Reduced prevalence of childhood asthma after housing renovations in an underresourced community

Background

Despite improvements in asthma symptom management and asthma morbidity, the prevalence of asthma in the United States remains high, especially in underresourced communities.

Objective

Our goal was to determine whether housing renovations affect the prevalence of asthma in an underresourced community.

Methods

The Fay Apartments (~800 units) in Cincinnati, Ohio, were renovated to "green building" standards between 2010 and 2012 and renamed the Villages at Roll Hill. The prevalence of asthma among 7-year-olds in the Villages at Roll Hill was determined by accessing Ohio Medicaid data for the years 2013 to 2021.

Results

In the first 6 years after the renovations (2013-2018), the prevalence of asthma among 7-year-olds in the community averaged 12.7%. In contrast, in postrenovation years 7 through 9 (2019-2021), the average prevalence of asthma was 5.9%. Logistic regression modeling for the log odds of asthma diagnosis in this age group was used to test the statistical significance of asthma prevalence for 2013-2018 versus for 2019-2021. The model resulted in demonstration of a significant (P < .001) reduction in asthma prevalence between 2013-2018 and 2019-2021.

Conclusions

The renovation of an underresourced community's housing resulted in a lower prevalence of asthma for 7-year-olds who were born after the renovations had been completed.

Comparison of ERMI results for dust collected from homes by an electrostatic cloth and by the standard vacuum method

The Environmental Relative Moldiness Index (ERMI) is a scale used to compare mold contamination levels in U.S. homes. To create the ERMI scale, a nationally representative set of U.S. homes was selected (n = 1,096). From each of these homes, a standard vacuum-dust sample was collected and then 36 common molds, the 26 Group 1 and 10 Group 2 molds, as grouped for forming the ERMI metric, were quantified using quantitative PCR assays. However, in investigations of mold in homes, it is not always practical or even possible to collect dust using the standard vacuum method. Therefore, we performed a comparative study of dust samples collected in the same homes (n = 151) by the standard vacuum method and by an electrostatic cloth (EC) method. First, floor dust was collected by vacuuming a 2 m² area in the living room and a 2 m² area in a bedroom, directly adjacent to the sofa or bed, for 5 min each with a Mitest sampler-fitted vacuum. Second, immediately after the collection of the vacuum dust sample, an EC dust sample was collected by wiping above-floor horizontal surfaces in the living room and bedroom. Then, the ERMI analysis of each sample was performed by a commercial laboratory. The results showed the average concentrations of 33 of the 36 ERMI molds were not significantly different in the vacuum and EC samples. Also, the average summed logs of the Group 1 molds, Group 2, or ERMI values were significantly (p < 0.001) correlated between the vacuum and EC samples. Logistic regression indicated that an EC sample could identify homes in the highest ERMI quartile 96% of the time by using the same ERMI value cutoff as vacuum sample ERMI value cutoff and 35% of samples proved to be false positives. When it is not practical to obtain the standard vacuum-dust sample, an EC sample can provide a useful practical alternative for ERMI analyses.

The Environmental Relative Moldiness Index reveals changes in mold contamination in United States homes over time

The Environmental Relative Moldiness Index (ERMI) is a scale created to compare mold contamination levels in U.S. homes. The ERMI was developed as a result of the Department of Housing and Urban Development's (HUD) first American Healthy Homes Survey (AHHS I), which sampled 1,096 homes selected to be representative of the U.S. housing stock. In AHHS I, a dust sample from each home was analyzed using quantitative PCR assays (qPCR) for 36 common indoor molds: 26 Group 1 molds, which were associated with water damage in homes and 10 Group 2 molds, which primarily enter the home from the outside environment. In 2019, HUD completed AHHS II by sampling 695 homes. Because lead was banned from paint in 1978, a larger proportion of homes selected for AHHS II had been built before 1978 compared to AHHS I. The 36 ERMI molds were analyzed in AHHS II exactly as in AHHS I. For the 36-ERMI molds, the rates of detection, average concentrations, and geometric means were in significant concordance (p < 0.001) between AHHS I and II, indicating that the ERMI methodology was stable over time. However, the average ERMI value in AHHS II homes was greater than in AHHS I. The reason for the difference was investigated by examining the Group 1 and 2 mold populations. The average summed logs of Group 1 molds were significantly greater in homes built before 1978 than the average for homes built later. Conversely, the average summed logs of Group 2 mold populations were the same in homes built before 1978 and homes built later. Since the summed logs of Group 2 mold is subtracted from the summed logs of Group 1 molds in the ERMI calculation, the average ERMI value was higher in AHHS II homes than AHHS I. In conclusion, by using the ERMI metric, we were able to demonstrate that water damage and mold growth were more likely to occur as homes get older.

American Healthy Homes Survey: a national study of residential pesticides measured from floor wipes

The U.S. Department of Housing and Urban Development in collaboration with the United States Environmental Protection Agency conducted a survey measuring lead, allergens, and insecticides in a randomly selected nationally representative sample of residential homes. Multistage sampling with clustering was used to select the 1131 homes of which a subset of 500 randomly selected homes included the collection of hard surface floor wipes. Samples were collected by trained field technicians between June 2005 and March 2006 using isopropanol wetted wipes. Samples were analyzed for a suite of 24 compounds which included insecticides in the organochlorine, organophosphate, pyrethroid and phenylpyrazole classes, and the insecticide synergist piperonyl butoxide. The most commonly detected were permethrin (89%), chlorpyrifos (78%), chlordane (64%), piperonyl butoxide (52%), cypermethrin (46%), and fipronil (40%). Mean and geometric mean (GM) concentrations varied widely among compounds, but were highest for trans-permethrin (mean 2.22 ng/cm2 and GM 0.14 ng/ cm2) and cypermethrin (mean 2.9 ng/cm2 and GM 0.03 ng/ cm2). Results show that most floors in occupied homes in the U.S. have measurable levels of insecticides that may serve as sources of exposure to occupants.