The Association between Perceived Annoyances in the Indoor Home Environment and Respiratory Infections: A Danish Cohort Study with up to 19 Years of Follow-Up
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Study Population
2.3. Assessment of Perceived Annoyances of Indoor Environment
2.4. Respiratory Infection Outcomes
2.5. Confounders and Other Variables
2.6. Risk Time
2.7. Statistical Analysis
3. Results
3.1. Study Participants
3.2. Follow-Up Time and Number of Respiratory Infections
3.3. Associations between Perceived Annoyances and Respiratory Infections
3.4. Sensitivity Analyses
4. Discussion
4.1. Summary of Findings
4.2. Comparison with Other Studies
4.3. Interpretations
4.4. Strengths and Limitations
4.5. Implications and Impact
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Baseline Characteristics | n (%) | Level of Annoyances, n (%) | |||
---|---|---|---|---|---|
Low (n = 14,820) | Moderate (n = 980) | High (n = 879) | |||
Participants | |||||
Sex | Male | 8181 (49) | 7307 (49.3) | 503 (51.3) | 371 (42.2) |
Female | 8498 (51) | 7513 (50.7) | 477 (48.7) | 508 (57.8) | |
Age group, years | <20 | 876 (5.3) | 771 (5.2) | 35 (3.6) | 70 (8) |
20–24 | 1307 (7.8) | 1053 (7.1) | 104 (10.6) | 150 (17.1) | |
25–29 | 1366 (8.2) | 1107 (7.5) | 112 (11.4) | 147 (16.7) | |
30–34 | 1452 (8.7) | 1241 (8.4) | 92 (9.4) | 119 (13.5) | |
35–39 | 1485 (8.9) | 1311 (8.9) | 97 (9.9) | 77 (8.8) | |
40–44 | 1512 (9.1) | 1351 (9.1) | 106 (10.8) | 55 (6.3) | |
45–49 | 1554 (9.3) | 1408 (9.5) | 85 (8.7) | 61 (6.9) | |
50–54 | 1628 (9.8) | 1492 (10.1) | 86 (8.8) | 50 (5.7) | |
55–59 | 1425 (8.5) | 1317 (8.9) | 75 (7.7) | 33 (3.8) | |
60–64 | 1059 (6.3) | 967 (6.5) | 54 (5.5) | 38 (4.3) | |
65–69 | 866 (5.2) | 798 (5.4) | 42 (4.3) | 26 (3) | |
70–74 | 753 (4.5) | 708 (4.8) | 28 (2.9) | 17 (1.9) | |
75–79 | 636 (3.8) | 583 (3.9) | 34 (3.5) | 19 (2.2) | |
80–84 | 433 (2.6) | 404 (2.7) | 20 (2) | 9 (1) | |
≥85 | 327 (2.0) | 309 (2.1) | 10 (1) | 8 (0.9) | |
Education a | Elementary | 6368 (38.2) | 5689 (38.4) | 321 (32.8) | 358 (40.7) |
Short | 6997 (42) | 6185 (41.7) | 452 (46.1) | 360 (41) | |
Medium/long | 3304 (19.8) | 2937 (19.8) | 206 (21) | 161 (18.3) | |
Smoking status | Smoker | 6184 (37.1) | 5382 (36.3) | 377 (38.5) | 425 (48.4) |
Non-smoker | 10,470 (62.8) | 9413 (63.5) | 603 (61.5) | 454 (51.7) | |
Missing | 25 (0.1) | 25 (0.2) | 0 (0) | 0 (0) | |
Country of origin | Danish | 16,349 (98) | 14,532 (98.1) | 959 (97.9) | 858 (97.6) |
Non-Danish b | 330 (2) | 288 (1.9) | 21 (2.1) | 21 (2.4) | |
Asthma or COPD diagnosis | Yes, n (%) | 1153 (6.9) | 1029 (6.9) | 52 (5.3) | 72 (8.2) |
No, n (%) | 15,526 (93.1) | 13,791 (93.1) | 928 (94.7) | 807 (91.8) | |
Household and Environment | |||||
Type of dwelling | Detached house | 8523 (51.1) | 7867 (53.1) | 419 (42.8) | 237 (27) |
Semi-detached and terrace houses | 2831 (17) | 2504 (16.9) | 157 (16) | 170 (19.3) | |
Apartments | 3427 (20.5) | 2713 (18.3) | 344 (35) | 370 (42.1) | |
