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Armstrong B, Bonnington O, Chalabi Z, Davies M, Doyle Y, Goodwin J, Green J, Hajat S, Hamilton I, Hutchinson E, Mavrogianni A, Milner J, Milojevic A, Picetti R, Rehill N, Sarran C, Shrubsole C, Symonds P, Taylor J, Wilkinson P. The impact of home energy efficiency interventions and winter fuel payments on winter- and cold-related mortality and morbidity in England: a natural equipment mixed-methods study. PUBLIC HEALTH RESEARCH 2018. [DOI: 10.3310/phr06110] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
England, and the UK more generally, has a large burden of winter- and cold-related mortality/morbidity in comparison with nearby countries in continental Europe. Improving the energy efficiency of the housing stock may help to reduce this, as well as being important for climate change and energy security objectives.
Objectives
To evaluate the impact of home energy efficiency (HEE) interventions on winter- and cold-related mortality/morbidity, including assessing the impact of winter fuel payments (WFPs) and fuel costs.
Design
A mixed-methods study – an epidemiological time-series analysis, an analysis of data on HEE interventions, the development and application of modelling methods including a multicriteria decision analysis and an in-depth interview study of householders.
Setting
England, UK.
Participants
The population of England. In-depth interviews were conducted with 12 households (2–4 participants each) and 41 individuals in three geographical regions.
Interventions
HEE interventions.
Main outcome measures
Mortality, morbidity and intervention-related changes to the home indoor environment.
Data sources
The Homes Energy Efficiency Database, mortality and hospital admissions data and weather (temperature) data.
Results
There has been a progressive decline in cold-related deaths since the mid-1970s. Since the introduction of WFPs, the gradient of association between winter cold and mortality [2.00%, 95% confidence interval (CI) 1.74% to 2.28%] per degree Celsius fall in temperature is somewhat weaker (i.e. that the population is less vulnerable to cold) than in earlier years (2.37%, 95% CI 0.22% to 2.53%). There is also evidence that years with above-average fuel costs were associated with higher vulnerability to outdoor cold. HEE measures installed in England in 2002–10 have had a relatively modest impact in improving the indoor environment. The gains in winter temperatures (around +0.09 °C on a day with maximum outdoor temperature of 5 °C) are associated with an estimated annual reduction of ≈280 cold-related deaths in England (an eventual maximum annual impact of 4000 life-years gained), but these impacts may be appreciably smaller than those of changes in indoor air quality. Modelling studies indicate the potential importance of the medium- and longer-term impacts that HEE measures have on health, which are not observable in short-term studies. They also suggest that HEE improvements of similar annualised cost to current WFPs would achieve greater improvements in health while reducing (rather than increasing) carbon dioxide emissions. In-depth interviews suggest four distinct householder framings of HEE measures (as home improvement, home maintenance, subsidised public goods and contributions to sustainability), which do not dovetail with current ‘consumerist’ national policy and may have implications for the uptake of HEE measures.
Limitations
The quantification of intervention impacts in this national study is reliant on various indirect/model-based assessments.
Conclusions
Larger-scale changes are required to the housing stock in England if the full potential benefits for improving health and for reaching increasingly important climate change mitigation targets are to be realised.
Future work
Studies based on data linkage at individual dwelling level to examine health impacts. There is a need for empirical assessment of HEE interventions on indoor air quality.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 6, No. 11. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Ben Armstrong
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Oliver Bonnington
- Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Zaid Chalabi
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Michael Davies
- Institute for Environmental Design and Engineering, University College London, London, UK
| | | | - James Goodwin
- Design School, Loughborough University, Loughborough, UK
- Energy Institute, University College London, London, UK
| | - Judith Green
- Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
- Department of Global Health and Social Medicine, King’s College London, London, UK
| | - Shakoor Hajat
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Ian Hamilton
- Energy Institute, University College London, London, UK
| | - Emma Hutchinson
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Anna Mavrogianni
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - James Milner
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Ai Milojevic
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Roberto Picetti
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Nirandeep Rehill
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Clive Shrubsole
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - Phil Symonds
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - Jonathon Taylor
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - Paul Wilkinson
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
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Reeder KM, Dunaway CW, Blackburn JP, Yu Z, Matalon S, Hastie AT, Ampleford EJ, Meyers DA, Steele C. The common γ-chain cytokine IL-7 promotes immunopathogenesis during fungal asthma. Mucosal Immunol 2018; 11:1352-1362. [PMID: 29907867 PMCID: PMC6319622 DOI: 10.1038/s41385-018-0028-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 01/06/2018] [Accepted: 02/03/2018] [Indexed: 02/04/2023]
Abstract
Asthmatics sensitized to fungi are reported to have more severe asthma, yet the immunopathogenic pathways contributing to this severity have not been identified. In a pilot assessment of human asthmatics, those subjects sensitized to fungi demonstrated elevated levels of the common γ-chain cytokine IL-7 in lung lavage fluid, which negatively correlated with the lung function measurement PC20. Subsequently, we show that IL-7 administration during experimental fungal asthma worsened lung function and increased the levels of type 2 cytokines (IL-4, IL-5, IL-13), proallergic chemokines (CCL17, CCL22) and proinflammatory cytokines (IL-1α, IL-1β). Intriguingly, IL-7 administration also increased IL-22, which we have previously reported to drive immunopathogenic responses in experimental fungal asthma. Employing IL22CreR26ReYFP reporter mice, we identified γδ T cells, iNKT cells, CD4 T cells and ILC3s as sources of IL-22 during fungal asthma; however, only iNKT cells were significantly increased after IL-7 administration. IL-7-induced immunopathogenesis required both type 2 and IL-22 responses. Blockade of IL-7Rα in vivo resulted in attenuated IL-22 production, lower CCL22 levels, decreased iNKT cell, CD4 T-cell and eosinophil recruitment, yet paradoxically increased dynamic lung resistance. Collectively, these results suggest a complex role for IL-7 signaling in allergic fungal asthma.
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Affiliation(s)
- Kristen M Reeder
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Chad W Dunaway
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jonathan P Blackburn
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Zhihong Yu
- Department of Anesthesiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sadis Matalon
- Department of Anesthesiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Annette T Hastie
- Department of Medicine, Wake Forest University, Winston-Salem, NC, USA
| | | | | | - Chad Steele
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
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103
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The Importance of Using Public Health Impact Criteria to Develop Environmental Health Indicators: The Example of the Indoor Environment in New Zealand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081786. [PMID: 30127284 PMCID: PMC6121674 DOI: 10.3390/ijerph15081786] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 08/06/2018] [Accepted: 08/14/2018] [Indexed: 12/15/2022]
Abstract
Developing environmental health indicators is challenging and applying a conceptual framework and indicator selection criteria may not be sufficient to prioritise potential indicators to monitor. This study developed a new approach for prioritising potential environmental health indicators, using the example of the indoor environment for New Zealand. A three-stage process of scoping, selection, and design was implemented. A set of potential indicators (including 4 exposure indicators and 20 health indicators) were initially identified and evaluated against indicator selection criteria. The health indicators were then further prioritised according to their public health impact and assessed by the five following sub-criteria: number of people affected (based on environmental burden of disease statistics); severity of health impact; whether vulnerable populations were affected and/or large inequalities were apparent; whether the indicator related to multiple environmental exposures; and policy relevance. Eight core indicators were ultimately selected, as follows: living in crowded households, second-hand smoke exposure, maternal smoking at two weeks post-natal, asthma prevalence, asthma hospitalisations, lower respiratory tract infection hospitalisations, meningococcal disease notifications, and sudden unexpected death in infancy (SUDI). Additionally, indicators on living in damp and mouldy housing and children's injuries in the home, were identified as potential indicators, along with attributable burden indicators. Using public health impact criteria and an environmental burden of disease approach was valuable in prioritising and selecting the most important health impacts to monitor, using robust evidence and objective criteria.
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Abstract
PURPOSE OF REVIEW The review provides insight into recent findings on bedroom allergen exposures, primarily focusing on pet, pest, and fungal exposures. RECENT FINDINGS Large-scale studies and improved exposure assessment technologies, including measurement of airborne allergens and of multiple allergens simultaneously, have extended our understanding of indoor allergen exposures and their impact on allergic disease. Practical, streamlined methods for exposure reduction have shown promise in some settings, and potential protective effects of early-life exposures have been further elucidated through the investigation of specific bacterial taxa. Advances in molecular allergology have yielded novel data on sensitization profiles and cross-reactivity. The role of indoor allergen exposures in allergic disease is complex and remains incompletely understood. Advancing our knowledge of various co-exposures, including the environmental and host microbiome, that interact with allergens in early life will be crucial for the development of efficacious interventions to reduce the substantial economic and social burden of allergic diseases including asthma.
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106
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Devien L, Giovannelli J, Cuny D, Matran R, Amouyel P, Hulo S, Edmé JL, Dauchet L. Sources of household air pollution: The association with lung function and respiratory symptoms in middle-aged adult. ENVIRONMENTAL RESEARCH 2018; 164:140-148. [PMID: 29486345 DOI: 10.1016/j.envres.2018.02.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 02/08/2018] [Accepted: 02/12/2018] [Indexed: 06/08/2023]
Abstract
INTRODUCTION The objective of the present study was to investigate the relationship between sources of household air pollution, respiratory symptoms and lung function. METHODS 3039 adults aged from 40 to 65 participated in the 2011-2013 ELISABET cross-sectional survey in northern France. Lung function was measured using spirometry. During a structured interview, respiratory symptoms, household fuels, exposure to moulds, and use of ventilation were recorded on a questionnaire. RESULTS The self-reported presence of mould in at least two rooms (not including the bathroom and the kitchen) was associated with a 2.5% lower predicted forced expiratory volume in 1 s (95% confidence interval, -4.7 to -0.29; p-trend <0.05) and a higher risk of wheezing (p-trend < 0.001). Visible condensation was associated with wheezing (p < .05) and chronic cough (p < .05). There were no significant associations with the type of household fuel or inadequate ventilation/aeration. Similar results were found when the analyses were restricted to participants without known respiratory disease. CONCLUSION Our results suggest that the presence of mould (known to be associated with more severe asthma symptoms) could also have an impact on respiratory symptoms and lung function in the general population and in populations without known respiratory disease.
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Affiliation(s)
- Laurent Devien
- Univ. Lille, Institut Pasteur de Lille, INSERM U1167 - RID-AGE Risk factors and molecular determinants of aging-related diseases, F-59000 Lille, France; CHU Lille, Epidemiology Service, Health Economics and Prevention, F-59000 Lille, France
| | - Jonathan Giovannelli
- Univ. Lille, Institut Pasteur de Lille, INSERM U1167 - RID-AGE Risk factors and molecular determinants of aging-related diseases, F-59000 Lille, France; CHU Lille, Epidemiology Service, Health Economics and Prevention, F-59000 Lille, France
| | - Damien Cuny
- Univ. Lille, EA4483 - IMPECS (IMPact of Environmental ChemicalS on human health), F-59000 Lille, France
| | - Régis Matran
- Univ. Lille, EA4483 - IMPECS (IMPact of Environmental ChemicalS on human health), F-59000 Lille, France; Pulmonary Function Testing Department, CHU Lille, F-59000 Lille, France
| | - Philippe Amouyel
- Univ. Lille, Institut Pasteur de Lille, INSERM U1167 - RID-AGE Risk factors and molecular determinants of aging-related diseases, F-59000 Lille, France; CHU Lille, Epidemiology Service, Health Economics and Prevention, F-59000 Lille, France
| | - Sébastien Hulo
- Univ. Lille, EA4483 - IMPECS (IMPact of Environmental ChemicalS on human health), F-59000 Lille, France; Pulmonary Function Testing Department, CHU Lille, F-59000 Lille, France
| | - Jean Louis Edmé
- Univ. Lille, EA4483 - IMPECS (IMPact of Environmental ChemicalS on human health), F-59000 Lille, France; Pulmonary Function Testing Department, CHU Lille, F-59000 Lille, France
| | - Luc Dauchet
- Univ. Lille, Institut Pasteur de Lille, INSERM U1167 - RID-AGE Risk factors and molecular determinants of aging-related diseases, F-59000 Lille, France; CHU Lille, Epidemiology Service, Health Economics and Prevention, F-59000 Lille, France.
