Disease Burden of Indoor Air Pollution

The Burden of Respiratory Disease from Formaldehyde, Damp and Mould in English Housing

“…The links between chronic formaldehyde exposures and cancers, such as leukaemia, lung cancer, Hodgkin's lymphoma, sinonasal cancer, and nasopharyngeal cancer, have been investigated, though the evidence is almost exclusively from occupational cohort studies in industrial settings [42][43][44][45] where levels of exposure, and mixtures with other pollutants, are greater than residential settings. Several recent reviews and metaanalyses of epidemiological studies have shown combined positive associations between formaldehyde exposures and asthma (diagnosis/self-report and exacerbation) within residential and school environments [20,42,46,47], which have been used to quantify the health burden (or conduct health impact assessments) of childhood asthma in some countries in Europe, the USA, and China [1, 14,16,17,20]. Some epidemiological studies conducted in residential or school settings have also shown positive associations with rhinitis, dermatitis, and conjunctivitis [42], though combined associations were not statistically significant in a recent meta-analysis [42].…”

“…Furthermore, quantification of the health impacts from exposure within indoor environments, at the population scale, has been performed previously for some key pollutants or sources/conditions affecting air quality: this includes second-hand smoke (SHS), fine particulate matter (PM 2 . 5 ), nitrogen dioxide (NO 2 ), radon, damp and mould, carbon monoxide, and volatile organic compounds (including formaldehyde) in some European countries [1, [13][14][15][16][17], the USA [18][19][20], Australia [21], New Zealand [22], and China [16], as well as household air pollution from burning solid fuels globally [23].…”

“…Following an initial scan of review papers, large synthesis reports, and previous burden of disease or health impact assessments [1, 14,16,17,39,42,43,74,95], we systematically searched the epidemiological literature for studies investigating the relationship between residential (a) formaldehyde concentrations/exposures as well as (b) damp and/or mould with the following respiratory diseases, illnesses, and/or symptoms: asthma, respiratory infections, rhinitis, cough, and wheeze (details of the literature search are in the Supplementary Materials S3 & Table S5 and S4 & Table S6). The epidemiology literature includes studies that assessed exposure via indoor concentrations (or presence indoors), as well as personal exposures.…”