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Weinberger KR, Veeravalli N, Wu X, Nassikas NJ, Spangler KR, Joyce NR, Wellenius GA. Long-term Impact of Tropical Cyclones on Disease Exacerbation Among Children with Asthma in the Eastern United States, 2000-2018. Epidemiology 2024; 35:398-407. [PMID: 38630511 DOI: 10.1097/ede.0000000000001728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
BACKGROUND Tropical cyclones are associated with acute increases in mortality and morbidity, but few studies have examined their longer-term health consequences. We assessed whether tropical cyclones are associated with a higher frequency of symptom exacerbation among children with asthma in the following 12 months in eastern United States counties, 2000-2018. METHODS We defined exposure to tropical cyclones as a maximum sustained windspeed >21 meters/second at the county center and used coarsened exact matching to match each exposed county to one or more unexposed counties. We used longitudinal, de-identified administrative claims data to estimate the county-level, monthly risk of experiencing at least one asthma exacerbation requiring medical attention among commercially insured children aged 5-17 with prior diagnosis of asthma. We used a difference-in-differences approach implemented via a Poisson fixed effects model to compare the risk of asthma exacerbation in the 12 months before versus after each storm in exposed versus unexposed counties. RESULTS Across 43 tropical cyclones impacting the eastern United States, we did not observe evidence of an increase in the risk of symptom exacerbation in the 12 months following the storm (random-effects meta-analytic summary estimate: risk ratio = 1.03 [95% confidence interval = 0.96, 1.10], I2 = 17%). However, certain storms, such as Hurricane Sandy, were associated with a higher risk of symptom exacerbation. CONCLUSIONS These findings are consistent with the hypothesis that some tropical cyclones are detrimental to children's respiratory health. However, tropical cyclones were not associated in aggregate with long-term exacerbation of clinically apparent asthma symptoms among a population of children with commercial health insurance.
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Affiliation(s)
- Kate R Weinberger
- From the School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Epidemiology, Brown University School of Public Health, Providence, RI
| | | | - Xiao Wu
- Department of Biostatistics, Mailman School of Public Health, Columbia University, NY
| | - Nicholas J Nassikas
- Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Keith R Spangler
- Department of Environmental Health, Boston University School of Public Health, Boston, MA
| | - Nina R Joyce
- Department of Epidemiology, Brown University School of Public Health, Providence, RI
| | - Gregory A Wellenius
- Department of Epidemiology, Brown University School of Public Health, Providence, RI
- Department of Environmental Health, Boston University School of Public Health, Boston, MA
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Vesper SJ. The development and application of the Environmental Relative Moldiness Index (ERMI). Crit Rev Microbiol 2024:1-11. [PMID: 38651788 DOI: 10.1080/1040841x.2024.2344112] [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: 10/31/2023] [Accepted: 04/11/2024] [Indexed: 04/25/2024]
Abstract
The prevalence of asthma in the United States (U.S.) has doubled since 1970, coinciding with the increased use of gypsum-drywall in home construction. Mold growth is promoted when gypsum-drywall gets wet. Since asthma is linked to mold exposures, accurate quantification of mold contamination in homes is critical. Therefore, qPCR assays were created and then used to quantify 36 common molds in dust collected in representative U.S. homes during the first American Health Homes Survey (AHHS). The concentrations of the 36 molds, i.e. 26 water-damage molds (Group 1) and 10 outside molds (Group 2), were used in the formulation of a home's Environmental Relative Moldiness Index (ERMI) value. The ERMI values for each of the AHHS homes were assembled from lowest to highest to create the ERMI scale, which ranges from -10 to 20. Subsequent epidemiological studies consistently demonstrated that higher ERMI values were linked to asthma development, reduced lung capacity or occupant asthma. Reducing mold exposures by remediation or with HEPA filtration resulted in a reduced prevalence of asthma and improvements in respiratory health. The ERMI scale has also been successfully applied in evaluating mold concentrations in schools and large buildings and appears to have applications outside the U.S.
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Yamaguchi H, Okubo T, Nozaki E, Osaki T. Differential impact of environmental factors on airborne live bacteria and inorganic particles in an underground walkway. PLoS One 2024; 19:e0300920. [PMID: 38512950 PMCID: PMC10956794 DOI: 10.1371/journal.pone.0300920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/05/2024] [Indexed: 03/23/2024] Open
Abstract
We previously reported that variations in the number and type of bacteria found in public spaces are influenced by environmental factors. However, based on field survey data alone, whether the dynamics of bacteria in the air change as a result of a single environmental factor or multiple factors working together remains unclear. To address this, mathematical modeling may be applied. We therefore conducted a reanalysis of the previously acquired data using principal component analysis (PCA) in conjunction with a generalized linear model (Glm2) and a statistical analysis of variance (ANOVA) test employing the χ2 distribution. The data used for the analysis were reused from a previous public environmental survey conducted at 8:00-20:00 on May 2, June 1, and July 5, 2016 (regular sampling) and at 5:50-7:50 and 20:15-24:15 on July 17, 2017 (baseline sampling) in the Sapporo underground walking space, a 520-meter-long underground walkway. The dataset consisted of 60 samples (22 samples for "bacterial flora"), including variables such as "temperature (T)," "humidity (H)," "atmospheric pressure (A)," "traffic pedestrians (TP)," "number of inorganic particles (Δ5: 1-5 μm)," "number of live airborne bacteria," and "bacterial flora." Our PCA with these environmental factors (T, H, A, and TP) revealed that the 60 samples could be categorized into four groups (G1 to G4), primarily based on variations in PC1 [Loadings: T(-0.62), H(-0.647), TP(0.399), A(0.196)] and PC2 [Loadings: A(-0.825), TP(0.501), H(0.209), T(-0.155)]. Notably, the number of inorganic particles significantly increased from G4 to G1, but the count of live bacteria was highest in G2, with no other clear pattern. Further analysis with Glm2 indicated that changes in inorganic particles could largely be explained by two variables (H/TP), while live bacteria levels were influenced by all explanatory variables (TP/A/H/T). ANOVA tests confirmed that inorganic particles and live bacteria were influenced by different factors. Moreover, there were minimal changes in bacterial flora observed among the groups (G1-G4). In conclusion, our findings suggest that the dynamics of live bacteria in the underground walkway differ from those of inorganic particles and are regulated in a complex manner by multiple environmental factors. This discovery may contribute to improving public health in urban settings.
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Affiliation(s)
- Hiroyuki Yamaguchi
- Department of Medical Laboratory Science, Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Torahiko Okubo
- Department of Medical Laboratory Science, Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Eriko Nozaki
- Department of Infectious Diseases, Kyorin University School of Medicine, Shinkawa, Mitaka, Tokyo, Japan
| | - Takako Osaki
- Department of Infectious Diseases, Kyorin University School of Medicine, Shinkawa, Mitaka, Tokyo, Japan
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Groot J, Keller A, Sigsgaard T, Loft S, Nybo Andersen AM. Residential exposure to mold, dampness, and indoor air pollution and risk of respiratory tract infections: a study among children ages 11 and 12 in the Danish National Birth Cohort. Eur J Epidemiol 2024; 39:299-311. [PMID: 38393605 PMCID: PMC10994992 DOI: 10.1007/s10654-024-01101-z] [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: 12/09/2022] [Accepted: 01/10/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND The burden of respiratory tract infections (RTIs) is high in childhood. Several residential exposures may affect relative rates. OBJECTIVES To determine risk of RTIs in children ages 11 and 12 by residential exposures. METHODS We included children in the Danish National Birth Cohort (DNBC) at ages 11 and 12. We estimated incidence risk ratios (IRR) and 95% confidence intervals (CI) for counts of RTIs within the last year by exposure to mold/dampness, gas stove usage, summer and winter candle-burning, fireplace usage, cats and dogs indoors, and farmhouse living. We also estimated IRR and 95% CI for RTIs for predicted scores of four extracted factors ('owned house', 'mold and dampness', 'candles', and 'density') from exploratory factor analyses (EFA). RESULTS We included 42 720 children with complete data. Mold/dampness was associated with all RTIs (common cold: IRRadj 1.09[1.07, 1.12]; influenza: IRRadj 1.10 [1.05, 1.15]; tonsillitis: IRRadj 1.19 [1.10, 1.28]; conjunctivitis: IRRadj 1.16 [1.02, 1.32]; and doctor-diagnosed pneumonia: IRRadj 1.05 [0.90, 1.21]), as was the EFA factor 'mold/dampness' for several outcomes. Gas stove usage was associated with conjunctivitis (IRRadj 1.25 [1.05, 1.49]) and with doctor-diagnosed pneumonia (IRRadj 1.14 [0.93, 1.39]). Candle-burning during summer, but not winter, was associated with several RTIs, for tonsillitis in a dose-dependent fashion (increasing weekly frequencies vs. none: [IRRadj 1.06 [0.98, 1.14], IRRadj 1.16 [1.04, 1.30], IRRadj 1.23 [1.06, 1.43], IRRadj 1.29 [1.00, 1.67], and IRRadj 1.41 [1.12, 1.78]). CONCLUSION Residential exposures, in particular to mold and dampness and to a lesser degree to indoor combustion sources, are related to the occurrence of RTIs in children.
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Affiliation(s)
- Jonathan Groot
- 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
| | - 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
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Keller A, Groot J, Clippet-Jensen C, Pinot de Moira A, Pedersen M, Sigsgaard T, Loft S, Budtz-Jørgensen E, Nybo Andersen AM. Exposure to different residential indoor characteristics during childhood and asthma in adolescence: a latent class analysis of the Danish National Birth Cohort. Eur J Epidemiol 2024; 39:51-65. [PMID: 37865616 PMCID: PMC10811114 DOI: 10.1007/s10654-023-01051-y] [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: 12/09/2022] [Accepted: 09/11/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND Many residential indoor environments may have an impact on children's respiratory health. OBJECTIVES The aims of this study were to identify latent classes of children from the Danish National Birth Cohort (DNBC) who share similar patterns of exposure to indoor home characteristics, and to examine the association between membership in the latent classes and asthma in adolescence. METHODS We included data on residential indoor characteristics of offspring from the DNBC whose mothers had responded to the child's 11-year follow-up and who had data on asthma from the 18-year follow-up. Number of classes and associations were estimated using latent class analysis. To account for sample selection, we applied inverse probability weighting. RESULTS Our final model included five latent classes. The probability of current asthma at 18 years was highest among individuals in class one with higher clustering on household dampness (9, 95%CI 0.06-0.13). Individuals in class four (with higher clustering on pets ownership and living in a farm) had a lower risk of current asthma at age 18 compared to individuals in class one (with higher clustering on household dampness) (OR 0.53 (95%CI 0.32-0.88), p = .01). CONCLUSION Our findings suggest that, in a high-income country such as Denmark, groups of adolescents growing up in homes with mold and moisture during mid-childhood might be at increased risk of current asthma at age 18. Adolescents who grew-up in a farmhouse and who were exposed to pets seem less likely to suffer from asthma by age 18.
