Mould and dampness in dwelling places, and onset of asthma: the population-based cohort ECRHS

Norbäck, Dan; Zock, Jan Paul; Plana, Estel; Heinrich, Joachim; Svanes, Cecilie; Sunyer, Jordi; Künzli, Nino; Villani, Simona; Olivieri, Mario; Soon, Argo; Jarvis, Déborah

doi:10.1136/oemed-2012-100963

Cited by 79 publications

(59 citation statements)

References 24 publications

(24 reference statements)

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“…This will, in the long run, result in impaired work ability and in the worst case a withdrawal from work [96]. A similar result has been shown among habitants of dwellings where 5% developed asthma after living in damp and moldy homes [97]. Another study showed the presence of rhinitis among adult habitants in moldy dwellings [98].…”

Section: Damp and Moldy Buildingssupporting

confidence: 54%

Upper Airway Mucosal Inflammation : Proteomic Studies after Exposure to Irritants and Microbial Agents

Fornander¹

2015

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People are, in their daily lives, exposed to a number of airborne foreign compounds that do not normally affect the body. However, depending on the nature of these compounds, dose and duration of exposure, various airway symptoms may arise. Early symptoms are often manifested as upper airway mucosal inflammation which generates changes in protein composition in the airway lining fluid.This thesis aims at identifying, understanding mechanisms and characterizing protein alterations in the upper airway mucosa that can be used as potential new biomarkers for inflammation in the mucosa. The protein composition in the mucosa was studied by sampling of nasal lavage fluid that was further analyzed with a proteomic approach using two-dimensional gel electrophoresis and mass spectrometry. Additionally, by studying factors on site through environmental examination, health questionnaires and biological analyses, we have tried to understand the background to these protein alterations and their impact on health.Respiratory symptoms from the upper airways are common among people who are exposed to irritative and microbial agents. This thesis have focused on personnel in swimming pool facilities exposed to trichloramine, metal industry workers exposed to metalworking fluids, employees working in damp and moldy buildings and infants diagnosed with respiratory syncytial virus infection. The common denominator in these four studies is that the subjects experience upper airway mucosal inflammation, which is manifested as cough, rhinitis, phlegm etc. In the three occupational studies, the symptoms were work related. Notably, a high prevalence of perceived mucosal symptoms was shown despite the relatively low levels of airborne irritants revealed by the environmental examination. Protein profiling verified an ongoing inflammatory response by identification of several proteins that displayed altered levels. Interestingly, innate immune proteins dominated and four protein alterations occurred in most of the studies; SPLUNC1, protein S100A8 and S100A9 and alpha-1-antitrypsin. Similarly, these proteins were also found in nasal fluid from children with virus infection and in addition a truncated form of SPLUNC1 and two other S100 proteins (S100A7-like 2 and S100A16), not previously found in nasal secretion, were identified.Altogether, the results indicate the potential use of a proteomic approach for identifying new biomarkers for the upper respiratory tract at an early stage in the disease process after exposure to irritant and microbial agents. The results indicate an effect on the innate immunity system and the proteins; SPLUNC1, protein S100A8 and S100A9 and alpha-1-antitrypsin are especially promising new biomarkers. Moreover, further studies of these proteins may help us to understand the molecular mechanisms involved in irritant-induced airway inflammation. POPULÄRVETENSKAPLIG SAMMANFATTNING FÖRÄNDRAD PROTEINSAMMANSÄTTNING I DE ÖVRE LUFTVÄGARNA EFTER EXPONERING FÖR SLEMHINNEIRRITERANDE ÄMNENVarje dag utsätts vi för partikla...

