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Walking to school promotes the health of school‐aged children. The safety and comfort of the walking environment are lacking in China due to the prioritization of motorized traffic. This paper focuses on the choice of walking routes for school‐aged children commuting in old urban areas of China. A walking route choice model is constructed by combining a weighted Voronoi diagram and the closest facility analysis in ArcMap. The walking route choices of school‐aged children from home to school and the flows along routes are analysed. Based on the model results, targeted design suggestions for updating existing street spaces are proposed. [ABSTRACT FROM AUTHOR]

There is now a growing interest in early-life influences on adult diseases in China. A number of birth cohorts have been established. This systematic review provided a better understanding of the development of mother–baby cohorts in China. Systematic review. We conducted a systematic review for research or profile papers in English/Chinese that reported data from mother–baby cohorts in mainland China, with ≥1y follow-up after birth. We identified 315 papers, corresponding to 31 cohorts from 19 provinces/megacities. All cohorts started in 1999–2017 (21 after 2010) and were set up with broad objectives or specific scientific focus. The baseline sample size varied, from <500 to >300,000 mothers. A majority of cohorts were initiated during pregnancy and followed children to <10y, only six to adolescence and none into adulthood. These cohorts mostly collected samples from mothers and babies, in addition to using interviews/questionnaires to collect information about pregnancy, birth and child health. Most cohorts were recruited from a single province/city. The large western region was understudied. Mother–baby cohorts have developed rapidly in China, but usually with a short follow-up duration. Extending the follow-up of children and developing cross-cohort collaboration will increase the diversity, size and coverage of the sample, allow studying early influences on life-course health and identify targets for early intervention in the Chinese population. [ABSTRACT FROM AUTHOR]

There is a growing literature documenting the link between parental migration and children's health. However, few studies have explained the underlying mechanism of this observed relationship. This paper examines the effect of parental migration on children's health through dietary diversity, using survey data collected in a less developed prefecture in South Central China in 2018. To overcome the potential endogeneity of parental migration, we instrument parental migration with the proportion of households with migrated labor force at the village level, and find that parental migration reduces children's dietary diversity at home. Moreover, we provide suggestive evidence that the reduction in dietary diversity may attribute to significant negative separation effects whereas minimal positive income effects in migrant-sending households. This study highlights the negative effects of labor migration on the next generation's nutrition. In those developing countries with a high prevalence of labor migration, policies that facilitate access to dietary diversity of those left-behind children are warranted. [ABSTRACT FROM AUTHOR]

Early childhood education programs have been found to effectively promote children's social and cognitive development. However, the health impact of these programs is less understood. Using a quasi-experiment of the first universal child care reform in China from 2010, this paper aims to identify whether the preschool reform produces any short-term effects on health-related outcomes of preschoolers (3-6 years old). Specifically, this reform expands access to affordable preschools that provide full-day center-based education, with school meals and essential health services on campus. I exploit the variation in the number of newly established preschools across provinces and implement difference-in-differences and triple-difference strategies. Results confirm the effectiveness of this reform by showing a strong and positive impact on preschool attendance. This paper then documents the benefits to alleviating underweight among preschoolers. Estimates show a larger effect in rural areas, suggesting that the reform narrows rural-urban disparities in education access and undernutrition prevention. I also explore the impact on caregivers' health consciousness and find improved health-seeking behavior when children get sick. [ABSTRACT FROM AUTHOR]

This paper examined the extent and risk factors of child subjective wellbeing and psychological health empirically using China Family Panel Studies data set. Child subjective wellbeing was measured in this paper using six indicators including the frequency in feelings of depression, nervousness, restlessness, hopelessness, helplessness, and meaninglessness. Risk factors of child subjective wellbeing have also been examined in particular to the domains of household multidimensional material deprivation, parenting practices, and children's personal health conditions. The results of this paper implied that providing adequate nutrition and ensuring children's access to basic water and sanitation facilities were important strategies for promoting children's psychological health and wellbeing. Also important factor for child wellbeing is parenting styles and practices, that is, how parents interact with children in daily lives and how they behave as parents. [ABSTRACT FROM AUTHOR]

