Damp housing and asthma: a case-control study
Abstract
BACKGROUND: Several epidemiological studies have reported a higher prevalence of respiratory symptoms in subjects living in damp housing, but links with specific respiratory diseases such as asthma have not been satisfactorily established. METHODS: One hundred and two subjects with physician diagnosed asthma and 196 age and sex matched controls were interviewed; 222 (75%) then agreed to have their dwelling surveyed for dampness. The prevalence of both self-reported and observed dampness in the homes of the asthmatic subjects and controls were compared. Both asthma and the severity of the dampness were quantified so that the possibility of a dose-response relationship could be investigated. RESULTS: Asthmatic subjects reported dampness in their current (odds ratio (OR) 1.92, 95% confidence interval (CI) 1.18 to 3.12) and previous (OR 2.11, 95% CI 1.29 to 3.47) dwellings more frequently than control subjects. The surveyor confirmed dampness in 58 of 90 (64%) dwellings of asthmatic subjects compared with 54 of 132 (41%) dwellings of control subjects (OR 2.62, 95% CI 1.50 to 4.55). This association persisted after controlling for socioeconomic and other confounding variables (adjusted OR 3.03, 95% CI 1.65 to 5.57). The severity of asthma was found to correlate statistically with measures of total dampness (r = 0.30, p = 0.006) and mould growth (r = 0.23, p = 0.035) in the dwelling. Patients living in homes with confirmed areas of dampness had greater evidence of airflow obstruction than those living in dry homes (mean difference in forced expiratory volume in one second (FEV1) 10.6%, 95% CI 1.0 to 20.3). CONCLUSIONS: Asthma is associated with living in damp housing and there appears to be a dose-response relationship. Action to improve damp housing conditions may therefore favourably influence asthma morbidity.
Full Text
The Full Text of this article is available as a PDF (134K).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Verhoeff AP, van Wijnen JH, van Reenen-Hoekstra ES, Samson RA, van Strien RT, Brunekreef B. Fungal propagules in house dust. II. Relation with residential characteristics and respiratory symptoms. Allergy. 1994 Aug;49(7):540–547. [PubMed] [Google Scholar]
- Colloff MJ. Mites from house dust in Glasgow. Med Vet Entomol. 1987 Apr;1(2):163–168. [PubMed] [Google Scholar]
- Martin CJ, Platt SD, Hunt SM. Housing conditions and ill health. Br Med J (Clin Res Ed) 1987 May 2;294(6580):1125–1127. [PMC free article] [PubMed] [Google Scholar]
- Hyndman SJ. Housing dampness and health amongst British Bengalis in east London. Soc Sci Med. 1990;30(1):131–141. [PubMed] [Google Scholar]
- Brunekreef B. Associations between questionnaire reports of home dampness and childhood respiratory symptoms. Sci Total Environ. 1992 Dec 15;127(1-2):79–89. [PubMed] [Google Scholar]
- Brunekreef B, Dockery DW, Speizer FE, Ware JH, Spengler JD, Ferris BG. Home dampness and respiratory morbidity in children. Am Rev Respir Dis. 1989 Nov;140(5):1363–1367. [PubMed] [Google Scholar]
- Dales RE, Burnett R, Zwanenburg H. Adverse health effects among adults exposed to home dampness and molds. Am Rev Respir Dis. 1991 Mar;143(3):505–509. [PubMed] [Google Scholar]
- Dales RE, Zwanenburg H, Burnett R, Franklin CA. Respiratory health effects of home dampness and molds among Canadian children. Am J Epidemiol. 1991 Jul 15;134(2):196–203. [PubMed] [Google Scholar]
- Andrae S, Axelson O, Björkstén B, Fredriksson M, Kjellman NI. Symptoms of bronchial hyperreactivity and asthma in relation to environmental factors. Arch Dis Child. 1988 May;63(5):473–478. [PMC free article] [PubMed] [Google Scholar]
- Dijkstra L, Houthuijs D, Brunekreef B, Akkerman I, Boleij JS. Respiratory health effects of the indoor environment in a population of Dutch children. Am Rev Respir Dis. 1990 Nov;142(5):1172–1178. [PubMed] [Google Scholar]
- Iversen M, Korsgaard J, Hallas T, Dahl R. Mite allergy and exposure to storage mites and house dust mites in farmers. Clin Exp Allergy. 1990 Mar;20(2):211–219. [PubMed] [Google Scholar]
- Wraith DG, Cunnington AM, Seymour WM. The role and allergenic importance of storage mites in house dust and other environments. Clin Allergy. 1979 Nov;9(6):545–561. [PubMed] [Google Scholar]
- Brunekreef B. Damp housing and adult respiratory symptoms. Allergy. 1992 Oct;47(5):498–502. [PubMed] [Google Scholar]
- Gravesen S. Fungi as a cause of allergic disease. Allergy. 1979 Jun;34(3):135–154. [PubMed] [Google Scholar]
- Mohamed N, Ng'ang'a L, Odhiambo J, Nyamwaya J, Menzies R. Home environment and asthma in Kenyan schoolchildren: a case-control study. Thorax. 1995 Jan;50(1):74–78. [PMC free article] [PubMed] [Google Scholar]
- Burr ML, Mullins J, Merrett TG, Stott NC. Indoor moulds and asthma. J R Soc Health. 1988 Jun;108(3):99–101. [PubMed] [Google Scholar]
- Koivikko A, Viander M, Lanner A. Use of the extended Phadebas RAST panel in the diagnosis of mould allergy in asthmatic children. Allergy. 1991 Feb;46(2):85–91. [PubMed] [Google Scholar]
- Korsgaard J. Mite asthma and residency. A case-control study on the impact of exposure to house-dust mites in dwellings. Am Rev Respir Dis. 1983 Aug;128(2):231–235. [PubMed] [Google Scholar]
- Burr ML, Butland BK, King S, Vaughan-Williams E. Changes in asthma prevalence: two surveys 15 years apart. Arch Dis Child. 1989 Oct;64(10):1452–1456. [PMC free article] [PubMed] [Google Scholar]
- Kuehr J, Frischer T, Karmaus W, Meinert R, Barth R, Schraub S, Daschner A, Urbanek R, Forster J. Natural variation in mite antigen density in house dust and relationship to residential factors. Clin Exp Allergy. 1994 Mar;24(3):229–237. [PubMed] [Google Scholar]
- Burney PG, Chinn S, Rona RJ. Has the prevalence of asthma increased in children? Evidence from the national study of health and growth 1973-86. BMJ. 1990 May 19;300(6735):1306–1310. [PMC free article] [PubMed] [Google Scholar]
- Verhoeff AP, van Wijnen JH, Brunekreef B, Fischer P, van Reenen-Hoekstra ES, Samson RA. Presence of viable mould propagules in indoor air in relation to house damp and outdoor air. Allergy. 1992 Apr;47(2 Pt 1):83–91. [PubMed] [Google Scholar]
