1
|
Lee S, Ryu SH, Sul WJ, Kim S, Kim D, Seo S. Association of exposure to indoor molds and dampness with allergic diseases at water-damaged dwellings in Korea. Sci Rep 2024; 14:135. [PMID: 38167981 PMCID: PMC10762174 DOI: 10.1038/s41598-023-50226-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024] Open
Abstract
This study aims to characterize levels of molds, bacteria, and environmental pollutants, identify the associations between indoor mold and dampness exposures and childhood allergic diseases, including asthma, allergic rhinitis, atopic dermatitis, using three different exposure assessment tools. A total of 50 children with their parents who registered in Seoul and Gyeonggi-do in Korea participated in this study. We collated the information on demographic and housing characteristics, environmental conditions, and lifestyle factors using the Korean version of the International Study of Asthma and Allergies in Childhood questionnaire. We also collected environmental monitoring samples of airborne molds and bacteria, total volatile organic compounds, formaldehyde, and particulate matter less than 10 µm. We evaluated and determined water damage, hidden dampness, and mold growth in dwellings using an infrared (IR) thermal camera and field inspection. Univariate and multivariate regression analyses were performed to evaluate the associations between prevalent allergic diseases and exposure to indoor mold and dampness. Indoor mold and bacterial levels were related to the presence of water damage in dwellings, and the mean levels of indoor molds (93.4 ± 73.5 CFU/m3) and bacteria (221.5 ± 124.2 CFU/m3) in water-damaged homes were significantly higher than those for molds (82.0 ± 58.7 CFU/m3) and for bacteria (152.7 ± 82.1 CFU/m3) in non-damaged dwellings (p < 0.05). The crude odds ratios (ORs) of atopic dermatitis were associated with < 6th floor (OR = 3.80), and higher indoor mold (OR = 6.42) and bacterial levels (OR = 6.00). The crude ORs of allergic diseases, defined as a group of cases who ever suffered from two out of three allergic diseases, e.g., asthma and allergic rhinitis, and allergic rhinitis were also increased by 3.8 and 9.3 times as large, respectively, with water damage (+) determined by IR camera (p < 0.05). The adjusted OR of allergic rhinitis was significantly elevated by 10.4 times in the water-damaged dwellings after adjusting age, sex, and secondhand smoke. Therefore, a longitudinal study is needed to characterize dominant mold species using DNA/RNA-based sequencing techniques and identify a causal relationship between mold exposure and allergic diseases in the future.
Collapse
Affiliation(s)
- Seokwon Lee
- Environmental Health Research Department, National Institute of Environmental Research, Incheon, 22689, Republic of Korea
| | - Seung-Hun Ryu
- Environmental Health Research Department, National Institute of Environmental Research, Incheon, 22689, Republic of Korea
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea
| | - Woo Jun Sul
- Department of Systems Biotechnology, College of Biotechnology and Natural Resources, Chung-Ang University, Anseong, Gyeonggi-do, 17546, Republic of Korea
| | - Seunghyun Kim
- Allergy Immunology Center, College of Medicine, Korea University, Seoul, 02841, Republic of Korea
| | - Dohyeong Kim
- School of Economic, Political and Policy Sciences, University of Texas at Dallas, Richardson, TX, 75080-3021, USA
| | - SungChul Seo
- Department of Nano, Chemical and Biological Engineering, College of Engineering, Seokyeong University, Seoul, 02173, Republic of Korea.
| |
Collapse
|
2
|
Groot J, Nielsen ET, Nielsen TF, Andersen PK, Pedersen M, Sigsgaard T, Loft S, Nybo Andersen AM, Keller A. Exposure to residential mold and dampness and the associations with respiratory tract infections and symptoms thereof in children in high income countries: A systematic review and meta-analyses of epidemiological studies. Paediatr Respir Rev 2023; 48:47-64. [PMID: 37482434 DOI: 10.1016/j.prrv.2023.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/08/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Multiple reviews have been conducted on the associations between residential mold and dampness and respiratory outcomes in children, with few specifically investigating respiratory tract infections (RTIs). OBJECTIVE We aimed to review and synthesize the available epidemiological literature on mold and dampness and risk of RTIs and respiratory symptoms compatible with RTIs in children living in high-income countries. METHOD We performed a systematic search of literature available from MEDLINE, Embase, and Web of Science for observational studies. We conducted meta-analyses using two-level random effects (RE) and multi-level random effects (ML) models for contrasts of three exposure and three outcome categories, including multiple estimates reported by single studies. We report central estimates for pooled odds ratios (OR) and 95 % confidence intervals (CI).We conducted a risk of bias assessment using the Joanna Briggs Initiative (JBI) checklists for cross-sectional, case-control, and cohort studies. We additionally report on cumulative meta-analyses, leave-one-out analyses of single estimates, subgroup analyses by study quality and study design and inclusion of all effect estimates. RESULTS Of the 932 studies initially screened by title and abstract, we included 30 studies with 267 effect estimates that met the inclusion criteria. Most were cross-sectional (n = 22), with fewer cohort (n = 5) and case-control (n = 3) studies. Most of the studies were according to the bias assessment of poor or fair quality (n = 24). The main meta-analyses generally provided similar results regardless of statistical model and central estimates ranged from OR 1.28 (95 % CI; 1.08, 1.53) for dampness and RTIs to OR 1.76 (95 % CI; 1.64, 1.88) for mold and respiratory symptoms. Most analyses were of moderate heterogeneity. Funnel plots did not indicate strong publication bias. CONCLUSION Our results are compatible with a weak to moderate effect of residential mold and or dampness on risk of RTIs in children in high-income countries. However, these results are based primarily on cross-sectional studies.
