Modern life makes children allergic. A cross-sectional study: associations of home environment and lifestyles with asthma and allergy among children in Tianjin region, China

  • Yuexia SunEmail author
  • Jing Hou
  • Ying Sheng
  • Xiangrui Kong
  • Louise B. Weschler
  • Jan Sundell
Original Article



In the past 60 years, the prevalences of asthma and allergy among children have increased around the world. Neither genetic nor outdoor environmental factors can explain this increase.


We performed a cross-sectional study of 7366 children in Tianjin, China, on associations of home environment and lifestyles with asthma and allergy.


The prevalences of diagnosed asthma, rhinitis and eczema among 0- to 8-year-old children in the Tianjin area were 4%, 9% and 39%. Home environment and lifestyle, together with infections, were strong risk factors. For asthma and allergy, the population attributable fraction (PAF) due to modern floors and wall coverings (i.e., laminated wooden floors and painted walls compared to tile floors and lime-coated walls) was 22%. Window condensation in winter and air conditioner use in summer, both of which are proxies for less ventilation, accounted for 7–17% of rhinitis and eczema. Cesarean delivery accounted for 10% of eczema symptoms. We developed a modern life index from appropriate home characteristics and lifestyle and food consumption habits and found it to have a clear dose–response relationship with asthma and allergy in Tianjin children.


The results indicate that a “modern” home environment together with a modern lifestyle is associated with increased prevalences of asthma and allergies among children. Appropriate indoor environmental interventions and education of children’s caregivers are important in the management of childhood asthma and allergy.


Asthma and allergy Home environment Lifestyle Modern decoration Ventilation Child 



Air conditioner


Attention–deficit/hyperactivity disorder


Adjusted odds ratios


China, children, health and home


Confidence interval


Environmental tobacco smoke


Semivolatile organic compound


Volatile organic compound



We gratefully acknowledge the investigated children and their parents for their participation. We also thank the teachers who helped us to distribute and collect questionnaires.

Author contributions

YS and JS designed the study, performed the questionnaire survey, analyzed the data and wrote the manuscript. LW and YS analyzed the data and wrote the manuscript. JH and XK performed the questionnaire survey. All authors read and approved the final manuscript.


This study was funded by the National Key Research and Development Program of China (2017YFC0702700), the National Natural Science Foundation of China (21207097), the Science and Technology Development Foundation of Universities of Tianjin (20110904) and the Natural Science Foundation of Tianjin City (16JCYBJC22700). These fundings have no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.

Compliance with ethical standards

Ethical approval

Ethical approval was obtained from the Research Office at Tianjin University. Our participants provided verbal informed consent to participate in this study. This study is an anonymous questionnaire survey. It involves no risk to the subjects. The study could not be carried out practically with written consent. Completed surveys reflected participant consent. The completed surveys were stored in a lock cabinet. The Tianjin University Research Office approved this consent procedure.

Conflict of interest

The authors declare that they have no competing interests.

Supplementary material

420_2018_1395_MOESM1_ESM.docx (111 kb)
Supplementary material 1 (DOCX 110 KB)
420_2018_1395_MOESM2_ESM.doc (204 kb)
Supplementary material 2 (DOC 204 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Tianjin Key Laboratory of Indoor Air Environmental Quality ControlSchool of Environmental Science and Engineering, Tianjin UniversityTianjinChina
  2. 2.School of ArchitectureTsinghua UniversityBeijingChina
  3. 3.Colts NeckUSA
  4. 4.Tianjin Key Laboratory for Advanced Mechatronic System Design and Intelligent Control, School of Mechanical EngineeringTianjin University of TechnologyTianjinChina

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