Environmental and Occupational Disorders
Housing characteristics, reported mold exposure, and asthma in the European Community Respiratory Health Survey,☆☆

https://doi.org/10.1067/mai.2002.126383Get rights and content

Abstract

Background: The effects of home dampness and mold exposure on adult asthma are not clear. Objective: We aimed to investigate the associations between housing characteristics related to dampness, mold exposure, and house dust mite levels and adult asthma in 38 study centers from the European Community Respiratory Health Survey. Methods: Data about the present home, heating and ventilation systems, double glazing, floor covers, recent water damage, and mold exposure were obtained by means of an interviewer-led questionnaire. The associations between these factors and asthma, as defined on the basis of symptoms in the last year, and of bronchial responsiveness, as determined with methacholine challenge, were evaluated. Odds ratios (ORs) were obtained by using random-effects meta-analyses adjusted within study centers for sex, age group, and smoking status. Results: Fitted carpets and rugs in the bedroom were related to fewer asthma symptoms and bronchial responsiveness (OR range, 0.69-0.91). This effect was consistent across centers and more pronounced among house dust mite-sensitized individuals. Reported mold exposure in the last year was associated with asthma symptoms and bronchial responsiveness (OR range, 1.14-1.44). This effect was homogeneous among centers and stronger in subjects sensitized to Cladosporium species. In centers with a higher prevalence of asthma, the prevalence of reported indoor mold exposure was also high. This association was observed for reported mold exposure by asthmatic subjects (Spearman r s = 0.46), as well as reported mold exposure by nonasthmatic subjects (r s = 0.54). Reported mold exposure was highest in older houses with recent water damage. Conclusion: We conclude that indoor mold growth has an adverse effect on adult asthma.

Section snippets

Study population and questionnaire

The methodology for the ECRHS has been described elsewhere.8 In this analysis data of a random general population sample from 38 study centers were included.13 Centers were located both in Europe (Belgium, Denmark, Estonia, France, Germany, Iceland, Ireland, Italy, The Netherlands, Norway, Spain, Sweden, Switzerland, and United Kingdom) and outside Europe (Australia, India, New Zealand, and the United States).

An interviewer-led questionnaire collected information on respiratory symptoms,

Results

There was a large variation in the prevalence of asthma symptoms and bronchial responsiveness across the study centers (Table I).

. General and respiratory health characteristics of a random population sample from 38 study centers in 18 countries (N = 18,873)

Empty CellNo.%Minimum and maximum across centers (%)
Men896747.540-54
Women990652.546-60
Age group, 20-29 y646234.218-49
Age group, 30-39 y770540.834-51
Age group, 40-45 y470624.914-38
Never smoked836044.330-86
Former smoker379220.13-27
Current smoker672135.6

Discussion

This cross-sectional community-based study among young adults from 18 different countries showed that reporting of mold exposure in homes was associated with current asthma symptoms and bronchial responsiveness. This relationship was consistent across study areas and more pronounced in individuals sensitized to mold. Associations of recent water damage with symptoms were explained by the presence of mold. Asthma symptoms and bronchial responsiveness were less common in individuals with textile

Acknowledgements

We thank Colette Baya and Dr Manuel Hallen for their help during the study and Professor K. Vuylsteek and the members of the COMAC for their support.

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    The coordination of this work was supported by the European Commission. The following grants helped to fund the local studies: Australia: Allen and Hanbury's, Australia; Belgium: Belgian Science Policy Office, National Fund for Scientific Research; Estonia: The Estonian Scientific Foundation (grant 1088), Glaxo Welcome; France: Ministere de la Santé, Glaxo France, Institut Pneumologique d’Aquitaine, Contrat de Plan Etat-Région Languedoc- Rousillon, CNMATS, CNMRT (90MR/10, 91AF/6), Ministre delegué de la santé, RNSP; Germany: GSF and the Bundesminister für Forschung und Technologie, Bonn; India: Bombay Hospital Trust; Italy: Ministero dell’Università e della Ricerca Scientifica e Tecnologica, CNR, Regione Veneto grant RSF no. 381/05.93; The Netherlands: Ministry of Welfare, Public Health and Culture; New Zealand: Asthma Foundation of New Zealand, Lotteries Grant Board, Health Research Council of New Zealand; Norway: Norwegian Research Council project no. 101422/310; Spain: Ministero Sanidad y Consumo FIS grants no. 91/0016060/00E-05E, no. 92/0319, no. 93/0393, Hospital General de Albacete, Hospital General Juan Ramón Jiménez, Consejeria de Sanidad Principado de Asturias; Sweden: The Swedish Heart Lung Foundation, the Swedish Medical Research Council, the Swedish Association against Asthma and Allergy; Switzerland: Swiss National Science Foundation grant 4026-28099; United Kingdom: National Asthma Campaign, British Lung Foundation, Department of Health, South Thames Regional Health Authority; United States: United States Department of Health, Education and Welfare Public Health Service Grant no. 2 S07 RR05521-28.

    ☆☆

    Reprint requests: Jan-Paul Zock, PhD, Municipal Institute of Medical Research (IMIM), Dr Aiguader 80, E-08003 Barcelona, Spain.

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