Collapse
Affiliation(s)
- Jonathan Groot
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Emilie Tange Nielsen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Trine Fuhr Nielsen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Per Kragh Andersen
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Marie Pedersen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Torben Sigsgaard
- Environment, Work and Health, Department of Public Health, University of Aarhus, Aarhus, Denmark
| | - Steffen Loft
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anne-Marie Nybo Andersen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Amélie Keller
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
3
|
Biagioni B, Cecchi L, D'Amato G, Annesi-Maesano I. Environmental influences on childhood asthma: Climate change. Pediatr Allergy Immunol 2023; 34:e13961. [PMID: 37232282 DOI: 10.1111/pai.13961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 05/03/2023] [Indexed: 05/27/2023]
Abstract
Climate change is a key environmental factor for allergic respiratory diseases, especially in childhood. This review describes the influences of climate change on childhood asthma considering the factors acting directly, indirectly and with their amplifying interactions. Recent findings on the direct effects of temperature and weather changes, as well as the influences of climate change on air pollution, allergens, biocontaminants and their interplays, are discussed herein. The review also focusses on the impact of climate change on biodiversity loss and on migration status as a model to study environmental effects on childhood asthma onset and progression. Adaptation and mitigation strategies are urgently needed to prevent further respiratory diseases and human health damage in general, especially in younger and future generations.
Collapse
Affiliation(s)
- Benedetta Biagioni
- Allergy and Clinical Immunology Unit, San Giovanni di Dio Hospital, Florence, Italy
| | - Lorenzo Cecchi
- Centre of Bioclimatology, University of Florence, Florence, Italy
- SOS Allergy and Clinical Immunology, USL Toscana Centro, Prato, Italy
| | - Gennaro D'Amato
- Division of Respiratory Diseases and Allergy AORN Cardarelli and University of Naples, Federico II, Naples, Italy
| | - Isabella Annesi-Maesano
- Department of Allergic and Respiratory Diseases, Montpellier University Hospital, Institute Desbrest of Epidemiology and Public Health, University of Montpellier and INSERM, Montpellier, France
| |
Collapse
|
4
|
Rodríguez-Vidal I, Martín-Garín A, González-Quintial F, Rico-Martínez JM, Hernández-Minguillón RJ, Otaegi J. Response to the COVID-19 Pandemic in Classrooms at the University of the Basque Country through a User-Informed Natural Ventilation Demonstrator. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14560. [PMID: 36361439 PMCID: PMC9658559 DOI: 10.3390/ijerph192114560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/30/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic has generated a renewed interest in indoor air quality to limit viral spread. In the case of educational spaces, due to the high concentration of people and the fact that most of the existing buildings do not have any mechanical ventilation system, the different administrations have established natural ventilation protocols to guarantee an air quality that reduces risk of contagion by the SARS-CoV-2 virus after the return to the classrooms. Many of the initial protocols established a ventilation pattern that opted for continuous or intermittent ventilation to varying degrees of intensity. This study, carried out on a university campus in Spain, analyses the performance of natural ventilation activated through the information provided by monitoring and visualisation of real-time data. In order to carry out this analysis, a experiment was set up where a preliminary study of ventilation without providing information to the users was carried out, which was then compared with the result of providing live feedback to the occupants of two classrooms and an administration office in different periods of 2020, 2021 and 2022. In the administration office, a CO2-concentration-based method was applied retrospectively to assess the risk of airborne infection. This experience has served as a basis to establish a route for user-informed improvement of air quality in educational spaces in general through low-cost systems that allow a rational use of natural ventilation while helping maintain an adequate compromise between IAQ, comfort and energy consumption, without having to resort to mechanical ventilation systems.
Collapse
Affiliation(s)
| | | | | | | | | | - Jorge Otaegi
- CAVIAR Research Group, Department of Architecture, University of the Basque Country UPV/EHU, Plaza Oñati, 2, 20018 Donostia-San Sebastián, Spain
| |
Collapse
|
5
|
Mortelliti CL, Banzon TM, Phipatanakul W, Vieira CZ. Environmental Exposures Impact Pediatric Asthma Within the School Environment. Immunol Allergy Clin North Am 2022; 42:743-760. [DOI: 10.1016/j.iac.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
6
|
Kespohl S, Liebers V, Maryska S, Meurer U, Litzenberger C, Merget R, Raulf M. What should be tested in patients with suspected mold exposure? Usefulness of serological markers for the diagnosis. Allergol Select 2022; 6:118-132. [PMID: 35392215 PMCID: PMC8982061 DOI: 10.5414/alx02298e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/11/2022] [Indexed: 11/18/2022] Open
Abstract
The associations of mold exposure, IgE-mediated sensitization, inflammatory markers, and respiratory symptoms were analyzed in 46 exposed and 23 non-exposed individuals. Both exposure and clinical symptoms were assessed by questionnaire. Specific (s)IgE to mold mixture (mx1) was significantly higher and found more frequently in exposed (41%) than non-exposed individuals (17%), which was not observed for sIgG to mold mix (Gmx6). Notably, exposed asthmatics were more frequently sensitized to molds (55%) compared to exposed non-asthmatics (18%). In addition, the serum concentrations of club cell protein (CC16) were significantly lower in exposed subjects, especially in asthmatics. Positive associations were observed among mold sensitization, asthma, and mold exposure, but not in subjects with predominantly environmental sensitizations without mold sensitization. Thus, sIgE to mx1 but not sIgG to Gmx6 is a useful diagnostic marker to verify mold-associated respiratory symptoms.