Benzene has been measured in indoor environments for many decades and has been identified to cause variety of health effects. Children spend most of their time indoors such as daycare centre, preschool and school, they are more likely to be exposed to indoor air pollutants. This paper was aimed to review the exposure to benzene among children within indoor environments from worldwide studies from 2003 to 2018. Based on 24 papers evaluated, 54% were conducted in primary schools. The highest concentration of benzene was found in preschools in China at 148.0 µg/m3. The benzene levels were found higher in indoors than outdoors for most of the studies. Active sampling techniques were used in 42% of studies that enable the determination of acute health effects on children during short-period of exposure time. Differences in sampling techniques and durations make it hard to compare the outcomes of the studies with health-effect guidelines. This review indicated a diversity of sampling approaches and techniques, pointing to the importance of establishment of standard method for collecting and reporting data. [ABSTRACT FROM AUTHOR]

Abstract Child nutritional health has always been a research focus and an essential indicator reflecting children's health and living conditions in developing countries. This study investigates how household income and other individual and family factors influence child nutritional status. The Chinese Health and Nutrition Survey data are used to analyze changing patterns of child malnutrition status, and to compare the gap between genders, rural and urban areas etc., and the WHO new child growth standards are used in this paper as the reference for each specific age and gender. The findings in this paper include three aspects. First of all, the headcount ratio of undernourished children in both stunting and underweight has declined over years from 1991 to 2009 in China. Second, regional disparity in child nutritional status was significant, and the economic growth was a key driver to improve the nutritional conditions of the poor children. Furthermore, this paper also employs the stepwise logistic regression models to illustrate the influencing mechanisms of family income and other factors on child nutrition, and finds that household income affected child nutritional status significantly through the mechanisms of community, household, parental and individual factors. Highlights • This paper studies stunting and underweight rates of Chinese children and finds both malnutritional indicators have declined from 1991 to 2009. • This paper studies the regional and demographic differences in child nutrition and finds certain heterogeneity in malnutritional indicators. • This paper studies the relationship between family income and child nutrition and reveals significant and positive correlation between the two. • This paper finds significant impact mechanisms of individual, parental, family and community factors on child nutrition. [ABSTRACT FROM AUTHOR]

The prevalence of stunting, wasting, overweight and their coexistence are various in different populations and they also have changed with social developing and environmental improving. In this paper, we aimed to analyze the prevalence of stunting, wasting, overweight and their coexistence in some developed regions of China. Data were collected in a population-based cross-sectional survey by a multi-stage cluster sampling method in nine cities located in the northern, central, and southern region of China in 2016. Children under seven years (n = 110,491) were measured. WHO growth standards were used to assess the growth status. Stunting, underweight, wasting, overweight and obesity were considered as the primary forms of malnutrition (includes undernutrition and overnutrition) for infant or young children at population-levels. The prevalence of stunting, underweight, wasting, and overweight or obesity were respectively 0.7%, 0.6%, 1.2%, and 7.6%. Most of these children (95.4%) suffered from one form of malnutrition, and only 0.2% of them concurrently stunted and wasted, 0.4% concurrently stunted and overweight, 1.7% concurrently stunted and underweight, 2.3% concurrently underweight and wasted. Among stunted children, 91.2% were appropriate body proportion, and only 2.3% were wasted, 6.5% were overweight or obesity. Among overweight or obese children, only 0.6% were stunted, whereas, 15.8% were high stature and 83.6% were the appropriate ranges of stature. Sex, age, urban/suburban, and region were associated with these primary forms of malnutrition in the multivariate logistic analysis. In conclusion, we found that the coexistence of stunting and overweight was not common at both population-level and individual-level. The situation for undernutrition had significantly improved, and overweight may be the leading public health issue for children under seven years in the nine cities of China. [ABSTRACT FROM AUTHOR]

