Indoor dampness and molds and development of adult-onset asthma: a population-based incident case-control study.

Jaakkola, Maritta S.; Nordman, Henrik; Piipari, Ritva; Uitti, Jukka; Laitinen, Jukka; Karjalainen, Antti; Hahtola, Paula; Jaakkola, Jouni J. K.

doi:10.1289/ehp.02110543

Cited by 163 publications

(121 citation statements)

References 29 publications

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“…An increased risk of asthma in professions not normally associated with OA has led to the suspicion that proteins derived from ubiquitous agents may be responsible. Moulds in water-damaged buildings have been suggested as an explanation for an increased risk of asthma among educators [71], confirming two other recent reports [72,73].…”

Section: Asthma Attributable To Work Exposuressupporting

confidence: 81%

Controversies in epidemiology of occupational asthma

Gautrin¹,

Aj²,

Nordman³

et al. 2003

Eur Respir J

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high-risk workplaces, medicolegal statistics and sentinel programmes indicate that y10% of adult-onset asthma is attributable to the workplace. The strategy to identify cases through questionnaires and tools that address functional, immunological and physiopathological issues needs to be improved.Although few in number and limited to a handful of workplaces, cohort studies found that the risk of developing occupational asthma is determined less by individual susceptibility (e.g. atopy, tobacco smoking, human leukocyte antigen phenotype) and more by the level of exposure to its causes; in general, the higher the exposure, the greater the risk, and, by implication, lowering the level of exposure reduces the incidence of disease.Occupational asthma can be used as a satisfactory model for the development of adult-onset asthma. There is a great need to develop intervention strategies through adequate surveillance programmes in high-risk workplaces. Eur Respir J 2003; 22: 551-559. Epidemiology of occupational asthma: general considerations on various study designs and methodological approachesEpidemiology is the study of the distribution, determinants and outcome of disease. In this article, the authors will describe recently acquired knowledge of the epidemiology of occupational asthma, as well as current areas of controversy.BECKLAKE et al.[1] have discussed the features, strengths and weaknesses of several designs used in epidemiological studies. These designs include the randomised control trial, the prospective cohort, the case-referent study, the crosssectional (prevalence) study and the case series. Which design to use in any particular situation is a matter of judgment, determined by a number of factors that may include resources, cost, collaboration of employers and employees, and the question under study. So far, primarily for practical convenience, most epidemiological studies of occupational asthma have been cross-sectional in type. As discussed in several reviews [1,2], this type of study, primarily in the case of occupational asthma (OA), suffers from survivor bias, whose magnitude can be difficult to quantify. Randomised control trials are usually not feasible and are probably unethical in workplace studies, but quasi-experimental studies can provide results of high internal and external validity. Prospective cohort studies are more expensive than cross-sectional studies but are more powerful and less likely to be affected by selection or survivor biases; in particular, it is often possible to track the participants who leave the cohort and determine the possible effect of attrition on the estimates of both the frequency of OA and exposure/effect relationships [3]. This type of study has recently been successfully applied in cohorts of young apprentices [4][5][6][7][8][9][10]. Some case-referent studies have been carried out in the field of OA [11,12]. These studies are valuable in identifying and quantifying risk factors. Finally, there are many case series that mainly describe clinical cases (often si...

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Section: Asthma Attributable To Work Exposuressupporting

confidence: 81%

Controversies in epidemiology of occupational asthma

Gautrin¹,

Aj²,

Nordman³

et al. 2003

Eur Respir J

View full text Add to dashboard Cite

show abstract

“…Waegemaekers et al 22 assessed the risk of asthma related to residential dampness stratified by sex and found a greater risk in women (OR: 4.16) than in men (OR: 1.15), which was consistent with our result. A recent case-control study in Finland 23 found a relatively stronger effect between workplace mold and asthma development in women (OR: 1.67) than in men (OR: 1.26). A cohort study of schoolchildren in Japan 24 found a significant association between the prevalence of respiratory symptoms and indoor nitrogen dioxide in girls but not in boys.…”

Section: E392mentioning

confidence: 96%

Indoor and Outdoor Environmental Exposures, Parental Atopy, and Physician-Diagnosed Asthma in Taiwanese Schoolchildren

et al. 2003

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ABSTRACT. Objective. Parental atopy and environmental exposures are recognized risk factors for childhood asthma. However, the relative contributions of specific risk factors and the overall contributions of indoor and outdoor exposures remain unexplored. This study was undertaken to identify risk factors, estimate the population attributable risk of each exposure, and compare the data for boys versus girls for physician-diagnosed asthma in Taiwanese schoolchildren.Methods. During a February to June 2001 cross-sectional national survey, 35 036 6-to 15-year-old schoolchildren were chosen from 22 elementary and 22 middle schools located within 1-km catchment areas of 22 airmonitoring stations in Taiwan. The main outcome measure was physician-diagnosed asthma, as reported by the parents. We investigated hereditary and indoor and outdoor environmental factors for childhood asthma by questionnaire. The adjusted prevalences of questionnaire-determined outdoor indicators were also compared with air-monitoring data.Results. Outdoor air pollutants were associated with parent-reported perceived ambient air pollution. Physician-diagnosed asthma was reported for 8.1% of the boys (1330 of 16 441) and 5.6% of the girls (894 of 16 056). The risk of physician-diagnosed asthma was significantly associated with parental atopy and perceived ambient air pollution in both sexes. A sthma is the single most common chronic childhood disease in developed nations, 1,2 and its prevalence and severity have been reported as increasing in many countries. [3][4][5][6] The changing pattern of the disease has not been fully explained, in part because of an incomplete understanding of its pathogenesis. The change has been too rapid to be accounted for by changes in gene frequencies. It is also unlikely that the increase can be totally accounted for by changes in either clinical diagnostic patterns or increased recognition of asthma symptoms by the general population. 7 This does, however, suggest a role for environmental exposures in the cause of this evolving epidemic. 8 Many factors have been proved to be associated with the prevalence and/or attacks of asthma, including personal factors (smoking habits, genetics, age, sex, nutritional status, number of siblings, coexisting lung disease, lifestyle, allergy status, family history, and occupation) and environmental stimuli (house dust, animal danders, molds, cockroach infestation, occupational exposure, environmental tobacco smoke, indoor/outdoor air pollution, cooking fumes, aeroallergens, and climate). 9 -29 Both genetic and environmental factors are believed to contribute to the relationship. However, epidemiologic evidence concerning different effects in boys and girls in relationships between environmental exposures and childhood asthma was insufficient and warranted additional investigations.The first aim of this study was to investigate the relationship between physician-diagnosed asthma and selected risk factors in a population-based sample of 6-to 15-year-old elementary-and middleschool...

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“…The program controls the interview logic, branching to or skipping questions as needed according to the responses of the interviewee, and it validates the logic of the data as they are entered. The exposure part of the questionnaire was designed specifically for this study, while the part on respiratory symptoms and diseases was modified from the questionnaire used in the Finnish Environment and Asthma Study that was originally designed for studying general population samples (8,(21)(22)(23). The questionnaire inquired about personal characteristics, occupational history, use of chemicals and other agents, job tasks, preventive measures, smoking, and the occurrence of upper and lower respiratory symptoms, asthma, skin symptoms, and some general symptoms.…”

Section: Questionnairementioning

confidence: 99%