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

Abstract

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...

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