Other house type | 1360 (8.2) | 1272 (8.6) | 30 (3.1) | 58 (6.6) | |
Farms | 435 (2.6) | 375 (2.5) | 24 (2.5) | 36 (4.1) | |
Missing | 103 (0.6) | 89 (0.6) | 6 (0.6) | 8 (0.9) | |
Degree of urbanisation | <200 residents | 2631 (15.8) | 2431 (16.4) | 91 (9.3) | 109 (12.4) |
200–4900 residents | 4228 (25.3) | 3884 (26.2) | 203 (20.7) | 141 (16.04) | |
5–49,000 residents | 4984 (29.9) | 4449 (30) | 283 (28.9) | 252 (28.7) | |
≥50,000 residents | 4195 (25.2) | 3485 (23.5) | 366 (37.4) | 344 (39.1) | |
Missing | 641 (3.8) | 571 (3.9) | 37 (3.8) | 33 (3.8) | |
Heating source | Direct electricity | 1254 (7.5) | 1150 (7.8) | 49 (5) | 55 (6.3) |
Central heating from liquid fuel | 3581 (21.5) | 3251 (21.9) | 169 (17.2) | 161 (18.3) | |
Central heating from natural gas | 2614 (15.7) | 2373 (16) | 152 (15.5) | 89 (10.1) | |
Other, gas furnace, solid fuel stove | 455 (2.7) | 408 (2.8) | 22 (2.2) | 25 (2.8) | |
Undisclosed | 8775 (52.6) | 7638 (51.5) | 588 (60) | 549 (62.5) | |
Residential density, m2/resident | <40 | 2748 (16.5) | 2501 (16.9) | 164 (16.7) | 83 (9.4) |
40–79 | 7691 (46.1) | 6948 (46.9) | 413 (42.1) | 330 (37.5) | |
≥80 | 5541 (33.2) | 4751 (32.1) | 364 (37.1) | 426 (48.5) | |
Missing m2 | 699 (4.2) | 620 (4.2) | 39 (4) | 40 (4.6) | |
Number of residents in household | 1 | 3349 (20.1) | 2916 (19.7) | 225 (23) | 208 (23.7) |
2 | 6358 (38.1) | 5644 (38.1) | 405 (41.3) | 309 (35.2) | |
3 | 2829 (17) | 2526 (17) | 150 (15.3) | 153 (17.4) | |
4 | 2723 (16.3) | 2442 (16.5) | 136 (13.9) | 145 (16.5) | |
≥5 | 1420 (8.5) | 1292 (8.7) | 64 (6.5) | 64 (7.3) | |
Years lived in the dwelling | <3 | 4841 (29) | 4054 (27.4) | 383 (39.1) | 404 (46) |
3–7 | 3691 (22.1) | 3245 (21.9) | 222 (22.7) | 224 (25.5) | |
8–12 | 2035 (12.2) | 1850 (12.5) | 93 (9.5) | 92 (10.5) | |
13–20 | 2595 (15.6) | 2397 (16.2) | 107 (10.9) | 91 (10.4) | |
≥21 | 3517 (21.1) | 3274 (22.1) | 175 (17.9) | 68 (7.7) | |
Interview Details | |||||
Season of interview | Spring | 4404 (26.4) | 3951 (26.7) | 286 (29.2) | 167 (19) |
Summer | 3166 (19) | 2856 (19.3) | 189 (19.3) | 121 (13.8) | |
Autumn | 4309 (25.8) | 3781 (25.5) | 289 (29.5) | 239 (27.2) | |
Winter | 4800 (28.8) | 4232 (28.6) | 216 (22) | 352 (40.1) |
Outcome | Level of Perceived Annoyances | n | Number of Events | PYs at Risk | IR Per 100 PY | IRR (95% CI) a | Adjusted IRR (95% CI) a,b |
---|---|---|---|---|---|---|---|
Respiratory infections of all causes c | |||||||
Low | 13,787 | 13,949 | 124,602 | 11.19 | 1 (reference) | 1 (reference) | |
Moderate | 928 | 875 | 7046 | 12.42 | 1.09 (0.98, 1.23) | 1.15 (1.02, 1.31) | |
High | 806 | 584 | 4675 | 12.49 | 1.16 (1.02, 1.32) | 1.16 (1.01, 1.34) | |
Bacterial respiratory infections d | |||||||
Low | 13,787 | 13,074 | 124,645 | 10.49 | 1 (reference) | 1 (reference) | |
Moderate | 928 | 826 | 7049 | 11.72 | 1.11 (0.99, 1.25) | 1.17 (1.03, 1.33) | |
High | 806 | 559 | 4676 | 11.96 | 1.19 (1.04, 1.36) | 1.18 (1.02, 1.37) | |
Viral respiratory infections e | |||||||
Low | 13,787 | 1179 | 125,267 | 0.94 | 1 (reference) | 1 (reference) | |