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Affiliation(s)
- Amélie Keller
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Jonathan Groot
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Clara Clippet-Jensen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Angela Pinot de Moira
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- National Heart and Lung Institute, Imperial College, London, United Kingdom
| | - 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
| | - Esben Budtz-Jørgensen
- Section of Biostatistics, 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
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Cochran SJ, Acosta L, Divjan A, Lemons AR, Rundle AG, Miller RL, Sobek E, Green BJ, Perzanowski MS, Dannemiller KC. Fungal diversity in homes and asthma morbidity among school-age children in New York City. ENVIRONMENTAL RESEARCH 2023; 239:117296. [PMID: 37806477 PMCID: PMC10842248 DOI: 10.1016/j.envres.2023.117296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 09/15/2023] [Accepted: 10/02/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Asthma development has been inversely associated with exposure to fungal diversity. However, the influence of fungi on measures of asthma morbidity is not well understood. OBJECTIVES This study aimed to test the hypothesis that fungal diversity is inversely associated with neighborhood asthma prevalence and identify specific fungal species associated with asthma morbidity. METHODS Children aged 7-8 years (n = 347) living in higher (11-18%) and lower (3-9%) asthma prevalence neighborhoods were recruited within an asthma case-control study. Fungal communities were analyzed from floor dust using high-throughput DNA sequencing. A subset of asthmatic children (n = 140) was followed to age 10-11 to determine asthma persistence. RESULTS Neighborhood asthma prevalence was inversely associated with fungal species richness (P = 0.010) and Shannon diversity (P = 0.059). Associations between neighborhood asthma prevalence and diversity indices were driven by differences in building type and presence of bedroom carpet. Among children with asthma at age 7-8 years, Shannon fungal diversity was inversely associated with frequent asthma symptoms at that age (OR 0.57, P = 0.025) and with asthma persistence to age 10-11 (OR 0.48, P = 0.043). Analyses of individual fungal species did not show significant associations with asthma outcomes when adjusted for false discovery rates. DISCUSSION Lower fungal diversity was associated with asthma symptoms in this urban setting. Individual fungal species associated with asthma morbidity were not detected. Further research is warranted into building type, carpeting, and other environmental characteristics which influence fungal exposures in homes.
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Affiliation(s)
- Samuel J Cochran
- Division of Pulmonary, Critical Care, and Sleep Medicine, College of Medicine, Ohio State University, Columbus, OH, 43210, USA
| | - Luis Acosta
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Adnan Divjan
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Angela R Lemons
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, 26505, USA
| | - Andrew G Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, 10032, NY, USA
| | - Rachel L Miller
- Division of Clinical Immunology, Icahn School of Medicine at Mount Sinai, New York, 10029, NY, USA
| | - Edward Sobek
- Assured Bio Laboratories, Oak Ridge, TN, 37830, USA
| | - Brett J Green
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, 26505, USA
| | - Matthew S Perzanowski
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA.
| | - Karen C Dannemiller
- Department of Civil, Environmental and Geodetic Engineering, College of Engineering, Ohio State University, Columbus, OH, 43210, USA; Environmental Health Sciences, College of Public Health, Ohio State University, Columbus, OH, 43210, USA; Sustainability Institute, Ohio State University, Columbus, OH, 43210, USA
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Murphy J, Tharumakunarajah R, Holden KA, King C, Lee AR, Rose K, Hawcutt DB, Sinha IP. Impact of indoor environment on children's pulmonary health. Expert Rev Respir Med 2023; 17:1249-1259. [PMID: 38240133 DOI: 10.1080/17476348.2024.2307561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/16/2024] [Indexed: 02/01/2024]
Abstract
INTRODUCTION A child's living environment has a significant impact on their respiratory health, with exposure to poor indoor air quality (IAQ) contributing to potentially lifelong respiratory morbidity. These effects occur throughout childhood, from the antenatal period through to adolescence. Children are particularly susceptible to the effects of environmental insults, and children living in socioeconomic deprivation globally are more likely to breathe air both indoors and outdoors, which poses an acute and long-term risk to their health. Adult respiratory health is, at least in part, determined by exposures and respiratory system development in childhood, starting in utero. AREAS COVERED This narrative review will discuss, from a global perspective, what contributes to poor IAQ in the child's home and school environment and the impact that indoor air pollution exposure has on respiratory health throughout the different stages of childhood. EXPERT OPINION All children have the right to a living and educational environment without the threat of pollution affecting their health. Action is needed at multiple levels to address this pressing issue to improve lifelong respiratory health. Such action should incorporate a child's rights-based approach, empowering children, and their families, to have access to clean air to breathe in their living environment.
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Affiliation(s)
- Jared Murphy
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
| | | | - Karl A Holden
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
- Lab to Life Child Health Data Centre, Alder Hey Children's Hospital, Liverpool, UK
| | - Charlotte King
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
| | - Alice R Lee
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
- Lab to Life Child Health Data Centre, Alder Hey Children's Hospital, Liverpool, UK
| | - Katie Rose
- Department of Respiratory Medicine, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Daniel B Hawcutt
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
- NIHR Alder Hey Clinical Research Facility, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Ian P Sinha
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
- Department of Respiratory Medicine, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
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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.
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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
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Denning DW, Pfavayi LT. Poorly controlled asthma - Easy wins and future prospects for addressing fungal allergy. Allergol Int 2023; 72:493-506. [PMID: 37544851 DOI: 10.1016/j.alit.2023.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/25/2023] [Accepted: 06/28/2023] [Indexed: 08/08/2023] Open
Abstract
Poorly controlled asthma is especially common in low resource countries. Aside from lack of access to, or poor technique with, inhaled beta-2 agonists and corticosteroids, the most problematic forms of asthma are frequently associated with both fungal allergy and exposure, especially in adults leading to more asthma exacerbations and worse asthma. The umbrella term 'fungal asthma' describes many disorders linked to fungal exposure and/or allergy to fungi. One fungal asthma endotype, ABPA, is usually marked by a very high IgE and its differential diagnosis is reviewed. Both ABPA and fungal bronchitis in bronchiectasis are marked by thick excess airway mucus production. Dermatophyte skin infection can worsen asthma and eradication of the skin infection improves asthma. Exposure to fungi in the workplace, home and schools, often in damp or water-damaged buildings worsens asthma, and remediation improves symptom control and reduces exacerbations. Antifungal therapy is beneficial for fungal asthma as demonstrated in nine of 13 randomised controlled studies, reducing symptoms, corticosteroid need and exacerbations while improving lung function. Other useful therapies include azithromycin and some biologics approved for the treatment of severe asthma. If all individuals with poorly controlled and severe asthma could be 'relieved' of their fungal allergy and infection through antifungal therapy without systemic corticosteroids, the health benefits would be enormous and relatively inexpensive, improving the long term health of over 20 million adults and many children. Antifungal therapy carries some toxicity, drug interactions and triazole resistance risks, and data are incomplete. Here we summarise what is known and what remains uncertain about this complex topic.
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Affiliation(s)
- David W Denning
- Manchester Fungal Infection Group, The University of Manchester and Manchester Academic Health Science Centre, Manchester, UK.
| | - Lorraine T Pfavayi
- Institute of Immunology & Infection Research, Ashworth Laboratories, School of Biological Sciences, University of Edinburgh, Edinburgh, UK
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Grant TL, Wood RA, Chapman MD. Indoor Environmental Exposures and Their Relationship to Allergic Diseases. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:2963-2970. [PMID: 37652348 PMCID: PMC10927277 DOI: 10.1016/j.jaip.2023.08.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/23/2023] [Accepted: 08/23/2023] [Indexed: 09/02/2023]
Abstract
Cockroach, dust mite, cat, dog, mouse, and molds are major indoor allergens that have been associated with the development of allergic diseases and disease morbidity in allergen-sensitized individuals. Physical characteristics, such as allergen particle size, hydrophobicity, and charge, can determine an allergen's propensity to become airborne, location of respiratory tract penetration, and ability to elicit IgE responses in genetically predisposed individuals. Standardization and recent advancements in indoor allergen assessment serve to identify sources and distribution of allergens in a patient's home and public environment, inform public policy, and monitor the efficacy of allergen avoidance and therapeutics. Allergen exposure interventions have yielded mixed results with current US and international asthma guidelines differing on recommendations. A pragmatic, patient-centered approach to allergen avoidance includes: (1) tailoring intervention to the patient's sensitization and exposure status, (2) using a rigorous multifaceted intervention strategy to reduce allergen exposure as much as possible, and (3) beginning the intervention as soon as the patient is diagnosed. Further research into the risks/benefits of early allergen exposure, rapid and affordable in-home allergen assessment, and best practices for environmental control measures for asthma is needed.
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Affiliation(s)
- Torie L Grant
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Md.
| | - Robert A Wood
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Md
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Petcu C, Hegyi A, Stoian V, Dragomir CS, Ciobanu AA, Lăzărescu AV, Florean C. Research on Thermal Insulation Performance and Impact on Indoor Air Quality of Cellulose-Based Thermal Insulation Materials. MATERIALS (BASEL, SWITZERLAND) 2023; 16:5458. [PMID: 37570162 PMCID: PMC10419949 DOI: 10.3390/ma16155458] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 07/27/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023]
Abstract
Worldwide, the need for thermal insulation materials used to increase the energy performance of buildings and ensure indoor thermal comfort is constantly growing. There are several traditional, well-known and frequently used thermal insulation materials on the building materials market, but there is a growing trend towards innovative materials based on agro-industrial waste. This paper analyses the performance of 10 such innovative thermal insulation materials obtained by recycling cellulosic and/or animal waste, using standardised testing methods. More precisely, thermal insulation materials based on the following raw materials were analysed: cellulose acetate, cigarette filter manufacturing waste; cellulose acetate, cigarette filter manufacturing waste and cigarette paper waste; cellulose acetate, waste from cigarette filter manufacturing, waste cigarette paper and waste aluminised paper; cellulose from waste paper (two types made by two independent manufacturers); wood fibres; cellulose from cardboard waste; cellulose from waste cardboard, poor processing, inhomogeneous product; rice husk waste and composite based on sheep wool, recycled PET fibres and cellulosic fibres for the textile industry. The analysis followed the performance in terms of thermal insulating quality, evidenced by the thermal conductivity coefficient (used as a measurable indicator) determined for both dry and conditioned material at 50% RH, in several density variants, simulating the subsidence under its own weight or under various possible stresses arising in use. The results showed in most cases that an increase in material density has beneficial effects by reducing the coefficient of thermal conductivity, but exceptions were also reported. In conjunction with this parameter, the analysis of the 10 types of materials also looked at their moisture sorption/desorption capacity (using as a measurable indicator the amount of water stored by the material), concluding that, although they have a capacity to regulate the humidity of the indoor air, under low RH conditions the water loss is not complete, leaving a residual quantity of material that could favour the development of mould. Therefore, the impact on indoor air quality was also analysed by assessing the risk of mould growth (using as a measurable indicator the class and performance category of the material in terms of nutrient content conducive to the growth of microorganisms) under high humidity conditions but also the resistance to the action of two commonly encountered moulds, Aspergillus niger and Penicillium notatum. The results showed a relative resistance to the action of microbiological factors, indicating however the need for intensified biocidal treatment.
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Affiliation(s)
- Cristian Petcu
- National Institute for Research & Development URBAN-INCERC Bucharest Branch, 266 Soseaua Pantelimon, 021652 Bucharest, Romania; (C.P.); (C.S.D.)
| | - Andreea Hegyi
- National Institute for Research & Development URBAN-INCERC Cluj-Napoca Branch, 117 Calea Floresti, 400524 Cluj-Napoca, Romania; (A.-V.L.); (C.F.)
- Faculty of Materials and Environmental Engineering, Technical University of Cluj-Napoca, 103-105 Muncii Boulevard, 400641 Cluj-Napoca, Romania
| | - Vlad Stoian
- Department of Microbiology, Faculty of Agriculture, University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, 3-5 Calea Mănăştur, 400372 Cluj-Napoca, Romania
| | - Claudiu Sorin Dragomir
- National Institute for Research & Development URBAN-INCERC Bucharest Branch, 266 Soseaua Pantelimon, 021652 Bucharest, Romania; (C.P.); (C.S.D.)
- Faculty of Land Reclamation and Environmental Engineering, University of Agronomic Sciences and Veterinary Medicine of Bucharest, 59 Mărăști Boulevard, 011464 Bucharest, Romania
| | - Adrian Alexandru Ciobanu
- National Institute for Research & Development URBAN-INCERC Iasi Branch, 6 Anton Sesan Street, 700048 Iasi, Romania;
| | - Adrian-Victor Lăzărescu
- National Institute for Research & Development URBAN-INCERC Cluj-Napoca Branch, 117 Calea Floresti, 400524 Cluj-Napoca, Romania; (A.-V.L.); (C.F.)
| | - Carmen Florean
- National Institute for Research & Development URBAN-INCERC Cluj-Napoca Branch, 117 Calea Floresti, 400524 Cluj-Napoca, Romania; (A.-V.L.); (C.F.)