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Vincent M, Corazza F, Chasseur C, Bladt S, Romano M, Huygen K, Denis O, Michel O. Relationship between mold exposure, specific IgE sensitization, and clinical asthma: A case-control study. Ann Allergy Asthma Immunol 2018; 121:333-339. [PMID: 29944956 DOI: 10.1016/j.anai.2018.06.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 06/13/2018] [Accepted: 06/18/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Most of the findings related to the noxious effect of mold sensitization on asthma come from investigations based on Alternaria alternata, Cladosporium herbarum, and Aspergillus fumigatus. However, species such as Penicillium spp, Cladosporium sphaerospermum, Cladosporium cladosporioides, or Aspergillus versicolor display a more pronounced indoor tropism, and their potential harmful respiratory effects cannot be neglected. OBJECTIVE The goal of this work was to relate mold sensitizations with asthma severity and with the level of indoor mold contamination among mold-sensitized patients with asthma and nonsensitized patients with asthma. METHODS A case-control study was conducted and several asthma severity markers were compared between patients with asthma with and without mold sensitization. Indoor contamination of patients' dwellings was also investigated. RESULTS Our findings confirmed the association between sensitization to A fumigatus and severity for patients with asthma in contrast with sensitization to other species. Indoor mold contamination was detected in approximately 90% of dwellings. Overall mold exposure was not associated with asthma severity. However, regardless of the sensitization, exposure to A fumigatus and Penicillium spp in dust was linked to an increased risk of severe asthma. CONCLUSION The harmful nature of mold sensitization and mold exposure for patients with asthma was not confirmed in this study. However, sensitization to A fumigatus was associated with an increased risk for severe asthma. A better investigation of the properties of Penicillium spp is recommended because its exposure was found to be associated with a more pronounced impairment of lung function.
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Affiliation(s)
- Muriel Vincent
- Program Allergology, Scientific Service Immunology, WIV-ISP (site Uccle), Brussels, Belgium.
| | - Francis Corazza
- Laboratory of Immunology and of Translational Research, CHU Brugmann (Université Libre de Bruxelles-ULB), Brussels, Belgium
| | - Camille Chasseur
- Program Health and Environment, Scientific Service Food, drugs and consumers security, WIV-ISP (site Ixelles), Brussels, Belgium
| | | | - Marta Romano
- Program Host-Pathogen Interaction, Scientific Service Immunology, WIV-ISP (site Uccle), Brussels, Belgium
| | - Kris Huygen
- Program Allergology, Scientific Service Immunology, WIV-ISP (site Uccle), Brussels, Belgium; Program Host-Pathogen Interaction, Scientific Service Immunology, WIV-ISP (site Uccle), Brussels, Belgium
| | - Olivier Denis
- Program Allergology, Scientific Service Immunology, WIV-ISP (site Uccle), Brussels, Belgium
| | - Olivier Michel
- Clinic of Immunology and Allergology, CHU Brugmann (Université Libre de Bruxelles-ULB), Brussels, Belgium
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An Official American Thoracic Society Workshop Report: Presentations and Discussion of the Sixth Jack Pepys Workshop on Asthma in the Workplace. Ann Am Thorac Soc 2018; 14:1361-1372. [PMID: 28862493 DOI: 10.1513/annalsats.201706-508st] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The Sixth Jack Pepys Workshop on Asthma in the Workplace focused on six key themes regarding the recognition and assessment of work-related asthma and airway diseases: (1) cleaning agents and disinfectants (including in swimming pools) as irritants and sensitizers: how to evaluate types of bronchial reactions and reduce risks; (2) population-based studies of occupational obstructive diseases: use of databanks, advantages and pitfalls, what strategies to deal with biases and confounding?; (3) damp environments, dilapidated buildings, recycling processes, and molds, an increasing problem: mechanisms, how to assess causality and diagnosis; (4) diagnosis of occupational asthma and rhinitis: how useful are recombinant allergens (component-resolved diagnosis), metabolomics, and other new tests?; (5) how does exposure to gas, dust, and fumes enhance sensitization and asthma?; and (6) how to determine probability of occupational causality in chronic obstructive pulmonary disease: epidemiological and clinical, confirmation, and compensation aspects. A summary of the presentations and discussion is provided in this proceedings document. Increased knowledge has been gained in each topic over the past few years, but there remain aspects of controversy and uncertainty requiring further research.
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109
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Caillaud D, Leynaert B, Keirsbulck M, Nadif R. Indoor mould exposure, asthma and rhinitis: findings from systematic reviews and recent longitudinal studies. Eur Respir Rev 2018; 27:27/148/170137. [PMID: 29769295 DOI: 10.1183/16000617.0137-2017] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 03/15/2018] [Indexed: 12/22/2022] Open
Abstract
Starting from the Institute of Medicine (IOM) and World Health Organization (WHO) reports, this review provides an overview of the literature published from 2006 to 2017 on the associations between indoor mould exposure and asthma and rhinitis separately in children and adults with a focus on longitudinal epidemiological studies.A systematic search of peer-reviewed literature was performed, including systematic reviews and meta-analyses, longitudinal, incident case-control and panel studies. 61 publications were identified reporting visible mould or mould odour or quantitative assessment of culturable fungi or mould species.In children, visible mould and mould odour were associated with the development and exacerbations of asthma, providing sufficient evidence of a causal relationship. Results from population-based studies in adults were too few and divergent to conclude at more than a limited level of evidence. Exposure to mould in a work building was associated with the incidence and exacerbations of occupational asthma, and we concluded at a sufficient evidence for an association. Systematic reviews, meta-analyses and longitudinal studies on the relationships between mould exposure and allergic rhinitis provide sufficient evidence of an association.This review extended the conclusions of the IOM and WHO reports, and highlighted the need for further longitudinal studies on asthma in adults, and on rhinitis.
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Affiliation(s)
- Denis Caillaud
- Pulmonary and Allergology Dept, CHU Clermont-Ferrand, Clermont Auvergne University, Clermont-Ferrand, France
| | - Benedicte Leynaert
- INSERM, UMR1152, Pathophysiology and Epidemiology of Respiratory Diseases. Epidemiology, Paris, France.,Univ Paris Diderot Paris 7, UMR 1152, Paris, France
| | - Marion Keirsbulck
- ANSES (French Agency for Food, Environmental and Occupational Health and Safety), Maisons-Alfort, France
| | - Rachel Nadif
- INSERM, U1168, VIMA: Ageing and Chronic Diseases, Epidemiological and Public Health Approaches, Villejuif, France.,Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France
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110
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Demain JG. Climate Change and the Impact on Respiratory and Allergic Disease: 2018. Curr Allergy Asthma Rep 2018; 18:22. [PMID: 29574605 DOI: 10.1007/s11882-018-0777-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW The purpose of this paper is to review allergic respiratory disease related to indoor and outdoor exposures and to examine the impact of known and projected changes in climate. The global burden of disease directly attributed to climate change is very difficult to measure and becomes more challenging when the capacity of humans to adapt to these changes is taken into consideration. Allergic respiratory disease, such as asthma, is quite heterogenous, though closely associated with environmental and consequently immunologic interaction. Where is the tipping point? RECENT FINDINGS Our climate has been measurably changing for the past 100 years. It may indeed be the most significant health threat of the twenty-first century, and consequently tackling climate change may be the greatest health opportunity. The impacts of climate change on human health are varied and coming more into focus. Direct effects, such as heatwaves, severe weather, drought, and flooding, are apparent and frequently in the news. Indirect or secondary effects, such as changes in ecosystems and the impact on health, are less obvious. It is these changes in ecosystems that may have the greatest impact on allergic and respiratory diseases. This review will explore some ways that climate change, current and predicted, influences respiratory disease. Discussion will focus on changing pollen patterns, damp buildings with increased mold exposure, air pollution, and heat stress.
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Affiliation(s)
- Jeffrey G Demain
- Allergy, Asthma and Immunology Center of Alaska, 3841 Piper Street, Suite T4-054, Anchorage, AK, 99508, USA. .,Department of Pediatrics, University of Washington, 3841 Piper Street, Suite T4-054, Anchorage, AK, 99508, USA. .,WWAMI School of Medical Education, University of Alaska, 3841 Piper Street, Suite T4-054, Anchorage, AK, 99508, USA.
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111
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Research on the Hygroscopicity of a Composite Hygroscopic Material and its Influence on Indoor Thermal and Humidity Environment. APPLIED SCIENCES-BASEL 2018. [DOI: 10.3390/app8030430] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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112
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Seibt S, Gilchrist CA, Reed PW, Best EJ, Harnden A, Camargo CA, Grant CC. Hospital readmissions with acute infectious diseases in New Zealand children < 2 years of age. BMC Pediatr 2018; 18:98. [PMID: 29506511 PMCID: PMC5838880 DOI: 10.1186/s12887-018-1079-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 02/22/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Infectious diseases are the leading cause of hospital admissions in young children. Hospitalisation with an infectious disease is a recurrent event for some children. Our objective was to describe risk factors for infectious disease readmission following hospital admission with an infectious disease in the first two years of life. METHODS We performed a national cohort study of New Zealand children, born 2005-2009, with an infectious disease admission before age 24 months. Children readmitted with an infectious disease within 12 months of the first infectious disease admission were identified. Every infectious disease admission was categorised as a respiratory, enteric, skin and soft tissue, urinary or other infection. Independent associations of demographic and child health factors with infectious disease readmission were determined using multiple variable logistic regression. RESULTS From 2005 to 2011, there were 69,902 infectious disease admissions for 46,657 children less than two years old. Of these 46,657 children, 10,205 (22%) had at least one infectious disease readmission within 12 months of their first admission. The first infectious disease admission was respiratory (54%), enteric (15%), skin or soft tissue (7%), urinary (4%) or other (20%). Risk of infectious disease readmission was increased if the first infectious disease admission was respiratory (OR = 1.87, 95% CI 1.78-1.95) but not if it was in any other infectious disease category. Risk factors for respiratory infectious disease readmission were male gender, Pacific or Māori ethnicity, greater household deprivation, presence of a complex chronic condition, or a first respiratory infectious disease admission during autumn or of ≥3 days duration. Fewer factors (younger age, male gender, presence of a complex chronic condition) were associated with enteric infection readmission. The presence of a complex chronic condition was the only factor associated with urinary tract infection readmission and none of the factors were associated with skin or soft tissue infection readmission. CONCLUSIONS In children less than two years old, infectious disease readmission risk is increased if the first infectious disease admission is a respiratory infectious disease but not if it is another infectious disease category. Risk factors for respiratory infectious disease readmission are different from those for other infectious disease readmissions.
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Affiliation(s)
- Silvia Seibt
- Paediatrics, Taranaki Base Hospital, New Plymouth, New Zealand
| | - Catherine A Gilchrist
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Wellesley Street, Auckland, 1142, New Zealand
| | - Peter W Reed
- Children's Research Centre, Starship Children's Hospital, Auckland, New Zealand
| | - Emma J Best
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Wellesley Street, Auckland, 1142, New Zealand.,Infectious Diseases, Starship Children's Hospital, Auckland District Health Board, Auckland, New Zealand
| | - Anthony Harnden
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, England
| | - Carlos A Camargo
- Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Cameron C Grant
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Wellesley Street, Auckland, 1142, New Zealand. .,General Paediatrics, Starship Children's Hospital, Auckland District Health Board, Auckland, New Zealand.
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113
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Poortinga W, Rodgers SE, Lyons RA, Anderson P, Tweed C, Grey C, Jiang S, Johnson R, Watkins A, Winfield TG. The health impacts of energy performance investments in low-income areas: a mixed-methods approach. PUBLIC HEALTH RESEARCH 2018. [DOI: 10.3310/phr06050] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
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.
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Affiliation(s)
| | - Sarah E Rodgers
- Farr Institute, College of Medicine, Swansea University, Swansea, UK
| | - Ronan A Lyons
- Farr Institute, College of Medicine, Swansea University, Swansea, UK
| | - Pippa Anderson
- Swansea Centre for Health Economics, College of Human and Health Sciences, Swansea University, Swansea, UK
| | - Chris Tweed
- Welsh School of Architecture, Cardiff University, Cardiff, UK
| | - Charlotte Grey
- Welsh School of Architecture, Cardiff University, Cardiff, UK
| | - Shiyu Jiang
- Welsh School of Architecture, Cardiff University, Cardiff, UK
| | - Rhodri Johnson
- Farr Institute, College of Medicine, Swansea University, Swansea, UK
| | - Alan Watkins
- Farr Institute, College of Medicine, Swansea University, Swansea, UK
| | - Thomas G Winfield
- Swansea Centre for Health Economics, College of Human and Health Sciences, Swansea University, Swansea, UK
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Kader R, Kennedy K, Portnoy JM. Indoor Environmental Interventions and their Effect on Asthma Outcomes. Curr Allergy Asthma Rep 2018; 18:17. [PMID: 29470668 DOI: 10.1007/s11882-018-0774-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PURPOSE OF REVIEW The use of environmental interventions to improve outcomes in asthmatics has long been an elusive goal. While numerous interventions have been studied, the results of clinical trials have been mixed. This review aims to identify combinations of interventions that have been proven to be effective and to propose a model for using them in a clinical setting. RECENT FINDINGS An NIH workshop emphasized a need for research to identify effective interventions for reducing indoor exposures and improving asthma outcomes. A number of innovative measures were described, though evidence supporting their use was lacking. A recent systematic review described various interventions for which evidence is available. The greatest challenge for this approach is the same as that for the medical approach to treatment: nonadherence. Given evidence for effective interventions, control of environmental exposures should lead to improved asthma outcomes. Methods to improve adherence need to be identified.