Social pensions are important cash transfers to the elderly and their families. The pensions may not only affect the wellbeing of the direct recipients, but also have household and intergenerational spillover effects. Using the 2012 and 2014 waves of the China Family Panel Studies (CFPS) data, this paper examines the effect of the New Rural Pension Scheme (NRPS) and its mechanisms on child health in rural China. Our study shows a significant association between the NRPS and the health status of children up to 15 years of age. Moreover, the association of the NRPS with health is larger for children who are boys, 'left behind', six to 10 years of age, and in poor health. In addition, we investigate possible mechanisms of the effect, including health consciousness of the caregiver, household sanitation conditions, and high-protein food consumption, and find the increase of child nutrition intake is the main channel through which the NRPS affects child health. [ABSTRACT FROM AUTHOR]

This paper reports the results of our study that assessed the treatment efficacy of multiple family therapy (MFT) from the perspective of participating Chinese children with attention deficit hyperactivity disorder (ADHD) and identified their subjective experiences. Forty‐three children with ADHD in the experimental group (EG) completed a forty‐two‐hour MFT, whilst forty‐five children with ADHD in the control group (CG) had attended two writing classes scheduled three months apart that were similar to those of the MFT. Data from the outcome study were gathered using standardized questionnaires and data from the qualitative study were drawn from thirteen children with ADHD who had completed the MFT and attended the focus group interviews (n = 5) or individual interviews (n = 8) conducted in the post‐treatment phase. The results of the Paired sample t‐test and MANOVA indicated no significant changes on the scores for the four measures adopted (perception of competence, hopefulness, parent‐child relationship and perceived social support) in the pre‐ and post‐treatment for the EG and the CG. Five themes emerged from the narratives of children with ADHD, which revealed the children's subjective experiences with the MFT: (a) full of fun; (b) building friendships through common experiences; (c) a happy family time; (d) safe space; and (e) positive parental responses and communications. [ABSTRACT FROM AUTHOR]

Background: Lack of physical activity is a growing problem in China, due to the fast economic development and changing living environment over the past two decades. The aim of this review is to summarize the factors related to physical activity in Chinese children and adolescents during this distinct period of development. Methods: A systematic search was finished on Jan 10th, 2017, and identified 2200 hits through PubMed and Web of Science. English-language published studies were included if they reported statistical associations between factors and physical activity. Adapted criteria from the Strengthening The Reporting of OBservational studies in Epidemiology (STROBE) statement and evaluation of the quality of prognosis studies in systematic reviews (QUIPS) were used to assess the risk of bias of the included studies. Related factors that were reported in at least three studies were summarized separately for children and adolescents using a semi-quantitative method. Results: Forty two papers (published 2002-2016) were included. Most designs were cross-sectional (79%), and most studies used questionnaires to assess physical activity. Sample size was above 1000 in 18 papers (43%). Thirty seven studies (88%) showed acceptable quality by methodological quality assessment. Most studies reported a low level of physical activity. Boys were consistently more active than girls, the parental physical activity was positively associated with children and adolescents' physical activity, children in suburban/rural regions showed less activity than in urban regions, and, specifically in adolescents, self-efficacy was positively associated with physical activity. Family socioeconomic status and parental education were not associated with physical activity in children and adolescents. Conclusions: The studies included in this review were large but mostly of low quality in terms of study design (cross-sectional) and methods (questionnaires). Parental physical activity and self-efficacy are promising targets for future physical activity promotion programmes. The low level of physical activity raises concern, especially in suburban/rural regions. Future research is required to enhance our understanding of other influences, such as the physical environment, especially in early childhood. [ABSTRACT FROM AUTHOR]

