Damp Housing Conditions Research Articles

Onset characteristics and breadth of occupants’ long-lasting building-related symptoms attributed to living in damp housing conditions in Australia: Qualitative insights

Few studies explore persistent building-related symptoms in a residential context. Additionally, a growing body of literature suggests symptoms related to indoor building dampness and mould (D/M) may present as a broader set of symptoms than previously thought. In this study, we performed deductive and inductive qualitative content analysis, using a Long COVID-19 symptom category framework, to analyse first person responses to open-ended symptom questions from an online survey. This study describes 154 residential occupants’ self-reported symptomatic experiences, at the onset of symptoms perceived to be related to living with indoor D/M. The majority of occupants experienced 3 or more D/M indicators and reported multiple concurrent symptoms that came on gradually and persisted for 1 year or more, significantly impacting quality of life. Neuropsychiatric symptoms, led by brain fog, headaches, sleep issues and memory loss, were the most prevalent symptom category, however new categories emerged for hypersensitivities, increased occurrence of infections and asthma-related symptoms. Occupants with short-term (1–30 days) and long-term (2 years or more) experience of living with D/M conditions reported long-lasting symptoms. In conclusion, in providing deeper insights into the symptomatic experiences of occupants, this study highlights the need for a framework that encompasses the breadth of symptoms and their system categories. It also provides a nuanced understanding of the characteristics of symptom onset and prevalence.

Domestic Risk Factors for Atopic and non-Atopic Asthma in First Nations Children Living in Saskatchewan, Canada.

Both allergic and non-allergic asthma phenotypes are thought to vary by specific housing and other indoor environmental conditions. This study evaluated risk factors for allergic asthma phenotypes in First Nation children, an understudied Canadian population with recognized increased respiratory morbidity. We conducted a cross-sectional survey with a clinical component to assess the respiratory health of 351 school-age children living on two rural reserve communities. Asthma was defined as parental report of physician diagnosed asthma or a report of wheeze in the past 12 months. Atopy was determined by a ≥ 3-mm wheal response to any of six respiratory allergens upon skin prick testing (SPT). Important domestic and personal characteristics evaluated included damp housing conditions, household heating, respiratory infections and passive smoking exposure. Asthma and atopy prevalence were 17.4% and 17.1%, respectively. Of those with asthma, 21.1% were atopic. We performed multivariate multinomial logistic regression modelling with three outcomes: non-atopic asthma, atopic asthma and no asthma for 280 children who underwent SPT. After adjusting for potential confounders, children with atopic asthma were more likely to be obese and to live in homes with either damage due to dampness (p < 0.05) or signs of mildew/mold (p = 0.06). Both natural gas home heating and a history of respiratory related infections were associated with non-atopic asthma (p < 0.01). Domestic risk factors for asthma appear to vary by atopic status in First Nations children. Determining asthma phenotypes could be useful in environmental management of asthma in this population.

Investigation of the Association between Adult Wheeze and Household Beta(1→3)-glucan Exposures in First Nations Communities in Canada

TPS 752: Respiratory effects and allergies, Exhibition Hall, Ground floor, August 27, 2019, 3:00 PM - 4:30 PM Background: In Canada, damp housing conditions in First Nations communities continues to be a major concern for respiratory health. In this context, no studies have reported the role of household beta glucans. We examined the association between β(1→3)-glucans in household dust and reports of wheeze. Methods: As part of the First Nations Longitudinal Respiratory Health Study initiated in 2012, participating adults who completed a respiratory and environmental questionnaire volunteered to partake in a home environmental assessment that included collection of settled dust for β(1→3)-glucan analysis. Information was obtained about housing conditions including water leaks/floods and subsequent damage in the past 12 months, mold or mildew odor and visible signs of mold. Dust samples were collected from floors of common living areas following the International Study of Asthma and Allergy in Children (ISAAC) protocol. Prior to laboratory analysis, dust was sieved and stored at -20°C. Analysis for β(1→3)-glucan was performed using Glucatell assay according to manufacturer’s specifications. Wheeze was defined as any wheeze without colds or wheezing most days or nights. Logistic regression with generalized estimating equations were used to examine associations between wheeze and β(1→3)-glucan (log transformed) adjusting for current smoking, damp housing, mildew odor, pets, age and sex. Results: Of the 874 participants, there were 317 adults living in 144 homes who participated in the home assessments. Of these, 293 adults had valid household β(1→3)-glucan results. The prevalence of wheeze was 47.0%. The mean (standard deviation) levels of soluble β(1→3)-glucan were 33.1(22.76) pg/mL. While reports of damp housing were associated with increased wheeze (p< 0.05), higher β(1→3)-glucan levels in the home were associated with lower wheeze (p < 0.05). Conclusion: The inverse association between household beta glucans levels and wheeze found in this study adds to the controversy regarding the varying role of β(1→3)-glucans for human respiratory health.