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Affiliation(s)
- Rebin Kader
- Division of Allergy, Asthma & Immunology, Children's Mercy Hospitals & Clinics, 2401 Gillham Road, Kansas City, MO, 64108, USA
| | - Kevin Kennedy
- Division of Toxicology and Environmental Health, Children's Mercy, Kansas City, USA
| | - Jay M Portnoy
- Division of Allergy, Asthma & Immunology, Children's Mercy Hospitals & Clinics, 2401 Gillham Road, Kansas City, MO, 64108, USA.
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115
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Casas L, Tischer C, Täubel M. Pediatric Asthma and the Indoor Microbial Environment. Curr Environ Health Rep 2018; 3:238-49. [PMID: 27230430 DOI: 10.1007/s40572-016-0095-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The global increase in the prevalence of asthma has been related to several risk factors; many of them linked to the "westernization" process and the characteristics of the indoor microbial environment during early life may play an important role. Living in moisture damaged homes contributes to the exacerbation and development of asthma. However, living in homes with a rich variety and high levels of microbes (e.g., traditional farming environments) may confer protection. While the results of previous research are rather consistent when it comes to observation/report of indoor moisture damage or when comparing farming versus non-farming homes, when actual measures targeting indoor microbial exposure are included, the picture becomes less clear and the associations appear inconsistent. This may partly be due to limitations of sampling and measurement techniques that make comparisons difficult and provide an incomplete picture of the indoor microbial environment and in particular also human exposure. In this regard, new generation sequencing techniques represent a potential revolution in better understanding the impact of the indoor microbiome on human health.
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Affiliation(s)
- Lidia Casas
- Department of Public Health and Primary Care, Centre for Environment and Health, KU Leuven, Herestraat 49, 3000, Leuven, Belgium. .,ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Dr Aiguader 88, 08003, Barcelona, Spain. .,University Pompeu Fabra (UPF), Barcelona, Spain. .,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - Christina Tischer
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Dr Aiguader 88, 08003, Barcelona, Spain.,University Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Martin Täubel
- Living Environment and Health Unit, National Institute for Health and Welfare, Neulaniementie 4, 70210, Kuopio, Finland
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Tuuminen T, Lohi J. Immunological and toxicological effects of bad indoor air to cause dampness and Mold Hypersensitivity Syndrome. AIMS ALLERGY AND IMMUNOLOGY 2018. [DOI: 10.3934/allergy.2018.4.190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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117
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Shorter C, Crane J, Pierse N, Barnes P, Kang J, Wickens K, Douwes J, Stanley T, Täubel M, Hyvärinen A, Howden-Chapman P. Indoor visible mold and mold odor are associated with new-onset childhood wheeze in a dose-dependent manner. INDOOR AIR 2018; 28:6-15. [PMID: 28779500 DOI: 10.1111/ina.12413] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 07/30/2017] [Indexed: 06/07/2023]
Abstract
Evidence is accumulating that indoor dampness and mold are associated with the development of asthma. The underlying mechanisms remain unknown. New Zealand has high rates of both asthma and indoor mold and is ideally placed to investigate this. We conducted an incident case-control study involving 150 children with new-onset wheeze, aged between 1 and 7 years, each matched to two control children with no history of wheezing. Each participant's home was assessed for moisture damage, condensation, and mold growth by researchers, an independent building assessor and parents. Repeated measures of temperature and humidity were made, and electrostatic dust cloths were used to collect airborne microbes. Cloths were analyzed using qPCR. Children were skin prick tested for aeroallergens to establish atopy. Strong positive associations were found between observations of visible mold and new-onset wheezing in children (adjusted odds ratios ranged between 1.30 and 3.56; P ≤ .05). Visible mold and mold odor were consistently associated with new-onset wheezing in a dose-dependent manner. Measurements of qPCR microbial levels, temperature, and humidity were not associated with new-onset wheezing. The association between mold and new-onset wheeze was not modified by atopic status, suggesting a non-allergic association.
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Affiliation(s)
- Caroline Shorter
- Wellington Asthma Research Group, Department of Medicine, University of Otago, Wellington, New Zealand
| | - Julian Crane
- Wellington Asthma Research Group, Department of Medicine, University of Otago, Wellington, New Zealand
| | - Nevil Pierse
- He Kainga Oranga/Housing and Health Research Group, Department of Public Health, University of Otago, Wellington, New Zealand
| | - Phillipa Barnes
- Wellington Asthma Research Group, Department of Medicine, University of Otago, Wellington, New Zealand
| | - Janice Kang
- Wellington Asthma Research Group, Department of Medicine, University of Otago, Wellington, New Zealand
| | - Kristin Wickens
- Wellington Asthma Research Group, Department of Medicine, University of Otago, Wellington, New Zealand
| | - Jeroen Douwes
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - Thorsten Stanley
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand
| | - Martin Täubel
- Department of Health Protection, National Institute for Health and Welfare (THL), Kuopio, Finland
| | - Anne Hyvärinen
- Department of Health Protection, National Institute for Health and Welfare (THL), Kuopio, Finland
| | - Philippa Howden-Chapman
- He Kainga Oranga/Housing and Health Research Group, Department of Public Health, University of Otago, Wellington, New Zealand
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118
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Morán G, Uberti B, Ortloff A, Folch H. Aspergillus fumigatus-sensitive IgE is associated with bronchial hypersensitivity in a murine model of neutrophilic airway inflammation. J Mycol Med 2017; 28:128-136. [PMID: 29233467 DOI: 10.1016/j.mycmed.2017.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 11/15/2017] [Accepted: 11/16/2017] [Indexed: 11/29/2022]
Abstract
Neutrophils are the predominant inflammatory cells that infiltrate airways during acute exacerbation of asthma. The importance of A. fumigatus sensitization, and IgE response in the airways in patients with acute asthma is unclear. Rockefeller (RK) mice were sensitized with A. fumigatus extract protein. The animals were subsequently challenged with different degrees of A. fumigatus contamination in the cage bedding. All groups of mice were euthanized to obtain bronchoalveolar lavage fluid (BALF) for cytological and Elisa assays, and lung tissue for histological analysis. Moreover, several bioassays were conducted to determine whether BALF IgE antibodies can activate mast cells. In this study, we demonstrated that exposure of sensitized mice to a known concentration of A. fumigatus conidia produces bronchial hyperreactivity with marked neutrophilic bronchial infiltration and increased BALF IgE, capable of triggering mast cell degranulation. This study suggests that IgE may play a role in bronchial hyperreactivity associated to A. fumigatus exposure in mice. Mice sensitized and challenged with this fungus showed characteristics of severe asthma, with an increase of BALF neutrophils, histological changes consistent with severe asthma and an increase of IgE capable of triggering type I hypersensitivity.
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Affiliation(s)
- G Morán
- Department of pharmacology, faculty of veterinary science, universidad Austral de Chile, Valdivia, Chile.
| | - B Uberti
- Department of clinical veterinary sciences, faculty of veterinary sciences, universidad Austral de Chile, Valdivia, Chile
| | - A Ortloff
- College of veterinary medicine, universidad Católica de Temuco, Temuco, Chile
| | - H Folch
- Department of immunology, faculty of medicine, universidad Austral de Chile, Valdivia, Chile
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119
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Trablesi H, Hadrich I, Neji S, Fendri N, Ghorbel D, Makni F, Ayadi H, Kammoun S, Ayadi A. Environmental and molecular study of fungal flora in asthmatic patients. J Mycol Med 2017; 28:180-185. [PMID: 29102311 DOI: 10.1016/j.mycmed.2017.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 09/17/2017] [Accepted: 09/18/2017] [Indexed: 11/29/2022]
Abstract
The aim of the present study was to investigate the epidemiological and fungal environmental profile in asthmatic patients. We conducted a prospective study involving 49 patients with allergic asthma. One hundred and forty-five clinical samples and 289 environmental samples were performed. Only 30 patients accepted to participate to the environmental study at their home. For specific IgE antibodies, ELISA assay was conducted for 21 patients. Molecular ITS sequencing was performed for 37 isolates. The frequency of attacks was significantly associated with the seasonality, which was closely related to climate (P=0.024), exposure to animals (cats, P=0.025), plants (olive, P=0.018), physical effort (P=0.04) and the number of permanent occupants in house (>6) (P=0.026). Fungal contaminants were detected from 78.6% of biological samples and 97.8% of environmental samples. Antibodies corresponding to the studied allergens were detected in 10 patients (10/21). PCR sequencing allowed as rectified morphological identification for 27.02% (10/37) strains of Aspergillus. The allergy in molds is an indisputable reality that is necessary to look for in front of any severe asthma. So, it is important to establish clearly a relationship between exposure to fungi and health disorders in order to set up specific and effective preventive measures.
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Affiliation(s)
- H Trablesi
- Laboratory of Fungal and Parasitic Molecular Biology, School of Medicine, University of Sfax, Sfax, Tunisia
| | - I Hadrich
- Laboratory of Fungal and Parasitic Molecular Biology, School of Medicine, University of Sfax, Sfax, Tunisia
| | - S Neji
- Laboratory of Fungal and Parasitic Molecular Biology, School of Medicine, University of Sfax, Sfax, Tunisia
| | - N Fendri
- Laboratory of Fungal and Parasitic Molecular Biology, School of Medicine, University of Sfax, Sfax, Tunisia
| | - D Ghorbel
- Laboratory of Fungal and Parasitic Molecular Biology, School of Medicine, University of Sfax, Sfax, Tunisia
| | - F Makni
- Laboratory of Fungal and Parasitic Molecular Biology, School of Medicine, University of Sfax, Sfax, Tunisia
| | - H Ayadi
- Department of Pneumology, UH Hedi Chaker, University of Sfax, Sfax, Tunisia.
| | - S Kammoun
- Department of Pneumology, UH Hedi Chaker, University of Sfax, Sfax, Tunisia
| | - A Ayadi
- Laboratory of Fungal and Parasitic Molecular Biology, School of Medicine, University of Sfax, Sfax, Tunisia
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120
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Dampness and Moisture Problems in Norwegian Homes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14101241. [PMID: 29039816 PMCID: PMC5664742 DOI: 10.3390/ijerph14101241] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 10/05/2017] [Accepted: 10/14/2017] [Indexed: 11/23/2022]
Abstract
The occurrence of dampness and mold in the indoor environment is associated with respiratory-related disease outcomes. Thus, it is pertinent to know the magnitude of such indoor environment problems to be able to estimate the potential health impact in the population. In the present study, the moisture damage in 10,112 Norwegian dwellings was recorded based on building inspection reports. The levels of moisture damage were graded based on a condition class (CC), where CC0 is immaculate and CC1 acceptable (actions not required), while CC2 and CC3 indicate increased levels of damage that requires action. Of the 10,112 dwellings investigated, 3125 had verified moisture or mold damage. This amounts to 31% of the surveyed dwellings. Of these, 27% had CC2 as the worst grade, whereas 4% had CC3 as the worst grade level. The room types and building structures most prone to moisture damage were (in rank order) crawl spaces, basements, un-insulated attics, cooling rooms, and bathrooms. The high proportion of homes with moisture damage indicate a possible risk for respiratory diseases in a relatively large number of individuals, even if only the more extensive moisture damages and those located in rooms where occupants spend the majority of their time would have a significant influence on adverse health effects.
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121
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Jayaprakash B, Adams RI, Kirjavainen P, Karvonen A, Vepsäläinen A, Valkonen M, Järvi K, Sulyok M, Pekkanen J, Hyvärinen A, Täubel M. Indoor microbiota in severely moisture damaged homes and the impact of interventions. MICROBIOME 2017; 5:138. [PMID: 29029638 PMCID: PMC5640920 DOI: 10.1186/s40168-017-0356-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 09/27/2017] [Indexed: 05/22/2023]
Abstract
BACKGROUND The limited understanding of microbial characteristics in moisture-damaged buildings impedes efforts to clarify which adverse health effects in the occupants are associated with the damage and to develop effective building intervention strategies. The objectives of this current study were (i) to characterize fungal and bacterial microbiota in house dust of severely moisture-damaged residences, (ii) to identify microbial taxa associated with moisture damage renovations, and (iii) to test whether the associations between the identified taxa and moisture damage are replicable in another cohort of homes. We applied bacterial 16S rRNA gene and fungal ITS amplicon sequencing complemented with quantitative PCR and chemical-analytical approaches to samples of house dust, and also performed traditional cultivation of bacteria and fungi from building material samples. RESULTS Active microbial growth on building materials had significant though small influence on the house dust bacterial and fungal communities. Moisture damage interventions-including actual renovation of damaged homes and cases where families moved to another home-had only a subtle effect on bacterial community structure, seen as shifts in abundance weighted bacterial profiles after intervention. While bacterial and fungal species richness were reduced in homes that were renovated, they were not reduced for families that moved houses. Using different discriminant analysis tools, we were able identify taxa that were significantly reduced in relative abundance during renovation of moisture damage. For bacteria, the majority of candidates belonged to different families within the Actinomycetales order. Results for fungi were overall less consistent. A replication study in approximately 400 homes highlighted some of the identified taxa, confirming associations with observations of moisture damage and mold. CONCLUSIONS The present study is one of the first studies to analyze changes in microbiota due to moisture damage interventions using high-throughput sequencing. Our results suggest that effects of moisture damage and moisture damage interventions may appear as changes in the abundance of individual, less common, and especially bacterial taxa, rather than in overall community structure.
