Association between volatile organic compound concentrations in daycares and child wheeze: the French CRESPI study.

BACKGROUND

Concern is increasing about of the role of poor indoor air quality in respiratory disorders especially in children. While the deleterious respiratory health impact of some volatile organic compounds (VOCs) in the home environment has been suggested, daycares have never been investigated. This study aims to investigate the association between VOCs concentrations in daycare facilities and children's respiratory health.

METHODS

This cross-sectional study included 532 children (mean age: 22.3 months; 47.4% female) of the French CRESPI cohort (100 daycares, 2019-2022). VOC/aldehyde (n = 54) concentrations were measured on a one-day active sampling in daycares. They were studied individually in 4 categories based on quartiles and grouped in factors using principal component analysis. Wheezing outcomes - ever wheeze, recurrent wheeze (≥ 3 times), and ever wheeze with inhaled corticosteroid (ICS) use - were evaluated by parental questionnaire. Associations between daycare VOC concentrations/ factors and wheezing outcomes were analyzed with Generalized Estimating Equations to account for a possible daycare effect, and adjusted for child age, parental smoking status and education level.

RESULTS

After correction for multiple testing, higher concentrations of methylisobutylketone (Odds-Ratio for Q4 vs. Q1, 95%CI: 2.40, 1.46-3.92; p-trend < 0.001, FDR-adjusted p = 0.02) and 1-methoxy-2-propylacetate (2.58, 1.54-4.33; p-trend < 0.001, FDR-adjusted p = 0.02) were associated with recurrent wheeze. Associations were further suggested for 1,2,4-trimethylbenzene (2.70, 1.34-5.45; p-trend = 0.01) and decamethylcyclopentasiloxane (2.27, 1.09-4.71; p-trend = 0.02) but were not significant after correction for multiple testing. Similar findings were observed for all wheezing outcomes. Using factor analysis, three identified factors were associated with wheezing outcomes, including a 'care/cleaning-products' factor associated with ever wheeze with ICS (OR: 1.22, 1.00-1.47).

CONCLUSIONS

Daycare exposure to specific VOCs was associated with wheeze in children. Their identification and control in daycares may reduce potential health risks.

TRIAL REGISTRATION: The CRESPI protocol was registered in the clinical trials register - NCT no 04170881.