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      Home Dampness and Molds, Parental Atopy, and Asthma in Childhood: A Six-Year Population-Based Cohort Study

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          Abstract

          Previous studies of how parental atopy and exposure to dampness and molds contribute to the risk of asthma have been mainly cross-sectional or prevalent case–control studies, where selection and information bias and temporality constitute problems. We assessed longitudinally the independent and joint effects of parental atopy and exposure to molds in dwellings on the development of asthma in childhood. We conducted a population-based, 6-year prospective cohort study of 1,984 children 1–7 years of age at the baseline in 1991 (follow-up rate, 77%). The study population included 1,916 children without asthma at baseline and complete outcome information. The data collection included a baseline and follow-up survey. The outcome of interest was development of asthma during the study period. The studied determinants were parental allergic diseases and four indicators of exposure at baseline: histories of water damage, presence of moisture and visible molds, and perceived mold odor in the home. A total of 138 (7.2%) children developed asthma during the study period, resulting in an incidence rate of 125 cases per 10,000 person-years [95% confidence interval (CI), 104–146]. In Poisson regression adjusting for confounding, parental atopy [adjusted incidence rate ratio (IRR) 1.52; 95% CI, 1.08–2.13] and the presence of mold odor in the home reported at baseline (adjusted IRR 2.44; 95% CI, 1.07–5.60) were independent determinants of asthma incidence, but no apparent interaction was observed. The results of this cohort study with assessment of exposure before the onset of asthma strengthen the evidence on the independent effects of parental atopy and exposure to molds on the development of asthma.

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          Most cited references16

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          Epidemiology Standardization Project (American Thoracic Society).

          B G Ferris (1978)
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            Prevalence of asthma and atopy in two areas of West and East Germany.

            The German reunification offers a unique opportunity to study the impact of environmental factors on the development of childhood respiratory and allergic disorders in ethnically similar populations. We investigated the prevalence of asthma, hay fever, atopy, and bronchial hyperresponsiveness (BHR) in 9- to 11-year old children in West Germany (n = 5,030) and East Germany (n = 2,623). A self-administered questionnaire was distributed to the parents. Children underwent cold air challenge and allergy skin prick tests. Atopic sensitization was considerably more frequent in West German children than in their peers in East Germany (36.7% versus 18.2%; odds ratio [OR] = 2.6, p < 0.0001). The prevalence of current asthma and hay fever was significantly higher in West Germany when compared with that in East Germany (5.9% versus 3.9%; OR = 1.5, p < 0.0001 and 8.6% versus 2.7%; OR = 3.4, p < 0.0001, respectively). Bronchitis, however, was more prevalent in East Germany than in the western part of the country. The prevalence of BHR as assessed by cold air challenge was higher in West Germany compared with that in East Germany (8.3% versus 5.5%, OR = 1.6, p < 0.001). Logistic regression showed that the West German study area was no longer a significant independent determinant of asthma once sensitization to mites, cats, and pollen was taken into account. We conclude that sensitization to aeroallergens is strikingly more frequent in West Germany than in East Germany and this may explain the differences in the prevalence of asthma and hay fever between the two parts of the country.
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              Home dampness and respiratory morbidity in children.

              This study examined the relationship between measures of home dampness and respiratory illness and symptoms in a cohort of 4,625 eight- to 12-yr-old children living in six U.S. cities. Home dampness was characterized from questionnaire reports of mold or mildew inside the home, water damage to the home, and the occurrence of water on the basement floor. Symptoms of respiratory and other illness were collected by questionnaire. Pulmonary function was measured by spirometry. Signs of home dampness were reported in a large proportion of the homes. In five of the six cities, one or more of the dampness indicators were reported in more than 50% of the homes. The association between measures of home dampness and both respiratory symptoms and other non-chest illness was both strong and consistent. Odds ratios for molds varied from 1.27 to 2.12, and for dampness from 1.23 to 2.16 after adjustment for maternal smoking, age, gender, city of residence, and parental education. The relationship between home dampness and pulmonary function was weak, with an estimated mean reduction of 1.0% in FEF25-75 associated with dampness and 1.6% with molds. We conclude that dampness in the home is common in many areas of the United States and that home dampness is a strong predictor of symptoms of respiratory and other illness symptoms among 8- to 12-yr-old children.
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                Author and article information

                Journal
                Environ Health Perspect
                Environmental Health Perspectives
                National Institue of Environmental Health Sciences
                0091-6765
                March 2005
                9 December 2004
                : 113
                : 3
                : 357-361
                Affiliations
                1Institute of Occupational and Environmental Medicine, University of Birmingham, Edgbaston, Birmingham, United Kingdom
                2Environmental Epidemiology Unit, Department of Public Health, University of Helsinki, Helsinki, Finland
                3Department of Health Care Administration, Diwan College of Management, Tainan, Taiwan
                Author notes
                Address correspondence to J.J.K. Jaakkola, Institute of Occupational and Environmental Medicine, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. Telephone: 44-121-414-6671. Fax: 44-121-414-66217. E-mail: j.jaakkola@bham.ac.uk

                The baseline study was supported by the Ministry of the Environment, the National Agency for Welfare, and Health and the Medical Research Council of the Academy of Finland, and the follow-up study by the Yrjö Jahnsson Foundation.

                The authors declare they have no competing financial interests.

                Article
                ehp0113-000357
                10.1289/ehp.7242
                1253765
                15743728
                6afac60f-ee99-4062-8f29-36f6b1bb23ff
                This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original DOI.
                History
                : 10 May 2004
                : 9 December 2004
                Categories
                Children's Health
                Articles

                Public health
                asthma,damp housing,interaction,molds,effect modification
                Public health
                asthma, damp housing, interaction, molds, effect modification

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