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Affiliation(s)
| | - Rachel I. Adams
- Plant and Microbial Biology, University of California, Berkeley, California USA
- California Department of Public Health, Richmond, California USA
| | - Pirkka Kirjavainen
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - Anne Karvonen
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - Asko Vepsäläinen
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - Maria Valkonen
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - Kati Järvi
- School of Engineering, Aalto University, Espoo, Finland
| | - Michael Sulyok
- Department for Agrobiotechnology (IFA-Tulln), University of Natural Resources and Life Sciences, (BOKU), Vienna, Tulln Austria
| | - Juha Pekkanen
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
- Department of Public Health, Helsinki University, Helsinki, Finland
| | - Anne Hyvärinen
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - Martin Täubel
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
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Okubo T, Osaki T, Nozaki E, Uemura A, Sakai K, Matushita M, Matsuo J, Nakamura S, Kamiya S, Yamaguchi H. Walker occupancy has an impact on changing airborne bacterial communities in an underground pedestrian space, as small-dust particles increased with raising both temperature and humidity. PLoS One 2017; 12:e0184980. [PMID: 28922412 PMCID: PMC5602640 DOI: 10.1371/journal.pone.0184980] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 09/05/2017] [Indexed: 11/18/2022] Open
Abstract
Although human occupancy is a source of airborne bacteria, the role of walkers on bacterial communities in built environments is poorly understood. Therefore, we visualized the impact of walker occupancy combined with other factors (temperature, humidity, atmospheric pressure, dust particles) on airborne bacterial features in the Sapporo underground pedestrian space in Sapporo, Japan. Air samples (n = 18; 4,800L/each sample) were collected at 8:00 h to 20:00 h on 3 days (regular sampling) and at early morning / late night (5:50 h to 7:50 h / 22:15 h to 24:45 h) on a day (baseline sampling), and the number of CFUs (colony forming units) OTUs (operational taxonomic units) and other factors were determined. The results revealed that temperature, humidity, and atmospheric pressure changed with weather. The number of walkers increased greatly in the morning and evening on each regular sampling day, although total walker numbers did not differ significantly among regular sampling days. A slight increase in small dust particles (0.3–0.5μm) was observed on the days with higher temperature regardless of regular or baseline sampling. At the period on regular sampling, CFU levels varied irregularly among days, and the OTUs of 22-phylum types were observed, with the majority being from Firmicutes or Proteobacteria (γ-), including Staphylococcus sp. derived from human individuals. The data obtained from regular samplings reveled that although no direct interaction of walker occupancy and airborne CFU and OTU features was observed upon Pearson's correlation analysis, cluster analysis indicated an obvious lineage consisting of walker occupancy, CFU numbers, OTU types, small dust particles, and seasonal factors (including temperature and humidity). Meanwhile, at the period on baseline sampling both walker and CFU numbers were similarly minimal. Taken together, the results revealed a positive correlation of walker occupancy with airborne bacteria that increased with increases in temperature and humidity in the presence of airborne small particles. Moreover, the results indicated that small dust particles at high temperature and humidity may be a crucial factor responsible for stabilizing the bacteria released from walkers in built environments. The findings presented herein advance our knowledge and understanding of the relationship between humans and bacterial communities in built environments, and will help improve public health in urban communities.
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Affiliation(s)
- Torahiko Okubo
- Department of Medical Laboratory Science, Faculty of Health Sciences, Hokkaido University, Kita-ku, Sapporo, Japan
| | - Takako Osaki
- Department of Infectious Diseases, Kyorin University School of Medicine, Shinkawa, Mitaka, Tokyo, Japan
| | - Eriko Nozaki
- Department of Infectious Diseases, Kyorin University School of Medicine, Shinkawa, Mitaka, Tokyo, Japan
| | - Akira Uemura
- Department of Medical Laboratory Science, Faculty of Health Sciences, Hokkaido University, Kita-ku, Sapporo, Japan
| | - Kouhei Sakai
- Department of Medical Laboratory Science, Faculty of Health Sciences, Hokkaido University, Kita-ku, Sapporo, Japan
| | - Mizue Matushita
- Department of Medical Laboratory Science, Faculty of Health Sciences, Hokkaido University, Kita-ku, Sapporo, Japan
| | - Junji Matsuo
- Department of Medical Laboratory Science, Faculty of Health Sciences, Hokkaido University, Kita-ku, Sapporo, Japan
| | - Shinji Nakamura
- Division of Biomedical Imaging Research, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Shigeru Kamiya
- Department of Infectious Diseases, Kyorin University School of Medicine, Shinkawa, Mitaka, Tokyo, Japan
| | - Hiroyuki Yamaguchi
- Department of Medical Laboratory Science, Faculty of Health Sciences, Hokkaido University, Kita-ku, Sapporo, Japan
- * E-mail:
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Wiesmüller GA, Heinzow B, Aurbach U, Bergmann KC, Bufe A, Buzina W, Cornely OA, Engelhart S, Fischer G, Gabrio T, Heinz W, Herr CEW, Kleine-Tebbe J, Klimek L, Köberle M, Lichtnecker H, Lob-Corzilius T, Merget R, Mülleneisen N, Nowak D, Rabe U, Raulf M, Seidl HP, Steiß JO, Szewzyk R, Thomas P, Valtanen K, Hurrass J. Kurzfassung der AWMF-Leitlinie medizinisch klinische Diagnostik bei Schimmelpilzexposition in Innenräumen. ALLERGO JOURNAL 2017. [DOI: 10.1007/s15007-017-1382-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Martynenko S, Kondratiuk T, Sukhomlyn M. Mycobiota of anthropogenic and natural underground objects. UKRAINIAN BOTANICAL JOURNAL 2017. [DOI: 10.15407/ukrbotj74.03.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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125
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Liu AH, Anderson WC, Dutmer CM, Searing DA, Szefler SJ. Advances in asthma 2015: Across the lifespan. J Allergy Clin Immunol 2017; 138:397-404. [PMID: 27497278 DOI: 10.1016/j.jaci.2016.06.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 06/21/2016] [Accepted: 06/23/2016] [Indexed: 12/19/2022]
Abstract
In 2015, progress in understanding asthma ranged from insights to asthma inception, exacerbations, and severity to advancements that will improve disease management throughout the lifespan. 2015's insights to asthma inception included how the intestinal microbiome affects asthma expression with the identification of specific gastrointestinal bacterial taxa in early infancy associated with less asthma risk, possibly by promoting regulatory immune development at a critical early age. The relevance of epigenetic mechanisms in regulating asthma-related gene expression was strengthened. Predicting and preventing exacerbations throughout life might help to reduce progressive lung function decrease and disease severity in adulthood. Although allergy has long been linked to asthma exacerbations, a mechanism through which IgE impairs rhinovirus immunity and underlies asthma exacerbations was demonstrated and improved by anti-IgE therapy (omalizumab). Other key molecular pathways underlying asthma exacerbations, such as cadherin-related family member 3 (CDHR3) and orosomucoid like 3 (ORMDL3), were elucidated. New anti-IL-5 therapeutics, mepolizumab and reslizumab, were US Food and Drug Administration approved for the treatment of patients with severe eosinophilic asthma. In a clinical trial the novel therapeutic inhaled GATA3 mRNA-specific DNAzyme attenuated early- and late-phase allergic responses to inhaled allergen. These current findings are significant steps toward addressing unmet needs in asthma prevention, severity modification, disparities, and lifespan outcomes.
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Affiliation(s)
- Andrew H Liu
- Breathing Institute and Pulmonary Medicine Section, Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colo.
| | - William C Anderson
- Allergy & Immunology Section, Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colo
| | - Cullen M Dutmer
- Allergy & Immunology Section, Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colo
| | - Daniel A Searing
- Allergy & Immunology Section, Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colo
| | - Stanley J Szefler
- Breathing Institute and Pulmonary Medicine Section, Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colo
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Abstract
INTRODUCTION fungi produce substances that contain pathogen-associated molecular patterns (pamps) and damage-associated molecular patterns (damps) which bind to pattern recognition receptors, stimulating innate immune responses in humans. they also produce allergens that induce production of specific ige. Areas covered: In this review we cover both innate and adaptive immune responses to fungi. Some fungal products can activate both innate and adaptive responses and in doing so, cause an intense and complex health effects. Methods of testing for fungal allergy and evidence for clinical treatment including environmental control are also discussed. In addition, we describe controversial issues including the role of Stachybotrys and mycotoxins in adverse health effects. Expert commentary: Concerns about long-term exposure to fungi have led some patients, attorneys and fungus advocates to promote fears about a condition that has been termed toxic mold syndrome. This syndrome is associated with vague symptoms and is believed to be due to exposure to mycotoxins, though this connection has not been proven. Ultimately, more precise methods are needed to measure both fungal exposure and the resulting health effects. Once that such methods become available, much of the speculation will be replaced by knowledge.
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Affiliation(s)
- Amanda Rudert
- a Division of Allergy, Asthma & Immunology , Children's Mercy Hospitals & Clinics , Kansas City , MO , USA
| | - Jay Portnoy
- a Division of Allergy, Asthma & Immunology , Children's Mercy Hospitals & Clinics , Kansas City , MO , USA
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127
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Zhao G, Yin G, Inamdar AA, Luo J, Zhang N, Yang I, Buckley B, Bennett JW. Volatile organic compounds emitted by filamentous fungi isolated from flooded homes after Hurricane Sandy show toxicity in a Drosophila bioassay. INDOOR AIR 2017; 27:518-528. [PMID: 27748984 DOI: 10.1111/ina.12350] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 10/12/2016] [Indexed: 06/06/2023]
Abstract
Superstorm Sandy provided an opportunity to study filamentous fungi (molds) associated with winter storm damage. We collected 36 morphologically distinct fungal isolates from flooded buildings. By combining traditional morphological and cultural characters with an analysis of ITS sequences (the fungal DNA barcode), we identified 24 fungal species that belong to eight genera: Penicillium (11 species), Fusarium (four species), Aspergillus (three species), Trichoderma (two species), and one species each of Metarhizium, Mucor, Pestalotiopsis, and Umbelopsis. Then, we used a Drosophila larval assay to assess possible toxicity of volatile organic compounds (VOCs) emitted by these molds. When cultured in a shared atmosphere with growing cultures of molds isolated after Hurricane Sandy, larval toxicity ranged from 15 to 80%. VOCs from Aspergillus niger 129B were the most toxic yielding 80% mortality to Drosophila after 12 days. The VOCs from Trichoderma longibrachiatum 117, Mucor racemosus 138a, and Metarhizium anisopliae 124 were relatively non-toxigenic. A preliminary analysis of VOCs was conducted using solid-phase microextraction-gas chromatography-mass spectrometry from two of the most toxic, two of the least toxic, and two species of intermediate toxicity. The more toxic molds produced higher concentrations of 1-octen-3-ol, 3-octanone, 3-octanol, 2-octen-1-ol, and 2-nonanone; while the less toxic molds produced more 3-methyl-1-butanol and 2-methyl-1-propanol, or an overall lower amount of volatiles. Our data support the hypothesis that at certain concentrations, some VOCs emitted by indoor molds are toxigenic.
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Affiliation(s)
- G Zhao
- College of Biological Sciences and Biotechnology, Beijing Forestry University, Beijing, China
| | - G Yin
- Department of Plant Biology and Pathology, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - A A Inamdar
- Department of Plant Biology and Pathology, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - J Luo
- Department of Plant Biology and Pathology, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - N Zhang
- Department of Plant Biology and Pathology, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - I Yang
- Environmental and Occupational Health Sciences Institute, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - B Buckley
- Environmental and Occupational Health Sciences Institute, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - J W Bennett
- Department of Plant Biology and Pathology, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
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128
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Emerson JB, Keady PB, Clements N, Morgan EE, Awerbuch J, Miller SL, Fierer N. High temporal variability in airborne bacterial diversity and abundance inside single-family residences. INDOOR AIR 2017; 27:576-586. [PMID: 27743387 DOI: 10.1111/ina.12347] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 10/10/2016] [Indexed: 05/14/2023]
Abstract
Our homes are microbial habitats, and although the amounts and types of bacteria in indoor air have been shown to vary substantially across residences, temporal variability within homes has rarely been characterized. Here, we sought to quantify the temporal variability in the amounts and types of airborne bacteria in homes, and what factors drive this variability. We collected filter samples of indoor and outdoor air in 15 homes over 1 year (approximately eight time points per home, two per season), and we used culture-independent DNA sequencing approaches to characterize bacterial community composition. Significant differences in indoor air community composition were observed both between homes and within each home over time. Indoor and outdoor air community compositions were not significantly correlated, suggesting that indoor and outdoor air communities are decoupled. Indoor air communities from the same home were often just as different at adjacent time points as they were across larger temporal distances, and temporal variation correlated with changes in environmental conditions, including temperature and relative humidity. Although all homes had highly variable indoor air communities, homes with the most temporally variable communities had more stable, lower average microbial loads than homes with less variable communities.
