Indoor mold odor in the workplace increases the risk of Asthma-COPD Overlap Syndrome: a population-based incident case\u2013control study

Maritta S Jaakkola,Taina K Lajunen,Jouni J K Jaakkola

doi:10.1186/s13601-019-0307-2

Maritta S Jaakkola, Taina K Lajunen + Show 1 more

Open Access

https://doi.org/10.1186/s13601-019-0307-2

Copy DOI

Abstract

BackgroundPrevious studies have suggested an increased risk of asthma related to indoor dampness problems, but their role in the etiology of Asthma-COPD Overlap Syndrome has not been studied. We utilized a population-based incident case–control study to assess potential effect of indoor dampness and molds at home and at work on development of ACOS.MethodsWe recruited systematically all new cases of asthma diagnosed during a 2.5-year study period (1997–2000) and randomly selected controls from the source population of adults 21–63 years old and representing 500,000 persons-years in the Pirkanmaa Hospital District, South Finland. Exposure indicators included water damage, damp stains or paint peeling, visible mold, and mold odor, asked separately for home and workplace. The clinically diagnosed case series consisted of 521 adults with newly diagnosed asthma. Altogether 25 of them satisfied the criteria for ACOS-cases, i.e. FEV1/FVC < 0.70 in post-bronchodilator spirometry. The control series, including 932 controls, were from a random sample of source population, after excluding 76 (7.5%) controls with asthma.ResultsIn logistic regression analysis adjusting for confounders, the risk of ACOS was significantly related to presence of mold odor in the workplace (OR 3.43; 95% CI 1.04–11.29), but not to other dampness indicators. The fraction of ACOS attributable to workplace mold odor was 70.8% (95% CI 3.8–91.1%) among the exposed. The risk of ACOS was not related to mold exposures at home.ConclusionsPresent results provide new evidence of the significant relation between workplace exposure to mold odor and adult-onset ACOS.

Highlights

Previous studies have suggested an increased risk of asthma related to indoor dampness problems, but their role in the etiology of Asthma-chronic obstructive pulmonary disease (COPD) Overlap Syndrome has not been studied
We observed in our population-based study of adult-onset asthma in Southern Finland that Asthma-COPD Overlap Syndrome (ACOS) was quite common among adults with newly diagnosed asthma [2]. In this Finnish Environment and Asthma Study (FEAS) we found that current smoking increased the risk of ACOS 7.9-fold and former smoking 3.2-fold compared to non-smokers
We have previously reported that both active smoking and ex-smoking are significant risk factors for ACOS [2], and in this study we investigated if indoor dampness or mold problems form a risk factor for ACOS

Summary

Introduction

Previous studies have suggested an increased risk of asthma related to indoor dampness problems, but their role in the etiology of Asthma-COPD Overlap Syndrome has not been studied. The recent identification of existence of concomitant asthma and COPD, called the Asthma-COPD Overlap Syndrome (i.e. ACOS) among adult obstructive lung diseases [1] raises the question, what determines development of this disease when compared to development of Jaakkola et al Clin Transl Allergy (2020) 10:3 exposure to air pollution, namely PM2.5 and ozone, to be a risk factor for ACOS [3]. Exposure to mold odor was related to reduced lung function levels among those with recently diagnosed asthma [7], the effect on FEV1 being on average − 240 ml (95% CI − 0.48 to − 0.003)

Methods

Results

Discussion

Conclusion