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2019

ANUÁRIO DO HOSPITAL
DONA ESTEFÂNIA

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CO2 concentration in day care centres is related to wheezing in attending children

Pedro Martins1,2, João Viegas3, Ana Luisa Papoila4,5, Daniel Aelenei6, Iolanda Caires1, José Martins1, João Marques1,2 , Maria Manuela Cano7, Ana Sofia Mendes8, Daniel Virella5, José Rosado-Pinto9, Paula Leiria-Pinto1,2, Isabella-Annesi Maesano10,11, Nuno Neuparth1,2

1. CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa,. Campo dos Mártires da Pátria, 130, 1169-056, Lisbon, Portugal ..
2. Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Rua Jacinta Marto, 1169-045 Lisbon, Portugal
3. Laboratório Nacional de Engenharia Civil, Avenida Brasil, 101, 1700-066 Lisbon, Portugal
4. Departamento de Bioestatística e Informática, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056, Lisbon, CEAUL, Portugal
5. Centro de Investigação, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Rua Jacinta Marto, 1169-045 Lisbon, Portugal
6. Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Campus da Caparica, 2829-516, Caparica, Portugal
7. Instituto Nacional de Saúde Dr. Ricardo Jorge – Lisboa, Avenida Padre Cruz, 1649- 016 Lisbon, Portugal
8. Instituto Nacional de Saúde Dr. Ricardo Jorge – Porto, Rua Alexandre Herculano,. 321, 4000-055 Oporto, Portugal
9. Hospital da Luz, Avenida Lusíada, 100, 1500-650, Lisbon, Portugal
10. INSERM, UMR S 707: EPAR, Paris, F-75012 France1
11. Université Pierre et Marie Curie - Paris 6, UMR S 707: EPAR, Paris, F-75012 France Eur J Pediatr. 2014 Aug;173(8):1041-9.

Poor ventilation at day care centers (DCC) was already reported, although its effects on attending children are not clear. This study aimed to evaluate the association between wheezing in children and indoor CO2 (a ventilation surrogate marker) in DCC and to identify behaviors and building characteristics potentially related to CO2. In Phase I, 45 DCC from Lisbon and Oporto (Portugal) were selected through a proportional stratified random sampling. In Phase II, three months later, 19 DCC were further reassessed after cluster analysis for greatest differences comparison. In both Phases, children’s respiratory health was assessed by ISAAC derived questionnaires. Indoor CO2 concentrations and building characteristics of the DCC were evaluated in both phases, using complementary methods. Mixed effect models were used to analyze the data. In Phase I, which included 3,186 children (mean age: 3.1 ± 1.5 years), indoor CO2 concentration in the DCC rooms was associated with reported wheezing in the past 12 months (27.5%) (adjusted OR for each increase of 200 ppm: 1.04, 95% CI: 1:01 to 1:07). In Phase II, the association in the subsample of 1,196 children seen in 19 out of the initial 45 DCC was not significant (adjusted OR: 1.02; 95% CI: 0.97 to 1.07). Indoor CO2 concentration was inversely associated with the practices of opening windows and internal doors and with higher wind velocity. A positive trend was observed between CO2 and prevalence of reported asthma (4.7%).

Conclusion: Improved ventilation is needed to achieve a healthier indoor environment in DCC.

Palavras-chave: Children, environmental health, indoor air quality, kindergarten, ventilation