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Affiliation(s)
- J B Emerson
- Cooperative Institute for Research in Environmental Sciences, University of Colorado at Boulder, Boulder, CO, USA
| | - P B Keady
- Department of Mechanical Engineering, University of Colorado at Boulder, Boulder, CO, USA
| | - N Clements
- Department of Mechanical Engineering, University of Colorado at Boulder, Boulder, CO, USA
| | - E E Morgan
- Department of Molecular, Cellular, and Developmental Biology, University of Colorado at Boulder, Boulder, CO, USA
| | - J Awerbuch
- Department of Mechanical Engineering, University of Colorado at Boulder, Boulder, CO, USA
| | - S L Miller
- Department of Mechanical Engineering, University of Colorado at Boulder, Boulder, CO, USA
| | - N Fierer
- Cooperative Institute for Research in Environmental Sciences, University of Colorado at Boulder, Boulder, CO, USA
- Department of Ecology and Evolutionary Biology, University of Colorado at Boulder, Boulder, CO, USA
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129
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Mendell MJ, Kumagai K. Observation-based metrics for residential dampness and mold with dose-response relationships to health: A review. INDOOR AIR 2017; 27:506-517. [PMID: 27663473 DOI: 10.1111/ina.12342] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 09/19/2016] [Indexed: 05/06/2023]
Abstract
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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Affiliation(s)
- M J Mendell
- Indoor Air Quality Section, California Department of Public Health, Richmond, CA, USA
| | - K Kumagai
- Indoor Air Quality Section, California Department of Public Health, Richmond, CA, USA
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130
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Azuma K, Ikeda K, Kagi N, Yanagi U, Osawa H. Evaluating prevalence and risk factors of building-related symptoms among office workers: Seasonal characteristics of symptoms and psychosocial and physical environmental factors. Environ Health Prev Med 2017; 22:38. [PMID: 29165170 PMCID: PMC5664800 DOI: 10.1186/s12199-017-0645-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 02/01/2017] [Indexed: 01/21/2023] Open
Abstract
Background Psychosocial and environmental factors at the workplace play a significant role in building-related symptoms (BRSs). Environmental factors change during summer cooling and winter heating using air-conditioning systems. Thus, significant risk factors in each season need to be clarified. Methods A nationwide cross-sectional study was conducted during summer in Japan and seasonal differences between summer and winter were evaluated. Self-administered questionnaires were distributed to 489 offices. Possible risk factors for BRSs associated with the work environment, indoor air quality, and job stressors were examined by multiple regression analyses. Results Among people having at least one BRS, the prevalence of BRSs in summer (27.8%) was slightly higher than that in winter (24.9%). High prevalence was observed for eye and nasal symptoms related to dryness and general symptoms related to psychological distress in both seasons. Analyses revealed that dryness of air was an important and significant risk factor associated with BRSs, and job stressors were significantly associated with general symptoms in both seasons. Conversely, humidity was a significant risk factor of general symptoms in summer (odds ratio, 1.20; 95% confidence interval, 1.02–1.43). Carpeting, recently painted walls, and unpleasant chemical odors in summer and noise, dust and dirt, and unpleasant odors such as body or food odors in both seasons were significant risk factors for BRSs. Conclusions Improvements in the physical environmental qualities in an office throughout the year are important along with the reduction in psychological distress related to work. Electronic supplementary material The online version of this article (doi:10.1186/s12199-017-0645-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kenichi Azuma
- Department of Environmental Medicine and Behavioral Science, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osakasayama, Osaka, 589-8511, Japan.
| | - Koichi Ikeda
- Department of Architecture, College of Science and Technology, Nihon University, 8-14 Kanda-Surugadai 1-chome, Chiyoda-ku, Tokyo, 101-8308, Japan
| | - Naoki Kagi
- Department of Mechanical and Environmental Informatics, Graduate School of Information Science and Engineering, Tokyo Institute of Technology, 2-12-1 Ookayama, Meguro-ku, Tokyo, 152-8550, Japan
| | - U Yanagi
- Department of Architecture, School of Architecture, Kogakuin University, 1-24-2 Nishi-Shinjuku, Shinjuku-ku, Tokyo, 163-8677, Japan
| | - Haruki Osawa
- Department of Environmental Health, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan
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131
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Gautier C, Charpin D. Environmental triggers and avoidance in the management of asthma. J Asthma Allergy 2017; 10:47-56. [PMID: 28331347 PMCID: PMC5349698 DOI: 10.2147/jaa.s121276] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Identifying asthma triggers forms the basis of environmental secondary prevention. These triggers may be allergenic or nonallergenic. Allergenic triggers include indoor allergens, such as house dust mites (HDMs), molds, pets, cockroaches, and rodents, and outdoor allergens, such as pollens and molds. Clinical observations provide support for the role of HDM exposure as a trigger, although avoidance studies provide conflicting results. Molds and their metabolic products are now considered to be triggers of asthma attacks. Pets, dogs, and especially cats can undoubtedly trigger asthmatic symptoms in sensitized subjects. Avoidance is difficult and rarely adhered to by families. Cockroach allergens contribute to asthma morbidity, and avoidance strategies can lead to clinical benefit. Mouse allergens are mostly found in inner-city dwellings, but their implication in asthma morbidity is debated. In the outdoors, pollens can induce seasonal asthma in sensitized individuals. Avoidance relies on preventing pollens from getting into the house and on minimizing seasonal outdoor exposure. Outdoor molds may lead to severe asthma exacerbations. Nonallergenic triggers include viral infections, active and passive smoking, meteorological changes, occupational exposures, and other triggers that are less commonly involved. Viral infection is the main asthma trigger in children. Active smoking is associated with higher asthma morbidity, and smoking cessation interventions should be personalized. Passive smoking is also a risk factor for asthma exacerbation. The implementation of public smoking bans has led to a reduction in the hospitalization of asthmatic children. Air pollution levels have been linked with asthmatic symptoms, a decrease in lung function, and increased emergency room visits and hospitalizations. Since avoidance is not easy to achieve, clean air policies remain the most effective strategy. Indoor air is also affected by air pollutants, such as cigarette smoke and volatile organic compounds generated by building and cleaning materials. Occupational exposures include work-exacerbated asthma and work-related asthma.
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Affiliation(s)
| | - Denis Charpin
- Department of Pulmonology and Allergy, North Hospital; Faculty of Medicine, Aix-Marseille University, Marseille, France
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132
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Oluwole O, Kirychuk SP, Lawson JA, Karunanayake C, Cockcroft DW, Willson PJ, Senthilselvan A, Rennie DC. Indoor mold levels and current asthma among school-aged children in Saskatchewan, Canada. INDOOR AIR 2017; 27:311-319. [PMID: 27108895 DOI: 10.1111/ina.12304] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 04/12/2016] [Indexed: 06/05/2023]
Abstract
Current knowledge regarding the association between indoor mold exposures and asthma is still limited. The objective of this case-control study was to investigate the relationship between objectively measured indoor mold levels and current asthma among school-aged children. Parents completed a questionnaire survey of health history and home environmental conditions. Asthma cases had a history of doctor-diagnosed asthma or current wheeze without a cold in the past 12 months. Controls were age- and sex-matched to cases. Vacuumed dust samples were collected from the child's indoor play area and mattress. Samples were assessed for mold levels and quantified in colony-forming units (CFU). Sensitization to mold allergens was also determined by skin testing. Being a case was associated with family history of asthma, pet ownership, and mold allergy. Mold levels (CFU/m2 ) in the dust samples of children's mattress and play area floors were moderately correlated (r = 0.56; P < 0.05). High mold levels (≥30 000 CFU/m2 ) in dust samples from play [adjusted odds ratio (aOR) = 2.6; 95% CI: 1.03-6.43] and mattress (aOR) = 3.0; 95% CI: 1.11-8.00) areas were significantly associated with current asthma. In this study high levels of mold are a risk factor for asthma in children.
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Affiliation(s)
- O Oluwole
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - S P Kirychuk
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - J A Lawson
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - C Karunanayake
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - D W Cockcroft
- Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - P J Willson
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- Vaccine and Infectious Disease Organization, University of Saskatchewan, Saskatoon, SK, Canada
| | - A Senthilselvan
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - D C Rennie
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
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133
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Casas L, Espinosa A, Pekkanen J, Asikainen A, Borràs-Santos A, Jacobs J, Krop EJM, Täubel M, Hyvärinen A, Heederik D, Zock JP. School attendance and daily respiratory symptoms in children: influence of moisture damage. INDOOR AIR 2017; 27:303-310. [PMID: 27224645 DOI: 10.1111/ina.12311] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 05/20/2016] [Indexed: 06/05/2023]
Abstract
We investigated the effect of weekends and school holidays on the daily frequency and severity of respiratory and other symptoms among children attending schools with (index) or without (reference) moisture damage in Spain, the Netherlands, and Finland. Throughout 1 year, parents of 419 children with a respiratory condition attending index (n=15) or reference (n=10) primary schools completed three symptom diaries. We assessed associations between lower respiratory tract, upper respiratory tract or allergy, and other symptom scores and school day, weekend, or summer holiday using mixed regression models stratified by country and moisture damage. We evaluated interactions between moisture damage and type of day. We combined country-specific estimates (incidence rate ratios [IRRs] and 95% confidence interval [CI]) in meta-analyses. Symptom scores were lower during weekends and holiday. Lower respiratory tract symptoms were statistically significantly less common during holiday with strongest effect in index schools (IRR=0.7; CI=0.6-0.8). Reporting of other symptoms was more reduced during holiday in index (IRR=0.6; CI=0.4-0.9) than in reference (IRR=0.95; CI=0.8-1.2) schools (interaction P<.01). In conclusion, symptoms were less frequent and/or severe during summer holiday and weekends. This pattern was stronger among children attending moisture-damaged schools, suggesting potential improvement in moisture damage-related symptoms during school breaks.
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Affiliation(s)
- L Casas
- Department of Public Health and Primary Care-Centre for Environment and Health, KU Leuven, Leuven, Belgium
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- University Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - A Espinosa
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- University Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - J Pekkanen
- Department Health Protection, National Institute for Health and Welfare, Kuopio, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - A Asikainen
- Department Health Protection, National Institute for Health and Welfare, Kuopio, Finland
| | - A Borràs-Santos
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- University Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- CIBER Respiratorio (CIBERES), Madrid, Spain
| | - J Jacobs
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - E J M Krop
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - M Täubel
- Department Health Protection, National Institute for Health and Welfare, Kuopio, Finland
| | - A Hyvärinen
- Department Health Protection, National Institute for Health and Welfare, Kuopio, Finland
| | - D Heederik
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - J-P Zock
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- University Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
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134
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Dannemiller KC, Weschler CJ, Peccia J. Fungal and bacterial growth in floor dust at elevated relative humidity levels. INDOOR AIR 2017; 27:354-363. [PMID: 27272645 DOI: 10.1111/ina.12313] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 05/31/2016] [Indexed: 05/22/2023]
Abstract
Under sustained, elevated building moisture conditions, bacterial and fungal growth occurs. The goal of this study was to characterize microbial growth in floor dust at variable equilibrium relative humidity (ERH) levels. Floor dust from one home was embedded in coupons cut from a worn medium-pile nylon carpet and incubated at 50%, 80%, 85%, 90%, 95%, and 100% ERH levels. Quantitative PCR and DNA sequencing of ribosomal DNA for bacteria and fungi were used to quantify growth and community shifts. Over a 1-wk period, fungal growth occurred above 80% ERH. Growth rates at 85% and 100% ERH were 1.1 × 104 and 1.5 × 105 spore equivalents d-1 mg dust-1 , respectively. Bacterial growth occurred only at 100% ERH after 1 wk (9.0 × 104 genomes d-1 mg dust-1 ). Growth resulted in significant changes in fungal (P<.00001) and bacterial community structure (P<.00001) at varying ERH levels. Comparisons between fungal taxa incubated at different ERH levels revealed more than 100 fungal and bacterial species that were attributable to elevated ERH. Resuspension modeling indicated that more than 50% of airborne microbes could originate from the resuspension of fungi grown at ERH levels of 85% and above.
