Respiratory

Respiratory
In 2012, the U.S. Centers for Disease Control (CDC) and the National Institute for Occupational Safety and Health (NIOSH) issued a new report.

Preventing Occupational Respiratory Disease from Exposures Caused by Dampness in Office Buildings, Schools, and Other Nonindustrial Buildings 

Office buildings, schools, and other nonindustrial buildings may develop moisture and dampness problems from roof and window leaks, high indoor humidity, and flooding events, among other things. For this Alert, we define “dampness” as the presence of unwanted and excessive moisture in buildings [AIHA 2008]. This can lead to the growth of mold, fungi, and bacteria; the release of volatile organic compounds; and the breakdown of building materials.

Research studies have shown that dampness-related exposures from building dampness and mold have been associated with respiratory symptoms, asthma, hypersensitivity pneumonitis, rhinosinusitis, bronchitis, and respiratory infections in research studies. Individuals with asthma or hypersensitivity pneumonitis may be at risk for progression to more severe disease if the relationship between illness and exposure to the damp building is not recognized and exposures continue.

Building dampness and subsequent respiratory illness in some building occupants (including children) occur in part from a lack of knowledge and understanding of the nature and severity of these problems among designers, builders, building owners, employers, and building occupants. 

Building dampness problems frequently occur because of suboptimal design, construction, and commissioning (assessing the building’s construction and operation prior to occupancy) of new buildings. These problems and associated health effects can be prevented by making dampness prevention a goal during the design, construction, and commissioning phases.

Once built, buildings may also develop dampness problems from improper or insufficient maintenance or operation and weather events.


For additional information, read these two additional, important research papers on schools, mold and asthma:

Simoni M, et al (2010) School air quality related to dry cough, rhinitis and nasal patency in children. European Respiratory Journal 35:742–749. Read the paper.

Simoni M, et al (2011) Total viable molds and fungal DNA in classrooms and association with respiratory health and pulmonary function of European school children. Pediatric Allergy and Immunology 22:843–852. Read the abstract.
Global Indoor Health Network - Respiratory effects of mold

Respiratory


Here is an abstract from another important paper about the connection between residential dampness and mold and respiratory tract infections and bronchitis.

Association of residential dampness and mold with respiratory tract infections and bronchitis: a meta-analysis. Environmental Health 2010, 9:72 doi:10.1186/1476-069X-9-72.

Abstract

Background

Dampness and mold have been shown in qualitative reviews to be associated with a variety of adverse respiratory health effects, including respiratory tract infections. Several published meta-analyses have provided quantitative summaries for some of these associations, but not for respiratory infections. Demonstrating a causal relationship between dampness-related agents, which are preventable exposures, and respiratory tract infections would suggest important new public health strategies. We report the results of quantitative meta-analyses of published studies that examined the association of dampness or mold in homes with respiratory infections and bronchitis. 

Methods

For primary studies meeting eligibility criteria, we transformed reported odds ratios (ORs) and confidence intervals (CIs) to the log scale. Both fixed and random effects models were applied to the log ORs and their variances. Most studies contained multiple estimated ORs. Models accounted for the correlation between multiple results within the studies analyzed. One set of analyses was performed with all eligible studies, and another set restricted to studies that controlled for age, gender, smoking, and socioeconomic status. Subgroups of studies were assessed to explore heterogeneity. Funnel plots were used to assess publication bias. 

Results

The resulting summary estimates of ORs from random effects models based on all studies ranged from 1.38 to 1.50, with 95% CIs excluding the null in all cases. Use of different analysis models and restricting analyses based on control of multiple confounding variables changed findings only slightly. ORs (95% CIs) from random effects models using studies adjusting for major confounding variables were, for bronchitis, 1.45 (1.32-1.59); for respiratory infections, 1.44 (1.31-1.59); for respiratory infections excluding nonspecific upper respiratory infections, 1.50 (1.32-1.70), and for respiratory infections in children or infants, 1.48 (1.33-1.65). Little effect of publication bias was evident. Estimated attributable risk proportions ranged from 9% to 20%. 

Conclusions

Residential dampness and mold are associated with substantial and statistically significant increases in both respiratory infections and bronchitis. If these associations were confirmed as causal, effective control of dampness and mold in buildings would prevent a substantial proportion of respiratory infections. 
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