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Environmental Epidemiological Associations of Psychosomatic Symptoms in Hungarian School Children

This study explores the associations between environmental factors and psychosomatic symptoms in 7-11-year-old children in Hungary. Data was collected through standardized questionnaires, and logistic regression analysis was used to analyze the results.

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Environmental Epidemiological Associations of Psychosomatic Symptoms in Hungarian School Children

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  1. "NEW CHALLENGES OF ENVIRONMENTAL HEALTH" Meeting of the Central and Eastern European Chapter of the International Society for Environmental Epidemiology Budapest, Hungary, 9–11 June 2005 • Environmental epidemiological associations • of psychosomatic symptoms • of 7–11 year old children, • Hungary, 1997–2002 • Mihály János Varró, Zoltán Virágh, Péter Rudnai • Fodor József National Center of Public Health • National Institute for Environmental Health, • Budapest, Hungary

  2. ISEE/CEEC Meeting, Budapest, Hungary, 9–11 June 2005 Introduction In a survey series, data on – respiratory/other symptoms, – demographic (gender, age, settlemenet type), – hereditary, perinatal, environmental, –lifestyle, social, etc. factors of 7–11 year old children were collected by highly standardised questionnaires in Hungary.

  3. ISEE/CEEC Meeting, Budapest, Hungary, 9–11 June 2005 Objective To assess associations between environmental factors and psychosomatic symptoms of school children.

  4. ISEE/CEEC Meeting, Budapest, Hungary, 9–11 June 2005 Methods 1. “Psychosomatic symptom”: at least one symptom out of – fatigue – headache – irritability – anxiety

  5. ISEE/CEEC Meeting, Budapest, Hungary, 9–11 June 2005 Methods 2. Data processing – Data entry: Epi Info 6.0x – Analysis: Stata 7.0 –Crude odds ratios (cORs) –Adjusted odds ratios (aORs): – in a validated logistic regression backward model –fix adjustment w. that model –95% confidence intervals (95% CI)

  6. ISEE/CEEC Meeting, Budapest, Hungary, 9–11 June 2005 Results Psychosomatic symptoms (n=13 973; 28.9%) Model (n=9461) – Gender, age, town – Parents’ any respiratory/allergic illness – Child’s serious chest illness (0–2 y) – Use of the kitchen gas cooker for additional heating – Mouldy flat; >20 cigarettes/day smoked in the flat – Mothers’education Pseudo-R2= 5.2%; Hosmer-Lemeshow p=0.558

  7. Psychosomatic symptoms of 7–11 year oldsby gender, age and settlement type Hungary, 1997–2002 % 40 30 20 10 0 Girls Boys 7y 8y 9y 10y 11y Towns Villages Age of the child

  8. ISEE/CEEC Meeting, Budapest, Hungary, 9–11 June 2005 DEMOGRAPHIC FACTORS Boys vs. girls (n=9461; 50.0%) aOR=1.05, 95% CI=0.96–1.16 Age(n=9461; -) aOR1y raise=1.18***, 95% CI=1.12–1.24 Town/county of village (n=9461; -) Living in villages (n=9461; 23.1%) aOR=1.34***, 95% CI=1.20–1.49 (adjusted not to town/county of village)

  9. Psychosomatic symptoms of 7–11 year oldsby questionnaire completing and parents’ respiratory-allergic illness Hungary, 1997–2002 % 40 30 20 10 0 - + - + Father completes qes Parents’ resp.-allergic illness

  10. ISEE/CEEC Meeting, Budapest, Hungary, 9–11 June 2005 OTHER Only father completes the questionnaire (n=9285; 5.1%) aOR=0.57***, 95% CI=0.43–0.74 PARENTS’ ILLNESSES ...any respiratory-allergic illness (n=9461; 20.9%) aOR=1.57***, 95% CI=1.38–1.77

  11. Psychosomatic symptoms of 7–11 year oldsby perinatal conditions Hungary, 1997–2002 % 50 40 30 20 10 0 - + - + - + Threatened Postponed labour Chest illness pregnancy (0–2y)

  12. ISEE/CEEC Meeting, Budapest, Hungary, 9–11 June 2005 PERINATAL Threatened pregnancy (n=9186; 19.7%) aOR=1.59***, 95% CI=1.42–1.79 Postponed labour (n=9305; 9.5%) aOR=1.59***, 95% CI=1.42–1.79 Serious chest illness of the child (n=9461; 22.1%) during the first two years of life aOR=1.73***, 95% CI=1.56–1.92