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Affiliation(s)
- K C Dannemiller
- Department of Civil, Environmental & Geodetic Engineering, College of Engineering, Ohio State University, Columbus, OH, USA
- Division of Environmental Health Sciences, College of Public Health, Ohio State University, Columbus, OH, USA
| | - C J Weschler
- Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ, USA
| | - J Peccia
- Department of Chemical and Environmental Engineering, Yale University, New Haven, CT, USA
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135
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Wiesmüller GA, Heinzow B, Aurbach U, Bergmann KC, Bufe A, Buzina W, Cornely OA, Engelhart S, Fischer G, Gabrio T, Heinz W, Herr CEW, Kleine-Tebbe J, Klimek L, Köberle M, Lichtnecker H, Lob-Corzilius T, Merget R, Mülleneisen N, Nowak D, Rabe U, Raulf M, Seidl HP, Steiß JO, Szewszyk R, Thomas P, Valtanen K, Hurraß J. Abridged version of the AWMF guideline for the medical clinical diagnostics of indoor mould exposure: S2K Guideline of the German Society of Hygiene, Environmental Medicine and Preventive Medicine (GHUP) in collaboration with the German Association of Allergists (AeDA), the German Society of Dermatology (DDG), the German Society for Allergology and Clinical Immunology (DGAKI), the German Society for Occupational and Environmental Medicine (DGAUM), the German Society for Hospital Hygiene (DGKH), the German Society for Pneumology and Respiratory Medicine (DGP), the German Mycological Society (DMykG), the Society for Pediatric Allergology and Environmental Medicine (GPA), the German Federal Association of Pediatric Pneumology (BAPP), and the Austrian Society for Medical Mycology (ÖGMM). ALLERGO JOURNAL INTERNATIONAL 2017; 26:168-193. [PMID: 28804700 PMCID: PMC5533814 DOI: 10.1007/s40629-017-0013-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
This article is an abridged version of the AWMF mould guideline "Medical clinical diagnostics of indoor mould exposure" presented in April 2016 by the German Society of Hygiene, Environmental Medicine and Preventive Medicine (Gesellschaft für Hygiene, Umweltmedizin und Präventivmedizin, GHUP), in collaboration with the above-mentioned scientific medical societies, German and Austrian societies, medical associations and experts. Indoor mould growth is a potential health risk, even if a quantitative and/or causal relationship between the occurrence of individual mould species and health problems has yet to be established. Apart from allergic bronchopulmonary aspergillosis (ABPA) and mould-caused mycoses, only sufficient evidence for an association between moisture/mould damage and the following health effects has been established: allergic respiratory disease, asthma (manifestation, progression and exacerbation), allergic rhinitis, hypersensitivity pneumonitis (extrinsic allergic alveolitis), and increased likelihood of respiratory infections/bronchitis. In this context the sensitizing potential of moulds is obviously low compared to other environmental allergens. Recent studies show a comparatively low sensitizing prevalence of 3-10% in the general population across Europe. Limited or suspected evidence for an association exist with respect to mucous membrane irritation and atopic eczema (manifestation, progression and exacerbation). Inadequate or insufficient evidence for an association exist for chronic obstructive pulmonary disease, acute idiopathic pulmonary hemorrhage in children, rheumatism/arthritis, sarcoidosis and cancer. The risk of infection posed by moulds regularly occurring indoors is low for healthy persons; most species are in risk group 1 and a few in risk group 2 (Aspergillus fumigatus, A. flavus) of the German Biological Agents Act (Biostoffverordnung). Only moulds that are potentially able to form toxins can be triggers of toxic reactions. Whether or not toxin formation occurs in individual cases is determined by environmental and growth conditions, above all the substrate. In the case of indoor moisture/mould damage, everyone can be affected by odour effects and/or mood disorders. However, this is not a health hazard. Predisposing factors for odour effects can include genetic and hormonal influences, imprinting, context and adaptation effects. Predisposing factors for mood disorders may include environmental concerns, anxiety, condition, and attribution, as well as various diseases. Risk groups to be protected particularly with regard to an infection risk are persons on immunosuppression according to the classification of the German Commission for Hospital Hygiene and Infection Prevention (Kommission für Krankenhaushygiene und Infektionsprävention, KRINKO) at the Robert Koch- Institute (RKI) and persons with cystic fibrosis (mucoviscidosis); with regard to an allergic risk, persons with cystic fibrosis (mucoviscidosis) and patients with bronchial asthma should be protected. The rational diagnostics include the medical history, physical examination, and conventional allergy diagnostics including provocation tests if necessary; sometimes cellular test systems are indicated. In the case of mould infections the reader is referred to the AWMF guideline "Diagnosis and Therapy of Invasive Aspergillus Infections". With regard to mycotoxins, there are currently no useful and validated test procedures for clinical diagnostics. From a preventive medicine standpoint it is important that indoor mould infestation in relevant dimension cannot be tolerated for precautionary reasons. With regard to evaluating the extent of damage and selecting a remedial procedure, the reader is referred to the revised version of the mould guideline issued by the German Federal Environment Agency (Umweltbundesamt, UBA).
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Affiliation(s)
- Gerhard A. Wiesmüller
- Institute for Occupational Medicine and Social Medicine, University Hospital, Medical Faculty, RWTH Aachen University, Aachen, Germany
- Department of Infection Control and Environmental Hygiene, Cologne Health Authority, Neumarkt 15–21, 50667 Cologne, Germany
| | - Birger Heinzow
- Formerly: Regional Social Security Authorities (LAsD) for Schleswig-Holstein, Kiel, Germany
| | - Ute Aurbach
- Department of Microbiology and Mycology, Dr. Wisplinghoff Laboratory, Cologne, Germany
| | | | - Albrecht Bufe
- Experimental Pneumology, Ruhr University, Bochum, Germany
| | - Walter Buzina
- Institute for Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Oliver A. Cornely
- Department I for Internal Medicine and Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Steffen Engelhart
- Institute for Hygiene and Public Health, Bonn University Hospital, Bonn, Germany
| | - Guido Fischer
- Baden-Württemberg Regional Health Authorities at the Regional Council Stuttgart, Stuttgart, Germany
| | - Thomas Gabrio
- Formerly: Baden-Württemberg Regional Health Authorities at the Regional Council in Stuttgart, Stuttgart, Germany
| | - Werner Heinz
- Medical Clinic and Outpatient Clinic II with Special Focus on Infectiology, Würzburg University Hospital, Würzburg, Germany
| | - Caroline E. W. Herr
- Bavarian Office for Health and Food Safety, Munich, Germany
- Adj. Prof. “Hygiene and Environmental Medicine”, Ludwig-Maximilian University, Munich, Germany
| | | | - Ludger Klimek
- Wiesbaden Centre for Rhinology and Allergology, Wiesbaden, Germany
| | - Martin Köberle
- Clinic and Outpatient Clinic for Dermatology and Allergology am Biederstein, Technical University of Munich, Munich, Germany
| | - Herbert Lichtnecker
- Medical Institute for Environmental and Occupational Medicine MIU GmbH, Erkrath, Germany
| | | | - Rolf Merget
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | | | - Dennis Nowak
- Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, Member of the German Centre for Lung Research, Munich University Hospital, Munich, Germany
| | - Uta Rabe
- Centre for Allergology and Asthma, Johanniter Hospital im Fläming Treuenbrietzen GmbH, Treuenbrietzen, Germany
| | - Monika Raulf
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | - Hans Peter Seidl
- Formerly: Chair of Microbiology and Clinic and Outpatient Clinic for Dermatology and Allergology am Biederstein, Technical University of Munich, Munich, Germany
| | - Jens-Oliver Steiß
- Centre for Pediatric and Adolescent Medicine, University Hospital Gießen and Marburg GmbH, Gießen, Germany
- Specialist Practice for Allergology and Pediatric Pneumology, Fulda, Germany
| | - Regine Szewszyk
- FG (specialist field) II 1.4 Microbiological Risks, Federal Environmental Agency, Berlin, Germany
| | - Peter Thomas
- Department and Outpatient Clinic for Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany
| | - Kerttu Valtanen
- FG (specialist field) II 1.4 Microbiological Risks, Federal Environmental Agency, Berlin, Germany
| | - Julia Hurraß
- Department of Infection Control and Environmental Hygiene, Cologne Health Authority, Neumarkt 15–21, 50667 Cologne, Germany
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Grey CNB, Jiang S, Nascimento C, Rodgers SE, Johnson R, Lyons RA, Poortinga W. The short-term health and psychosocial impacts of domestic energy efficiency investments in low-income areas: a controlled before and after study. BMC Public Health 2017; 17:140. [PMID: 28143612 PMCID: PMC5282634 DOI: 10.1186/s12889-017-4075-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 01/26/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research suggests that living in fuel poverty and cold homes contributes to poor physical and mental health, and that interventions targeted at those living in poor quality housing may lead to health improvements. However, little is known about the socio-economic intermediaries and processes that contribute to better health. This study examined the relationship between energy efficiency investments to homes in low-income areas and mental and physical health of residents, as well as a number of psychosocial outcomes likely to be part of the complex relationship between energy efficiency measures and health outcomes. METHODS A quasi-experimental field study with a controlled pretest-posttest design was conducted (intervention n = 364; control n = 418) to investigate the short-term health and psychosocial impacts of a domestic energy efficiency programme that took place across Wales between 2013 and 2015. Survey data were collected in the winters before and after installation of energy efficiency measures, including external wall insulation. The study used a multilevel modelling repeated measures approach to analyse the data. RESULTS The energy efficiency programme was not associated with improvements in physical and mental health (using the SF-12v2 physical and mental health composite scales) or reductions in self-reported respiratory and asthma symptoms. However, the programme was associated with improved subjective wellbeing (B = 0.38, 95% CI 0.12 to 0.65), as well as improvements in a number of psychosocial outcomes, including increased thermal satisfaction (OR = 3.83, 95% CI 2.40 to 5.90), reduced reports of putting up with feeling cold to save heating costs (OR = 0.49, CI = 0.25 to 0.94), fewer financial difficulties (B = -0.15, 95% CI -0.25 to -0.05), and reduced social isolation (OR = 0.32, 95% CI 0.13 to 0.77). CONCLUSION The study showed that investing in energy efficiency in low-income communities does not lead to self-reported health improvements in the short term. However, investments increased subjective wellbeing and were linked to a number of psychosocial intermediaries that are conducive to better health. It is likely that better living conditions contribute to improvements in health outcomes in the longer term. Better understanding of the impacts on recipients of energy efficiency schemes, could improve targeting of future fuel poverty policies.
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Affiliation(s)
- Charlotte N B Grey
- Welsh School of Architecture, Cardiff University, Bute Building, King Edward VII Avenue, Cardiff, CF10 3NB, Wales, UK
| | - Shiyu Jiang
- Welsh School of Architecture, Cardiff University, Bute Building, King Edward VII Avenue, Cardiff, CF10 3NB, Wales, UK
| | - Christina Nascimento
- School of Social Sciences, Cardiff University, Glamorgan Building, King Edward VII Avenue, Cardiff, CF10 3WT, UK
| | - Sarah E Rodgers
- Farr Institute, Swansea University Medical School, Swansea University, Singleton Park, Swansea, SA2 8PP, Wales, UK
| | - Rhodri Johnson
- Farr Institute, Swansea University Medical School, Swansea University, Singleton Park, Swansea, SA2 8PP, Wales, UK
| | - Ronan A Lyons
- Farr Institute, Swansea University Medical School, Swansea University, Singleton Park, Swansea, SA2 8PP, Wales, UK
| | - Wouter Poortinga
- Welsh School of Architecture, Cardiff University, Bute Building, King Edward VII Avenue, Cardiff, CF10 3NB, Wales, UK.
- School of Psychology, Cardiff University, 70 Park Place, Cardiff, CF10 3AT, Wales, UK.
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137
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Daschner A. An Evolutionary-Based Framework for Analyzing Mold and Dampness-Associated Symptoms in DMHS. Front Immunol 2017; 7:672. [PMID: 28119688 PMCID: PMC5220099 DOI: 10.3389/fimmu.2016.00672] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 12/20/2016] [Indexed: 01/20/2023] Open
Abstract
Among potential environmental harmful factors, fungi deserve special consideration. Their intrinsic ability to actively germinate or infect host tissues might determine a prominent trigger in host defense mechanisms. With the appearance of fungi in evolutionary history, other organisms had to evolve strategies to recognize and cope with them. Existing controversies around dampness and mold hypersensitivity syndrome (DMHS) can be due to the great variability of clinical symptoms but also of possible eliciting factors associated with mold and dampness. An hypothesis is presented, where an evolutionary analysis of the different response patterns seen in DMHS is able to explain the existing variability of disease patterns. Classical interpretation of immune responses and symptoms are addressed within the field of pathophysiology. The presented evolutionary analysis seeks for the ultimate causes of the vast array of symptoms in DMHS. Symptoms can be interpreted as induced by direct (toxic) actions of spores, mycotoxins, or other fungal metabolites, or on the other side by the host-initiated response, which aims to counterbalance and fight off potentially deleterious effects or fungal infection. Further, individual susceptibility of immune reactions can confer an exaggerated response, and magnified symptoms are then explained in terms of immunopathology. IgE-mediated allergy fits well in this scenario, where individuals with an atopic predisposition suffer from an exaggerated response to mold exposure, but studies addressing why such responses have evolved and if they could be advantageous are scarce. Human history is plenty of plagues and diseases connected with mold exposure, which could explain vulnerability to mold allergy. Likewise, multiorgan symptoms in DMHS are analyzed for its possible adaptive role not only in the defense of an active infection, but also as evolved mechanisms for avoidance of potentially harmful environments in an evolutionary past or present setting.
