ORIGINAL ARTICLE

¹ Pulmonary Environmental Epidemiology Unit-CNR Institute of Clinical Physiology, Pisa, Italy
² Pediatric Pulmonology Service, "Anna Meyer" Children’s University Hospital, Florence, Italy
³ Area di Epidemiologia Ambientale, ARPA Piemonte, Grugliasco, Italy
⁴ Epidemiology Unit, "Anna Meyer" Children’s University Hospital, Florence, Italy
⁵ Unità di Allergologia e Pneumologia, Dipartimento di Pediatria, Azienda di Rilievo Nazionale ad Alta Specializzazione (ARNAS), Ospedale Civico and Istituto di Biomedicina e Immunologia Molecolare (IBIM-CNR), Palermo, Italy
⁶ Servizio Osservatorio Epidemiologico, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
⁷ UOS Salute e Ambiente, Empoli, Florence, Italy
⁸ Servizio di Epidemiologia dei Tumori, AO San Giovanni Battista - CPO Piemonte, Torino, Italy
⁹ Dipartimento di Epidemiologia, ASL Roma E, Rome, Italy

Correspondence to:
Correspondence to:
Dr G Viegi
Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Via Trieste, 41, 56126 Pisa, Italy; viegig{at}ifc.cnr.it

Aims: To report on the relation between home mould and/or dampness exposure and respiratory disorders in a large sample of children and adolescents in Italy, accounting for age at time of exposure.

Methods: 20 016 children (mean age 7 years) and 13 266 adolescents (mean age 13 years) completed questionnaires on indoor exposures and respiratory symptoms/diseases. Statistical analyses were adjusted for sex, age, questionnaire’s compiler, area of residence, season of interview, parental educational status, family history of asthma, rhinitis, eczema, chronic obstructive pulmonary disease, presence of gas water heaters, passive smoking, pets, and active smoking (only for adolescents). Population attributable risk % (PAR) was also computed.

Results: Asthma was more strongly related to only early than to only current exposure, both in children (OR 1.80, 95% CI 1.41 to 2.30) and adolescents (OR 1.89, 95% CI 1.38 to 2.59). The same result was found for rhino-conjunctivitis (OR 1.46, 95% CI 1.17 to 1.82), in children, and for wheeze among adolescents (OR 1.56, 95% CI 1.15 to 2.11). In children, wheeze (OR 1.98, 95% CI 1.47 to 2.66) and eczema (OR 1.44, 95% CI 1.09 to 1.91) were more strongly related to mould/dampness when exposed both early and currently; the same occurred in adolescents for rhino-conjunctivitis (1.78, 95% CI 1.30 to 2.45). Although persistent cough/phlegm was significantly related to mould/dampness exposure in children, regardless of exposure timing, no significant association between mould/dampness exposure and eczema or cough/phlegm was found among adolescents. PAR estimates were higher for only early than only current exposures. Avoiding early only exposure would abate wheeze by 6%, asthma or cough/phlegm by 7%, rhino-conjunctivitis in children by 4%, and in adolescents, asthma by 6%, and wheeze by 4%.

Conclusions: Respiratory disorders such as wheeze and asthma can often be explained by exposure to home mould/dampness, especially early in life. The association seems more evident in children than in adolescents. These findings may suggest the need for environmental prevention strategies.

Abbreviations: CI, confidence interval; COPD, chronic obstructive pulmonary disease; ISAAC, International Study of Asthma and Allergies in Childhood; OR, odds ratio; PAR, population attributable risk; SIDRIA, Studi Italiani sui Disordini Respiratori dell’Infanzia e l’Ambiente

Keywords: indoor; moulds; children; asthma; wheezing; rhinitis

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