Home dampness, moulds and their influence on respiratory infections and symptoms in adults in Finland

Pirhonen, I; Nevalainen, Aino; Husman, Tuula; Pekkanen, Juha

doi:10.1183/09031936.96.09122618

Cited by 138 publications

(137 citation statements)

References 22 publications

(28 reference statements)

Supporting

Mentioning

124

Contrasting

Unclassified

Order By: Relevance

“…Fig. 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).…”

Section: Association Between Indoor Damp or Mould Growth And Healthmentioning

confidence: 99%

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

Peat

Dickerson

1998

Allergy

283

164

View full text Add to dashboard Cite

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.

show abstract

Section: Association Between Indoor Damp or Mould Growth And Healthmentioning

confidence: 99%

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

Peat

Dickerson

1998

Allergy

283

164

View full text Add to dashboard Cite

show abstract

“…10 Living in low temperatures has been linked to a higher prevalence of respiratory infections and hospital admissions among the elderly, [19][20][21] as well as to increased severity and frequency of asthmatic symptoms in children. 4 Low indoor temperatures can also encourage the development of damp and mould in the home, 22 which are known risk factors for respiratory disease in adults [23][24][25][26] and children. 22,27 In addition to links with cardiorespiratory conditions and excess winter mortality, living in cold and damp homes has been associated with negative impacts on mental health.…”

Section: Introductionmentioning

confidence: 99%

The health impacts of energy performance investments in low-income areas: a mixed-methods approach

et al. 2018

View full text Add to dashboard Cite

BackgroundCold homes and fuel poverty contribute to health inequalities in ways that could be addressed through energy efficiency interventions.ObjectivesTo determine the health and psychosocial impacts of energy performance investments in low-income areas, particularly hospital admissions for cardiorespiratory conditions, prevalence of respiratory symptoms and mental health status, hydrothermal conditions and household energy use, psychosocial outcomes, cost consequences to the health system and the cost utility of these investments.DesignA mixed-methods study comprising data linkage (25,908 individuals living in 4968 intervention homes), a field study with a controlled pre-/post-test design (intervention,n = 418; control,n = 418), a controlled multilevel interrupted time series analysis of internal hydrothermal conditions (intervention,n = 48; control,n = 40) and a health economic assessment.SettingLow-income areas across Wales.ParticipantsResidents who received energy efficiency measures through the intervention programme and matched control groups.Main outcome measuresPrimary outcomes – emergency hospital admissions for cardiorespiratory conditions, self-reported respiratory symptoms, mental health status, indoor air temperature and indoor relative humidity. Secondary outcomes – emergency hospital admissions for chronic obstructive pulmonary disease-related cardiorespiratory conditions, excess winter admissions, health-related quality of life, subjective well-being, self-reported fuel poverty, financial stress and difficulties, food security, social interaction, thermal satisfaction and self-reported housing conditions.MethodsAnonymously linked individual health records for emergency hospital admissions were analysed using mixed multilevel linear models. A quasi-experimental controlled field study used a multilevel repeated measures approach. Controlled multilevel interrupted time series analyses were conducted to estimate changes in internal hydrothermal conditions following the intervention. The economic evaluation comprised cost–consequence and cost–utility analyses.Data sourcesThe Patient Episode Database for Wales 2005–14, intervention records from 28 local authorities and housing associations, and scheme managers who delivered the programme.ResultsThe study found no evidence of changes in physical health. However, there were improvements in subjective well-being and a number of psychosocial outcomes. The household monitoring study found that the intervention raised indoor temperature and helped reduce energy use. No evidence was found of substantial increases in indoor humidity levels. The health economic assessment found no explicit cost reductions to the health service as a result of non-significant changes in emergency admissions for cardiorespiratory conditions.LimitationsThis was a non-randomised intervention study with household monitoring and field studies that relied on self-response. Data linkage focused on emergency admissions only.ConclusionAlthough there was no evidence that energy performance investments provide physical health benefits or reduce health service usage, there was evidence that they improve social and economic conditions that are conducive to better health and improved subjective well-being. The intervention has been successful in reducing energy use and improving the living conditions of households in low-income areas. The lack of association of emergency hospital admissions with energy performance investments means that we were unable to evidence cost saving to health-service providers.Future workOur research suggests the importance of incorporating evaluations with follow-up into intervention research from the start.FundingThe National Institute for Health Research Public Health Research programme.