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Affiliation(s)
- Alvaro Daschner
- Instituto de Investigación Sanitaria, Hospital Universitario de la Princesa, Servicio de Alergia, Madrid, Spain
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138
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Korpelainen H, Pietiläinen M. Diversity of indoor fungi as revealed by DNA metabarcoding. Genome 2017; 60:55-64. [DOI: 10.1139/gen-2015-0191] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
In the present study, we conducted DNA metabarcoding (the nuclear ITS2 region) for indoor fungal samples originating from two nursery schools with a suspected mould problem (sampling before and after renovation), from two university buildings, and from an old farmhouse. Good-quality sequences were obtained, and the results showed that DNA metabarcoding provides high resolution in fungal identification. The pooled proportions of sequences representing filamentous ascomycetes, filamentous basidiomycetes, yeasts, and other fungi equalled 62.3%, 8.0%, 28.3%, and 1.4%, respectively, and the total number of fungal genera found during the study was 585. When comparing fungal diversities and taxonomic composition between different types of buildings, no obvious pattern was detected. The average pairwise values of SørensenChao indices that were used to compare similarities for taxon composition between samples among the samples from the two university buildings, two nurseries, and farmhouse equaled 0.693, 0.736, 0.852, 0.928, and 0.981, respectively, while the mean similarity index for all samples was 0.864. We discovered that making explicit conclusions on the relationship between the indoor air quality and mycoflora is complicated by the lack of appropriate indicators for air quality and by the occurrence of wide spatial and temporal changes in diversity and compositions among samples.
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Affiliation(s)
- Helena Korpelainen
- Department of Agricultural Sciences, P.O. Box 27 (Latokartanonkaari 5), FI-00014 University of Helsinki, Finland
- Department of Agricultural Sciences, P.O. Box 27 (Latokartanonkaari 5), FI-00014 University of Helsinki, Finland
| | - Maria Pietiläinen
- Department of Agricultural Sciences, P.O. Box 27 (Latokartanonkaari 5), FI-00014 University of Helsinki, Finland
- Department of Agricultural Sciences, P.O. Box 27 (Latokartanonkaari 5), FI-00014 University of Helsinki, Finland
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139
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Tin Tin S, Woodward A, Saraf R, Berry S, Atatoa Carr P, Morton SMB, Grant CC. Internal living environment and respiratory disease in children: findings from the Growing Up in New Zealand longitudinal child cohort study. Environ Health 2016; 15:120. [PMID: 27931228 PMCID: PMC5146862 DOI: 10.1186/s12940-016-0207-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 12/05/2016] [Indexed: 05/08/2023]
Abstract
BACKGROUND The incidence of early childhood acute respiratory infections (ARIs) has been associated with aspects of the indoor environment. In recent years, public awareness about some of these environmental issues has increased, including new laws and subsequent changes in occupant behaviours. This New Zealand study investigated current exposures to specific risk factors in the home during the first five years of life and provided updated evidence on the links between the home environment and childhood ARI hospitalisation. METHODS Pregnant women (n = 6822) were recruited in 2009 and 2010, and their 6853 children created a child cohort that was representative of New Zealand births from 2007-10. Longitudinal data were collected through face-to-face interviews and linkage to routinely collected national datasets. Incidence rates with Poisson distribution confidence intervals were computed and Cox regression modelling for repeated events was performed. RESULTS Living in a rented dwelling (48%), household crowding (22%) or dampness (20%); and, in the child's room, heavy condensation (20%) or mould or mildew on walls or ceilings (13%) were prevalent. In 14% of the households, the mother smoked cigarettes and in 30%, other household members smoked. Electric heaters were commonly used, followed by wood, flued gas and unflued portable gas heaters. The incidence of ARI hospitalisation before age five years was 33/1000 person-years. The risk of ARI hospitalisation was higher for children living in households where there was a gas heater in the child's bedroom: hazard ratio for flued gas heater 1.69 (95% CI: 1.21-2.36); and for unflued gas heater 1.68 (95% CI: 1.12-2.53); and where a gas heater was the sole type of household heating (hazard ratio: 1.64 (95% CI: 1.29-2.09)). The risk was reduced in households that used electric heaters (Hazard ratio: 0.74 (95% CI: 0.61-0.89)) or wood burners (hazard ratio: 0.79 (95% CI: 0.66-0.93)) as a form of household heating. The associations with other risk factors were not significant. CONCLUSIONS The risk of early childhood ARI hospitalisation is increased by gas heater usage, specifically in the child's bedroom. Use of non-gas forms of heating may reduce the risk of early childhood ARI hospitalisation.
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Affiliation(s)
- Sandar Tin Tin
- Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
| | - Alistair Woodward
- Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
| | - Rajneeta Saraf
- Centre for Longitudinal Research - He Ara ki Mua and Growing Up in New Zealand, University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
| | - Sarah Berry
- Centre for Longitudinal Research - He Ara ki Mua and Growing Up in New Zealand, University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
| | - Polly Atatoa Carr
- National Institute of Demographic and Economic Analysis, University of Waikato and Waikato District Health Board, Hamilton, New Zealand
| | - Susan M. B. Morton
- Centre for Longitudinal Research - He Ara ki Mua and Growing Up in New Zealand, University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
| | - Cameron C. Grant
- Centre for Longitudinal Research - He Ara ki Mua and Growing Up in New Zealand, University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
- Department of Paediatrics: Child and Youth Health, University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
- Starship Children’s Hospital, Auckland District Health Board, Auckland, New Zealand
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Hurraß J, Heinzow B, Aurbach U, Bergmann KC, Bufe A, Buzina W, Cornely OA, Engelhart S, Fischer G, Gabrio T, Heinz W, Herr CEW, Kleine-Tebbe J, Klimek L, Köberle M, Lichtnecker H, Lob-Corzilius T, Merget R, Mülleneisen N, Nowak D, Rabe U, Raulf M, Seidl HP, Steiß JO, Szewszyk R, Thomas P, Valtanen K, Wiesmüller GA. Medical diagnostics for indoor mold exposure. Int J Hyg Environ Health 2016; 220:305-328. [PMID: 27986496 DOI: 10.1016/j.ijheh.2016.11.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 11/29/2016] [Indexed: 01/24/2023]
Abstract
In April 2016, the German Society of Hygiene, Environmental Medicine and Preventative Medicine (Gesellschaft für Hygiene, Umweltmedizin und Präventivmedizin (GHUP)) together with other scientific medical societies, German and Austrian medical societies, physician unions and experts has provided an AWMF (Association of the Scientific Medical Societies) guideline 'Medical diagnostics for indoor mold exposure'. This guideline shall help physicians to advise and treat patients exposed indoors to mold. Indoor mold growth is a potential health risk, even without a quantitative and/or causal association between the occurrence of individual mold species and health effects. Apart from the allergic bronchopulmonary aspergillosis (ABPA) and the mycoses caused by mold, there is only sufficient evidence for the following associations between moisture/mold damages and different health effects: Allergic respiratory diseases, asthma (manifestation, progression, exacerbation), allergic rhinitis, exogenous allergic alveolitis and respiratory tract infections/bronchitis. In comparison to other environmental allergens, the sensitizing potential of molds is estimated to be low. Recent studies show a prevalence of sensitization of 3-10% in the total population of Europe. The evidence for associations to mucous membrane irritation and atopic eczema (manifestation, progression, exacerbation) is classified as limited or suspected. Inadequate or insufficient evidence for an association is given for COPD, acute idiopathic pulmonary hemorrhage in children, rheumatism/arthritis, sarcoidosis, and cancer. The risk of infections from indoor molds is low for healthy individuals. Only molds that are capable to form toxins can cause intoxications. The environmental and growth conditions and especially the substrate determine whether toxin formation occurs, but indoor air concentrations are always very low. In the case of indoor moisture/mold damages, everyone can be affected by odor effects and/or impairment of well-being. Predisposing factors for odor effects can be given by genetic and hormonal influences, imprinting, context and adaptation effects. Predisposing factors for impairment of well-being are environmental concerns, anxieties, conditioning and attributions as well as a variety of diseases. Risk groups that must be protected are patients with immunosuppression and with mucoviscidosis (cystic fibrosis) with regard to infections and individuals with mucoviscidosis and asthma with regard to allergies. If an association between mold exposure and health effects is suspected, the medical diagnosis includes medical history, physical examination, conventional allergy diagnosis, and if indicated, provocation tests. For the treatment of mold infections, it is referred to the AWMF guidelines for diagnosis and treatment of invasive Aspergillus infections. Regarding mycotoxins, there are currently no validated test methods that could be used in clinical diagnostics. From the perspective of preventive medicine, it is important that mold damages cannot be tolerated in indoor environments.
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Affiliation(s)
- Julia Hurraß
- Abteilung Infektions- und Umwelthygiene, Gesundheitsamt der Stadt Köln, Germany.
| | - Birger Heinzow
- Formerly: Landesamt für soziale Dienste (LAsD) Schleswig-Holstein, Kiel, Germany
| | - Ute Aurbach
- Abteilung Mikrobiologie und Mykologie, Labor Dr. Wisplinghoff, Köln, Germany
| | | | - Albrecht Bufe
- Experimentelle Pneumologie, Ruhr-Universität Bochum, Germany
| | - Walter Buzina
- Institut für Hygiene, Mikrobiologie und Umweltmedizin, Medizinische Universität Graz, Austria
| | - Oliver A Cornely
- Klinik I für Innere Medizin, ZKS Köln und Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Universität zu Köln, Germany
| | - Steffen Engelhart
- Institut für Hygiene und Öffentliche Gesundheit, Universitätsklinikum Bonn, Germany
| | - Guido Fischer
- Landesgesundheitsamt Baden-Württemberg im Regierungspräsidium Stuttgart, Germany
| | - Thomas Gabrio
- Formerly: Landesgesundheitsamt Baden-Württemberg im Regierungspräsidium Stuttgart, Germany
| | - Werner Heinz
- Medizinische Klinik und Poliklinik II, Schwerpunkt Infektiologie, Universitätsklinikum Würzburg, Germany
| | - Caroline E W Herr
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, München, Germany; Ludwig-Maximilians-Universität München, apl. Prof. "Hygiene und Umweltmedizin", Germany
| | | | - Ludger Klimek
- Zentrums für Rhinologie und Allergologie, Wiesbaden, Germany
| | - Martin Köberle
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technische Universität München, Germany
| | | | | | - Rolf Merget
- Institut für Prävention und Arbeitsmedizin der Deutschen Gesetzlichen Unfallversicherung, Institut der Ruhr-Universität Bochum (IPA), Germany
| | | | - Dennis Nowak
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Mitglied Deutsches Zentrum für Lungenforschung, Klinikum der Universität München, Germany
| | - Uta Rabe
- Zentrum für Allergologie und Asthma, Johanniter-Krankenhaus im Fläming Treuenbrietzen GmbH, Treuenbrietzen, Germany
| | - Monika Raulf
- Institut für Prävention und Arbeitsmedizin der Deutschen Gesetzlichen Unfallversicherung, Institut der Ruhr-Universität Bochum (IPA), Germany
| | - Hans Peter Seidl
- Formerly: Lehrstuhl für Mikrobiologie sowie Dermatologische Klinik der Technischen Universität München, Germany
| | - Jens-Oliver Steiß
- Zentrum für Kinderheilkunde und Jugendmedizin, Universitätsklinikum Gießen und Marburg GmbH, Gießen, Germany
| | - Regine Szewszyk
- Umweltbundesamt, FG II 1.4 Mikrobiologische Risiken, Berlin, Germany
| | - Peter Thomas
- Klinik und Poliklinik für Dermatologie und Allergologie der Ludwig-Maximilians-Universität München, Germany
| | - Kerttu Valtanen
- Umweltbundesamt, FG II 1.4 Mikrobiologische Risiken, Berlin, Germany
| | - Gerhard A Wiesmüller
- Abteilung Infektions- und Umwelthygiene, Gesundheitsamt der Stadt Köln, Germany; Institut für Arbeitsmedizin und Sozialmedizin, Medizinische Fakultät der RWTH Aachen, Germany
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141
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Holst GJ, Høst A, Doekes G, Meyer HW, Madsen AM, Plesner KB, Sigsgaard T. Allergy and respiratory health effects of dampness and dampness-related agents in schools and homes: a cross-sectional study in Danish pupils. INDOOR AIR 2016; 26:880-891. [PMID: 26643593 DOI: 10.1111/ina.12275] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 11/24/2015] [Indexed: 05/16/2023]
Affiliation(s)
- G. J. Holst
- Section of Environment, Occupation and Health; Aarhus University; Aarhus C Denmark
| | - A. Høst
- H.C. Andersen Children's Hospital; Odense University Hospital; Odense Denmark
| | - G. Doekes
- Institute for Risk Assessment Sciences; Utrecht University; Utrecht The Netherlands
| | - H. W. Meyer
- Department of Occupational and Environmental Medicine; Copenhagen University Hospital; Bispebjerg Denmark
| | - A. M. Madsen
- National Research Centre for the Working Environment; Copenhagen Denmark
| | - K. B. Plesner
- Department of Anaesthesiology and Intensive Care; Odense University Hospital; Odense Denmark
| | - T. Sigsgaard
- Section of Environment, Occupation and Health; Aarhus University; Aarhus C Denmark
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142
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Development of a Dot-Blot Assay for the Detection of Mould-Specific IgE in the Belgian Population. Mycopathologia 2016; 182:319-329. [DOI: 10.1007/s11046-016-0091-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 11/08/2016] [Indexed: 10/20/2022]
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143
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Lanthier-Veilleux M, Baron G, Généreux M. Respiratory Diseases in University Students Associated with Exposure to Residential Dampness or Mold. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13111154. [PMID: 27869727 PMCID: PMC5129364 DOI: 10.3390/ijerph13111154] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 11/08/2016] [Accepted: 11/15/2016] [Indexed: 11/20/2022]
Abstract
University students are frequently exposed to residential dampness or mold (i.e., visible mold, mold odor, dampness, or water leaks), a well-known contributor to asthma, allergic rhinitis, and respiratory infections. This study aims to: (a) describe the prevalence of these respiratory diseases among university students; and (b) examine the independent contribution of residential dampness or mold to these diseases. An online survey was conducted in March 2014 among the 26,676 students registered at the Université de Sherbrooke (Quebec, Canada). Validated questions and scores were used to assess self-reported respiratory diseases (i.e., asthma-like symptoms, allergic rhinitis, and respiratory infections), residential dampness or mold, and covariates (e.g., student characteristics). Using logistic regressions, the crude and adjusted odd ratios between residential dampness or mold and self-reported respiratory diseases were examined. Results from the participating students (n = 2097; response rate: 8.1%) showed high prevalence of allergic rhinitis (32.6%; 95% CI: 30.6–34.7), asthma-like symptoms (24.0%; 95% CI: 22.1–25.8) and respiratory infections (19.4%; 95% CI: 17.7–21.2). After adjustment, exposure to residential dampness or mold was associated with allergic rhinitis (OR: 1.25; 95% CI: 1.01–1.55) and asthma-like symptoms (OR: 1.70; 95% CI: 1.37–2.11), but not with respiratory infections (OR: 1.07; 95% CI: 0.85–1.36). Among symptomatic students, this exposure was also associated with uncontrolled and burdensome respiratory symptoms (p < 0.01). University students report a high prevalence of allergic rhinitis, asthma-like symptoms and respiratory infections. A common indoor hazard, residential dampness or mold, may play a role in increasing atopic respiratory diseases and their suboptimal control in young adults. These results emphasize the importance for public health organizations to tackle poor housing conditions, especially amongst university students who should be considered “at-risk”.
