Home dampness and molds as determinants of respiratory symptoms and asthma in pre-school children

Abstract

The objective of our study was to assess the occurrence of respiratory symptoms in relation to dampness and molds in dwellings in pre-school children. A population-based cross-sectional study was carried out by mailing a parent-administered questionnaire to a random sample of children in a source population consisting of all children aged 1 to 6 years of Espoo, an urban-suburban city (pop. 170,000) in the Helsinki metropolitan area. The study population included a total of 2568 children whose parents filled the questionnaire (response rate 80%). Included were questions on respiratory health, partly modified from ATS-DLD-78-C questionnaire, and potential personal and environmental determinants of the outcome. The determinants of interest were histories of water damage, presence of moisture and visible molds and perceived mold odor at home. The outcomes included persistent cough, phlegm and wheezing, persistent nasal congestion and excretion during the past 12 months and current asthma. The determinant-outcome relations were estimated in the logistic regression controlling for age, gender, parents' education, single parent or guardian, environmental tobacco smoke, gas cooking, pets and type of day care. The occurrence of persistent cough (OR 2.17; 95% CI 1.39, 3.39), phlegm (2.20; 1.27, 3.82), wheezing (2.62; 1.39, 4.39), nasal congestion (1.94; 1.15, 4.98), and nasal excretion (1.43; 0.95, 2.17) during the past year were higher with the presence of any determinant, but the occurrence of asthma (OR 1.10; 0.54, 2.24) was similar compared to the reference group. Mold odor during the past year (ORs from 2.38 to 6.87) and water damage over a year ago (ORs from 2.54 to 8.67) had the strongest association with the respiratory symptoms. A dose-response relation of the occurrence of the symptoms associated with the frequency of days with mold odor was observed. There was also a compatible time sequence between water damage taking place more than a year ago and the occurrence of symptoms during the past year. The results provide further evidence on the importance of home dampness and molds in the etiology of respiratory symptoms and new information on the role of mold odor as a risk indicator.