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Section: Damp and Moldy Buildingssupporting

confidence: 54%

Upper Airway Mucosal Inflammation : Proteomic Studies after Exposure to Irritants and Microbial Agents

Fornander¹

2015

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“…Ineligible studies or metrics included those reporting unadjusted correlation coefficients; those reporting no estimates of strength of association; metrics combining D/M assessments far apart in time; metrics based on instrument‐measured wall moisture; and studies of non‐residential buildings …”

Section: Resultsmentioning

confidence: 99%

Observation‐based metrics for residential dampness and mold with dose–response relationships to health: A review

Mendell

Kumagai

2016

Indoor Air

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An important proportion of respiratory illness is considered attributable to residential dampness or mold (D/M). Developing health-protective D/M guidelines has been challenging, in part because unhealthy levels of indoor D/M cannot be defined using available microbiological measurements. This review paper explores reported multilevel, observation-based (eg visual or olfactory) D/M metrics for potential in defining unhealthy levels of residential D/M. For many of the 33 multilevel residential D/M metrics identified, health risks generally increased as observed D/M increased. Although some metrics seemed too complex for practical use, simple metrics had among the strongest associations with health outcomes. Available findings suggest the feasibility of setting observation-based D/M thresholds to trigger remedial action, using further improved D/M metrics without microbiological measurements (at least until the actual dampness-related agents that cause illness are better quantified). Additional data would allow setting health-protective D/M thresholds more precisely. Also, metrics could better reflect hidden D/M by more strongly emphasizing mold odor, which has demonstrated strong associations with health effects.

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“…There has been an initiative to create a common European approach to a healthy indoor environment in order to reduce asthma, allergies, and the sick building syndrome (SBS) . We have previously published two articles from the European Community Respiratory Health Survey (ECRHS) on associations between self‐reported and observed dampness and mold in homes and incidence of asthma and lung function decline among adults in Europe . As ECRHS includes both self‐reported and inspection data from dwellings, it is a suitable study to investigate the interrelationship between climate, building characteristics, and socio‐economic status (SES) determinants for building dampness and mold across Europe.…”

Section: Introductionmentioning

confidence: 99%

Building dampness and mold in European homes in relation to climate, building characteristics and socio-economic status: The European Community Respiratory Health Survey ECRHS II

et al. 2017

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We studied dampness and mold in homes in relation to climate, building characteristics and socio-economic status (SES) across Europe, for 7127 homes in 22 centers. A subsample of 3118 homes was inspected. Multilevel analysis was applied, including age, gender, center, SES, climate, and building factors. Self-reported water damage (10%), damp spots (21%), and mold (16%) in past year were similar as observed data (19% dampness and 14% mold). Ambient temperature was associated with self-reported water damage (OR=1.63 per 10°C; 95% CI 1.02-2.63), damp spots (OR=2.95; 95% CI 1.98-4.39), and mold (OR=2.28; 95% CI 1.04-4.67). Precipitation was associated with water damage (OR=1.12 per 100 mm; 95% CI 1.02-1.23) and damp spots (OR=1.11; 95% CI 1.02-1.20). Ambient relative air humidity was not associated with indoor dampness and mold. Older buildings had more dampness and mold (P<.001). Manual workers reported less water damage (OR=0.69; 95% CI 0.53-0.89) but more mold (OR=1.27; 95% CI 1.03-1.55) as compared to managerial/professional workers. There were correlations between reported and observed data at center level (Spearman rho 0.61 for dampness and 0.73 for mold). In conclusion, high ambient temperature and precipitation and high building age can be risk factors for dampness and mold in homes in Europe.

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Mould and dampness in dwelling places, and onset of asthma: the population-based cohort ECRHS

Cited by 79 publications

References 24 publications

Upper Airway Mucosal Inflammation : Proteomic Studies after Exposure to Irritants and Microbial Agents

Upper Airway Mucosal Inflammation : Proteomic Studies after Exposure to Irritants and Microbial Agents

Observation‐based metrics for residential dampness and mold with dose–response relationships to health: A review

Building dampness and mold in European homes in relation to climate, building characteristics and socio-economic status: The European Community Respiratory Health Survey ECRHS II

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