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Affiliation(s)
- Mathieu Lanthier-Veilleux
- Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada.
| | - Geneviève Baron
- Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada.
- Public Health Department of Eastern Townships, 300 King East, Sherbrooke, QC J1G 1B1, Canada.
| | - Mélissa Généreux
- Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada.
- Public Health Department of Eastern Townships, 300 King East, Sherbrooke, QC J1G 1B1, Canada.
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Condensation Risk Due to Variations in Airtightness and Thermal Insulation of an Office Building in Warm and Wet Climate. ENERGIES 2016. [DOI: 10.3390/en9110875] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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145
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Wåhlén K, Fornander L, Olausson P, Ydreborg K, Flodin U, Graff P, Lindahl M, Ghafouri B. Protein profiles of nasal lavage fluid from individuals with work-related upper airway symptoms associated with moldy and damp buildings. INDOOR AIR 2016; 26:743-754. [PMID: 26451694 DOI: 10.1111/ina.12257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 10/03/2015] [Indexed: 06/05/2023]
Abstract
Upper airway irritation is common among individuals working in moldy and damp buildings. The aim of this study was to investigate effects on the protein composition of the nasal lining fluid. The prevalence of symptoms in relation to work environment was examined in 37 individuals working in two damp buildings. Microbial growth was confirmed in one of the buildings. Nasal lavage fluid was collected from 29 of the exposed subjects and 13 controls, not working in a damp building. Protein profiles were investigated with a proteomic approach and evaluated by multivariate statistical models. Subjects from both workplaces reported upper airway and ocular symptoms. Based on protein profiles, symptomatic subjects in the two workplaces were discriminated from each other and separated from healthy controls. The groups differed in proteins involved in inflammation and host defense. Measurements of innate immunity proteins showed a significant increase in protein S100-A8 and decrease in SPLUNC1 in subjects from one workplace, while alpha-1-antitrypsin was elevated in subjects from the other workplace, compared with healthy controls. The results show that protein profiles in nasal lavage fluid can be used to monitor airway mucosal effects in personnel working in damp buildings and indicate that the profile may be separated when the dampness is associated with the presence of molds.
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Affiliation(s)
- K Wåhlén
- Division of Community Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Pain and Rehabilitation Center, Anaesthetics, Operations and Speciality Surgery Center, Region Östergötland, Linkoping, Sweden
| | - L Fornander
- Occupational and Environmental Medicine, Div of Neuro and Inflammation Science, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - P Olausson
- Division of Community Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Pain and Rehabilitation Center, Anaesthetics, Operations and Speciality Surgery Center, Region Östergötland, Linkoping, Sweden
| | - K Ydreborg
- Clinic of Otorhinolaryngology, County Hospital Ryhov, Jönköping, Sweden
| | - U Flodin
- Division of Neuro and Inflammation Science, Department of Clinical and Experimental Medicine, Linköping University, Occupational and Environmental Medicine Center, Heart and Medicine Center, Region Östergötland, Linkoping, Sweden
| | - P Graff
- Department of Occupational and Environmental Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - M Lindahl
- Occupational and Environmental Medicine, Div of Neuro and Inflammation Science, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - B Ghafouri
- Division of Community Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Pain and Rehabilitation Center, Anaesthetics, Operations and Speciality Surgery Center, Region Östergötland, Linkoping, Sweden.
- Division of Neuro and Inflammation Science, Department of Clinical and Experimental Medicine, Linköping University, Occupational and Environmental Medicine Center, Heart and Medicine Center, Region Östergötland, Linkoping, Sweden.
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146
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Lewinska AM, Hoof JB, Peuhkuri RH, Rode C, Lilje O, Foley M, Trimby P, Andersen B. Visualization of the structural changes in plywood and gypsum board during the growth of Chaetomium globosum and Stachybotrys chartarum. J Microbiol Methods 2016; 129:28-38. [PMID: 27476483 DOI: 10.1016/j.mimet.2016.07.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 07/26/2016] [Accepted: 07/26/2016] [Indexed: 11/28/2022]
Abstract
Fungal growth in indoor environments is associated with many negative health effects. Many studies focus on brown- and white-rot fungi and their effect on wood, but there is none that reveals the influence of soft-rot fungi, such as Stachybotrys spp. and Chaetomium spp., on the structure of building materials such as plywood and gypsum wallboard. This study focuses on using micro-computed tomography (microCT) to investigate changes of the structure of plywood and gypsum wallboard during fungal degradation by S. chartarum and C. globosum. Changes in the materials as a result of dampness and fungal growth were determined by measuring porosity and pore shape via microCT. The results show that the composition of the building material influenced the level of penetration by fungi as shown by scanning electron microscopy (SEM). Plywood appeared to be the most affected, with the penetration of moisture and fungi throughout the whole thickness of the sample. Conversely, fungi grew only on the top cardboard in the gypsum wallboard and they did not have significant influence on the gypsum wallboard structure. The majority of the observed changes in gypsum wallboard occurred due to moisture. This paper suggests that the mycelium distribution within building materials and the structural changes, caused by dampness and fungal growth, depend on the type of the material.
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Affiliation(s)
- Anna M Lewinska
- Department of Bioengineering and Biomedicine, Technical University of Denmark, Kgs. Lyngby, Denmark.
| | - Jakob B Hoof
- Department of Bioengineering and Biomedicine, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Ruut H Peuhkuri
- Danish Building Research Institute, Aalborg University, København SV, Denmark
| | - Carsten Rode
- Department of Civil Engineering, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Osu Lilje
- School of Life and Environmental Sciences, University of Sydney, Sydney, Australia
| | - Matthew Foley
- Australian Center for Microscopy and Microanalysis, University of Sydney, Sydney, Australia
| | - Patrick Trimby
- Australian Center for Microscopy and Microanalysis, University of Sydney, Sydney, Australia
| | - Birgitte Andersen
- Department of Bioengineering and Biomedicine, Technical University of Denmark, Kgs. Lyngby, Denmark
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147
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Cornwell EY. Household Disorder, Network Ties, and Social Support in Later Life. JOURNAL OF MARRIAGE AND THE FAMILY 2016; 78:871-889. [PMID: 27524834 PMCID: PMC4979606 DOI: 10.1111/jomf.12299] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Family relationships, social interactions, and exchanges of support often revolve around the household context, but scholars rarely consider the social relevance of this physical space. In this article the author considers social causes and consequences of household disorder in the dwellings of older adults. Drawing from research on neighborhood disorder and social connectedness in later life, she describes how network characteristics may contribute to household disorder and how household disorder may weaken relationships and reduce access to support. This is explored empirically by estimating cross-lagged panel models with data from 2 waves of the National Social Life, Health, and Aging Project. The results reveal that household disorder reflects a lack of social support, and it leads to more kin-centered networks and more strain within family relationships. The author concludes by urging greater attention to how the household context shapes-and is shaped by-the social interactions and processes that occur within it.
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Affiliation(s)
- Erin York Cornwell
- Department of Sociology, Cornell University, 364 Uris Hall, Ithaca, NY 14853
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148
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Cox-Ganser JM. Indoor dampness and mould health effects - ongoing questions on microbial exposures and allergic versus nonallergic mechanisms. Clin Exp Allergy 2016; 45:1478-82. [PMID: 26372722 DOI: 10.1111/cea.12601] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J M Cox-Ganser
- Division of Respiratory Disease Studies, National Institute for Occupational Health, Morgantown, WV, USA
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149
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Castro-Rodriguez JA, Forno E, Rodriguez-Martinez CE, Celedón JC. Risk and Protective Factors for Childhood Asthma: What Is the Evidence? THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2016; 4:1111-1122. [PMID: 27286779 DOI: 10.1016/j.jaip.2016.05.003] [Citation(s) in RCA: 161] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 05/03/2016] [Accepted: 05/06/2016] [Indexed: 01/08/2023]
Abstract
To summarize the principal findings on risk and protective factors for childhood asthma, we retrieved systematic reviews on these topics in children (aged 1 to 18 years), up to January 2016, through MEDLINE, EMBASE, CINAHL, SCOPUS, and CDSR. A total of 227 studies were searched from databases. Among those, 41 systematic reviews (SRs) were included: 9 focused on prenatal factors, 5 on perinatal factors, and 27 on postnatal factors. Of these 41 SRs, 83% had good methodological quality, as determined by the Assess Systematic Reviews tool. After reviewing all evidence, parental asthma, prenatal environmental tobacco smoke, and prematurity (particularly very preterm birth) are well-established risk factors for childhood asthma. Current findings do suggest mild-to-moderate causal effects of certain modifiable behaviors or exposures during pregnancy (maternal weight gain or obesity, maternal use of antibiotics or paracetamol, and maternal stress), the perinatal period (birth by Caesarean delivery), or postnatal life (severe respiratory syncytial virus infection, overweight or obesity, indoor exposure to mold or fungi, and outdoor air pollution) on childhood asthma, but this suggestive evidence must be confirmed in interventional studies or (if interventions are not feasible) well-designed prospective studies.
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Affiliation(s)
- Jose A Castro-Rodriguez
- Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
| | - Erick Forno
- Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa
| | - Carlos E Rodriguez-Martinez
- Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia; Department of Pediatric Pulmonology and Pediatric Critical Care Medicine, School of Medicine, Universidad El Bosque, Bogotá, Colombia; Research Unit, Military Hospital of Colombia, Bogotá, Colombia
| | - Juan C Celedón
- Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa
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150
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Al horr Y, Arif M, Katafygiotou M, Mazroei A, Kaushik A, Elsarrag E. Impact of indoor environmental quality on occupant well-being and comfort: A review of the literature. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.ijsbe.2016.03.006] [Citation(s) in RCA: 311] [Impact Index Per Article: 38.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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