Dampness and Mould - WHO guidelines for indoor air quality - PRWeb

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68 WHO GUIDELINES FOR INDOOR AIR QUALITY: DAMPNESS AND MOULD factors: exposure to damp indoor environments and the presence of mould or other agents in damp indoor environments. Table 5 summarizes the conclusions of the review with regard to the epidemiological evidence on dampness-related health effects. Sufficient evidence was considered not to be available for any of the associations. Sufficient evidence of associations with exposure to damp indoor environments and with the presence of mould or other agents in damp indoor environments was considered to exist for four outcomes: upper respiratory (nose and throat) tract symptoms, cough, wheeze and asthma symptoms in sensitized people (i.e. asthma exacerbation). Sufficient evidence was also considered to exist for an association between dampness-related agents and hypersensitivity pneumonitis in susceptible persons. Table 6 shows the numbers of published studies included in the review, by study design for the health effect categories. It also shows the numbers of studies identified in the current review that were not included in the Institute of Medicine review. The results of the newly identified studies are discussed below. Fisk, Lei-Gomez and Mendell (2007) reported the results of a quantitative meta-analysis on residential dampness-related risks for adverse respiratory health effects, which was based on studies available through early 2006 (which included most of the studies on specific outcomes used in the current review) and which met specified inclusion criteria. They estimated summary odds ratios and 95% confidence intervals for associations between dampness-related risk factors and six types of health outcome, including some of those in the Institute of Medicine review (upper respiratory tract symptoms, cough, wheeze and asthma development) and some other categories (current asthma and ever-diagnosed asthma). All types of visible dampness, mould or mould odour, reported by either occupants or researchers, were considered to represent a single set of dampness-related risks. Studies of measured concentrations of microbiological agents or of measured or reported air humidity were excluded. The results of the meta-analysis are summarized in Table 7. The central estimates of the odds ratio ranged from 1.34 to 1.75, with a lower confidence limit exceeding 1.0 in 9 of 10 estimates (i.e. for all except asthma development). The authors also estimated the percentage increase in prevalence of each outcome in houses with dampness or mould. Fisk, Lei-Gomez and Mendell (2007) concluded that “building dampness and mould are associated with approximately 30–50% increases in a variety of respiratory and asthma-related health outcomes.” In a companion paper, Mudarri and Fisk (2007) estimated that, if the reported associations were causal, 21% of the cases of asthma in the United States could be attributable to dampness and mould in housing, for a total annual national cost of US$ 3.5 billion. 4.1.3.2. Additional published studies The search conducted for the present review resulted in an initial 153 articles published between 1986 and 2007, excluding the 45 articles in the Institute of
HEALTH EFFECTS ASSOCIATED WITH DAMPNESS AND MOULD 69 Table 6 . Numbers of published studies on health effects of damp indoor environments Health outcome category Included in review of the Institute of Medicine (2004) Study design No. of studies Study design Additional studies No. of studies Asthma development Current asthma Respiratory infections (in otherwise healthy people) Upper respiratory tract symptoms Allergic rhinitis Cough Wheeze Dyspnoea Altered lung function Bronchitis Other respiratory effects Allergy or atopy Asthma, ever Asthma symptoms in people with asthma Cohort Case–control Cross-sectional – – Cohort Case–control Cross-sectional – Cohort Case–control Cross-sectional Cohort Case-control Cross-sectional Cohort Case–control Cross-sectional – – – – – Intervention Cohort Case–control Cross-sectional 2 6 0 – – 0 0 14 – 0 1 20 0 1 19 0 0 4 – – – – – 0 0 5 18 Prospective Retrospective Cross-sectional Prospective Retrospective Cross-sectional Prospective Retrospective Cross-sectional Prospective Retrospective Cross-sectional Prospective Retrospective Cross-sectional Prospective Retrospective Cross-sectional Prospective Retrospective Cross-sectional Prospective Retrospective Cross-sectional Intervention Prospective Retrospective Cross-sectional Prospective Retrospective Cross-sectional Prospective Retrospective Cross-sectional Prospective Retrospective Cross-sectional Prospective Retrospective Cross-sectional Intervention Prospective Retrospective Cross-sectional 3 2 0 1 0 17 3 0 5 1 0 11 3 0 3 1 0 19 5 1 24 0 0 8 1 2 0 7 0 0 6 2 0 7 3 0 10 2 0 6 2 1 0 3 Total 1 45 68 1 Totals are less than the sum of the numbers above, as findings for several health effects may be reported.
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WHO GUIDELINES FOR INDOOR AIR QUALI
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Keywords AIR POLLUTION, INDOOR - ad
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Abstract Microbial pollution is a k
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4. Health effects associated with d
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VIII WHO GUIDELINES FOR INDOOR AIR
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X Acknowledgements Preparation of t
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XII Executive summary This document
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XIV WHO GUIDELINES FOR INDOOR AIR Q
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XVI WHO GUIDELINES FOR INDOOR AIR Q
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2 WHO GUIDELINES FOR INDOOR AIR QUA
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130 HEALTH RISKS OF OZONE FROM LONG
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When sufficient moisture is availab
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