Collapse
Affiliation(s)
- Sabine Kespohl
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | - Verena Liebers
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | - Silke Maryska
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | - Ursula Meurer
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | - Claudia Litzenberger
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | - Rolf Merget
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | - Monika Raulf
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| |
Collapse
|
7
|
Gray-Ffrench M, Fernandes RM, Sinha IP, Abrams EM. Allergen Management in Children with Type 2-High Asthma. J Asthma Allergy 2022; 15:381-394. [PMID: 35378923 PMCID: PMC8976481 DOI: 10.2147/jaa.s276994] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 03/17/2022] [Indexed: 11/30/2022] Open
Abstract
Children exposed to various indoor and outdoor allergens are placed at an increased risk of developing asthma in later life, with sensitization in these individuals being a strong predictor of disease morbidity. In addition, aeroallergen exposure influences asthma outcomes through an interplay with adverse determinants of health. The goal of this review is to provide an introductory overview of factors related to aeroallergen exposure in type 2-high childhood asthma. These include the relevance of exposure in asthma exacerbations and severity, and the evidence-base for avoidance and treatment for sensitization to these allergens. This review will focus on both indoor aeroallergens (house dust mite, pet, cockroach, mold, and rodent) and outdoor aeroallergens (pollens and molds). Treatment of aeroallergen sensitization in children with asthma includes avoidance and removal measures, although there is limited evidence of clinical benefit especially with single-strategy approaches. We will also address the interplay of aeroallergens and climate change, adverse social determinants, and the current COVID-19 pandemic, when we have seen a dramatic reduction in asthma exacerbations and emergency department visits among children. While there are many factors that are hypothesized to contribute to this reduction, among them is a reduced exposure to outdoor seasonal aeroallergens.
Collapse
Affiliation(s)
| | - Ricardo M Fernandes
- Clinical Pharmacology Unit, Faculty of Medicine and Instituto de Medicina Molecular, Universidade de Lisboa, Lisbon, Portugal
- Department of Pediatrics, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisbon, Portugal
| | - Ian P Sinha
- Alder Hey Children’s Hospital, Liverpool, UK
- Department of Women’s and Children’s Health, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - Elissa M Abrams
- Department of Pediatrics, Section of Allergy and Clinical Immunology, University of Manitoba, Winnipeg, Canada
- Department of Pediatrics, Division of Allergy and Immunology, University of British Columbia, Vancouver, British Columbia, Canada
- Correspondence: Elissa M Abrams, Department of Pediatrics, Section of Allergy and Clinical Immunology, University of Manitoba, FE125-685 William Avenue, Winnipeg, MB, R2A 5L9, Canada, Tel +1 204-255-7650, Fax +1 204-254-0730, Email
| |
Collapse
|
8
|
Adams RI, Leppänen H, Karvonen AM, Jacobs J, Borràs-Santos A, Valkonen M, Krop E, Haverinen-Shaughnessy U, Huttunen K, Zock JP, Hyvärinen A, Heederik D, Pekkanen J, Täubel M. Microbial exposures in moisture-damaged schools and associations with respiratory symptoms in students: A multi-country environmental exposure study. INDOOR AIR 2021; 31:1952-1966. [PMID: 34151461 DOI: 10.1111/ina.12865] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/20/2021] [Accepted: 05/19/2021] [Indexed: 06/13/2023]
Abstract
Moisture-damaged buildings are associated with respiratory symptoms and underlying diseases among building occupants, but the causative agent(s) remain a mystery. We first identified specific fungal and bacterial taxa in classrooms with moisture damage in Finnish and Dutch primary schools. We then investigated associations of the identified moisture damage indicators with respiratory symptoms in more than 2700 students. Finally, we explored whether exposure to specific taxa within the indoor microbiota may explain the association between moisture damage and respiratory health. Schools were assessed for moisture damage through detailed inspections, and the microbial composition of settled dust in electrostatic dustfall collectors was determined using marker-gene analysis. In Finland, there were several positive associations between particular microbial indicators (diversity, richness, individual taxa) and a respiratory symptom score, while in the Netherlands, the associations tended to be mostly inverse and statistically non-significant. In Finland, abundance of the Sphingomonas bacterial genus and endotoxin levels partially explained the associations between moisture damage and symptom score. A few microbial taxa explained part of the associations with health, but overall, the observed associations between damage-associated individual taxa and respiratory health were limited.