- Faculty of Materials and Environmental Engineering, Technical University of Cluj-Napoca, 103-105 Muncii Boulevard, 400641 Cluj-Napoca, Romania
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Bhatt R. Mould and its human toll. Br J Gen Pract 2023; 73:361. [PMID: 37500467 PMCID: PMC10405956 DOI: 10.3399/bjgp23x734541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023] Open
Affiliation(s)
- Ree'Thee Bhatt
- Ree'Thee is a GPST3 trainee on the Imperial College Healthcare NHS Trust scheme in North West London, with a previous background in paediatric training.
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Holden KA, Lee AR, Hawcutt DB, Sinha IP. The impact of poor housing and indoor air quality on respiratory health in children. Breathe (Sheff) 2023; 19:230058. [PMID: 37645022 PMCID: PMC10461733 DOI: 10.1183/20734735.0058-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 06/23/2023] [Indexed: 08/31/2023] Open
Abstract
It is becoming increasingly apparent that poor housing quality affects indoor air quality, significantly impacting on respiratory health in children and young people. Exposure to damp and/or mould in the home, cold homes and the presence of pests and pollutants all have a significant detrimental impact on child respiratory health. There is a complex relationship between features of poor-quality housing, such as being in a state of disrepair, poor ventilation, overcrowding and being cold, that favour an environment resulting in poor indoor air quality. Children living in rented (private or public) housing are more likely to come from lower-income backgrounds and are most at risk of living in substandard housing posing a serious threat to respiratory health. Children have the right to safe and adequate housing, and research has shown that either rehousing or making modifications to poor-quality housing to improve indoor air quality results in improved respiratory health. Urgent action is needed to address this threat to health. All stakeholders should understand the relationship between poor-quality housing and respiratory health in children and act, working with families, to redress this modifiable risk factor. Educational aims The reader should understand how housing quality and indoor air quality affect respiratory health in children.The reader should understand which children are at most risk of living in poor-quality housing.The reader should understand what policy recommendations have been made and what actions need to be undertaken to improve housing quality and respiratory health in children and young people.
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Affiliation(s)
- Karl A. Holden
- Lab to Life Child Health Data Centre, Alder Hey Children's Hospital, Liverpool, UK
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
- Contributed equally to the preparation of this manuscript and share first authorship
| | - Alice R. Lee
- Lab to Life Child Health Data Centre, Alder Hey Children's Hospital, Liverpool, UK
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
- Contributed equally to the preparation of this manuscript and share first authorship
| | - Daniel B. Hawcutt
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
- NIHR Alder Hey Clinical Research Facility, Alder Hey Children's Hospital, Liverpool, UK
| | - Ian P. Sinha
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
- Respiratory Medicine, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
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Fakunle AG, Jafta N, Okekunle AP, Smit LAM, Naidoo RN. Exposure-response relationship of residential dampness and mold damage with severe lower respiratory tract infections among under-five children in Nigeria. Environ Epidemiol 2023; 7:e247. [PMID: 37064421 PMCID: PMC10097558 DOI: 10.1097/ee9.0000000000000247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 02/23/2023] [Indexed: 03/31/2023] Open
Abstract
Previous epidemiological studies demonstrated an increased risk of respiratory health effects in children and adults exposed to dampness or mold. This study investigated associations of quantitative indicators of indoor dampness and mold exposure with severe lower respiratory tract infections (LRTI) among children aged 1-59 months in Ibadan, Nigeria. Methods In-home visits were conducted among 178 children hospitalized with LRTI matched by age (±3 months), sex, and geographical location with 180 community-based children without LRTI. Trained study staff evaluated the indoor environment using a standardized home walkthrough checklist and measured visible dampness and mold damage. Damp-moldy Index (DMI) was also estimated to quantify the level of exposure. Exposure-response relationships of dampness and mold exposure with severe LRTI were assessed using multivariable restricted cubic spline regression models adjusting for relevant child, housing, and environmental characteristics. Results Severe LRTI cases were more often male than female (61.8%), and the overall mean (SD) age was 7.3 (1.35) months. Children exposed to dampness <0.3 m2 (odds ratio [OR] = 2.11; 95% confidence interval [CI] = 1.05, 4.36), and between 0.3 and 1.0 m2 (OR = 2.34; 95% CI = 1.01, 7.32), had a higher odds of severe LRTI compared with children not exposed to dampness. The restricted cubic spline showed a linear exposure-response association between severe LRTI and residential dampness (P < 0.001) but a nonlinear relationship with DMI (P = 0.01). Conclusions Residential dampness and DMI were exposure-dependently associated with higher odds of severe LRTI among under-five children. If observed relationships were causal, public health intervention strategies targeted at reducing residential dampness are critically important to mitigate the burden of severe LRTI among under-five children.
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Wang J, Janson C, Gislason T, Gunnbjörnsdottir M, Jogi R, Orru H, Norbäck D. Volatile organic compounds (VOC) in homes associated with asthma and lung function among adults in Northern Europe. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 321:121103. [PMID: 36690293 DOI: 10.1016/j.envpol.2023.121103] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 06/17/2023]
Abstract
Associations between measured specific VOC reported to be associated with dampness and microbial growth in dwellings and asthma, lung function were investigated in 159 adults (one adult/home) from three North European cities (Reykjavik, Uppsala and Tartu). Spirometry was performed and forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and FEV1/FVC were measured. Among 159 participants, 58% were females, 24.5% atopics, 25.8% current smokers and 41% reported dampness or mold at home. Dimethyl disulphide (p = 0.004), ethyl isobutyrate (p = 0.021) and ethyl 2-methylbutyrate (p = 0.035) were associated with asthma. Isobutanol (p = 0.043), 3-methyl-1-butanol (p = 0.020), 2-hexanone (p = 0.033), 1-octen-3-ol (p = 0.027), 2-methyl-1-butanol (p = 0.022) and 2-ethyl-1-hexanol (p = 0.045) were associated with lower FEV1. Isobutanol (p = 0.004), 3-methyl-1-butanol (p = 0.001), 2-heptanone (p = 0.047) and 2-methyl-1-butanol (p = 0.002) were associated with lower FEV1/FVC. The association between dimethyl disulphide and asthma was more pronounced in females (p for interaction 0.099). The association between 1-butanol and lower FEV1 was more pronounced in males (p for interaction 0.046). The associations between 3-octanone (p for interaction 0.064), 2-ethyl-1-hexanol (p for interaction 0.049) and lower FEV1, and between 2-heptanone (p for interaction 0.021), 3-octanone (p for interaction 0.008) and lower FEV1/FVC were stronger in homes with dampness/mold. Factor analysis identified one VOC factor related to asthma and two VOC factors related to lower lung function. Increased air concentrations of 2-heptanone, ethyl 2-methylbutyrate and ethyl isobutyrate were related to prescence of certain mold species (Aspergillus sp., Cladosporum sp. and Penicillium sp.) or building dampness. Some VOC were associated with type of dwelling, building age and pet keeping. In conclusion, some VOC reported to be associated with dampness and microbial growth can be associated with asthma and lower lung function in adults. Associations between these VOC and respiratory illness can be stronger in homes with dampness/mold. There can be gender differences in respiratory health effects when exposed to indoor VOC.
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Affiliation(s)
- Juan Wang
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
| | - Christer Janson
- Department of Medical Sciences, Respiratory-, Allergy- and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Thorarinn Gislason
- Department of Sleep, Landspitali University Hospital, Reykjavik, Iceland; Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Maria Gunnbjörnsdottir
- Department of Sleep, Landspitali University Hospital, Reykjavik, Iceland; Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Rain Jogi
- Lung Clinic, Tartu University Hospital, Tartu, Estonia
| | - Hans Orru
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia; Occupational and Environmental Medicine, Dept of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Dan Norbäck
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
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Valdebenito R, Angelini F, Schmitt C, Baeza F, Cortinez-O'Ryan A, González F, Vives-Vergara A. [Developing tools to study the health impact of urban transformations in high vulnerability contexts: the RUCAS study]. CAD SAUDE PUBLICA 2023; 39:e00148322. [PMID: 37132718 DOI: 10.1590/0102-311xes148322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 03/02/2023] [Indexed: 05/04/2023] Open
Abstract
This article describes the design and characteristics of a questionnaire and an intradomiciliary observation tool developed to assess the housing-neighborhood-health relationship both cross-sectionally and longitudinally in the context of urban transformations carried out in populations of high socio-territorial vulnerability. The instruments were developed for the multi-method longitudinal study RUCAS (Urban Regeneration, Quality of Life and Health), a natural experiment aiming to assess the quality of life and health impact of a comprehensive Urban Regeneration Program in two social housing complexes in Chile. The design of the instruments followed four main stages: (1) narrative review of the literature to define the dimensions of the study, and of existing measurement instruments to identify appropriate items for measuring them; (2) content validation with experts; (3) pre-test; and (4) pilot study. The resulting questionnaire, composed of 262 items, considers the different stages of the life course and gender issues. The intradomiciliary observation tool (77 items) is applied by the interviewer. The instruments assess (i) characteristics of the current residential situation that are known to affect health and will be intervened by the program; (ii) dimensions of health potentially affected by the residential situation and/or by the intervention within the time frame of the study (4 years); (iii) other health and health-related conditions that are relevant, even if changes will not be modified within the time frame of the study; and (iv) relevant socioeconomic, occupational and demographic dimensions. The instruments have shown to be capable of addressing the multidimensionality of urban transformation processes in contexts of urban poverty in formal housing.
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Affiliation(s)
- Roxana Valdebenito
- Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Flavia Angelini
- Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Cristian Schmitt
- Escuela de Arquitectura, Pontificia Universidad Católica de Chile, Santiago, Chile
- Instituto de Geografía, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Fernando Baeza
- Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile
- Departamento de Educación Física, Deportes y Recreación, Universidad de la Frontera, Temuco, Chile
| | - Andrea Cortinez-O'Ryan
- Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile
- Facultad de Arquitectura, Artes y Diseño, Universidad Católica de Temuco, Temuco, Chile
| | - Francisca González
- Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alejandra Vives-Vergara
- Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile
- Centro de Desarrollo Urbano Sustentable, Pontificia Universidad Católica de Chile, Santiago, Chile
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Kumar R, Gaur S, Agarwal M, Menon B, Goel N, Mrigpuri P, Spalgais S, Priya A, Kumar K, Meena R, Sankararaman N, Verma A, Gupta V, Sonal, Prakash A, Safwan MA, Behera D, Singh A, Arora N, Prasad R, Padukudru M, Kant S, Janmeja A, Mohan A, Jain V, Nagendra Prasad K, Nagaraju K, Goyal M. Indian Guidelines for diagnosis of respiratory allergy. INDIAN JOURNAL OF ALLERGY, ASTHMA AND IMMUNOLOGY 2023. [DOI: 10.4103/0972-6691.367373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Wang J, Janson C, Malinovschi A, Holm M, Franklin KA, Modig L, Johannessen A, Schlünssen V, Gislason T, Jogi NO, Norbäck D. Asthma, allergic rhinitis and atopic dermatitis in association with home environment - The RHINE study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 853:158609. [PMID: 36089044 DOI: 10.1016/j.scitotenv.2022.158609] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 09/02/2022] [Accepted: 09/04/2022] [Indexed: 06/15/2023]
Abstract
We studied home environment exposures in relation to asthma, allergic rhinitis and atopic dermatitis among offspring of participants (parents) in the Respiratory Health in Northern Europe (RHINE) study (age ≤ 30 y). Totally 17,881 offspring from Iceland, Norway, Sweden, Denmark and Estonia were included. Home environment exposures, including dampness and mold, type of dwelling, construction year and indoor painting were registered through a questionnaire answered by parents in the first follow up (RHINE II). The parents reported ten years later with in the frame of RHINE III offspring's birth year and offspring's asthma, allergic rhinitis, atopic dermatitis. They also reported dampness and mold at home from RHINE II to RHINE III. The prevalence of offspring's asthma before 10 y, asthma after 10 y, allergic rhinitis at any age and atopic dermatitis at any age were 9.7 %, 4.3 %, 15.6 % and 17.3 %, respectively. Asthma before 10 y was related to any indoor painting at RHINE II (OR = 1.14, 95%CI (1.02, 1.29)). Asthma after 10 y was associated with dampness/mold at home (OR = 1.33-1.62) and living in the newest buildings (constructed in 1986-2001) (OR = 1.30, 95%CI (1.02, 1.66)). Allergic rhinitis was associated with living in newer buildings (constructed in 1961-2001) (OR = 1.16-1.24). Atopic dermatitis was associated with visible mold (OR = 1.35, 95%CI(1.12, 1.62)), dampness/mold at home (OR = 1.18-1.38), living in apartments (OR = 1.22, 95%CI(1.10, 1.35)) and living in newer buildings (constructed in 1961-2001) (OR = 1.14-1.25). There were dose-response effects of dampness and mold on offspring's asthma after 10 y and atopic dermatitis (20 years exposure vs. 10 years exposure). Older offspring had increased risk of developing asthma after 10 y and atopic dermatitis. In conclusion, home dampness and mold, living in apartments, living in newer buildings and indoor painting were associated with offspring's asthma or allergic diseases. Stronger health effects were found among offspring with prolonged exposure of dampness/mold.