show abstract

“…Appendix Description of studies included in the meta-analyses Koskinen et al (1999b)) Surveyor-assessed moisture Rhinitis Pirhonen et al (1996) Dampness or mold Allergic rhinitis Rhinitis Children Bornehag et al (2005) Water leakage Rhinitis Floor moisture Visible dampness Condensation Brunekreef et al (1989) Damp ever Hay fever Mold ever Jaakkola et al (1993) Any dampness indicator ever Nasal congestion Nasal excretion Mold odor last year Nasal congestion Nasal excretion Visible mold last year Nasal congestion Nasal excretion Moisture past year Nasal congestion Nasal excretion Water damage past yr Nasal congestion Nasal excretion Jędrychowski and Flak (1998) Jędrychowski and Flak (1998) Mold or damp Dr dx. asthma Lee et al (2003) Water damage Dr dx.…”

mentioning

confidence: 99%

Meta-analyses of the associations of respiratory health effects with dampness and mold in homes

2007

View full text Add to dashboard Cite

IntroductionThe association of adverse health effects with dampness and mold in buildings has been the subject of much research. Most studies on this topic have found an increased risk of one or more adverse health effects in buildings with signs of dampness or visible mold. The Institute of Medicine (IOM) of the National Academy of Sciences recently completed a critical review (IOM, 2004) of this scientific literature. The IOM concluded that excessive indoor dampness is a public health problem, noted that dampness problems are common, and recommended corrective measures. While the IOM report summarized the main features and results of the reviewed studies, which included a broad range of health outcomes, it provided no quantitative summaries of the findings of these studies.In this paper, we report the results of quantitative meta-analyses of the studies reviewed in the IOM report and other similar studies that met specified study inclusion criteria. A meta-analysis uses statistical methods to combine data from different but comparable research studies, in order to provide a quantitative summary estimate on the size and variability of an association. Studies are generally selected for relevance, quality, and similarity. The contribution of larger, more precise studies to the summary estimate is generally more heavily weighted. Results of metaanalyses presented here are central point estimates and confidence intervals (CIs) of odds ratios (ORs) that summarize the magnitude of increased risk of several health outcomes in buildings with dampness and mold. The central estimates and CIs of ORs, if assumed to reflect causal relationships, can be used to communicate Abstract The Institute of Medicine (IOM) of the National Academy of Sciences recently completed a critical review of the scientific literature pertaining to the association of indoor dampness and mold contamination with adverse health effects. In this paper, we report the results of quantitative meta-analyses of the studies reviewed in the IOM report plus other related studies. We developed point estimates and confidence intervals (CIs) of odds ratios (ORs) that summarize the association of several respiratory and asthma-related health outcomes with the presence of dampness and mold in homes. The ORs and CIs from the original studies were transformed to the log scale and random effect models were applied to the log ORs and their variance. Models accounted for the correlation between multiple results within the studies analyzed. Central estimates of ORs for the health outcomes ranged from 1.34 to 1.75. CIs (95%) excluded unity in nine of 10 instances, and in most cases the lower bound of the CI exceeded 1.2. Based on the results of the meta-analyses, building dampness and mold are associated with approximately 30-50% increases in a variety of respiratory and asthma-related health outcomes. Practical ImplicationsThe results of these meta-analyses reinforce the IOM's recommendation that actions be taken to prevent and reduce building dampness problems, and a...

show abstract

Home dampness, moulds and their influence on respiratory infections and symptoms in adults in Finland

Cited by 138 publications

References 22 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

The health impacts of energy performance investments in low-income areas: a mixed-methods approach

Meta-analyses of the associations of respiratory health effects with dampness and mold in homes

Contact Info

Product

Resources

About