Collapse
Affiliation(s)
- Rachel I Adams
- California Department of Public Health, Richmond, CA, USA
| | - Hanna Leppänen
- Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Anne M Karvonen
- Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - José Jacobs
- Institute for Risk Assessment Sciences (IRAS, Utrecht University, Utrecht, The Netherlands
| | - Alicia Borràs-Santos
- Barcelona Institute for Global Health (ISGlobal, Barcelona, Spain
- Escola Universitària d'Infermeria, Escoles Universitàries Gimbernat, Universitat Autònoma de Barcelona, Sant Cugat del Vallès, Spain
| | - Maria Valkonen
- Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Esmeralda Krop
- Institute for Risk Assessment Sciences (IRAS, Utrecht University, Utrecht, The Netherlands
| | | | - Kati Huttunen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Jan-Paul Zock
- Barcelona Institute for Global Health (ISGlobal, Barcelona, Spain
| | - Anne Hyvärinen
- Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Dick Heederik
- Institute for Risk Assessment Sciences (IRAS, Utrecht University, Utrecht, The Netherlands
| | - Juha Pekkanen
- Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Finland
- Department of Public Health, Helsinki University, Helsinki, Finland
| | - Martin Täubel
- Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Finland
| |
Collapse
|
9
|
Tischer C, Karvonen AM, Kirjavainen PV, Flexeder C, Roponen M, Hyvärinen A, Renz H, Frey UP, Fuchs O, Pekkanen J. Early age exposure to moisture and mould is related to FeNO at the age of 6 years. Pediatr Allergy Immunol 2021; 32:1226-1237. [PMID: 33894090 DOI: 10.1111/pai.13526] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 04/16/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Exposure to indoor moisture damage and visible mold has been found to be associated with asthma and respiratory symptoms in several questionnaire-based studies by self-report. We aimed to define the prospective association between the early life exposure to residential moisture damage or mold and fractional exhaled nitric oxide (FeNO) and lung function parameters as objective markers for airway inflammation and asthma in 6-year-old children. METHODS Home inspections were performed in children's homes when infants were on average 5 months old. At age 6 years, data on FeNO (n = 322) as well as lung function (n = 216) measurements were collected. Logistic regression and generalized additive models were used for statistical analyses. RESULTS Early age major moisture damage and moisture damage or mold in the child's main living areas were significantly associated with increased FeNO levels (>75th percentile) at the age of 6 years (adjusted odds ratios, 95% confidence intervals, aOR (95% CI): 3.10 (1.35-7.07) and 3.16 (1.43-6.98), respectively. Effects were more pronounced in those who did not change residential address throughout the study period. For lung function, major structural damage within the whole home was associated with reduced FEV1 and FVC, but not with FEV1/FVC. No association with lung function was observed with early moisture damage or mold in the child's main living areas. CONCLUSION These results underline the importance of prevention and remediation efforts of moisture and mold-damaged buildings in order to avoid harmful effects within the vulnerable phase of the infants and children's immunologic development.
Collapse
Affiliation(s)
- Christina Tischer
- Institute for Health Resort Medicine and Health Promotion, State Institute of Health, Bavarian Health and Food Safety Authority, Bad Kissingen, Germany.,Institute of Social Medicine and Health Systems Research (ISMHSR), Medical faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Anne M Karvonen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Pirkka V Kirjavainen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Claudia Flexeder
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Marjut Roponen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Anne Hyvärinen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Harald Renz
- Institute of Laboratory Medicine, Philipps University of Marburg, Marburg, Germany.,German Center for Lung Research (DZL), Marburg, Germany
| | - Urs Peter Frey
- Department of Pediatrics, Division of Pediatric Pulmonology and Allergology, University Children's Hospital, University of Bern, Bern, Switzerland
| | - Oliver Fuchs
- Department of Pediatrics, Division of Pediatric Pulmonology and Allergology, University Children's Hospital, University of Bern, Bern, Switzerland.,University Children's Hospital (UKBB), University of Basel, Basel, Switzerland.,Department for Biomedical Research, University of Bern, Bern, Switzerland.,Department of Pediatric Pulmonology & Allergology, University Childrens's Hospital Schleswig-Holstein Campus Lübeck, Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Lübeck, Germany
| | - Juha Pekkanen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
| |
Collapse
|
10
|
Suzuki N, Nakaoka H, Nakayama Y, Tsumura K, Takaguchi K, Takaya K, Eguchi A, Hanazato M, Todaka E, Mori C. Association between sum of volatile organic compounds and occurrence of building-related symptoms in humans: A study in real full-scale laboratory houses. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 750:141635. [PMID: 32882497 DOI: 10.1016/j.scitotenv.2020.141635] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/03/2020] [Accepted: 08/09/2020] [Indexed: 06/11/2023]
Abstract
It is well known that the indoor environment, particularly indoor air quality (IAQ), has significant effects on building-related symptoms (BRSs) in humans, such as irritation of mucosal membranes, headaches, and allergies, such as asthma and atopic dermatitis. In 2017, Chiba University launched the "Chemiless Town Project Phase 3" to investigate the relationship between IAQ and human health. Two laboratory houses (LHs) were built on a university campus in which the interiors and exteriors were similar, but the levels of indoor air volatile organic compounds (VOCs) were different. A total of 141 participants evaluated IAQ using their sensory perception. There was a significant relationship between differences in VOC levels and BRSs occurrence (OR: 6.89, 95% CI: 1.40-33.98). It was suggested that people with a medical history of allergies (OR: 5.73, 95% CI: 1.12-29.32) and those with a high sensitivity to chemicals (OR: 8.82, 95% CI: 1.16-67.16) tended to experience BRSs. Thus, when buildings are constructed, people with a history of allergies or with a sensitivity to chemicals may be at high risk to BRSs, and it is important to pay attention to IAQ to prevent BRSs.