Eczema and indoor environment: lessons from the International Study of Asthma and Allergies in Childhood (ISAAC) Phase 2

BackgroundNumerous studies have reported a positive association between damp housing conditions and asthma, but little is known about indoor environmental exposures in relation to childhood eczema. We aimed to specifically investigate the effect of indoor mould and dampness on eczema risk in the International Study of Asthma and Allergies in Childhood (ISAAC). MethodsISAAC Phase 2 is a cross-sectional study of 46 051 children aged 8–12 years from 20 countries. Information on demographics, eczema symptoms, and dampness was gathered with parental questionnaires. Children were examined for eczema and underwent skin prick testing. In a stratified subgroup, dust samples were collected to measure house dust mite exposure. Sex, maternal education, parental allergy, pet ownership, maternal smoking, having an older sibling, bedroom sharing, and cooking with fuels were explored as potential confounders or effect modifiers in logistic regression analysis. FindingsCurrent residential exposure to dampness and mould was significantly associated with flexural eczema in the previous year, with a stronger association seen in non-affluent than in affluent countries (adjusted odds ratio [OR] 1·96, 95% CI 1·62–2·37, vs 1·34, 1·18–1·51). Dampness and mould in the first year of life was also significantly associated with parent-reported eczema ever (1·94, 1·40–2·68, vs 1·43, 1·28–1·60). However, the association with flexural eczema on examination was not significant (0·93, 0·76–1·13). Risk estimates were similar in children positive and negative on skin prick testing, and were not appreciably altered by the effect modifiers, apart from parental allergic disease (parental allergies OR 1·35, 95% CI 1·18–1·54, vs no parental allergies 1·61, 1·37–1·90). InterpretationThese data suggest an association between damp housing conditions and childhood eczema symptoms, which may be causal. Further work is needed to elucidate possible mechanisms. Modification to home environment to reduce dampness and mould could be harnessed to improve or even prevent this common and debilitating condition. FundingNone.

Dampness and moulds in relation to respiratory and allergic symptoms in children: results from Phase Two of the International Study of Asthma and Allergies in Childhood (ISAAC Phase Two)

Many studies report that damp housing conditions are associated with respiratory symptoms. Less is known about mechanisms and possible effect modifiers. Studies of dampness in relation to allergic sensitization and eczema are scarce. We study the influence of damp housing conditions world-wide on symptoms and objective outcomes. Cross-sectional studies of 8-12-year-old children in 20 countries used standardized methodology from Phase Two of the International Study of Asthma and Allergies in Childhood (ISAAC). Symptoms of asthma, rhinitis and eczema, plus residential exposure to dampness and moulds, were ascertained by parental questionnaires (n=46051). Skin examination, skin prick tests (n=26967) and hypertonic saline bronchial challenge (n=5713) were performed. In subsamples stratified by wheeze (n=1175), dust was sampled and analysed for house dust mite (HDM) allergens and endotoxin. Current exposure to dampness was more common for wheezy children (pooled odds ratio 1.58, 95% CI 1.40-1.79) and was associated with greater symptom severity among wheezers, irrespective of atopy. A significant (P<0.01) adverse effect of dampness was also seen for cough and phlegm, rhinitis and reported eczema, but not for examined eczema, nor bronchial hyperresponsiveness. HDM sensitization was more common in damp homes (OR 1.16, 1.03-1.32). HDM-allergen levels were higher in damp homes and were positively associated with HDM-sensitization, but not wheeze. A consistent association of dampness with respiratory and other symptoms was found in both affluent and non-affluent countries, among both atopic and non-atopic children. HDM exposure and sensitization may contribute, but the link seems to be related principally to non-atopic mechanisms.