  13. Psychosomatic symptoms of 7–11 year oldsby environmental factors Hungary, 1997–2002 % 70 60 50 40 30 20 10 0 - + - + - + - + Gas cooker Mould Heavy Agricult. airborne addit. heating ETS sprays

  14. ISEE/CEEC Meeting, Budapest, Hungary, 9–11 June 2005 ENVIRONMENTAL FACTORS Use of the kitchen gas cooker for additional heating (n=9461; 5.1%) aOR=1.80***, 95% CI=1.47–2.21 Mouldy flat (n=9461; 24.4%) aOR=1.61***, 95% CI=1.44–1.79 >20 cigarettes/day smoked in the flat (n=9461; 4.1%) aOR=2.16***, 95% CI=1.64–2.84 Reported house or garden exposure to agricult. airborne sprays (n=1606; 7.2%) aOR=1.78**, 95% CI=1.19–2.66 (practically in one survey only)

  15. Psychosomatic symptoms of 7–11 year oldsby lifestyle factors Hungary, 1997–2002 80 70 60 50 40 30 20 10 0 % <0 1 2 3 4 0 1 2 3 4 5 6 >4 0–3 hrs sleeping defic. hrs television/day hrs sport/week

  16. ISEE/CEEC Meeting, Budapest, Hungary, 9–11 June 2005 LIFESTYLE Sleeping deficiency, SD (n=9066; -) (if sleeping hours [SH]<10 then SD=10–SH else SD=0) aOR1h raise=1.17***, 95% CI=1.09–1.25 Watching television (n=8838; -) (hours/day, max. 6 hours) aOR1h raise=1.10***, 95% CI=1.04–1.16 Sport: 0–3 hours/week (n=6828; 77.8%) aOR=1.43***, 95% CI=1.24–1.64

  17. Psychosomatic symptoms of 7–11 year oldsby chocolate-sweets consumption and mother’s education Hungary, 1997–2002 % 50 40 30 20 10 0 - + >8 ys <8 ys Every day Mother school classes chocolate-sweets

  18. ISEE/CEEC Meeting, Budapest, Hungary, 9–11 June 2005 Eating chocolate… every day (n=1846; 29.0%) aOR=1.49***, 95% CI=1.21–1.84 SOCIAL FACTORS Mother with low education (n=9461; 15.8%) (<8 elementary school classes) aOR=1.37***, 95% CI=1.20–1.57

  19. Psychosomatic symptoms of 7–11 year oldsby number of regression model factors Hungary, 1997–2002 % 100 90 80 70 60 50 40 30 20 10 0 0 1 2 3 4 5 m

  20. ISEE/CEEC Meeting, Budapest, Hungary, 9–11 June 2005 NUMBER OF REGRESSION MODEL FACTORS +1, if parents: any respiratory-allergic illness +1, if child: serious chest illness (0–2 y) +1, if use of the kitchen gas cooker for additional heating +1, if mouldy flat +1, if >20 cigarettes/day smoked in the flat m (n=9461; -) aORraise in m=1.62***, 95% CI=1.55–1.72 (adjusted to gender, age and town)

  21. ISEE/CEEC Meeting, Budapest, Hungary, 9–11 June 2005 Conclusions 1. The environmental factors (found to be associated with respiratory symptoms) had strong associations with psychosomatic symptoms, too.

  22. ISEE/CEEC Meeting, Budapest, Hungary, 9–11 June 2005 Conclusions 2. – Living in villages – Only father completes the questionnaire – Threatened pregnancy, postponed labour – Sleeping deficiency, television seeing, sport, eating chocolate-sweets every day

  23. ISEE/CEEC Meeting, Budapest, Hungary, 9–11 June 2005 Conclusions 3. Validated backward logistic regression model – Use of the kitchen gas cooker for additional heating: aOR=1.80*** – Mouldy flat: aOR=1.61*** – >20 cigarettes/day smoked in the flat: aOR=2.16*** –Reported house or garden exposure to agricultural airborne sprays: aOR=1.78**

  24. Thanks „Fodor József” NCPH NIEH DEPT. COMMUNITY HEALTH Annamária Mácsik, Tamás Rudnai, Eszter Szabó, Renáta Szentmihályi, Györgyi Tóth National Public Health and Medical Officer Service All collabourating colleagues SCHOOLS, MUNICIPALITIES, HEALTH SERVICESdirectorship of schools, class leaders, maires, youth and district nurses FAMILIES parents, children

  25. ISEE/CEEC Meeting, Budapest, Hungary, 9–11 June 2005 Thank you for your attention! E-mail: varromj@okk.antsz.hu

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