Collapse
Affiliation(s)
- Norimichi Suzuki
- Center for Preventive Medical Sciences, Chiba University, 6-2-1 Kashiwanoha, Kashiwa, Chiba 277-0882, Japan.
| | - Hiroko Nakaoka
- Center for Preventive Medical Sciences, Chiba University, 6-2-1 Kashiwanoha, Kashiwa, Chiba 277-0882, Japan; Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
| | - Yoshitake Nakayama
- Center for Preventive Medical Sciences, Chiba University, 6-2-1 Kashiwanoha, Kashiwa, Chiba 277-0882, Japan.
| | - Kayo Tsumura
- Center for Preventive Medical Sciences, Chiba University, 6-2-1 Kashiwanoha, Kashiwa, Chiba 277-0882, Japan; Graduate School of Medical and Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
| | - Kohki Takaguchi
- Center for Preventive Medical Sciences, Chiba University, 6-2-1 Kashiwanoha, Kashiwa, Chiba 277-0882, Japan.
| | - Kazunari Takaya
- National Institute of Occupational Safety and Health, 6-21-1 Nagao, Tama-ku, Kawasaki 214-8585, Japan.
| | - Akifumi Eguchi
- Center for Preventive Medical Sciences, Chiba University, 6-2-1 Kashiwanoha, Kashiwa, Chiba 277-0882, Japan.
| | - Masamichi Hanazato
- Center for Preventive Medical Sciences, Chiba University, 6-2-1 Kashiwanoha, Kashiwa, Chiba 277-0882, Japan.
| | - Emiko Todaka
- Center for Preventive Medical Sciences, Chiba University, 6-2-1 Kashiwanoha, Kashiwa, Chiba 277-0882, Japan; Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
| | - Chisato Mori
- Center for Preventive Medical Sciences, Chiba University, 6-2-1 Kashiwanoha, Kashiwa, Chiba 277-0882, Japan; Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
| |
Collapse
|
11
|
Lin J, Lin W, Yin Z, Fu X, Mai D, Fu S, Zhang JJ, Gong J, Feng N, He L. Respiratory health effects of residential individual and cumulative risk factors in children living in two cities of the Pearl River Delta Region, China. J Thorac Dis 2020; 12:6342-6355. [PMID: 33209473 PMCID: PMC7656417 DOI: 10.21037/jtd.2020.03.92] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Indoor environment is complex, with many factors potentially interacting with each other to affect health. However, previous studies have usually focused on effect of a single factor. Assessment of the combined effects of multiple factors can help with understanding the overall health risk. Methods A cross-sectional study was conducted among 2,306 school children in Guangzhou and Shenzhen. Questionnaire data on respiratory symptoms and diseases were collected along with sociodemographic and residential environmental information. A subset of children (N=987) were measured for their lung function. A random forest algorithm was applied to screen the top-ranked indoor environmental exposure variables and to form a composite index for cumulative risk of indoor pollution (CRIP). Logistic regressions were conducted to analyze the independent effect of single indoor environmental risk factors and the combined effect of CRIP on children’s respiratory health. Multiple linear regressions were used to examine the independent and combined effects of indoor environmental exposure on lung function. Results We found that home dampness and molds as well as environmental tobacco smoke (ETS) were significantly and independently associated with increased prevalence of children’s respiratory symptoms and diseases and with reduced lung function. A higher CRIP level was significantly associated with increased risk of cough with cold (OR =1.37, 95% CI: 1.05–1.79) and wheeze (OR =2.71, 95% CI: 1.16–6.34). A higher CRIP level was also associated with reduced lung function measured as FVC, FEV1, PEF, FEF25%, FEF25–75% and VC. Conclusions In children living in the subtropical region of the Pearl River Delta, home dampness and the presence of mold as well as ETS were individual risk factors for children’s respiratory health. The composite CRIP index was associated with respiratory symptoms and lung function, suggesting the utility of this index for predicting the combined effects of multiple risk factors.
Collapse
Affiliation(s)
- Jianqing Lin
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - Weiwei Lin
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - Zixuan Yin
- Key Laboratory for Urban Habitat Environmental Science and Technology, School of Environment and Energy, Peking University Shenzhen Graduate School, Shenzhen 518055, China
| | - Xi Fu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - Dejian Mai
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - Shaojie Fu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - Junfeng Jim Zhang
- Nicholas School of Environment & Duke Global Health Institute, Duke University, Durham, USA.,Duke Kunshan University, Kunshan 215316, China.,Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Jicheng Gong
- Beijing Innovation Center for Engineering Science and Advanced Technology, State Key Joint Laboratory for Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, and Center for Environment and Health, Peking University, Beijing 100871, China
| | - Ning Feng
- Key Laboratory for Urban Habitat Environmental Science and Technology, School of Environment and Energy, Peking University Shenzhen Graduate School, Shenzhen 518055, China
| | - Lingyan He
- Key Laboratory for Urban Habitat Environmental Science and Technology, School of Environment and Energy, Peking University Shenzhen Graduate School, Shenzhen 518055, China
| |
Collapse
|
12
|
Abstract
The school is a complex microenvironment of indoor allergens, pollutants, and other exposures. The school represents an occupational model for children and exposures in this environment have a significant health effect. Current research establishes an association between school exposure and asthma morbidity in children. This review will focus on common school environmental exposures (cockroach, rodents, cat, dog, classroom pets, dust mite, fungus, and pollution) and their impact on children with allergies and asthma. Understanding and evaluation of school-based environments is needed to help guide school-based interventions. School-based interventions have the potential for substantial benefit to the individual, school, community, and public health. However, there is a paucity data on school-based environmental interventions and health outcomes. The studies performed to date are small and cross-sectional with no control for home exposures. Randomized controlled school-based environmental intervention trials are needed to assess health outcomes and the cost-effectiveness of these interventions. The School Inner-City Asthma Intervention Study (SICAS 2), a NIH/NIAID randomized controlled clinical trial using environmental interventions modeled from successful home-based interventions, is currently underway with health outcome results pending. If efficacious, these interventions could potentially help further guide school-based interventions potentially with policy implications. In the meanwhile, the allergist/immunologist can continue to play a vital role in improving the quality of life in children with allergies and asthma at school through the use of the ADA policy and Section 504 of the Rehabilitation Act as well as encouraging adoption of toolkits to build successful school-based asthma programs and asthma-friendly schools.
