Symptoms of bronchial hyperreactivity and asthma in relation to environmental factors.

Andrae, S; Axelson, Olav; Björkstén, Bengt; Fredriksson, Mats; Kjellman, N.‐I. M.

doi:10.1136/adc.63.5.473

Cited by 240 publications

(122 citation statements)

References 9 publications

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“…Although it has been suggested that the effects of exposure to damp and to other factors such as environmental tobacco smoke are independent (40), no studies have investigated possible interacting effects of damp or mould with other documented risk factors.…”

Section: Methodological Considerationsmentioning

confidence: 99%

“…3 shows the odds ratios for cough and wheeze in adults associated with damp and mould in the home (36,(43)(44)(45), and Fig. 4 shows the odds ratios for asthma in both children and adults (33,(39)(40)(41)(43)(44)(45)(46)(47)(48)(49)(50). Approximately half of the studies show a significant association between respiratory symptoms and the presence of damp and mould.…”

Section: Association Between Indoor Damp or Mould Growth And Healthmentioning

confidence: 99%

“…1 shows the odds ratios from the studies which have investigated an association between damp or mould in the home and wheeze in children (32)(33)(34)(35)(36)(37)(38)(39), and Fig. 2 shows the odds ratios for cough (32)(33)(34)(35)(36)(37)(38)(39)(40)(41). One study which did not find a significant effect between damp and respiratory symptoms but which yielded insufficient information to compute an odds ratio (42) is excluded.…”

Section: Association Between Indoor Damp or Mould Growth And Healthmentioning

confidence: 99%

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Effects of damp and mould in the home on respiratory health: a review of the literature

Peat

Dickerson

1998

Allergy

283

164

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This review examines whether there is a direct or indirect relation between damp or mould in the home and respiratory health. Home dampness is thought to have health consequences because it has the potential to increase the proliferation of house‐dust mites and moulds, both of which are allergenic. The results from the many studies conducted to investigate whether damp and mould are associated with health outcomes are diffecult to compare because the methods of measuring exposures and helth outcomes have not been standardized. However, the studies that have been conducted in children are probably the most reliable because the confounding effects of active smoking or occupational exposures are absent, and because the presence of symptoms of cough and wheeze have been consistently investigated in many studies. The increased risk of children having these symptoms if the home has damp or mould is fairly small with an odds ratio that is generally in the range 1.5–3.5, these estimates being statistically significant when the sample size has been large enough. This range is consistent with the measured effects of other environmental exposures which are considered important to helth, such as environmental tobacco smoke or outdoor air pollutants. The potential benefits or reducing mould in the home have not been investigated, and the few studies that have investigated health improvement as a result of increasing ventilation or reducing damp in order to reduce house‐dust mite levels suggest that this intervention is expensive, requires a large commitment, and is unlikely to be successful in the long term. This implies that houses need to be specifically designed for primary prevention of respiratory problems associated with indoor allergen proliferation rather than using post hoc procedures to improve indoor climate and reduce allergen load as a secondary or tertiary preventive strategy.

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Section: Methodological Considerationsmentioning

confidence: 99%

Section: Association Between Indoor Damp or Mould Growth And Healthmentioning

confidence: 99%

Section: Association Between Indoor Damp or Mould Growth And Healthmentioning

confidence: 99%

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Effects of damp and mould in the home on respiratory health: a review of the literature

Peat

Dickerson

1998

Allergy

283

164

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“…Although this method is convenient and favourable, questionnaire-based methods are difficult to validate against microbial measurements [40,48]. Numerous studies validated self-reported visible mould questions against inspector-reported observations [36,31,[78][79][80][81] and did not find any evidence for over-or underreporting of dampness and mould by occupants. Further, against the backdrop of fungal diversity, it is not clear whether the obviously visible mould or unknown, invisible species contribute to the observed effects in children's health [69,82].…”

Section: Validity Of Exposure Assessmentmentioning

confidence: 99%

Association between domestic mould and mould components, and asthma and allergy in children: a systematic review

Tischer¹,

Cm²,

Heinrich³

2011

Eur Respir J

146

108

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Critical reviews over the past 10 yrs have found increased respiratory and allergic health outcomes for children living in damp and mouldy environments. However, recent studies have suggested that early childhood exposure to specific mould components may actually protect children from developing allergy.We conducted a systematic review of observational studies published in English from January 1980 to July 2010. This review was conducted according to systematic guidelines for Metaanalyses of Observational Studies in Epidemiology (MOOSE). The literature was searched using a computerised bibliographic database, PubMed. In order to increase the quality of the reviewed studies, meta-analyses of the effects of visible mould exposure on allergic health outcomes were performed and we evaluated the findings according to the Bradford Hill criteria for evidence of causation.The literature search identified 1,398 peer-reviewed scientific publications, and 61 studies that fulfilled the inclusion criteria were included in this review. We observed increased risks of allergic respiratory health outcomes in children exposed to visible mould and mould spores. These findings were confirmed by the results of the meta-analysis and in line with the evaluation criteria according to Bradford Hill. Visible mould was positively associated with asthma (OR 1.49 (95% CI 1.28-1.72)), wheeze (OR 1.68 (95% CI 1.48-1.90)) and allergic rhinitis (OR 1.39 (95% CI 1.28-1.51)). However, there was a tendency of lower risk for allergic health outcomes in children exposed to mouldderived components such as (1,3)-b-D-glucan and extracellular polysaccharides.These findings suggest that home environments with visible mould and mould spore exposure increase the risk of allergic respiratory health outcomes in children. However, further investigations are needed to examine the effects of exposure to mould-derived components as the current literature is inconclusive. In order to disentangle the different effects of overall microbial exposure on children's health, research should focus on specific microbial markers in the home, in combination with new assessment techniques including molecular methods.

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“…It is therefore a possibility that indoor pollutants might be of greater importance in the development of asthma than outdoor pollutants. Several studies have shown significant associations between health outcomes and exposure to indoor components like environmental tobacco smoke (12)(13)(14)(15), NO2 (16), mite allergens (17)(18)(19), and mold or dampness (20)(21)(22)(23)(24).…”

mentioning

confidence: 99%

Residential exposure to plasticizers and its possible role in the pathogenesis of asthma.

Øie¹,

Hersoug²,

Madsen³

1997

Environ Health Perspect

211

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Symptoms of bronchial hyperreactivity and asthma in relation to environmental factors.

Cited by 240 publications

References 9 publications

Effects of damp and mould in the home on respiratory health: a review of the literature

Effects of damp and mould in the home on respiratory health: a review of the literature

Association between domestic mould and mould components, and asthma and allergy in children: a systematic review

Residential exposure to plasticizers and its possible role in the pathogenesis of asthma.

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