The quantity-quality trade-off is one important motivation for the family planning policies in many developing countries. In this paper, we examine the effect of number of siblings on children's health and education in China. We find evidence of quantity-quality trade-off in children's health but not in children's education. Our study has three contributions. First, we focus not only on children's education but also on children's health, which has received rather little attention in the literature. Secondly, we use a new source of exogenous variation in fertility - variations of the strictness of the One-Child policy across localities in China - to construct instrumental variable's (IV's). Finally, we empirically explore the underlying mechanism of the quantity-quality trade-off, and find supporting evidence for the resource dilution hypothesis. [ABSTRACT FROM AUTHOR]

Background: Overweight/obesity is a serious public health problem that affects a large part of the world population across all age and racial/ethnic groups. However, there has not been a meta-analysis of the prevalence of childhood and adolescent overweight/obesity in China during the past 30 years. Methods: The China National Knowledge Infrastructure and Wanfang DATA, MEDLINE, EMBASE and Cumulative Index to Nursing and Allied Health Literature were searched for relevant studies published between January 1970 and June 2012. The prevalence of overweight/obesity over time was pooled using Stata/SE, version 9. Summary statistics (odds ratios, ORs) were used to compare sex-specific and urban-rural preponderance of overweight/obesity using Review Manager. Results: After screening 1326 papers, we included 35 papers (41 studies), most of medium quality. The prevalence of overweight/obesity increased from 1.8% (95% confidence interval [CI], 0.4%-3.1%) and 0.4% (95% CI, 20.1% to 20.8%) respectively in 1981-1985 to 13.1% (95% CI, 11.2%-15.0%) and 7.5% (95% CI, 6.6%-8.4%) respectively in 2006-2010. The average annual increase was 8.3% and 12.4% respectively. Boys were more likely to be overweight/obese than girls (OR, 1.36; 95% CI, 1.24-1.49 and OR, 1.68; 95% CI, 1.52-1.86 respectively). The prevalence of overweight/obesity was higher in urban areas than in rural areas (OR, 1.66; 95% CI, 1.54-1.79 and OR, 1.97; 95% CI, 1.68-2.30 respectively). For age-specific subgroup analyses, both overweight and obesity increased more rapidly in the toddler stage than in other developmental stages. Sensitivity analyses showed that sample-size differences, study quality, overweight/obesity criteria and geographical distribution affected overweight/obesity prevalence. Conclusions: Toddlers and urban boys were at particularly high risk; the prevalence in these groups increased more rapidly than in their counterparts. Public health prevention strategies are urgently needed to modify health behaviors of children and adolescents and control overweight/obesity in China. [ABSTRACT FROM AUTHOR]

Few studies were conducted for associations of home environment with childhood health by on-site inspection in China. During 2013–2014, we conducted a case-control study with home inspection among 454 children (186 asthma children and 268 non-asthma children) in Shanghai, China. In this paper, we detailedly described the inspected methods and analyzed the preliminarily collected data. Except in winter, most residences meet the national standard for indoor temperature and relative humidity. Most living rooms had ≤1000 ppm CO 2 , whereas over half of the child's bedrooms had slightly >1000 ppm CO 2 during night. Most residences had notably lower than 2500 cfu/m 3 airborne culturable fungi and ≤100 μg/m 3 formaldehyde. More than 70% of the child's bedrooms had ≤75 μg/m 3 PM 2.5 and ≤150 μg/m 3 PM 10 . Indoor and outdoor concentrations of particulate matters had strong linear correlations ( r =0.891–0.922; p -value <0.001). Most differences between cases and controls were not significant with respect to CO 2 , culturable fungi, formaldehyde, and particulate matters. Before and after adjusted for potential confounders, indoor averaged concentration of CO 2 and particulate matters generally had negative associations with childhood history of doctor-diagnosed asthma in spring, summer, and autumn. Only in winter, indoor CO 2 concentration was significantly associated with the increased odds of childhood asthma. Our results indicated that air quality among most residences in Shanghai could meet the national standard for indoor air quality in warm seasons; but household air quality and ventilation status in winter should be greatly improved. We suspected that those “unexpected” negative associations could exist due to changes in lifestyle behaviors regarding indoor air quality after the child being diagnosed asthma by a doctor. [ABSTRACT FROM AUTHOR]