Collapse
|
13
|
Milanzi EB, Koppelman GH, Smit HA, Wijga AH, Vonk JM, Brunekreef B, Gehring U. Timing of secondhand smoke, pet, dampness or mould exposure and lung function in adolescence. Thorax 2019; 75:153-163. [PMID: 31748257 DOI: 10.1136/thoraxjnl-2019-213149] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 10/02/2019] [Accepted: 10/03/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND The relevance of timing of exposure in the associations of secondhand tobacco smoke (SHS), pets, and dampness or mould exposure with lung function is unclear. We investigated the relevance of timing of these exposures for lung function in adolescence. METHODS We used data from participants of the Dutch Prevention and Incidence of Asthma and Mite Allergy (PIAMA) cohort with spirometric measurements at ages 12 and 16 years (n=552). Data on residential exposure to SHS, pets, and dampness or mould were obtained by repeated parental questionnaires. We characterised timing of exposure through longitudinal patterns using latent class growth modelling and assessed associations of these patterns with FEV1 and FVC at ages 12 and 16 and FEV1 and FVC growth between ages 12 and 16 using linear regression models. RESULTS Childhood SHS exposure was associated with reduced FEV1 growth/year (95% CI) (-0.34% (-0.64% to -0.04%)). Late childhood and early life pet exposure was associated with increased FEV1 growth (0.41% (0.14% to 0.67%)) and reduced FVC growth (-0.28% (-0.53% to -0.03%)), respectively, compared with very low exposure. Early life dampness or mould exposure was associated with reduced lung function growth. All time windows of SHS exposure tended to be associated with lower attained lung function and pet exposure tended to be associated with higher FEV1. CONCLUSION SHS exposure during childhood could lead to reduced lung function growth and lower attained lung function in adolescence. While pet exposure in late childhood may not adversely affect lung function, early childhood pet exposure may slow down FVC growth in adolescence.
Collapse
Affiliation(s)
- Edith B Milanzi
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Gerard H Koppelman
- Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, Groningen, The Netherlands.,Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children's Hospital, University Medical Center Groningen, Groningen, The Netherlands
| | - Henriette A Smit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Alet H Wijga
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Judith M Vonk
- Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, Groningen, The Netherlands.,Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| |
Collapse
|
14
|
Fisk WJ, Chan WR, Johnson AL. Does dampness and mold in schools affect health? Results of a meta-analysis. INDOOR AIR 2019; 29:895-902. [PMID: 31310034 DOI: 10.1111/ina.12588] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/03/2019] [Accepted: 07/10/2019] [Indexed: 06/10/2023]
Abstract
This paper provides meta-analyses of the published findings relating the respiratory health of occupants of schools with visible dampness, water damage, visible mold, and/or mold odor. Random effects models were used to develop central estimates and confidence limits for the associations of respiratory health effects with school dampness and mold. Eleven studies, all with cross-sectional designs, were included in the meta-analyses; however, analyses for some health outcomes were based on as few as four studies. Analyses were performed using data from adults and children combined, using only data from children, and using data from adults and children after excluding two studies. The central estimates of odds ratios from the meta-analyses were consistently above unity. The evidence of adverse health effects was strongest for cough and wheeze, which had confidence limits excluding unity in some or all analyses. The odds ratios of 1.32 for cough and 1.68 for wheeze suggest moderate increases in health risk. Studies not included in the meta-analyses provide additional evidence that dampness and mold in schools are associated with adverse health outcomes. These meta-analyses and the published literature not included in the meta-analyses suggest that dampness and mold in schools are associated with adverse respiratory health effects.
Collapse
Affiliation(s)
- William J Fisk
- Indoor Environment Group, Lawrence Berkeley National Laboratory, Berkeley, CA
| | - Wanyu R Chan
- Indoor Environment Group, Lawrence Berkeley National Laboratory, Berkeley, CA
| | - Alexandra L Johnson
- Indoor Environment Group, Lawrence Berkeley National Laboratory, Berkeley, CA
| |
Collapse
|
15
|
School exposure and asthma. Ann Allergy Asthma Immunol 2019; 120:482-487. [PMID: 29407419 DOI: 10.1016/j.anai.2018.01.028] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 01/18/2018] [Accepted: 01/22/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To provide a comprehensive overview of common school exposures and the association between school exposures and pediatric asthma morbidity. DATA SOURCES A comprehensive literature review was performed using PubMed. STUDY SELECTIONS Full-length, peer-reviewed studies published in English were considered for review. In vivo, in vitro, and animal studies were excluded. Studies of school exposure to cockroach, mouse, dust mite, dog, cat, molds, pollution, and endotoxin associated with asthma and asthma morbidity were considered. RESULTS The current literature establishes an association between school exposure and pediatric asthma morbidity. There is a need for ongoing research to evaluate the effects of school-based environmental interventions on asthma morbidity. CONCLUSION It is evident that the indoor school environment is a significant reservoir of allergens, molds, pollutants, and endotoxin and that there is an association between school exposure and pediatric asthma morbidity. School-based interventions have the potential for substantial individual, community, and public health benefit. It is important that researchers continue to study the health effects associated with school exposures and assess cost-effectiveness of multifaceted school-based interventions.
