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Meta-Analysis
. 2012;7(11):e47526.
doi: 10.1371/journal.pone.0047526. Epub 2012 Nov 7.

Residential dampness and molds and the risk of developing asthma: a systematic review and meta-analysis

Reginald Quansah  1 , Maritta S Jaakkola, Timo T Hugg, Sirpa A M Heikkinen, Jouni J K Jaakkola
Affiliations
Meta-Analysis

Residential dampness and molds and the risk of developing asthma: a systematic review and meta-analysis

Reginald Quansah et al. PLoS One. 2012.

Erratum in

  • PLoS One. 2014;9(3):e93454

Abstract

Context: Studies from different geographical regions have assessed the relations between indoor dampness and mold problems and the risk of asthma, but the evidence has been inconclusive.

Objective: To assess the relations between indicators of indoor dampness and mold problems and the risk of developing new asthma, and to investigate whether such relations differ according to the type of exposure.

Data sources: A systematic literature search of PubMed database from 1990 through March 2012 and the reference lists of recent reviews and of relevant articles identified in our search.

Study selection: Cohort/longitudinal and incident case-control studies assessing the relation between mold/dampness and new asthma were included.

Data extraction: Three authors independently evaluated eligible articles and extracted relevant information using a structured form.

Synthesis: SIXTEEN STUDIES WERE INCLUDED: 11 cohort and 5 incident case-control studies. The summary effect estimates (EE) based on the highest and lowest estimates for the relation between any exposure and onset of asthma were for the highest estimates 1.48 (95% confidence interval [CI] 1.23-1.78, random-effects model, Q-statistic 38.75 (16), P = 0.001) ; and for the lowest estimates: 1.27 (95% CI 1.06-1.53, random-effects model, Q-statistic 38.12 (16), P = 0.000) [corrected].The summary effect estimates were significantly elevated for dampness (fixed-effects model: EE 1.33, 95% CI 1.12-1.56, Q-statistic 8.22 (9), P = 0.413), visible mold (random-effects model; EE 1.29, 95% CI 1.04-1.60, 30.30 (12), P = 0.001), and mold odor (random-effects model; EE 1.73, 95% CI 1.19-2.50, Q-statistics 14.85 (8), P = 0.038), but not for water damage (fixed-effects model; EE 1.12, 95% CI 0.98-1.27). Heterogeneity was observed in the study-specific effect estimates.

Conclusion: The evidence indicates that dampness and molds in the home are determinants of developing asthma. The association of the presence of visible mold and especially mold odor to the risk of asthma points towards mold-related causal agents.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Diagram of the systematic search showing selection of the studies.
Figure 2
Figure 2. Forest plots.
A. Forest plot for the relation between any exposure and onset of asthma (n = 16). B. Forest plot for the relation between water damage and onset of asthma (n = 8). C. Forest plot for the relation between dampness and onset of asthma (n = 9). D. Forest plot for the relation between visible mold and onset of asthma (n = 12). E. Forest plot for the relation between mold odour and onset of asthma (n = 8).
Figure 3
Figure 3. Effect estimates for exposure indicators according to the hypothesized simplified causal pathway.
See this image and copyright information in PMC

References

    1. Jaakkola MS, Jaakkola JJK (2004) Indoor molds and asthma in adults. Adv Appl Microbiol 55: 309–338. - PubMed
    1. Jaakkola MS, Haverinen-Shaugnessy U, Doewes J, Nevalainen A (2011) Indoor dampness and mold problems in homes and asthma onset in children. In: Braubach M, Jacobs DE, Ormandy D, editors. Environmental burden of disease associated with inadequate housing-A method guide to the quantification of health effects of selected housing risks in the WHO European Region. Geneva: World Health Organization.
    1. World Health Organization (WHO) Europe (2009) WHO Guidelines for Indoor Air Quality: dampness and mold. Copenhagen: World Health Organization. Available: http://www.euro.who.int/_data/assets/pdf_file/0017/43325/E92645.pdf. Accessed 2011 Jul 14.
    1. Institute of Medicine (IOM) (2004) Damp indoor spaces and health. Washington, DC: National Academies Press. Available: http://www.iom.edu/.../Damp-Indoor-Spaces-and-Health.aspx. Accessed 2011 Aug 1.
    1. Fisk WJ, Lei-Gomez Q, Mendell MJ (2007) Meta-analyses of associations of respiratory health effects with dampness and mold in homes. Indoor Air 17: 284–296. - PubMed

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