Objective To assess the usefulness of serology as an indicator of Echinococcus transmission for developing preventive measures against echinococcosis in rural communities. Methods Cross-sectional survey in 2002 among 861 children aged 7 to 18 years in Xiji County, Ningxia, China. Before ultrasound abdominal examination, a questionnaire was used to identify socioeconomic, sanitary and hygiene risk factors for echinococcal infection; filter paper blood samples were collected from each child for specific antibody detection using EmP ( Echinococcus multilocularis) and EgB ( Echinococcus granulosus) antigens. Results Transmission of both E. multilocularis and E. granulosus occur in this area. Serological prevalence was far higher than disease prevalence in this age range. We found no gender-related differences of seroprevalence among the children, suggesting an equal chance of exposure to echinococcal egg-contaminated environments. The seroprevalence distribution was associated with changes in the ecology of wild hosts for E. multilocularis contamination, and with changes in socio-geographic features of the communities for E. granulosus contamination. Conclusions Serological data obtained for children in mass surveys of echinococcosis appear to be a comprehensive and useful tool to monitor changes of transmission dynamics in humans and provide ‘warning signals’ to decision makers for the instigation of specific control measures against the disease. [ABSTRACT FROM AUTHOR]

Numerous questionnaire-based studies were conducted to investigate associations of home environment with childhood health, whereas few studies confirmed validity of parents-reported questionnaire regarding dwelling characteristics and dampness-related indicators. According to data obtained by standard questions regarding these items via on-site inspection in 454 residences with young children during 2013–2014, and data collected for these items from their parents-reported questionnaires in cross-sectional survey during 2011–2012 in Shanghai, China, this paper validated consistencies of information for these items between the two phases, thus to confirm validity of parents-reported questionnaire regarding these items. According to Kappa ( k ) values, parents and inspectors had moderate/substantial consistencies regarding dwelling characteristics ( k = 0.212–0.894), but had slight consistencies regarding dampness-related indicators and indoor odors (absolute k = 0.019–0.144). However, according to the observed, positive, and negative proportional agreement (P o , P pos , and P neg ), parents and inspectors had substantial/prefect consistencies in most of the studied items (P o = 0.45–0.96). These trends of consistencies for different items had no notable differences, regardless of father or mother as the questionnaire-reporter, and among the residences inspected in different seasons. This study suggests parents-reported questionnaire could be a reliable and valid method to indicate the overall status of dwelling characteristics and home dampness-related exposures. [ABSTRACT FROM AUTHOR]

The development of economy promotes the improvement of living standards, but the environment has been severely damaged, and it greatly affects the survival and development of human beings. In addition, most Chinese families have only one or two children, who are treated as hottest babies, because of the one-child policy. This asks for higher medical service quality when the child is sick. Moreover, there is a serious lack of medical resources, clinical nurses with abundant experiences in particular. Therefore, in order to provide high-quality medical care and rehabilitation environment for children and protect children healthy growth, the study on the performance evaluating system of pediatric clinical nurse would be of great significance. The background and related theories are reviewed in this paper and the analytic hierarchy process (AHP) method has been employed to construct an index system for pediatric clinical performance appraisal from four aspects: professionalism, knowledge level, professional ability, work performance, which totally involve 16 level-Π indexes. An analysis summary was also made at last. The index system has important reference value to improve the level of pediatric care, pediatric clinical nurse management and performance appraisal. [ABSTRACT FROM AUTHOR]

