Association between indoor environmental risk factors and pneumonia among preschool children in Urumqi：A case-control study

Background: Pediatric pneumonia presents a significant global health challenge, particularly in low- and middle-income countries. This study aimed to investigate the incidence of pneumonia in preschool children in Urumqi and its association with indoor environmental factors. Methods: This case-control study collected data from December 2018 to December 2019 on 1522 preschool children in Urumqi (779 boys and 743 girls) who were diagnosed with pneumonia by a physician. A control group of children who had never had pneumonia was matched in a 1:1 ratio based on gender, age, and ethnicity. Using questionnaires, data were collected on children's general characteristics, passive smoking, types of housing, flooring materials, and indoor dampness, analyzing potential factors associated with the incidence of pediatric pneumonia. Results: Multivariate analysis revealed that cesarean birth (odds ratio [OR] = 1.27; 95 % confidence interval [95%CI] = 1.08–1.48), being an only child (OR = 1.32; 95%CI = 1.13–1.55), antibiotic treatment during the first year of life (OR = 2.51; 95%CI = 1.98–3.19), passive smoking during the mother's pregnancy (OR = 1.62; 95%CI = 1.24–2.13), living in multi-family apartment housing (OR = 1.64; 95%CI = 1.28–2.10) and other types of housing (OR = 1.47; 95%CI = 1.09–1.99), laminate flooring (OR = 1.31; 95%CI = 1.01–1.72), and tile/stone/cement flooring flooring (OR = 1.31; 95%CI = 1.06–1.61), and dampness in dwelling (during first year of mother's pregnancy) (OR = 1.30; 95%CI = 1.04–1.63) were risk factors for pediatric pneumonia. The use of fresh air filtration systems in children's residences (OR = 0.66; 95%CI = 0.50–0.86) was identified as a protective factor. Conclusion: This study underscores the importance of indoor environmental factors in the prevention of pediatric pneumonia. Public health strategies should consider these factors to reduce the incidence of pneumonia in children. Future research needs to be conducted over a broader geographical range and consider a more comprehensive range of factors influencing pediatric pneumonia.