Safeguarding: the missing seat at the table

Safeguarding: the missing seat at the table

Changes in social inequality with respect to health-related living conditions of 6-year-old children in East Germany after re-unification

BackgroundSince Germany re-unified in 1990, substantial social and economic changes have happened in East Germany, the former socialist German Democratic Republic (GDR). The aim of this study was to investigate the influence of these socio-economic changes in East Germany on the association between social status, measured by parental educational level, and health-related living conditions of children during the ten-year period after re-unification.MethodsIn total, 25,864 6-year-old school beginner children (51.2% male and 48.8% female) participated in cross-sectional studies which have been repeated every year from 1991 to 2000 in East Germany. Parental educational level as a social indicator was the independent variable. Dependent variables included not employed parents, small living space and health-related living conditions (e. g. damp housing, single oven heating and living at busy road). The relationships were described by odds ratios using logistic regression.ResultsA large overall effect of parental educational level on health-related living conditions was observed. The time trends showed that the situation regarding small living space, damp housing conditions and single oven heating improved from 1991 to 2000, while regarding not employed parents (1996–2000) and living at busy road (1991–2000) did not, but even deteriorated. 6-year old children with low parental educational level, who lived at the time of re-unification, were often under damp housing conditions and with single oven heating at homes. Nevertheless, this social inequality has almost vanished ten years later. In contrast, we found an increasing gap between low and high parental educational level with respect to the proportion of parents who were not employed (22%: 4% gain), or lived under cramped housing conditions (22%: 37% reduction), or close to a busy road (7% gain: 2% reduction).ConclusionThe social inequalities which already existed under the socialist system in East Germany persisted in the system of social market economy between 1991 and 2000. 6-year-old children from families with the lowest social status were living under the worst domestic conditions (e. g. living at busy road, having damp housing conditions, single oven heating and small living space) and for some conditions (e. g. living at busy road and having small living space) the gap betweenlow and high social status was even bigger in 2000 than in 1991.

House dust mites and storage compartment mites as allergy inducers

Perennial respiratory diseases like chronic rhinopathy or bronchial asthma can often be related to an allergy to indoor allergens. Of these, the most relevant allergens are derived from house dust mites. Epidemiologic data show that 8.9% of the general population exhibit a sensitization to house dust mites. Based on a better knowledge of the biology and the living habits of house dust mites effective allergen avoidance measures can be performed which are, however, quite cumbersome and go beyond just encasing mattresses. Of particular relevance is the reduction of the relative humidity below 50%. Relatives of house dust mites are storage mites which are increasingly realized as an important cause of respiratory allergies. The most important is Lepidoglyphus destructor which is dominant in dust probes from Europe and shows crossreactivity with other storage mites. They are found in barns and grain stores and are thus important causes for occupational respiratory diseases in farmers. The existence of storage mites in house dust is connected with damp housing conditions.

Differences between infants and adults in the social aetiology of wheeze. The ALSPAC Study Team. Avon Longitudinal Study of Pregnancy and Childhood.

OBJECTIVES: To compare the relation between relative deprivation, its associated social risk factors and the prevalence of wheeze in infancy and in adulthood. DESIGN: A cross sectional population study. SETTING:...

Effect of dampness at home in childhood on bronchial hyperreactivity in adolescence

BACKGROUNDRelatively little is known about risk factors for the persistence of asthma and respiratory symptoms from childhood into adolescence, and few studies have included objective measurements to assess outcomes and...

Clinical and immunologic aspects of storage mite allergy.