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Affiliation(s)
- Juan Wang
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
| | - Christer Janson
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Andrei Malinovschi
- Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Mathias Holm
- Occupational and Environmental Medicine, Gothenburg University, Gothenburg, Sweden
| | - Karl A Franklin
- Department of Surgical and Preoperative Sciences, Surgery, Umeå University, SE-901 85 Umeå, Sweden
| | - Lars Modig
- Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Umeå, Sweden
| | - Ane Johannessen
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Vivi Schlünssen
- Department of Public Health, Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Thorarinn Gislason
- Department of Sleep, Landspitali University Hospital, Reykjavik, Iceland; Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Nils Oskar Jogi
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Dan Norbäck
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
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Topalušić I, Stipić Marković A, Artuković M, Dodig S, Bucić L, Lugović Mihić L. Divergent Trends in the Prevalence of Children's Asthma, Rhinitis and Atopic Dermatitis and Environmental Influences in the Urban Setting of Zagreb, Croatia. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121788. [PMID: 36553232 PMCID: PMC9777289 DOI: 10.3390/children9121788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 11/18/2022] [Accepted: 11/19/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Previous studies have reported that the allergy epidemic in developed countries has reached its plateau, while a rise is expected in developing ones. Our aim was to compare the prevalence of allergic diseases among schoolchildren from the city of Zagreb, Croatia after sixteen years. METHODS Symptoms of asthma, allergic rhinitis (AR) and atopic dermatitis (AD) and risk factors were assessed using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. An allergic profile was determined by a skin prick test. RESULTS The prevalence of current, ever-in-a-lifetime and diagnosed AR of 35.7%, 42.5% and 14.9% and AD of 18.1%, 37.1% and 31.1% demonstrated a significant increase. The asthma prevalence has remained unchanged. The allergen sensitivity rate has remained similar, but pollens have become dominant. Mould and dog exposure are risks for asthma (OR 14.505, OR 2.033). Exposure to cat allergens is protective in AR (OR 0.277). Parental history of allergies is a risk factor in all conditions. CONCLUSION Over sixteen years, the prevalence of AR and AD, but not of asthma, have increased. The proportion of atopy has remained high. The AR/AD symptom rise is probably a consequence of increased pollen sensitisation united with high particulate matter concentrations. The stable asthma trend could be a result of decreasing exposures to indoor allergens.
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Affiliation(s)
- Iva Topalušić
- Division of Pulmology, Immunology, Allergology and Rheumatology, Department of Paediatrics, University Children’s Hospital Zagreb, 10 000 Zagreb, Croatia
- Correspondence: ; Tel.: +385-98-1857-599
| | - Asja Stipić Marković
- Department of Pulmology, Special Hospital for Pulmonary Diseases, 10 000 Zagreb, Croatia
| | - Marinko Artuković
- Department of Pulmology, Special Hospital for Pulmonary Diseases, 10 000 Zagreb, Croatia
| | - Slavica Dodig
- Faculty of Pharmacy and Biochemistry, University of Zagreb, 10 000 Zagreb, Croatia
| | - Lovro Bucić
- Division for Environmental Health, Croatian Institute for Public Health, 10 000 Zagreb, Croatia
| | - Liborija Lugović Mihić
- Department of Dematology, School of Dental Medicine, Clinical Hospital Center Sisters of Mercy, 10 000 Zagreb, Croatia
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Brambilla A, Candido C, Gocer O. Indoor air quality and early detection of mould growth in residential buildings: a case study. UCL OPEN ENVIRONMENT 2022; 4:e049. [PMID: 37228466 PMCID: PMC10171410 DOI: 10.14324/111.444/ucloe.000049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 09/09/2022] [Indexed: 05/27/2023]
Abstract
Mould growth affects one in three homes, and it is the biggest cause for complaints and litigations filed to the relevant authorities in Australia, while also significantly affecting the physical and psychological health of the building's occupants. Indoor mould is caused by excessive dampness, resulting from poor architectural specification, construction and maintenance practices, as well as inappropriate behaviour of the occupants. The consequences range from early biodeterioration of building materials, requiring anticipated renovation works, to deterioration of the indoor environment, posing a serious threat to the building's occupants. This study investigates indoor air quality (IAQ) and mould growth, providing a snapshot of the current IAQ of Australian residential buildings regarding air pollutants. It uses a case study representative of the typical Australian suburban home to investigate the effects of unnoticed mould growth. The results of the monitoring campaign indicate that buildings with a high concentration of fungal spores are also more likely to present poor IAQ levels, high concentrations of particulate matters (PM10 and PM2.5) and carbon dioxide (CO2). This research suggests the need for the development of early detection strategies that could minimise the health hazard to people, thereby preventing the need for any major renovations.
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Affiliation(s)
- Arianna Brambilla
- School of Architecture, Design and Planning, The University of Sydney, Sydney, Australia
| | - Christhina Candido
- Faculty of Architecture, Building and Planning, The University of Melbourne, Melbourne, Australia
| | - Ozgur Gocer
- School of Architecture, Design and Planning, The University of Sydney, Sydney, Australia
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Fowler PJ, Marcal KE, Hovmand PS. Meeting housing needs of child welfare-involved families: Policy insights from simulation modeling. CHILD ABUSE & NEGLECT 2022; 132:105809. [PMID: 35882089 DOI: 10.1016/j.chiabu.2022.105809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/24/2022] [Accepted: 07/18/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Inadequate housing contributes to the risk of family separation in nearly one-quarter of child maltreatment investigations. Child welfare struggles to identify and address the demand for housing assistance. A range of housing interventions shows promise for stabilizing families. Still, aid remains difficult to access, and little evidence exists for prioritizing households to interventions. Inefficient decisions about who to serve with scarce housing resources threaten to diminish resources and unintentionally place children at greater risk. OBJECTIVE The present study leverages computational modeling to simulate the complex dynamics of coordinated child welfare response to inadequate housing. Simulations address the lack of microdata on current service delivery to inform policy-making that protects children from family insecurity. PARTICIPANTS AND SETTINGS A series of simulated policy experiments test strategies for maximizing access to appropriate housing assistance and minimizing system-wide family separations using US estimates of housing insecurity and child welfare involvement. Models incorporate the feedback loops involved in seeking and waiting for needed services, using information on national rates of housing insecurity among child welfare-involved families. RESULTS Results demonstrate population-level improvements in family stability from enhanced targeting of housing assistance to families most likely to benefit, plus expanded access to housing interventions. Neither improved screening procedures nor more housing supports alone improve child welfare outcomes. CONCLUSIONS Findings emphasize the importance of data-driven upstream policies for protecting inadequately housed children at risk of maltreatment.
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Affiliation(s)
- Patrick J Fowler
- The Brown School, Washington University in St. Louis, USA; Division of Computational and Data Sciences, Washington University in St. Louis, USA.
| | | | - Peter S Hovmand
- School of Medicine, Case Western Reserve University, USA; Mandel School of Applied Social Sciences, Case Western Reserve University, USA
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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]
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23
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Joint association between ambient air pollutant mixture and pediatric asthma exacerbations. Environ Epidemiol 2022; 6:e225. [PMID: 36249268 PMCID: PMC9556053 DOI: 10.1097/ee9.0000000000000225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/07/2022] [Indexed: 11/23/2022] Open
Abstract
Exposure to air pollutants is known to exacerbate asthma, with prior studies focused on associations between single pollutant exposure and asthma exacerbations. As air pollutants often exist as a complex mixture, there is a gap in understanding the association between complex air pollutant mixtures and asthma exacerbations. We evaluated the association between the air pollutant mixture (52 pollutants) and pediatric asthma exacerbations. Method This study focused on children (age ≤ 19 years) who lived in Douglas County, Nebraska, during 2016-2019. A seasonal-scale joint association between the outdoor air pollutant mixture adjusting for potential confounders (temperature, precipitation, wind speed, and wind direction) in relation to pediatric asthma exacerbation-related emergency department (ED) visits was evaluated using the generalized weighted quantile sum (qWQS) regression with repeated holdout validation. Results We observed associations between air pollutant mixture and pediatric asthma exacerbations during spring (lagged by 5 days), summer (lag 0-5 days), and fall (lag 1-3 days) seasons. The estimate of the joint outdoor air pollutant mixture effect was higher during the summer season (adjusted-βWQS = 1.11, 95% confidence interval [CI]: 0.66, 1.55), followed by spring (adjusted-βWQS = 0.40, 95% CI: 0.16, 0.62) and fall (adjusted-βWQS = 0.20, 95% CI: 0.06, 0.33) seasons. Among the air pollutants, PM2.5, pollen, and mold contributed higher weight to the air pollutant mixture. Conclusion There were associations between outdoor air pollutant mixture and pediatric asthma exacerbations during the spring, summer, and fall seasons. Among the 52 outdoor air pollutant metrics investigated, PM2.5, pollen (sycamore, grass, cedar), and mold (Helminthosporium, Peronospora, and Erysiphe) contributed the highest weight to the air pollutant mixture.
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Fyfe C, Barnard LT, Douwes J, Howden‐Chapman P, Crane J. Retrofitting home insulation reduces incidence and severity of chronic respiratory disease. INDOOR AIR 2022; 32:e13101. [PMID: 36040274 PMCID: PMC9545372 DOI: 10.1111/ina.13101] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/31/2022] [Accepted: 08/05/2022] [Indexed: 09/13/2023]
Abstract
To assess whether retrofitting home insulation can reduce the risk of respiratory disease incidence and exacerbation, a retrospective cohort study was undertaken using linked data from a national intervention program. The study population was made up of 1 004 795 residents from 205 001 New Zealand houses that received an insulation subsidy though a national Energy Efficiency and Conservation Authority program. A difference-in-difference model compared changes in the number of prescriptions dispensed for respiratory illness post- insulation to a control population over the same timeframe. New prescribing of chronic respiratory disease medication at follow-up was used to compare incidence risk ratios between intervention and control groups. Chronic respiratory disease incidence was significantly lower in the intervention group at follow-up: odds ratio 0.90 (95% CI: 0.86-0.94). There was also a 4% reduction in medication dispensed for treating exacerbations of chronic respiratory disease symptoms in the intervention group compared with the control group: relative rate ratio (RRR) 0.96 (95% CI: 0.96-0.97). There was no change in medication dispensed to prevent symptoms of chronic respiratory disease RRR: 1,00 (95% CI: 0.99-1.00). These findings support home insulation interventions as a means of improving respiratory health outcomes.