This paper investigates whether associations between birth weights and prenatal ambient environmental conditions—pollution and extreme temperatures—differ by 1) maternal education; 2) children's innate health; and 3) interactions between these two. We link birth records from Guangzhou, China, during a period of high pollution, to ambient air pollution (PM 10 and a composite measure) and extreme temperature data. We first use mean regressions to test whether, overall, maternal education is an "effect modifier" in the relationships between ambient air pollution, extreme temperature, and birth weight. We then use conditional quantile regressions to test for effect heterogeneity according to the unobserved innate vulnerability of babies after conditioning on other confounders. Results show that 1) the negative association between ambient exposures and birth weight is twice as large at lower conditional quantiles of birth weights as at the median; 2) the protection associated with college-educated mothers with respect to pollution and extreme heat is heterogeneous and potentially substantial: between 0.02 and 0.34 standard deviations of birth weights, depending on the conditional quantiles; 3) this protection is amplified under more extreme ambient conditions and for infants with greater unobserved innate vulnerabilities. • We test maternal education as an effect modifier in associations between air pollution/extreme temperature and birth weight. • We link birth records to environmental data from Guangzhou, China during a period of high and variable air pollution. • Infants with unobserved vulnerabilities—at lower conditional quantiles of birth weight—face more risk from ambient exposures. • The protection associated with college-educated mothers with respect to pollution and extreme heat is substantial. • Protection is amplified under more extreme ambient conditions and for infants with greater unobserved innate vulnerability. [ABSTRACT FROM AUTHOR]

Aims. To explore whether Astragalus or its formulations could prevent upper respiratory infection in children with nephrotic syndrome and how best to use it. Methods. We transformed a common clinical question in practice to an answerable question according to the PICO principle. Databases, including the Cochrane Library (Issue 5, 2012), PUBMED (1966-2012.8), CBM (1978-2012.8), VIP (1989-2012.8), and CNKI (1979-2012.8), were searched to identify Cochrane systematic reviews and clinical trials. Then, the quality of and recommendations from the clinical evidence were evaluated using the GRADEpro software. Results. The search yielded 537 papers. Only two studies with high validity were included for synthesis calculations. The results showed that Astragalus granules could effectively reduce URTI in children with nephrotic syndrome compared with prednisone treatment alone (23.9% versus 42.9%; RR = 0.56 and 95% CI = 0.33-0.93). The dose of Astragalus granules was 2.25 gram (equivalent to 15 gram crude Astragalus) twice per day, at least for 3-6 months. The level of evidence quality was low, but we still recommended the evidence to the patient according to GRADEpro with the opinion of the expert. Followup showed the incidence of URTI in this child decreased significantly. Conclusions. Astragalus granules may reduce the incidence of URTI in children with nephrotic syndrome. [ABSTRACT FROM AUTHOR]

The Shanghai Refugee Children Nutritional Aid Committee, formed in 1937, sought to improve refugee children's nutritional health by making and distributing a scientifically tested soybean milk and soybean cakes. By 1942, the Committee had adopted a national platform and changed its moniker to the Chinese Nutritional Aid Council, with plans to open offices and nutrition clinics in Chongqing, Chengdu, Guiyang and Kunming. This paper argues that in linking biomedical understandings of nutrition with social change, this group of Western-trained physicians and young female social workers enacted a new kind of social activism, one which seized upon the food-as-fuel idea and staked the welfare of the nation upon the nutritional health of its citizenry. In contrast to earlier social relief projects promoted by the imperial state and the local philanthropic initiatives of gentry elites, the Chinese Nutritional Aid Committee articulated an image of professional and specialised expertise in the science of nutrition and care. Theirs was a project of modern refashioning in which science played a key and foundational role in crafting their understanding of both relief and the children they aimed to save. [ABSTRACT FROM AUTHOR]

