Browsing by Author "de Oliveira Fernandes, Eduardo"
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- Indoor air quality and atopic sensitization in primary schools: A follow-up studyPublication . Cavaleiro Rufo, João; Madureira, Joana; Paciência, Inês; Aguiar, Lívia; Teixeira, João Paulo; Moreira, André; de Oliveira Fernandes, EduardoBackground: The onset and exacerbation of allergic diseases and asthma have been associated with poorindoor air quality (IAQ) inside classrooms.Objective: The aim was to investigate how IAQ changed in primary schools after applying indoor air qualityrecommendations, and to explore how these changes influenced allergic sensitization on children.Methods: Total volatile organic compounds, PM2.5, PM10, CO2, CO, temperature and relative humidity inthe indoor and outdoor air of 20 primary schools were measured in 2010–2012. The school staff receivedinstructions on how to improve IAQ in accordance with the SINPHONIE guidelines. Atopy status wasassessed in children attending the participating classrooms by skin prick tests and exhaled nitric oxide.A follow-up sampling campaign was performed in 2014–2015 in the same schools.Results: Indoor PM2.5and PM10concentrations were approximately 40% lower in the follow-up mea-surements (p < 0.05). There were no significant differences regarding outdoor PM concentrations.Nevertheless, PM levels from the follow-up campaign still exceeded the reference value established byPortuguese legislation. Moreover, there were no significant differences in atopic prevalence and FENOvalues between the campaigns.Conclusion: These findings suggest that adoption of the recommendations based on the SINPHONIE guide-lines was particularly successful in reducing PM2.5and PM10in primary schools of Porto. Nevertheless,the schools failed to reduce the levels of other IAQ pollutants, as well as the prevalence of atopic disease.
- Indoor air quality in schools and its relationship with children's respiratory symptomsPublication . Madureira, Joana; Paciência, Inês; Rufo, João; Ramos, Elisabete; Barros, Henrique; Teixeira, João Paulo; de Oliveira Fernandes, EduardoA cross-sectional survey was conducted to characterize the indoor air quality (IAQ) in schools and its relationship with children's respiratory symptoms. Concentrations of volatile organic compounds (VOC), aldehydes, PM2.5, PM10, carbon dioxide, bacteria and fungi were assessed in 73 classrooms from 20 public primary schools located in Porto, Portugal. Children who attended the selected classrooms (n = 1134) were evaluated by a standardised health questionnaire completed by the legal guardians; spirometry and exhaled nitric oxide tests. The results indicated that no classrooms presented individual VOC pollutant concentrations higher than the WHO IAQ guidelines or by INDEX recommendations; while PM2.5, PM10 and bacteria levels exceeded the WHO air quality guidelines or national limit values. High levels of total VOC, acetaldehyde, PM2.5 and PM10 were associated with higher odds of wheezing in children. Thus, indoor air pollutants, some even at low exposure levels, were related with the development of respiratory symptoms. The results pointed out that it is crucial to take into account the unique characteristics of the public primary schools, to develop appropriate control strategies in order to reduce the exposure to indoor air pollutants and, therefore, to minimize the adverse health effects.
- School environment associates with lung function and autonomic nervous system activity in children: a cross-sectional studyPublication . Paciência, Inês; Rufo, João Cavaleiro; Silva, Diana; Martins, Carla; Mendes, Francisca; Rama, Tiago; Rodolfo, Ana; Madureira, Joana; Delgado, Luís; de Oliveira Fernandes, Eduardo; Padrão, Patrícia; Moreira, Pedro; Severo, Milton; Pina, Maria Fátima; Teixeira, João Paulo; Barros, Henrique; Ruokolainen, Lasse; Haahtela, Tari; Moreira, AndréChildren are in contact with local environments, which may affect respiratory symptoms and allergic sensitization. We aimed to assess the effect of the environment and the walkability surrounding schools on lung function, airway inflammation and autonomic nervous system activity. Data on 701 children from 20 primary schools were analysed. Lung function, airway inflammation and pH from exhaled breath condensate were measured. Pupillometry was performed to evaluate autonomic activity. Land use composition and walkability index were quantified within a 500 m buffer zone around schools. The proportion of effects explained by the school environment was measured by mixed-effect models. We found that green school areas tended to be associated with higher lung volumes (FVC, FEV1 and FEF25-75%) compared with built areas. FVC was significantly lower in-built than in green areas. After adjustment, the school environment explained 23%, 34% and 99.9% of the school effect on FVC, FEV1, and FEF25-75%, respectively. The walkability of school neighbourhoods was negatively associated with both pupil constriction amplitude and redilatation time, explaining -16% to 18% of parasympathetic and 8% to 29% of sympathetic activity. Our findings suggest that the environment surrounding schools has an effect on the lung function of its students. This effect may be partially mediated by the autonomic nervous system.