enkätmaterial som Taloustutkimus inhämtat år 2013. Utgående från detta material har sedan den egentliga granskningen av hälsoeffekterna gjorts. Resultaten angavs i form av funktionsjusterade levnadsår (Disability Adjusted Life Year DALY). För de nyttiga näringsämnenas del granskades i rapporten omega-3-fettsyrorna eikosapentaensyra (EPA) och dokosahexaensyra (DHA) och vitamin D. Av de hälsovådliga miljögifterna som förekommer i strömming granskades dioxiner, polyklorerade dibenzo-p-dioxinerna och plyklorerade dibenzofuranerna jämte dioxinliknande polyklorerade bifenylerna (PCB). Resultaten visar att konsumtion av strömming i Finland orsakar cirka 11 (95 % förtroende intervall , FI 0-54) funktionsjusterade levnadsår (DALY) som beror på utvecklingsstörningar (tandskada) och som alla via modern drabbar barn under graviditeten och amningen. Konsumtion av strömming medför också cirka 12 (95 %, FI 1,7-56) DALY via den cancerrisk som dioxinerna orsakar i hela befolkningen. Hos över 50 åriga kvinnor och framförallt män är fördelarna av att äta strömming klart större än hälsoskadorna. De största hälsofördelarna kommer av att risken för hjärtsjukdomar och dödligheten i hjärtsjukdomar minskar, cirka -688 (95 %, FI -2126 -41) DALY/år. Enligt resultaten konsumtion av strömming I Finland har sjunkit till en så låg nivå , att de nuvarande allmänna rekommenderade intagen av fisk konsumtion är tillräckliga för att skydda befolkningen mot hälsoskador av dioxiner eller dioxinlika föreningar. I risk-nytta-analys i framtiden bör ändå utvärderas totala hälsoeffekter av olika miljögifter i andra feta fiskarter ock kolla lämpligheten av rekommendationer av fisk konsumtion.The objective of this study was to determine whether the benefits of eating Baltic Sea herring exceed the risks in Finland, and what the situation is in different age groups. Previous risk-benefit analyses have shown that eating fish is in general healthier than not eating fish. This is particularly due to the healthy omega 3 fatty acids of fish. However, the benefits are largely enjoyed by adults with an elevated risk of heart disease, while children suffer the majority of the risks in the form of dental problems and other developmental disorders. In the riskbenefit analysis carried out to the order of Evira in collaboration with THL during 2014, different age groups were specifically considered separately in the light of current fish consumption. The results are based on the survey of the consumption of Baltic herring conducted by Taloustutkimus in 2013, which was used as the basis for the actual analysis of health effects. The results were expressed as Disability Adjusted Life Years (DALY). Omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) as well as vitamin D were analysed in the report as beneficial nutrients. As far as environmental toxins harmful to health are concerned, Baltic herring were analysed for compounds classified as dioxins, which include polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans, as well dioxin-like biphenyls (PCB). According to the results, in Finland eating herring causes ca. 11 (95% confidence interval, CI 0-54) Disability Adjusted Life Years (DALYs) resulting from developmental disorders (dental damage); these affect children via the mother during pregnancy and breastfeeding. In addition, eating herring causes a ca. 12 (95%, CI 1,7-56) DALY cancer risk due to dioxins in the entire population. The health benefits of eating herring clearly exceed risks to health for women and particularly men after the age of 50 years. The greatest health benefits result from the reduction in heart disease and heart-related fatality, ca. –688 (95%, CI -2126 -41) DALY/year. The results show that the consumption of Baltic herring has decreased in Finland to a low level and that the current common dietary advices on fish consumption are adequate to protect the population against the adverse health effects of dioxins and dioxin-like compounds. However, in risk benefit analysis in future it is important to estimate the total health effects of different environmental pollutants and of other fatty fish, and the sufficiency of dietary advices on fish consumption

Test-retest repeatability of child's respiratory symptoms and perceived indoor air quality - comparing self-and parent-administered questionnaires

Background: Questionnaires can be used to assess perceived indoor air quality and symptoms in schools. Questionnaires for primary school aged children have traditionally been parent-administered, but self-administered questionnaires would be easier to administer and may yield as good, if not better, information. Our aim was to compare the repeatability of self- and parent-administered indoor air questionnaires designed for primary school aged pupils. Methods: Indoor air questionnaire with questions on child's symptoms and perceived indoor air quality in schools was sent to parents of pupils aged 7-12 years in two schools and again after two weeks. Slightly modified version of the questionnaire was administered to pupils aged 9-12 years in another two schools and repeated after a week. 351 (52%) parents and 319 pupils (86%) answered both the first and the second questionnaire. Test-retest repeatability was assessed with intra-class correlation (ICC) and Cohen's kappa coefficients (k). Results: Test-retest repeatability was generally between 0.4-0.7 (ICC; k) in both self-and parent-administered questionnaire. In majority of the questions on symptoms and perceived indoor air quality test-retest repeatability was at the same level or slightly better in self-administered compared to parent-administered questionnaire. Agreement of self-and parent administered questionnaires was generally <0.4 (ICC; k) in reported symptoms and 0.4-0.6 (ICC; k) in perceived indoor air quality. Conclusions: Children aged 9-12 years can give as, or even more, repeatable information about their respiratory symptoms and perceived indoor air quality than their parents. Therefore, it may be possible to use self-administered questionnaires in future studies also with children.Peer reviewe