AIM: This paper described a case study of a randomised controlled trial with the aim to illuminate how the intervention described takes into account the important methodological considerations for enhancing the efficacy of psychoeducational interventions for paediatric patients. BACKGROUND: Many nursing intervention studies commit a Type II error despite the fact that the intervention is effective. Lack of attention given to the threats of validity of an intervention study may lead to inaccurate inference about the efficacy of the intervention study, thereby precluding any definitive conclusions being drawn. DESIGN: A case study of a randomised controlled trial was described. METHOD: Two hundred and three Hong Kong Chinese children, admitted for elective surgery, were invited to participate in the study. By using a simple complete randomisation method, 97 children were assigned to the experimental group and received therapeutic play intervention and 106 children were assigned to the control group and received routine information preparation. RESULTS: Children received preoperative therapeutic play intervention experienced lower anxiety levels, fewer negative emotions and lower heart rates and mean arterial blood pressures. CONCLUSION: This case study illustrates that the more a measure is sensitive to differentiate between the experimental and control groups, the greater the likelihood of documenting intervention efficacy. Besides, the timing of measuring a dependent variable that matches with peak response to an intervention is crucial in evaluating the efficacy of an intervention. Additionally, outcome measures that are sensitive enough to differentiate between the experimental and control groups are extremely important to ensure greater accuracy in evaluating the efficacy of psychoeducational interventions. RELEVANCE TO CLINICAL PRACTICE: It is anticipated that designing an effective psychoeducational intervention research design can facilitate the development of holistic and quality care in preparing children for hospitalisation. [ABSTRACT FROM AUTHOR]

This paper reports an estimate of the dietary intake of lead by children and adults from the Jinhu area in South-eastern China. A duplicate diet approach was used to collect food samples in November and December 2007. The lead content was measured by furnace atomic absorption spectrometry. Median lead intakes for different groups were as follows: children: 1.65 µg(kgbw)-1 day-1; and adults: 1.10 µg(kgbw)-1 day-1. No exposure exceeded the provisional tolerable weekly intake (PTWI) of 25 µg(kgbw)-1 week-1 proposed by the World Health Organization (WHO). However, median and maximum exposure for the children group amounted to 60.8% and 97.2% of the PTWI, respectively, which were higher than those for adults, which were 40.5% and 86.4%, respectively. It was concluded that health risks due to dietary lead intake seem to be high in Jinhu. [ABSTRACT FROM AUTHOR]

There is a significant lack of scientific knowledge on population exposure to ultrafine particles (UFP) in China to date. This paper quantifies and characterises school children's personal UFP exposure and exposure intensity against their indoor and outdoor activities during a school day (home, school and commuting) in the city of Heshan within the Pearl River Delta (PRD) region, southern China. Time-series of UFP number concentrations and average size were measured over 24 h for 24 children (9–13 years old), using personal monitors over two weeks in April 2016. Time-activity diaries and a questionnaire on the general home environment and potential sources of particles at home were also collected for each participating child. The analysis included concurrently measured size distributions of ambient UFP at a nearby fixed reference site (Heshan Supersite). Hourly average UFP concentrations exhibited three peaks in the morning, midday and evening. Time spent indoors at home was found to have the highest average exposure (1.26 × 104 cm−3 during sleeping) and exposure intensity (2.41). While there is always infiltration of outdoor particles indoors (from nearby traffic and general urban background sources), indoor exposure at home was significantly higher than outdoor exposure. Based on the collected questionnaire data, this was considered to be driven predominantly by adults smoking and the use of mosquito repellent incense during the night. Outdoor activities at school were associated with the lowest average exposure (6.87 × 102 cm−3) and exposure intensity (0.52). Despite the small sample size, this study characterised, for the first time, children's personal UFP exposure in a city downwind of major pollution sources of the PRD region in China. Particularly, the results highlighted the impact of smoking at home on children's exposure. While the study could not apportion the specific contributions of second hand-smoking and mosquito coil burning, considering the prevalence of smokers among the parents who smoke at home, smoking is a very significant factor. Exposure to second-hand smoke is avoidable, and these findings point out to the crucial role of government authorities and public health educators in engaging with the community on the role of air quality on health, and the severity of the impact of second-hand smoke on children's health. • Epidemiological studies do not account for indoor UFP exposures. • Children's highest exposure and exposure intensity in Heshan were during time spent indoors at home. • Main indoor sources of UFP at home in Heshan were smoking and use of mosquito repellent incense. • The results highlighted the impact of smoking at home on children's exposure. [ABSTRACT FROM AUTHOR]