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Study Finds Environmental, Lifestyle Risk Factors of Atopic Dermatitis in Preschool Children


Several environmental and lifestyle factors were associated with significant risk of atopic dermatitis development in preschool children of Shenzhen, China, including the presence of mold in the child’s room, living in a villa/townhouse, and using composite wood floors.

Certain environmental and lifestyle factors may predispose preschool children to greater risk of atopic dermatitis (AD) development, according to study findings published in Frontiers in Public Health.

One of the most prevalent inflammatory skin diseases among children, AD risk has been shown to be potentially influenced by genetic, environmental, and social factors. Moreover, residential and household environment variables may also play a role regarding risk of AD, although few studies have investigated this effect in children.

Dietary habits such as vegetable and fruit intake and lifestyle factors (eg, parental smoking) may also increase odds of eczema. But current findings have partially been conflicting, which may be because there are many confounders in dietary and lifestyle factors,” they added.

Seeking to investigate the associations of dietary habits, residential/household environment, and lifestyle with risk of children AD, researchers conducted a cross-sectional analysis of data on preschool children in Shenzhen, China, derived from the nationwide China-Children-Homes-Health (CCHH) study between 2015-2016.

“The rapid urbanization and industrialization in China have changed people’s consumption patterns, lifestyles, and living environments," noted the study authors. "Meanwhile, the prevalence of eczema in children has also increased rapidly."

Of the 4614 questionnaires collected across 30 kindergartens in Shenzhen, China, 2781 were included in the analysis. Several factors were assessed regarding dietary habits, residential/household environment, and lifestyle, with logistic regression models used to analyze the associations:

  • dietary habits examined were meats, seafood, fruits, vegetables, beans/grains, rice/pasta, eggs, milk, and fast food
  • residential environment included the location (residential area and located near a highway or not), size, age, and the type of dwelling
  • household environment, being the indoor environment formed by individual habits, encompassed mold, damp stains, water damage, window condensation, and house decoration status (floor materials and repainting the child’s room or not)
  • lifestyles were defined as the daily routine and living habits of children and their families, including the frequency of cleaning and ventilating and airing bedclothes, the time spent watching TV/playing with a computer, keeping pets at home, and smoking in the child’s room
  • the effect of ambient air pollution was adjusted in the regression models

Across the study cohort, prevalence of AD among preschool children was 24.6%, which was comparable to trends observed in other Chinese cities, such as Wuhan (23%) and Shanghai (21.1%), as well as in developed countries of Spain (21.9%) and Sweden (23.0%), suggesting that AD is a widely distributed problem of public health.

Significiant associations for doctor-diagnosed AD and AD-like symptoms, respectively, were observed for several variables, including the use of composite wood floors (adjusted OR [aOR], 1.777; aOR, 1.911), living in a villa/townhouse (aOR, 3.102; aOR, 2.156), the presence of mold or damp stains in the child’s room (aOR, 1.807; aOR, 2.279), and rarely cleaning the child’s room (aOR, 1.513; aOR, 1.540).

Furthermore, watching TV/playing computer games for more than 1 hour per day was significantly associated with doctor-diagnosed AD (aOR, 1.172) and AD-like symptoms (aOR, 1.174). Eating rice/pasta one to 3 times per week was also indicated to elevate the risk of AD-like symptoms (aOR, 1.343), which researchers said warrants further investigation.

As ambient air pollution was included in the adjusted covariates, they added this may also affect risk of childhood AD.

“Parents and kindergarten staff should make an attempt to avoid giving their children too many electronics-based tasks and create a low risk living environment for children during their growth stage,” concluded researchers.


Liu Y, Sun S, Zhang D, Li W, Duan Z, Lu S. Effects of residential environment and lifestyle on atopic eczema among preschool children in Shenzhen, China. Front Public Health. Published online May 16, 2022. doi:10.3389/fpubh.2022.844832

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