Moderate | 928 | 60 | 7089 | 0.85 | 0.84 (0.60, 1.17) | 0.96 (0.66, 1.39) | |
High | 806 | 32 | 4704 | 0.68 | 0.65 (0.42, 0.99) | 0.82 (0.50, 1.33) | |
Hospital admissions caused by respiratory infections f | |||||||
Low | 13,787 | 855 | 125,593 | 0.68 | 1 (reference) | 1 (reference) | |
Moderate | 928 | 40 | 7110 | 0.56 | 0.76 (0.50, 1.15) | 0.93 (0.58, 1.50) | |
High | 806 | 20 | 4748 | 0.42 | 0.55 (0.32, 0.95) | 0.74 (0.39, 1.40) |
Outcome | Level of Perceived Annoyances | n | Number of Events | PYs at Risk | IR Per 100 PY | IRR (95% CI) a | Adjusted IRR (95% CI) a,b,c |
---|---|---|---|---|---|---|---|
Respiratory infections of all causes d | |||||||
Low | 2100 | 1476 | 16,297 | 9.06 | 1 (reference) | 1 (reference) | |
Moderate | 105 | 63 | 782 | 8.06 | 0.80 (0.55, 1.18) | 0.84 (0.59, 1.21) | |
High | 110 | 80 | 745 | 10.74 | 1.20 (0.85, 1.71) | 1.20 (0.85, 1.69) | |
Bacterial respiratory infections e | |||||||
Low | 2100 | 901 | 16,323 | 5.52 | 1 (reference) | 1 (reference) | |
Moderate | 105 | 38 | 783 | 4.85 | 0.88 (0.64, 1.22) | 0.80 (0.52, 1.23) | |
High | 110 | 48 | 746 | 6.43 | 1.17 (0.87, 1.56) | 1.22 (0.82, 1.83) | |
Viral respiratory infections f | |||||||
Low | 2100 | 634 | 16,343 | 3.88 | 1 (reference) | 1 (reference) | |
Moderate | 105 | 25 | 784 | 3.19 | 0.70 (0.55, 1.40) | 0.76 (0.38, 1.49) | |
High | 110 | 33 | 747 | 4.41 | 1.11 (0.59, 2.06) | 1.28 (0.68, 2.42) | |
Hospital admissions caused by respiratory infections e | |||||||
Low | 2100 | 547 | 16,367 | 3.34 | 1 (reference) | 1 (reference) | |
Moderate | 105 | 22 | 785 | 2.80 | 0.70 (0.33, 1.45) | 0.79 (0.39, 1.61) | |
High | 110 | 28 | 749 | 3.74 | 1.14 (0.59, 2.19) | 1.31 (0.68, 2.53) |
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Kirkegaard, A.M.; Kloster, S.; Davidsen, M.; Christensen, A.I.; Vestbo, J.; Nielsen, N.S.; Ersbøll, A.K.; Gunnarsen, L. The Association between Perceived Annoyances in the Indoor Home Environment and Respiratory Infections: A Danish Cohort Study with up to 19 Years of Follow-Up. Int. J. Environ. Res. Public Health 2023, 20, 1911. https://doi.org/10.3390/ijerph20031911
Kirkegaard AM, Kloster S, Davidsen M, Christensen AI, Vestbo J, Nielsen NS, Ersbøll AK, Gunnarsen L. The Association between Perceived Annoyances in the Indoor Home Environment and Respiratory Infections: A Danish Cohort Study with up to 19 Years of Follow-Up. International Journal of Environmental Research and Public Health. 2023; 20(3):1911. https://doi.org/10.3390/ijerph20031911
Chicago/Turabian StyleKirkegaard, Anne Marie, Stine Kloster, Michael Davidsen, Anne Illemann Christensen, Jørgen Vestbo, Niss Skov Nielsen, Annette Kjær Ersbøll, and Lars Gunnarsen. 2023. "The Association between Perceived Annoyances in the Indoor Home Environment and Respiratory Infections: A Danish Cohort Study with up to 19 Years of Follow-Up" International Journal of Environmental Research and Public Health 20, no. 3: 1911. https://doi.org/10.3390/ijerph20031911