Collapse
|
16
|
Bhattacharjee S, Haldar P, Gopal Maity S, Debnath S, Moitra S, Saha S, Mitra R, Annesi-Maesano I, Garcia-Aymerich J, Moitra S. Prevalence and Risk Factors of Asthma and Allergy-Related Diseases among Adolescents (PERFORMANCE) study: rationale and methods. ERJ Open Res 2018; 4:00034-2018. [PMID: 29977901 PMCID: PMC6019742 DOI: 10.1183/23120541.00034-2018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 05/15/2018] [Indexed: 01/14/2023] Open
Abstract
Despite a considerable number of international reports on allergic diseases among children, information about the prevalence and risk factors of asthma and allergy-related diseases among Indian adolescents is relatively sparse. The Prevalence and Risk Factors of Asthma and Allergy-Related Diseases among Adolescents (PERFORMANCE) study has been conceived to study the aetiology of asthma and allergic diseases including rhinoconjunctivitis, atopic eczema and food allergies among adolescents in West Bengal, India, using standardised methods and collaborations. The aims of the study are: 1) to estimate the prevalence and risk factors of asthma and allergic diseases among the adolescents residing in rural, suburban and urban areas of West Bengal; 2) to obtain information about the possible role of lifestyle factors (smoking, diet and physical activity) on the disease prevalence; and 3) to create a network for further investigation on social, environmental and genetic factors affecting the diseases. The PERFORMANCE study comprises two phases. The phase I study will investigate the prevalence and possible contributing factors of asthma and allergic diseases in a defined population. The phase II study will be performed as a follow-up of phase I to assess the incidence of asthma and allergic diseases. The PERFORMANCE study: investigating the prevalence and risk factors of allergy and asthma among Indian adolescentshttp://ow.ly/jP2v30kmt8u
Collapse
Affiliation(s)
- Soumya Bhattacharjee
- Dept of Chest Medicine, Murshidabad Medical College and Hospital, Berhampore, India.,These authors contributed equally
| | - Prasun Haldar
- Dept of Pneumology, Allergy and Asthma Research Centre, Kolkata, India.,These authors contributed equally
| | | | - Smriti Debnath
- Dept of Pneumology, Allergy and Asthma Research Centre, Kolkata, India
| | - Saibal Moitra
- Dept of Pneumology, Allergy and Asthma Research Centre, Kolkata, India
| | - Sujoy Saha
- Dept of Pediatrics, B.R. Singh Hospital (Eastern Railways), Kolkata, India
| | - Ritabrata Mitra
- Dept of Pulmonary Medicine, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | | | - Judith Garcia-Aymerich
- ISGlobal, Barcelona, Spain.,University of Pompeu Fabra, Barcelona, Spain.,CIBER Epidemiologia y Salud Pública, Barcelona, Spain
| | - Subhabrata Moitra
- Dept of Pneumology, Allergy and Asthma Research Centre, Kolkata, India.,ISGlobal, Barcelona, Spain
| |
Collapse
|
17
|
Ramalho O, Le Ponner E, Ribéron J, Derbez M, Dassonville C, Mandin C. [Occurrence of visible molds in French schools and nurseries]. Rev Mal Respir 2018; 35:659-672. [PMID: 29937314 DOI: 10.1016/j.rmr.2017.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 06/09/2017] [Indexed: 10/28/2022]
Abstract
Children exposure to molds in the school and preschool environment is not well described in France. A nationwide survey was performed in 2009-2011 in 310 schools and nurseries from France including two oversea territories, Reunion and Martinique. It showed that 5 % of the audited rooms had visible molds, mainly on the ceiling. These rooms belonged to 34 buildings (11 %). The multivariate analysis shows that several factors are associated with visible molds in rooms: the presence of textile wall covering, the location of the building in a suburban area, the size of the building (less visible molds in large buildings), the absence of a ventilation system with exhaust located in the room, and the absence of double-glazed windows. The prevalence of visible molds is comparable to the one observed in large European studies: 7 % of the 334 classrooms in the frame of the SINPHONIE project and 11 % of the buildings in 193 elementary schools in the HITEA study.
Collapse
Affiliation(s)
- O Ramalho
- Centre scientifique et technique du bâtiment (CSTB), université Paris-Est, 77100 Champs-sur-Marne, France.