Exposure to storage (nonpyroglyphid) mites has been increasingly recognized as a cause of asthma and rhinitis. Several species have been identified in Europe; e.g., Lepidoglyphus destructor, Acarus farris/siro, Tyrophagus spp., Glycyphagus domesticus, and Blomia tjibodas. Blomia tropicalis, on the other hand, predominates in subtropical and tropical areas. Studies from several countries have shown that IgE-mediated allergy in rural populations is of considerable importance and that storage mites are major allergens. Since these mites are found in homes, especially in regions with damp housing conditions, urban populations are at risk of becoming sensitized. Therefore, sensitization is not restricted only to those with occupational exposure. Several major allergens from storage mites have been identified and characterized. There seems to be a limited allergenic cross-reactivity between storage- and house dust mites. Molecular cloning has demonstrated that the Group 2 allergens from storage mites (Lep d 2 and Tyr p 2) show more than 40% sequence identity with the Group 2 allergens from Dermatophagoides spp. The availability of a large number of recombinant dust mite allergens will make it possible to investigate their homology and the number of allergens required for the diagnosis and treatment of storage mite allergy.

Damp housing conditions and respiratory symptoms in primary school children

Damp housing conditions and respiratory symptoms in primary school children

Damp housing conditions and respiratory symptoms in primary school children.

There is evidence that indoor air pollution contributes to the development of respiratory symptoms. This study examined the relationships between dampness in houses and respiratory symptoms in 4,164 primary school children in the subtropical rural areas of the Kaohsiung region, Taiwan. Dampness in homes was assessed by questionnaires that reported 1) general dampness, 2) mold or mildew inside the home, or 3) flooding (appearance of standing water within the home, water damage, or leaks of water into the building). Evidence for upper and lower respiratory symptoms were also collected by questionnaires. Recorded symptoms included cough, wheezing, pneumonia, bronchitis, and asthma. Degrees of dampness were reported as 12.2%, 30.1%, and 43.4%, respectively by the parents or guardians of the study population. The prevalence of respiratory symptoms was consistently higher in homes with indications of dampness than in non-damp homes. After adjustments for potential confounders, selected respiratory symptoms among the childhood population were significantly higher in damp than non-damp homes, with the exception of pneumonia. We conclude that dampness in the home is a strong predictor of and risk factor for respiratory symptoms and constitutes a significant public health problem in subtropical area.

Damp housing and asthma: a case-control study.

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...

Mite allergy and exposure to storage mites and house dust mites in farmers

Sensitization to house dust mites, storage mites and other common inhalation allergens was studied in 144 farmers using SPT and RAST. The study population was selected from a random sample of 808 farmers and consisted of 47 persons who had declared themselves to suffer from asthma, 63 persons who had reported respiratory symptoms, and 34 healthy persons without respiratory symptoms. The most prevalent RAST was towards storage mites and was found in 17% of farmers who suffered from asthma and was estimated to occur in 5% of the random sample of farmers. A positive RAST to house dust mites was found in 17% of farmers who reported to suffer from asthma. Sensitization to pollens, animal dander and grain species was rare. A positive RAST to moulds was not found. There was a strong association between a positive RAST to house dust mites and a positive RAST to storage mites (odds ratio 21.0). A positive RAST to storage mites was significantly associated with living in a dwelling in the past which was recalled as damp (odds ratio 4.9). A high number of house dust mites was found in nearly all dwellings (median count 148 mites/0.1 g dust) and a high number of storage mites was found in some dwellings. This study suggests that in humid and temperate regions of Europe, allergy to storage mites in farmers is not caused exclusively by occupational exposure but damp housing conditions and indoor exposure to storage mites may also be important.

Allergy to storage mites in asthmatic patients and its relation to damp housing conditions

The relation between allergy to house dust mites and allergy to storage mites was studied in 326 patients with bronchial asthma. A positive RAST to house dust mites was found in 24.5% and to storage mites in 7.4%. There was a close association between a positive RAST to house dust mites and a positive RAST to storage mites, and 91.6% had a positive RAST to both. Only 0.9% with a negative RAST to house dust mites had a positive RAST to storage mites, whereas the frequency was 27.5% in those with a positive RAST to house dust mites. Present occupation with exposure to storage mites was found in 20.8% with a positive RAST to storage mites. A positive RAST to both house dust mites and storage mites was significantly associated with anamnestic indicators of damp housing conditions. The close association between allergy to house dust mites and allergy to storage mites in this study is probably caused by a common environmental factor, i.e. damp housing conditions.