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Dampness, bacterial and fungal components in dust in primary schools and respiratory health in schoolchildren across Europe
  1. José Jacobs1,
  2. Alicia Borràs-Santos2,3,4,
  3. Esmeralda Krop1,
  4. Martin Täubel5,
  5. Hanna Leppänen5,
  6. Ulla Haverinen-Shaughnessy5,
  7. Juha Pekkanen5,6,
  8. Anne Hyvärinen5,
  9. Gert Doekes1,
  10. Jan-Paul Zock2,3,4,
  11. Dick Heederik1
  1. 1Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
  2. 2Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
  3. 3Hospital del Mar Research Institute (IMIM), Barcelona, Spain
  4. 4CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
  5. 5Department Environmental Health, National Institute for Health and Welfare, Kuopio, Finland
  6. 6Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
  1. Correspondence to Dr José Jacobs, Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Yalelaan 2, 3584 CM Utrecht, The Netherlands; j.h.jacobs{at}


Background Respiratory health effects of damp housing are well recognised, but less is known about the effect of dampness and water damage in schools. The HITEA study previously reported a higher prevalence of respiratory symptoms in pupils from moisture damaged schools, but the role of specific microbial exposures remained unclear.

Objectives To study associations between school dampness, levels of fungal and bacterial markers, respiratory symptoms and lung function in children.

Methods Primary schools in Spain, the Netherlands and Finland were selected on the basis of the observed presence (n=15) or absence (n=10) of moisture, dampness and/or mould. Settled dust was repeatedly sampled in 232 classrooms and levels of 14 different microbial markers and groups of microbes were determined. Parental reports of respiratory symptoms were available from 3843 children aged 6–12 years, of whom 2736 provided acceptable forced spirometry testing. Country-specific associations between exposure and respiratory health were evaluated by multilevel mixed-effects logistic and linear regression models and combined using random-effects meta-analysis.

Results The prevalence of respiratory symptoms was higher in moisture damaged schools, being more pronounced in Finnish pupils. Effects on lung function were not apparent. Levels of microbial markers were generally higher in moisture damaged schools, varied by season and were lower in Finnish schools. Wheeze tended to be inversely associated with microbial levels. All other respiratory symptoms were not consistently associated with microbial marker levels.

Conclusions Health effects of moisture and microbial exposures may vary between countries, but this requires further study.

  • microbial exposure
  • moisture/mould
  • school children
  • respiratory health

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