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Affiliation(s)
- Caroline Fyfe
- He Kāinga Oranga, Department of Public HealthUniversity of Otago WellingtonWellingtonNew Zealand
| | - Lucy Telfar Barnard
- He Kāinga Oranga, Department of Public HealthUniversity of Otago WellingtonWellingtonNew Zealand
| | - Jeroen Douwes
- Research Centre for Hauora and HealthMassey University WellingtonWellingtonNew Zealand
| | - Philippa Howden‐Chapman
- He Kāinga Oranga, Department of Public HealthUniversity of Otago WellingtonWellingtonNew Zealand
| | - Julian Crane
- Wellington Asthma Research Group, Department of MedicineUniversity of Otago WellingtonWellingtonNew Zealand
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Asthma, bronchitis respiratory symptoms, allergies and home environment: how are they related? Postepy Dermatol Alergol 2022; 39:729-738. [PMID: 36090730 PMCID: PMC9454342 DOI: 10.5114/ada.2021.109696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 06/10/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction Home environmental conditions can affect the prevalence of childhood asthma and allergies. Aim To assess the relationship between the prevalence of childhood asthma, bronchitis, and allergies and the condition of the home environment. Material and methods In 2018 and 2019, a cross-sectional study on 2932 children from elementary schools in the Silesian Voivodship (Southern Poland) was conducted. The questionnaire was based on the International Study of Asthma and Allergies in Childhood (ISAAC). In order to determine the association between the home environment (presence of moulds, furry pets) and respiratory symptoms and diseases, a logistic regression analysis was performed by calculating the odds ratio (OR), determining p < 0.05 as the level of significance. Results Asthma risk factors were male sex, heating with solid fuel and presence of moulds. The prevalence of respiratory symptoms, bronchitis, and allergic diseases is statistically more common with the presence of moulds in dwellings. A protective effect of the presence of pets on the prevalence of asthma (OR = 0.77; 95% CI: 0.59–0.99), allergy to pet allergens (OR = 0.59; 95% CI: 0.45–0.76), allergy to house dust mite (OR = 0.70; 95% CI: 0.56–0.87) and wheeze in the last 12 months (OR = 0.70; 95% CI: 0.54–0.91) and ever (OR = 0.85; 95% CI: 0.70–1.02) was observed. Conclusions The study confirmed the known adverse influence of the presence of moulds and heating with solid fuel on the prevalence of asthma, bronchitis, respiratory symptoms and allergic diseases. The protective influence of pets on the occurrence of the health disorders under study was demonstrated.
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Influence of Home Indoor Dampness Exposure on Volatile Organic Compounds in Exhaled Breath of Mothers and Their Infants: The NELA Birth Cohort. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12146864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Currently, the effect of exposure to indoor air contaminants and the presence of dampness at home on respiratory/atopic health is of particular concern to physicians. The measurement of volatile organic compounds (VOCs) in exhaled breath is a useful approach for monitoring environmental exposures. A great advantage of this strategy is that it allows the study of the impact of pollutants on the metabolism through a non-invasive method. In this paper, the levels of nine VOCs (acetone, isoprene, toluene, p/m-xylene, o-xylene, styrene, benzaldehyde, naphthalene, and 2-ethyl-1-hexanol) in the exhaled breath of subjects exposed and not exposed to home dampness were assessed. Exhaled breath samples were collected from 337 mother–child pairs of a birth cohort and analysed by gas-chromatography–mass-spectrometry. It was observed that the levels of 2-ethyl-1-hexanol in the exhaled breath of the mothers were significantly influenced by exposure to household humidity. In the case of the infants, differences in some of the VOC levels related to home dampness exposure; however, they did not reach statistical significance. In addition, it was also found that the eosinophil counts of the mothers exposed to home dampness were significantly elevated compared to those of the non-exposed mothers. To our knowledge, these findings show, for the first time, that exposure to home dampness may influence VOC patterns in exhaled breath.
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27
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Grant TL, Wood RA. The influence of urban exposures and residence on childhood asthma. Pediatr Allergy Immunol 2022; 33:e13784. [PMID: 35616896 PMCID: PMC9288815 DOI: 10.1111/pai.13784] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 12/19/2022]
Abstract
Children with asthma who live in urban neighborhoods experience a disproportionately high asthma burden, with increased incident asthma and increased asthma symptoms, exacerbations, and acute visits and hospitalizations for asthma. There are multiple urban exposures that contribute to pediatric asthma morbidity, including exposure to pest allergens, mold, endotoxin, and indoor and outdoor air pollution. Children living in urban neighborhoods also experience inequities in social determinants of health, such as increased poverty, substandard housing quality, increased rates of obesity, and increased chronic stress. These disparities then in turn can increase the risk of urban exposures and compound asthma morbidity as poor housing repair is a risk factor for pest infestation and mold exposure and poverty is a risk factor for exposure to air pollution. Environmental interventions to reduce in-home allergen concentrations have yielded inconsistent results. Population-level interventions including smoking bans in public places and legislation to decrease traffic-related air pollution have been successful at reducing asthma morbidity and improving lung function growth. Given the interface and synergy between urban exposures and social determinants of health, it is likely population and community-level changes will be needed to decrease the excess asthma burden in children living in urban neighborhoods.
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Affiliation(s)
- Torie L Grant
- Division of Pediatric Allergy, Immunology, and Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Robert A Wood
- Division of Pediatric Allergy, Immunology, and Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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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.
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Lemire E, Samuels EA, Wang W, Haber A. Unequal Housing Conditions And Code Enforcement Contribute To Asthma Disparities In Boston, Massachusetts. Health Aff (Millwood) 2022; 41:563-572. [PMID: 35377754 DOI: 10.1377/hlthaff.2021.01403] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Housing quality is a primary determinant of asthma disparities by race and social class in the US. We sought to assess how housing code enforcement systems in Boston, Massachusetts, address tenants' reports of asthma triggers. After adjustment for income and other neighborhood characteristics, racial demographics were significantly associated with asthma trigger incidence. For each 10 percent decrease in neighborhood proportion of White residents, trigger incidence increased by 3.14 reports per thousand residents. These disparities persisted during the study period (from 2011 through 2021), and for mold, which is an established asthma trigger, regressions showed that racial disparities are widening. The municipal response also demonstrated disparities: In neighborhoods with the fewest White residents compared to neighborhoods with the most White residents, adjusted models showed a 17 percent (3.51 days) slower median time until cases (tenant requests for inspections to the Inspectional Services Department) were closed, a 14 percent higher probability of being flagged as overdue, and a 54.4 percent lower probability of a repair. We found evidence that in Boston, despite several healthy housing initiatives, current regulatory systems are insufficient to address disparities in access to healthy housing. To reduce disparities in asthma burden, stronger inspectional standards and further enforcement policies to increase landlords' accountability and support tenants' rights to have repairs made are essential.
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Affiliation(s)
- Evan Lemire
- Evan Lemire, Harvard University, Boston, Massachusetts
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Castellano J, Sanz V, Cañas E, Sánchez E. Assessment of humidity self-regulation functionality for ceramic tiles. Ann Ital Chir 2022. [DOI: 10.1016/j.jeurceramsoc.2021.10.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Saijo Y, Yoshioka E, Sato Y, Azuma H, Tanahashi Y, Ito Y, Kobayashi S, Minatoya M, Ait Bamai Y, Yamazaki K, Itoh S, Miyashita C, Ikeda-Araki A, Kishi R, Kamijima M, Yamazaki S, Ohya Y, Yaegashi N, Hashimoto K, Mori C, Ito S, Yamagata Z, Inadera H, Nakayama T, Iso H, Shima M, Kurozawa Y, Suganuma N, Kusuhara K, Katoh T. Relations of mold, stove, and fragrance products on childhood wheezing and asthma: A prospective cohort study from the Japan Environment and Children's Study. INDOOR AIR 2022; 32:e12931. [PMID: 34773308 DOI: 10.1111/ina.12931] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/04/2021] [Accepted: 09/07/2021] [Indexed: 06/13/2023]
Abstract
This prospective cohort study aimed to examine the associations between mold growth, type of stoves, and fragrance materials and early childhood wheezing and asthma, using data from the Japan Environment and Children's Study. Mold growth at home, usage of kerosene/gas stove, wood stove/fireplace, and air freshener/deodorizer were surveyed using a questionnaire at 1.5-year-old, and childhood wheezing and doctor-diagnosed asthma during the previous year were obtained using a 3-year-old questionnaire. Multilevel logistic regression analysis was performed to evaluate the association between exposure to childhood wheezing and asthma. A total of 60 529 children were included in the analysis. In multivariate analyses, mold growth and wood stove/fireplace had significantly higher odds ratios (ORs) for wheezing (mold growth: 1.13; 95% CI, 1.06-1.22; wood stove/fireplace: 1.23; 95% CI, 1.03-1.46). All four exposures had no significant ORs for childhood doctor-diagnosed asthma; however, in the supplemental analysis of northern regions, wood stove/fireplace had a significantly higher OR for asthma. Mold growth and wood stove/fireplace had significant associations with childhood wheezing in the northern regions. Mold elimination in the dwellings and use of clean heating (no air pollution emissions) should be taken into consideration to prevent and improve childhood wheezing and asthma.
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Affiliation(s)
- Yasuaki Saijo
- Division of Public Health and Epidemiology, Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
| | - Eiji Yoshioka
- Division of Public Health and Epidemiology, Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
| | - Yukihiro Sato
- Division of Public Health and Epidemiology, Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
| | - Hiroshi Azuma
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
| | - Yusuke Tanahashi
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
| | - Yoshiya Ito
- Faculty of Nursing, Japanese Red Cross Hokkaido College of Nursing, Kitami, Japan
| | - Sumitaka Kobayashi
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Machiko Minatoya
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Yu Ait Bamai
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Keiko Yamazaki
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Sachiko Itoh
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Chihiro Miyashita
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Atsuko Ikeda-Araki
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
- Facutly of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Reiko Kishi
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Michihiro Kamijima
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shin Yamazaki
- National Institute for Environmental Studies, Tsukuba, Japan
| | - Yukihiro Ohya
- National Center for Child Health and Development, Tokyo, Japan
| | | | | | | | | | | | | | | | | | | | | | | | - Koichi Kusuhara
- University of Occupational and Environmental Health, Kitakyushu, Japan
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Hoxha V, Hoxha D, Hoxha J. Current situation, challenges and future development directions of facilities management in Kosovo. PROPERTY MANAGEMENT 2021. [DOI: 10.1108/pm-05-2021-0034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
While facilities management (FM) in Kosovo is a constantly growing discipline, the studies so far in Kosovo have been scarce and too general. The purpose of the paper is to discuss the current situation of FM in Kosovo, identify challenges and recommend new future development directions of the sector with regard to capabilities of facility managers, integration of technology in FM and FM standardization.
Design/methodology/approach
The present study uses qualitative method by using semi-structured interviews with purposive sample of 20 FM professionals with experience of more than 15 years that cover public, private sector and international organizations.
Findings
The present study finds that FM in Kosovo is in its infancy stage, and it is mainly perceived as maintenance and cleaning with the low level of outsourcing. Generally, it was agreed that FM industry in Kosovo faces several challenges such as lack of budget, resources and staff; inappropriate FM planning; absence of uniform KPIs and low sensitivity of FM to sustainability. The study finally finds that FM in Kosovo can be enhanced only through integration of novel technologies, development of adaptive capability of facility managers and adequate FM standardization.