| | - E Le Ponner
- Centre scientifique et technique du bâtiment (CSTB), université Paris-Est, 77100 Champs-sur-Marne, France
| | - J Ribéron
- Centre scientifique et technique du bâtiment (CSTB), université Paris-Est, 77100 Champs-sur-Marne, France
| | - M Derbez
- Centre scientifique et technique du bâtiment (CSTB), université Paris-Est, 77100 Champs-sur-Marne, France
| | - C Dassonville
- Centre scientifique et technique du bâtiment (CSTB), université Paris-Est, 77100 Champs-sur-Marne, France
| | - C Mandin
- Centre scientifique et technique du bâtiment (CSTB), université Paris-Est, 77100 Champs-sur-Marne, France
| |
Collapse
|
18
|
Residential Ambient Traffic in Relation to Childhood Pneumonia among Urban Children in Shandong, China: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061076. [PMID: 29799501 PMCID: PMC6025011 DOI: 10.3390/ijerph15061076] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 05/21/2018] [Accepted: 05/22/2018] [Indexed: 12/21/2022]
Abstract
Pneumonia is a leading cause of childhood death. Few studies have investigated associations between residential ambient environmental exposures and pneumonia. In January⁻April 2015, we conducted a cross-sectional study in Shandong Province (China) and collected 9597 (response rate: 78.7%) parent-reported questionnaires for 3⁻6-year-old children from 69 urban kindergartens. We then selected 5640 children who had never changed residence since birth and examined associations between residential ambient traffic-related facilities and childhood pneumonia considering residential characteristics. Prevalence of doctor-diagnosed pneumonia during lifetime-ever was 25.9%. In the multivariate logistic regression analyses, residence close to a main traffic road (adjusted odds ratio, 95% confidence interval: 1.23, 1.08⁻1.40) and automobile 4S shop (1.76, 1.16⁻2.67) within 200 m, residence close to a filling station within 100 m (1.71, 1.10⁻2.65; reference: >200 m), as well as having a ground car park in the residential community (1.24, 1.08⁻1.42) were significantly associated with childhood pneumonia. The cumulative numbers of these traffic-related facilities had a positive dose-response relationship with the increased odds of childhood pneumonia. These associations and dose-response relationships were stronger among boys and among children with worse bedroom ventilation status during the night. Associations of residence close to the main traffic road and ground car parks in the residential community with childhood pneumonia were stronger among children living in the 1st⁻3rd floors than those living on higher floors. Similar results were found in the two-level (kindergarten-child) logistic regression analyses. Our findings indicate that living near traffic-related facilities is likely a risk factor for childhood pneumonia among urban children. The child's sex, bedroom floor level, and bedroom ventilation could modify associations of ambient traffic-related facilities with childhood pneumonia.
Collapse
|
19
|
Abstract
There are possibly millions of mold species on earth. The vast majority of these mold spores live in harmony with humans, rarely causing disease. The rare species that does cause disease does so by triggering allergies or asthma, or may be involved in hypersensitivity diseases such as allergic bronchopulmonary aspergillosis or allergic fungal sinusitis. Other hypersensitivity diseases include those related to occupational or domiciliary exposures to certain mold species, as in the case of Pigeon Breeder's disease, Farmer's lung, or humidifier fever. The final proven category of fungal diseases is through infection, as in the case of onchomycosis or coccidiomycosis. These diseases can be treated using anti-fungal agents. Molds and fungi can also be particularly important in infections that occur in immunocompromised patients. Systemic candidiasis does not occur unless the individual is immunodeficient. Previous reports of "toxic mold syndrome" or "toxic black mold" have been shown to be no more than media hype and mass hysteria, partly stemming from the misinterpreted concept of the "sick building syndrome." There is no scientific evidence that exposure to visible black mold in apartments and buildings can lead to the vague and subjective symptoms of memory loss, inability to focus, fatigue, and headaches that were reported by people who erroneously believed that they were suffering from "mycotoxicosis." Similarly, a causal relationship between cases of infant pulmonary hemorrhage and exposure to "black mold" has never been proven. Finally, there is no evidence of a link between autoimmune disease and mold exposure.
Collapse
|
20
|
Permaul P, Phipatanakul W. School Environmental Intervention Programs. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2018; 6:22-29. [PMID: 29310758 PMCID: PMC5773264 DOI: 10.1016/j.jaip.2017.10.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 09/29/2017] [Accepted: 10/03/2017] [Indexed: 12/30/2022]
Abstract
Exposure to indoor allergens and pollutants plays a significant part in the development of asthma and its associated morbidity. Inner-city children with asthma are disproportionately affected by these exposures with increased asthma morbidity. Although years of previous research have linked exposures in the urban home environment with significant childhood asthma disease, many of these allergens are also present in inner-city school environments. Therefore, evaluation of the school environment of patients with asthma is also essential. School-based environmental interventions may offer benefit for this problem and has the potential to help many children with asthma at once in a cost-effective manner. It is important that environmental health researchers continue to assess which interventions are most practical and result in the greatest measurable improvements.
Collapse
Affiliation(s)
- Perdita Permaul
- Division of Pediatric Allergy and Immunology, Massachusetts General Hospital for Children, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Wanda Phipatanakul
- Harvard Medical School, Boston, Mass; Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass.
| |
Collapse
|
21
|
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.
Collapse
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
| |
Collapse
|
22
|
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.
Collapse
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
| |
Collapse
|
23
|
Abstract
PURPOSE OF REVIEW The aim of the present review is to discuss updates on research regarding the relationship between indoor allergen exposure and childhood asthma with a focus on clinical effects, locations of exposure, and novel treatments. RECENT FINDINGS Recent data continue to demonstrate that early life sensitization to indoor allergens is a predictor of asthma development later in life. Furthermore, avoidance of exposure to these allergens continues to be important especially given that the vast majority of children with asthma are sensitized to at least one indoor allergen. New research suggests that mouse allergen, more so than cockroach allergen, may be the most relevant urban allergen. Recent evidence reminds us that children are exposed to clinically important levels of indoor allergens in locations away from their home, such as schools and daycare centers. Exposure to increased levels of indoor mold in childhood has been associated with asthma development and exacerbation of current asthma; however, emerging evidence suggests that early exposure to higher fungal diversity may actually be protective for asthma development. Novel treatments have been developed that target TH2 pathways thus decreasing asthmatic responses to allergens. These therapies show promise for the treatment of severe allergic asthma refractory to avoidance strategies and standard therapies. SUMMARY Understanding the relationship between indoor allergens and asthma outcomes is a constantly evolving study of timing, location, and amount of exposure.
Collapse
|