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Mould and dampness in dwelling places, and onset of asthma: the population-based cohort ECRHS
  1. Dan Norbäck1,
  2. Jan-Paul Zock2,3,4,
  3. Estel Plana2,3,4,
  4. Joachim Heinrich5,
  5. Cecilie Svanes6,
  6. Jordi Sunyer2,3,4,7,
  7. Nino Künzli2,8,
  8. Simona Villani9,
  9. Mario Olivieri10,
  10. Argo Soon11,12,
  11. Deborah Jarvis13
  1. 1Department of Medical Sciences, Uppsala University, Uppsala, Sweden
  2. 2Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
  3. 3Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain
  4. 4CIBER Epidemiologia y Salud Publica, (CIBERESP), Barcelona, Spain
  5. 5Helmholtz Zentrum München, German Research Centre for Environmental Health, Institute of Epidemiology, Neuherberg, Germany
  6. 6Department of Occup. Med., Bergen respiratory Research Group, Institute of Medicine, University of Bergen, Haukeland University Hospital, Bergen, Norway
  7. 7Department of Experimental and Health Sciences, Pompeu Fabra University, (UFP), Barcelona, Spain
  8. 8Department of Epidemiology and Public Health, Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland
  9. 9Department of Health Science, University of Pavia, Pavia, Italy
  10. 10Department of Occupational Medicine, University of Verona, Verona, Italy
  11. 11Department of Public Health, University of Tartu, Tartu, Estonia
  12. 12Archimedes Foundation, Research and Cooperation Centre, Tartu, Estonia
  13. 13Respiratory Epidemiology and Public Health Group, National Heart and Lung Institute, Imperial College, London, UK
  1. Correspondence to Dr Dan Norbäck, Department of Medical Science, Uppsala University and Occupational and Environmental Medicine, University Hospital, SE-751 85 Uppsala, Sweden; dan.norback{at}


Objectives To study new onset of adult asthma in relation to dampness and moulds in dwelling places.

Methods Totally, 7104 young adults from 13 countries who participated in the European Community Respiratory Health Survey (ECRHS I and II) who did not report respiratory symptoms or asthma at baseline were followed prospectively for 9 years. Asthma was assessed by questionnaire data on asthmatic symptoms and a positive metacholine challenge test at follow-up. Data on the current dwelling was collected at the beginning and at the end of the follow-up period by means of an interviewer-led questionnaire, and by inspection. Relative risks (RR) for new onset asthma were calculated with log-binomial models adjusted for age, sex, smoking and study centre.

Results There was an excess of new asthma in subjects in homes with reports on water damage (RR 1.46; 95% CI 1.09 to 1.94) and indoor moulds (RR=1.30; 95% CI 1.00 to 1.68) at baseline. A dose-response effect was observed. The effect was stronger in those with multisensitisation and in those sensitised to moulds. Observed damp spots were related to new asthma (RR=1.49; 95% CI 1.00 to 2.22). The population-attributable risk was 3–10% for reported, and 3–14% for observed dampness/moulds.

Conclusions Dampness and mould are common in dwellings, and contribute to asthma incidence in adults.

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