Research limitations/implications
The present study helps researchers and practitioners to understand the current situation of FM in Kosovo in terms of planning, outsourcing and primary purpose of FM in Kosovo. The study also provides an overview of challenges of FM in Kosovo, which can be used by researchers and practitioners to identify future development directions for the sector and profession.
Originality/value
The study contributes to the current knowledge about the state of development of FM in transitional countries such as Kosovo. The findings will identify future development areas of FM in Kosovo especially with regard to capability and skills of FM professionals and integration of technology in FM, which can be used by other countries facing the same perceptional and developmental challenges in FM.
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Pacheco SE, Guidos G, Annesi-Maesano I, Pawankar R, Amato GD, Latour-Staffeld P, Urrutia-Pereira M, Kesic MJ, Hernandez ML. Climate Change and Global Issues in Allergy and Immunology. J Allergy Clin Immunol 2021; 148:1366-1377. [PMID: 34688774 DOI: 10.1016/j.jaci.2021.10.011] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/12/2021] [Accepted: 10/18/2021] [Indexed: 11/17/2022]
Abstract
The steady increase in global temperatures, resulting from the combustion of fossil fuels and the accumulation of greenhouse gases (GHG), continues to destabilize all ecosystems worldwide. Although annual emissions must halve by 2030 and reach net-zero by 2050 to limit some of the most catastrophic impacts associated with a warming planet, the world's efforts to curb GHG emissions fall short of the commitments made in the 2015 Paris Agreement (1). To this effect, July 2021 was recently declared the hottest month ever recorded in 142 years (2). The ramifications of these changes on global temperatures are complex and further promote outdoor air pollution, pollen exposure, and extreme weather events. Besides worsening respiratory health, air pollution, promotes atopy and susceptibility to infections. The GHG effects on pollen affect the frequency and severity of asthma and allergic rhinitis. Changes in temperature, air pollution, and extreme weather events exert adverse multisystemic health effects and disproportionally affect disadvantaged and vulnerable populations. This article is an update for allergists and immunologists about the health impacts of climate change, already evident in our daily practices. It is also a call to action and advocacy, including integrating climate change-related mitigation, education, and adaptation measures to protect our patients and avert further injury to our planet.
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Affiliation(s)
- Susan E Pacheco
- Professor of Pediatrics, University of Texas McGovern Medical School, MSB3.228, Houston, Texas 77030.
| | - Guillermo Guidos
- Professor of Immunology, School of Medicine, ENMH, Instituto Politecnico Nacional, Mexico City
| | - Isabella Annesi-Maesano
- Deputy Director of Institute Desbrest of Epiddemioloy and Public Health, INSERM and Montpellier University, Montpellier, France
| | - Ruby Pawankar
- Professor, Division of Allergy, Dept. of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - Gennaro D' Amato
- Fellow and Honorary member of EAACI, FAAAAI, FERS. , Chairman Committee World Allergy Organization on "Aerobiology, Climate change, Biodiversity and Allergy"; Division of Respiratory Diseases and Allergy, High Specialty Hospital A. Cardarelli, Naples
| | - Patricia Latour-Staffeld
- Allergy and Clinical Immunology, Distinguished Graduate Universidad Nacional Pedro Henriquez Ureña, Medical director of Centro Avanzado De Alergia y Asma Santo Domingo, President Latin American Society of Allergy, Asthma and Immunology, Associate Professor School of Medicine Universidad Nacional Pedro Henriquez Ureña, Dominican Republic
| | | | - Matthew J Kesic
- Campbell University, Physician Assistant Program, College of Pharmacy and Health Sciences, 4150 US HWY 421 South, Lillington, NC 27546
| | - Michelle L Hernandez
- Professor of Pediatrics Division of Allergy & Immunology Director, Clinical Research Unit, Children's Research Institute, UNC School of Medicine, 5008C Mary Ellen Jones Building, 116 Manning Drive, CB #7231 Chapel Hill, NC 27599-7231
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Haines SR, Hall EC, Marciniak K, Misztal PK, Goldstein AH, Adams RI, Dannemiller KC. Microbial growth and volatile organic compound (VOC) emissions from carpet and drywall under elevated relative humidity conditions. MICROBIOME 2021; 9:209. [PMID: 34666813 PMCID: PMC8524935 DOI: 10.1186/s40168-021-01158-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 08/27/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Microbes can grow in indoor environments if moisture is available, and we need an improved understanding of how this growth contributes to emissions of microbial volatile organic compounds (mVOCs). The goal of this study was to measure how moisture levels, building material type, collection site, and microbial species composition impact microbial growth and emissions of mVOCs. We subjected two common building materials, drywall, and carpet, to treatments with varying moisture availability and measured microbial communities and mVOC emissions. RESULTS Fungal growth occurred in samples at >75% equilibrium relative humidity (ERH) for carpet with dust and >85% ERH for inoculated painted drywall. In addition to incubated relative humidity level, dust sample collection site (adonis p=0.001) and material type (drywall, carpet, adonis p=0.001) drove fungal and bacterial species composition. Increased relative humidity was associated with decreased microbial species diversity in samples of carpet with dust (adonis p= 0.005). Abundant volatile organic compounds (VOCs) that accounted for >1% emissions were likely released from building materials and the dust itself. However, certain mVOCs were associated with microbial growth from carpet with dust such as C10H16H+ (monoterpenes) and C2H6SH+ (dimethyl sulfide and ethanethiol). CO2 production from samples of carpet with dust at 95% ERH averaged 5.92 mg hr-1 kg-1, while the average for carpet without dust at 95% ERH was 2.55 mg hr-1 kg-1. CONCLUSION Microbial growth and mVOC emissions occur at lower relative humidity in carpet and floor dust compared to drywall, which has important implications for human exposure. Even under elevated relative humidity conditions, the VOC emissions profile is dominated by non-microbial VOCs, although potential mVOCs may dominate odor production. Video Abstract.
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Affiliation(s)
- Sarah R. Haines
- Department of Civil & Mineral Engineering, University of Toronto, Toronto, Ontario M5S 1A4 Canada
| | - Emma C. Hall
- Department of Civil, Architectural and Environmental Engineering, University of Texas at Austin, Austin, TX 78712 USA
| | | | - Pawel K. Misztal
- Department of Civil, Architectural and Environmental Engineering, University of Texas at Austin, Austin, TX 78712 USA
| | - Allen H. Goldstein
- Department of Environmental Science, Policy and Management, University of California, Berkeley, CA 94720 USA
| | - Rachel I. Adams
- Department of Plant and Microbial Biology, University of California, Berkeley, CA 94720 USA
| | - Karen C. Dannemiller
- Department of Civil, Environmental & Geodetic Engineering, College of Engineering, Ohio State University, Columbus, OH 43210 USA
- Division of Environmental Health Sciences, College of Public Health, Ohio State University, Columbus, OH 43210 USA
- Sustainability Institute, Ohio State University, Columbus, OH 43210 USA
- Department of Civil, Environmental & Geodetic Engineering, Environmental Health Sciences, Ohio State University, 470 Hitchcock Hall, 2070 Neil Ave, Columbus, OH 43210 USA
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Hegyi A, Grebenişan E, Lăzărescu AV, Stoian V, Szilagyi H. Influence of TiO 2 Nanoparticles on the Resistance of Cementitious Composite Materials to the Action of Fungal Species. MATERIALS 2021; 14:ma14164442. [PMID: 34442965 PMCID: PMC8398090 DOI: 10.3390/ma14164442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 07/27/2021] [Accepted: 08/05/2021] [Indexed: 11/27/2022]
Abstract
The development of mold films on the cement surfaces of buildings is a health and safety problem for the population, aesthetic but also in terms of their durability. The use of specific performance of cementitious composites containing TiO2 nanoparticles, photoactivated by UV radiation, can be a viable solution to mitigate to eliminate these problems. The experimental studies presented aim to analyze the capacity to inhibit the development of mold type Aspergillus and Penicillium on the surface of composite materials with nano-TiO2 content and the identification of the optimal range of nanomaterial addition. The identification and analysis of the inhibition halo (zone with a biological load of maximum 1–10 colonies of microorganisms) confirmed the biocidal capacity of the cementitious composites, but also indicated the possibility that an excess of TiO2 nanoparticles in the mixture could induce a development of cell resistance, which would be unfavorable both in terms of behavior and in terms of cost.
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Affiliation(s)
- Andreea Hegyi
- NIRD URBAN-INCERC Cluj-Napoca Branch, 117 Calea Floreşti, 400524 Cluj-Napoca, Romania;
- Correspondence: (A.H.); (A.-V.L.); (V.S.); (H.S.)
| | - Elvira Grebenişan
- NIRD URBAN-INCERC Cluj-Napoca Branch, 117 Calea Floreşti, 400524 Cluj-Napoca, Romania;
- IOSUD-UTCN Doctoral School, Technical University of Cluj-Napoca, 15 Daicoviciu Street, 400020 Cluj-Napoca, Romania
| | - Adrian-Victor Lăzărescu
- NIRD URBAN-INCERC Cluj-Napoca Branch, 117 Calea Floreşti, 400524 Cluj-Napoca, Romania;
- IOSUD-UTCN Doctoral School, Technical University of Cluj-Napoca, 15 Daicoviciu Street, 400020 Cluj-Napoca, Romania
- Correspondence: (A.H.); (A.-V.L.); (V.S.); (H.S.)
| | - Vlad Stoian
- Department of Microbiology, Faculty of Agriculture, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, 3-5 Calea Mănăştur, 400372 Cluj-Napoca, Romania
- Correspondence: (A.H.); (A.-V.L.); (V.S.); (H.S.)
| | - Henriette Szilagyi
- NIRD URBAN-INCERC Cluj-Napoca Branch, 117 Calea Floreşti, 400524 Cluj-Napoca, Romania;
- Correspondence: (A.H.); (A.-V.L.); (V.S.); (H.S.)
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Abstract
The prevalence of allergic diseases is increasing rapidly and has already reached an epidemic level. Two major drivers of this development are climate change and globalization, which both induce an increase in allergens. Concomitant climate change fosters the spreading of the latter on a global scale. The increase in allergens not only aggravates the symptoms and the degree of suffering for patients who already are allergic, but also gives rise to new cases of allergies. The distribution of allergies in society follows a steep socioeconomic gradient worldwide. According to well-established theories of justice such a distribution of the allergy burden is unfair. This fact adds a major ethical dimension and challenge to the allergy epidemic. This chapter draws on the key points of policies for allergy prevention and treatment. It shows how related programs and measures can be conceptualized and prioritized according to the principles of distributional justice.
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Affiliation(s)
- Clemens Heuson
- Zentrum für Klimaresilienz, Universität Augsburg, Augsburg, Germany.
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Factors Affecting Occupants’ Satisfaction in Governmental Buildings: The Case of the Kingdom of Bahrain. BUILDINGS 2021. [DOI: 10.3390/buildings11060231] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Satisfaction is a very important factor in improving productivity and performance in the work environment. This study aims to investigate the levels of occupants’ satisfaction with the indoor environmental quality (IEQ) in the governmental buildings in the Kingdom of Bahrain and to investigate the impact of occupants’ demographics and building attributes (non-IEQ factors) on these levels. For these purposes, the study used a questionnaire that has 17 indoor environmental quality (IEQ) factors in addition to a group of non-IEQ factors. The questionnaire was distributed by hand or using email to 279 employees in the Bahraini governmental sector. The findings of the study revealed that occupants in the Bahraini governmental buildings are not strongly satisfied with IEQ factors, especially with sound privacy, followed by visual privacy and amount of space, and then noise levels. The findings also showed that for most IEQ factors, men are more satisfied than women are, those who work in enclosed private offices are more satisfied than those who work in open-plan offices, and those who have central air-conditioning at their workplace are more than those who have a wall-mounted air conditioner. The impact of age, nature of work, duration of working in the current building and at the current workstation, weekly working hours, and proximity to the window were also investigated. Accordingly, a group of recommendations was suggested aiming to improve the levels of occupants’ satisfaction.
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Van Mason J, Portnoy JM. Immunologic Strategies for Prevention of Asthma. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 8:834-847. [PMID: 32147137 DOI: 10.1016/j.jaip.2019.11.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 11/25/2019] [Accepted: 11/26/2019] [Indexed: 12/16/2022]
Abstract
A new understanding of factors leading to the development of asthma has pointed to potential primary, secondary, and tertiary prevention strategies. Some, such as genetic makeup, are not yet modifiable. Interventions targeting other factors such as maternal intake of vitamin D or environmental control can be used to decrease the risk of asthma development (primary prevention). The benefits of a diversified microbiome could be considered when recommending allergen avoidance and pet ownership. In addition to reducing symptoms, allergen immunotherapy is also worth considering for prevention of new sensitivities (secondary prevention) in addition to the development of asthma. Ongoing studies involving the use of bacterial vaccines and biologics may provide additional strategies for primary prevention of asthma and for reducing symptoms once it has developed (tertiary prevention). As the relative benefits of these strategies are defined, they should have an increasingly important place in the prevention and management of asthma.
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Affiliation(s)
- Jessica Van Mason
- Section of Allergy, Asthma & Immunology, Children's Mercy Hospital, Kansas City, Mo
| | - Jay M Portnoy
- Section of Allergy, Asthma & Immunology, Children's Mercy Hospital, Kansas City, Mo.
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Climate change, air pollution, and allergic respiratory diseases: a call to action for health professionals. Chin Med J (Engl) 2021; 133:1552-1560. [PMID: 32590458 PMCID: PMC7386356 DOI: 10.1097/cm9.0000000000000861] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Rising emissions of greenhouse gases in the atmosphere have warmed the planet substantially and are also accompanied by poor air quality. The increased prevalence of allergic airway disease worldwide can be partially attributed to those global environmental changes. Climate change and air pollution pose adverse impacts on respiratory allergies, and that the mechanisms are complex and interactive. Adverse weather conditions, such as extreme temperatures, can act directly on the respiratory tract to induce allergic respiratory illnesses. Thunderstorms and floods can alter the production and distribution of aeroallergens while wildfires and dust storms increase air pollution, and therefore indirectly enhance health risks. Concentrations of particulate matter and ozone in the air have been projected to increase with climate warming and air stagnation, and the rising temperatures and CO2 increase pollen, molds, and spores, which escalate the risk of allergic respiratory diseases. The synergistic effects of extreme heat and aeroallergens intensify the toxic effect of air pollutants, which in turn augment the allergenicity of aeroallergens. With the Earth's climate change, migration of humans and plants shift the living environments and allergens of susceptible people. Urban residents are exposed to multiple factors while children are sensitive to environmental exposure. Since climate change may pose many unexpected and persistent effects on allergic respiratory diseases, health professionals should advocate for effective mitigation and adaptation strategies to minimize its respiratory health effects.
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A novel qPCR based-method for detection and quantification of three recurrent species of Penicillium isolated from bioaerosols in mold-damaged homes. J Microbiol Methods 2021; 186:106236. [PMID: 33984389 DOI: 10.1016/j.mimet.2021.106236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/07/2021] [Accepted: 05/07/2021] [Indexed: 11/21/2022]
Abstract
Fungal contamination of indoor environments can cause respiratory diseases and induce damages to building materials. Among the fungal species found in mold-damaged homes, Penicillium brevicompactum, P. chrysogenum and P. crustosum can be considered as recurrent strains. In this study, we therefore propose a rapid and novel qPCR-based method in order to allow the monitoring of these three fungal species. The method developed allows the quantification of the target DNA of these three Penicillium species with a limit of quantification of 0.01 ng/μL without significant difference with spectrophotometry quantification assay for DNA concentrations between 5 and 100 ng/μL. This technique also enables the rapid detection of these three species in complex mixtures of DNA extracted from 15 bioaerosols collected in mold-damaged homes and previously cultured on agar plate. This new sensitive and specific qPCR technique can thus be easily integrated into bioaerosol studies.
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Martin-Sanchez PM, Estensmo ELF, Morgado LN, Maurice S, Engh IB, Skrede I, Kauserud H. Analysing indoor mycobiomes through a large-scale citizen science study in Norway. Mol Ecol 2021; 30:2689-2705. [PMID: 33830574 DOI: 10.1111/mec.15916] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 03/30/2021] [Accepted: 04/01/2021] [Indexed: 01/04/2023]
Abstract
In the built environment, fungi can cause important deterioration of building materials and have adverse health effects on occupants. Increased knowledge about indoor mycobiomes from different regions of the world, and their main environmental determinants, will enable improved indoor air quality management and identification of health risks. This is the first citizen science study of indoor mycobiomes at a large geographical scale in Europe, including 271 houses from Norway and 807 dust samples from three house compartments: outside of the building, living room and bathroom. The fungal community composition determined by DNA metabarcoding was clearly different between indoor and outdoor samples, but there were no significant differences between the two indoor compartments. The 32 selected variables, related to the outdoor environment, building features and occupant characteristics, accounted for 15% of the overall variation in community composition, with the house compartment as the key factor (7.6%). Next, climate was the main driver of the dust mycobiomes (4.2%), while building and occupant variables had significant but minor influences (1.4% and 1.1%, respectively). The house-dust mycobiomes were dominated by ascomycetes (⁓70%) with Capnodiales and Eurotiales as the most abundant orders. Compared to the outdoor samples, the indoor mycobiomes showed higher species richness, which is probably due to the mixture of fungi from outdoor and indoor sources. The main indoor indicator fungi belonged to two ecological groups with allergenic potential: xerophilic moulds and skin-associated yeasts. Our results suggest that citizen science is a successful approach for unravelling the built microbiome at large geographical scales.
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Affiliation(s)
- Pedro M Martin-Sanchez
- Section for Genetics and Evolutionary Biology (Evogene), Department of Biosciences, University of Oslo, Oslo, Norway
| | - Eva-Lena F Estensmo
- Section for Genetics and Evolutionary Biology (Evogene), Department of Biosciences, University of Oslo, Oslo, Norway
| | - Luis N Morgado
- Section for Genetics and Evolutionary Biology (Evogene), Department of Biosciences, University of Oslo, Oslo, Norway.,Naturalis Biodiversity Center, Leiden, the Netherlands
| | - Sundy Maurice
- Section for Genetics and Evolutionary Biology (Evogene), Department of Biosciences, University of Oslo, Oslo, Norway
| | | | - Inger Skrede
- Section for Genetics and Evolutionary Biology (Evogene), Department of Biosciences, University of Oslo, Oslo, Norway
| | - Håvard Kauserud
- Section for Genetics and Evolutionary Biology (Evogene), Department of Biosciences, University of Oslo, Oslo, Norway
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Mapping Housing Laws in the United States: A Resource for Evaluating Housing Policies' Impacts on Health. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2021; 26 Suppl 2, Advancing Legal Epidemiology:S29-S36. [PMID: 32004220 DOI: 10.1097/phh.0000000000001111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
CONTEXT Safe, stable housing is essential to good health. Housing hazards, including mold, vermin, and lead, can contribute to the development or exacerbation of chronic illnesses such as asthma and neurological disorders. In addition, eviction has been associated with poor physical and mental health outcomes. There are many laws aimed at maintaining healthy housing, or protecting access to stable housing, but their impacts are mostly unknown. POLICY Using scientific legal mapping, the Center for Public Health Law Research (the Center) created legal data sets on state landlord-tenant laws, state fair housing laws, and city nuisance property ordinances. These data sets track the incidence and key features of these laws, creating legal data that can be used for evaluation. Some important elements of these laws include property maintenance duties; protections against retaliation; protected classes under state fair housing laws; discriminatory acts prohibited by state fair housing laws; types of conduct that constitute nuisance activity; and required nuisance abatement actions. IMPLEMENTATION AND/OR DISSEMINATION As of August 1, 2017, all 50 states and the District of Columbia have a state landlord-tenant law; all states except Mississippi have a state fair housing law; and 37 of the 40 most populous US cities have a local nuisance property ordinance. EVALUATION Evaluation of these laws is needed to determine their effectiveness and impacts and to spread the use of evidence-based policies. The creation of these legal data sets is the first step toward evaluation. DISCUSSION Law can play an important role in promoting healthy housing, but evaluating the law is essential to determining its impact. Tracking the prevalence and key elements of laws is an important first step in conducting evaluation. The legal data created by the Center can be used to evaluate the efficacy and impacts of state landlord-tenant laws, state fair housing protections, and city nuisance property ordinances.
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Associations between Housing Factors and Respiratory Symptoms in Two Saskatchewan First Nations Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073744. [PMID: 33916673 PMCID: PMC8038413 DOI: 10.3390/ijerph18073744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/23/2021] [Accepted: 03/31/2021] [Indexed: 11/17/2022]
Abstract
Inadequate housing is commonplace in First Nations in Canada, often leading to environmental impacts on housing such as dampness and mold. First Nations communities suffer from a higher prevalence of respiratory-related health conditions than the general Canadian population. There is limited Canadian literature evaluating the relationship between housing factors and the respiratory health of adults within First Nations communities. This study was undertaken with two Saskatchewan First Nations communities. The study population consisted of 293 individuals within 131 households. The individuals completed questionnaires on their general and respiratory health, and one member of each household completed a household questionnaire. The collection of environmental samples from within the house was undertaken. The respiratory outcomes of interest focused on the individuals with ever wheeze, reported by 77.8% of the individuals, and shortness of breath, reported by 52.6% of the individuals. Body mass index, the nontraditional use of tobacco (i.e., current and ex-smoking), the nontraditional use of tobacco in the house (i.e., smoking in the house), dampness in the house in the last 12 months, and always having a smell of mold in the house were significantly associated with respiratory symptoms. The results reveal that respiratory symptom rates were high in the population and housing factors were significantly associated with respiratory symptoms. Addressing and redressing housing inadequacies in First Nations communities are important in preventing additional burdens to health.
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Mannan M, Al-Ghamdi SG. Indoor Air Quality in Buildings: A Comprehensive Review on the Factors Influencing Air Pollution in Residential and Commercial Structure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3276. [PMID: 33810001 PMCID: PMC8004912 DOI: 10.3390/ijerph18063276] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 03/07/2021] [Accepted: 03/09/2021] [Indexed: 11/17/2022]
Abstract
Worldwide people tend to spend approximately 90% of their time in different indoor environments. Along with the penetration of outside air pollutants, contaminants are produced in indoor environments due to different activities such as heating, cooling, cooking, and emissions from building products and the materials used. As people spend most of their lives in indoor environments, this has a significant influence on human health and productivity. Despite the two decades of indoor air quality (IAQ) research from different perspectives, there is still a lack of comprehensive evaluation of peer-reviewed IAQ studies that specifically covers the relationship between the internal characteristics of different types of building environments with IAQ to help understand the progress and limitations of IAQ research worldwide. Therefore, this review of scientific studies presents a broad spectrum of pollutants identified in both residential and commercial indoor environments, highlighting the trends and gaps in IAQ research. Moreover, analysis of literature data enabled us to assess the different IAQs in buildings located in different countries/regions, thus reflecting the current global scientific understanding of IAQ. This review has the potential to benefit building professionals by establishing indoor air regulations that account for all indoor contaminant sources to create healthy and sustainable building environments.
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Affiliation(s)
| | - Sami G. Al-Ghamdi
- Division of Sustainable Development, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar;
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45
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James E, Linde B, Redlich CA. Master Clinician and Public Health Practitioner: Selected Occupational and Environmental Pulmonary Cases. Clin Chest Med 2021; 41:567-580. [PMID: 33153680 DOI: 10.1016/j.ccm.2020.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Occupational and environmental exposures contribute to the development and progression of most lung diseases, yet their impact is greatly under-recognized in clinical practice. Clinicians caring for patients with respiratory diseases should maintain a high index of suspicion for occupational and environmental contributing factors. Mastering occupational and environmental medicine clinical decision making requires specialized clinical skills. These skills include obtaining an appropriate work and exposure history; making an assessment of the magnitude and relevance of exposures and their contribution to a patient's respiratory disease; utilizing appropriate resources for evaluation and management of exposure-related disease; and considering socioeconomic and public health factors.
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Affiliation(s)
- Efia James
- Department of Medicine, Yale Occupational and Environmental Medicine Program, Yale School of Medicine, 367 Cedar Street, ESHA 2nd Floor, New Haven, CT 06510, USA.
| | - Brian Linde
- Department of Medicine, Yale Occupational and Environmental Medicine Program, Yale School of Medicine, 367 Cedar Street, ESHA 2nd Floor, New Haven, CT 06510, USA
| | - Carrie A Redlich
- Department of Medicine, Yale Occupational and Environmental Medicine Program, Yale School of Medicine, 367 Cedar Street, ESHA 2nd Floor, New Haven, CT 06510, USA
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Xiao S, Ngo AL, Mendola P, Bates MN, Barcellos AL, Ferrara A, Zhu Y. Household mold, pesticide use, and childhood asthma: A nationwide study in the U.S. Int J Hyg Environ Health 2021; 233:113694. [PMID: 33556714 DOI: 10.1016/j.ijheh.2021.113694] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 01/13/2021] [Accepted: 01/22/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To investigate the associations of household mold and pesticide use with risk of childhood asthma and examine the potential effect modification by child's sex at a national level in the U.S. METHODS Nationally representative data were drawn from the cross-sectional 2017 and 2018 National Surveys of Children's Health. Household mold and pesticide exposures during the past 12 months and physician-diagnosed childhood asthma were assessed by standard questionnaires administered to primary caregivers. Multivariable logistic regression models were used to calculate adjusted odds ratios (aOR) for current asthma, adjusting for child, caregiver, and household covariates. We also examined potential effect modification by child's sex. Sampling weights accounted for the complex survey design. RESULTS Among 41,423 U.S. children in 2017-2018, the weighted prevalence of current asthma was 10.8% in household mold-exposed children, compared with 7.2% in non-exposed children (P < 0.001). After adjusting for covariates including child's obesity, children with household mold exposure compared to those with no household mold exposure had a 1.41-fold (95% CI: 1.07, 1.87) higher odds of current asthma. Associations between household mold and current asthma were pronounced among boys (aOR 1.57; 95% CI: 1.03-2.38) but not girls (aOR 1.28; 0.90-1.83; P for interaction <0.001). No significant associations were observed between household pesticide use and current asthma, after adjusting for covariates. CONCLUSIONS Our findings suggest that household mold is associated with current asthma among children, independent of other major risk factors including child's obesity status. Our findings may inform strategies targeting mitigation of household mold as an important indoor environment factor to address childhood asthma.
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Affiliation(s)
- Siyuan Xiao
- School of Public Health, University of California, Berkeley, United States
| | - Amanda L Ngo
- Kaiser Permanente Northern California Division of Research, Oakland, CA, United States
| | - Pauline Mendola
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States
| | - Michael N Bates
- School of Public Health, University of California, Berkeley, United States
| | - Anna L Barcellos
- School of Public Health, University of California, Berkeley, United States
| | - Assiamira Ferrara
- Kaiser Permanente Northern California Division of Research, Oakland, CA, United States
| | - Yeyi Zhu
- Kaiser Permanente Northern California Division of Research, Oakland, CA, United States; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, United States.
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Riggs L, Keall M, Howden-Chapman P, Baker MG. Environmental burden of disease from unsafe and substandard housing, New Zealand, 2010-2017. Bull World Health Organ 2021; 99:259-270. [PMID: 33953443 PMCID: PMC8085632 DOI: 10.2471/blt.20.263285] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 11/05/2020] [Accepted: 11/18/2020] [Indexed: 11/27/2022] Open
Abstract
Objective To assess the burden of disease related to unsafe and substandard housing conditions in New Zealand from 2010 to 2017. Methods We focused on substandard housing conditions most relevant for New Zealand homes: crowding, cold, damp or mould, and injury hazards linked to falls. We estimated the population attributable fraction using existing estimates of the population exposed and exposure–response relationships of health disorders associated with each housing condition. We used government hospitalization data, no-fault accident insurance claims and mortality data to estimate the annual disease burden from the most severe cases, as well as the resulting costs to the public sector in New Zealand dollars (NZ$). Using value of a statistical life measures, we estimated the indirect cost of deaths. Findings We estimated that illnesses attributable to household crowding accounted for 806 nights in hospital annually; cold homes for 1834 hospital nights; and dampness and mould for 36 649 hospital nights. Home injury hazards resulted in 115 555 annual accident claims. We estimated that direct public sector costs attributable to these housing conditions were approximately NZ$ 141 million (100 million United States dollars, US$) annually. We also estimated a total of 229 deaths annually attributable to adverse housing and the costs to society from these deaths at around NZ$ 1 billion (US$ 715 million). Conclusion Of the conditions assessed in this study, damp and mouldy housing accounted for a substantial proportion of the burden of disease in New Zealand. Improving people’s living conditions could substantially reduce total hospitalization costs and potentially improve quality of life.
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Affiliation(s)
- Lynn Riggs
- Motu Economic and Public Policy Research, 97 Cuba Street, Wellington 6011, New Zealand
| | - Michael Keall
- Department of Public Health, University of Otago, Dunedin, New Zealand
| | | | - Michael G Baker
- Department of Public Health, University of Otago, Dunedin, New Zealand
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Demain JG, Choi YJ, Oh JW. The Impact of Climate Change on the Pollen Allergy and Sporulation of Allergic Fungi. CURRENT TREATMENT OPTIONS IN ALLERGY 2021. [DOI: 10.1007/s40521-020-00277-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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49
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Wang J, Zhang Y, Li B, Zhao Z, Huang C, Zhang X, Deng Q, Lu C, Qian H, Yang X, Sun Y, Sundell J, Norbäck D. Asthma and allergic rhinitis among young parents in China in relation to outdoor air pollution, climate and home environment. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 751:141734. [PMID: 32882555 DOI: 10.1016/j.scitotenv.2020.141734] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 08/14/2020] [Indexed: 05/14/2023]
Abstract
We estimated associations between ambient air pollution, home environment and asthma as well as rhinitis among adults across China. A total of 40,279 young adults from eight Chinese cities participated in a questionnaire survey (participation rate 75%). There were questions on health and home environment. Information on city level gross domestic product (GDP) per capita, ambient temperature and PM10 and NO2 were collected from registers. Two-level logistic regression models were used to study health associations. Totally 1.6% reported asthma and 6.6% reported allergic rhinitis (AR). Higher temperature was associated with more asthma but less AR. Higher GDP was associated with less asthma but more AR. Higher degree of urbanization, higher level of NO2 and living near heavily trafficked road were risk factors for asthma and AR. Participants in older buildings reported more asthma. Redecoration and buying new furniture were related to more asthma and AR (OR = 1.15-1.91). Using natural gas (OR = 1.34) and biomass (OR = 1.35) for cooking were risk factors for AR. Burning mosquito coils and incense increased the risk of asthma and AR. Cat keeping (OR = 2.88), dog keeping (OR = 2.04), cockroaches (OR = 1.54) and rats or mice (OR = 1.46) were associated with asthma. Cockroaches increased the risk of AR (OR = 1.22). Air humidifier and air cleaner were linked to asthma and AR. Frequent cleaning and exposing bedding to sunshine were protective. In conclusion, urbanization, NO2 and traffic exhaust can increase the risk of adult asthma and AR. Higher ambient temperature was related to more asthma but less AR. Indoor animals such as cats, dogs, rats/mice and presence of cockroaches were associated with asthma or AR. Indoor chemical sources such as redecoration and new furniture were other risk factors. Cooking with natural gas or biomass and burning mosquito coils and incense were associated with asthma or AR. Frequent cleaning and exposing bedding to sunshine were protective.
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Affiliation(s)
- Juan Wang
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
| | - Yinping Zhang
- School of Architecture, Tsinghua University, Beijing, China
| | - Baizhan Li
- Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Chongqing University, Chongqing, China
| | - Zhuohui Zhao
- Department of Environmental Health, Fudan University, Shanghai, China
| | - Chen Huang
- Department of Building Environment and Energy Engineering, School of environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Xin Zhang
- Research Center for Environmental Science and Engineering, Shanxi University, Taiyuan, China
| | - Qihong Deng
- Xiangya School of Public Health, Central South University, Changsha, China; School of Energy Science and engineering, Central South University, Changsha, China
| | - Chan Lu
- Xiangya School of Public Health, Central South University, Changsha, China; School of Energy Science and engineering, Central South University, Changsha, China
| | - Hua Qian
- School of Energy Environment, Southeast University, Nanjing, China
| | - Xu Yang
- College of Life Sciences, Central China Normal University, Wuhan, China
| | - Yuexia Sun
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Jan Sundell
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Dan Norbäck
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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50
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Fyfe C, Telfar L, Barnard, Howden-Chapman P, Douwes J. Association between home insulation and hospital admission rates: retrospective cohort study using linked data from a national intervention programme. BMJ 2020; 371:m4571. [PMID: 33376083 PMCID: PMC7770561 DOI: 10.1136/bmj.m4571] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To investigate whether retrofitting insulation into homes can reduce cold associated hospital admission rates among residents and to identify whether the effect varies between different groups within the population and by type of insulation. DESIGN A quasi-experimental retrospective cohort study using linked datasets to evaluate a national intervention programme. PARTICIPANTS 994 317 residents of 204 405 houses who received an insulation subsidy through the Energy Efficiency and Conservation Authority Warm-up New Zealand: Heat Smart retrofit programme between July 2009 and June 2014. MAIN OUTCOME MEASURE A difference-in-difference approach was used to compare the change in hospital admissions of the study population post-insulation with the change in hospital admissions of the control population that did not receive the intervention over the same two timeframes. Relative rate ratios were used to compare the two groups. RESULTS 234 873 hospital admissions occurred during the study period. Hospital admission rates after the intervention increased in the intervention and control groups for all population categories and conditions with the exception of acute hospital admissions among Pacific Peoples (rate ratio 0.94, 95% confidence interval 0.90 to 0.98), asthma (0.92, 0.86 to 0.99), cardiovascular disease (0.90, 0.88 to 0.93), and ischaemic heart disease for adults older than 65 years (0.79, 0.74 to 0.84). Post-intervention increases were, however, significantly lower (11%) in the intervention group compared with the control group (relative rate ratio 0.89, 95% confidence interval 0.88 to 0.90), representing 9.26 (95% confidence interval 9.05 to 9.47) fewer hospital admissions per 1000 in the intervention population. Effects were more pronounced for respiratory disease (0.85, 0.81 to 0.90), asthma in all age groups (0.80, 0.70 to 0.90), and ischaemic heart disease in those older than 65 years (0.75, 0.66 to 0.83). CONCLUSION This study showed that a national home insulation intervention was associated with reduced hospital admissions, supporting previous research, which found an improvement in self-reported health.
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Affiliation(s)
- Caroline Fyfe
- He Kianga Oranga, Department of Public Health, University of Otago Wellington, PO Box 7343, Wellington South 6242, New Zealand
| | | | - Barnard
- He Kianga Oranga, Department of Public Health, University of Otago Wellington, PO Box 7343, Wellington South 6242, New Zealand
| | - Philippa Howden-Chapman
- He Kianga Oranga, Department of Public Health, University of Otago Wellington, PO Box 7343, Wellington South 6242, New Zealand
| | - Jeroen Douwes
- Centre for Public Health Research, Massey University Wellington, New Zealand
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