Christina Tischer1,2, Anne M Karvonen3, Pirkka V Kirjavainen3,4, Claudia Flexeder5, Marjut Roponen6, Anne Hyvärinen3, Harald Renz7,8, Urs Peter Frey9, Oliver Fuchs9,10,11,12, Juha Pekkanen3,13. 1. Institute for Health Resort Medicine and Health Promotion, State Institute of Health, Bavarian Health and Food Safety Authority, Bad Kissingen, Germany. 2. Institute of Social Medicine and Health Systems Research (ISMHSR), Medical faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany. 3. Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland. 4. Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland. 5. Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany. 6. Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland. 7. Institute of Laboratory Medicine, Philipps University of Marburg, Marburg, Germany. 8. German Center for Lung Research (DZL), Marburg, Germany. 9. Department of Pediatrics, Division of Pediatric Pulmonology and Allergology, University Children's Hospital, University of Bern, Bern, Switzerland. 10. University Children's Hospital (UKBB), University of Basel, Basel, Switzerland. 11. Department for Biomedical Research, University of Bern, Bern, Switzerland. 12. Department of Pediatric Pulmonology & Allergology, University Childrens's Hospital Schleswig-Holstein Campus Lübeck, Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Lübeck, Germany. 13. Department of Public Health, University of Helsinki, Helsinki, Finland.
Abstract
BACKGROUND: Exposure to indoor moisture damage and visible mold has been found to be associated with asthma and respiratory symptoms in several questionnaire-based studies by self-report. We aimed to define the prospective association between the early life exposure to residential moisture damage or mold and fractional exhaled nitric oxide (FeNO) and lung function parameters as objective markers for airway inflammation and asthma in 6-year-old children. METHODS: Home inspections were performed in children's homes when infants were on average 5 months old. At age 6 years, data on FeNO (n = 322) as well as lung function (n = 216) measurements were collected. Logistic regression and generalized additive models were used for statistical analyses. RESULTS: Early age major moisture damage and moisture damage or mold in the child's main living areas were significantly associated with increased FeNO levels (>75th percentile) at the age of 6 years (adjusted odds ratios, 95% confidence intervals, aOR (95% CI): 3.10 (1.35-7.07) and 3.16 (1.43-6.98), respectively. Effects were more pronounced in those who did not change residential address throughout the study period. For lung function, major structural damage within the whole home was associated with reduced FEV1 and FVC, but not with FEV1/FVC. No association with lung function was observed with early moisture damage or mold in the child's main living areas. CONCLUSION: These results underline the importance of prevention and remediation efforts of moisture and mold-damaged buildings in order to avoid harmful effects within the vulnerable phase of the infants and children's immunologic development.
BACKGROUND: Exposure to indoor moisture damage and visible mold has been found to be associated with asthma and respiratory symptoms in several questionnaire-based studies by self-report. We aimed to define the prospective association between the early life exposure to residential moisture damage or mold and fractional exhaled nitric oxide (FeNO) and lung function parameters as objective markers for airway inflammation and asthma in 6-year-old children. METHODS: Home inspections were performed in children's homes when infants were on average 5 months old. At age 6 years, data on FeNO (n = 322) as well as lung function (n = 216) measurements were collected. Logistic regression and generalized additive models were used for statistical analyses. RESULTS: Early age major moisture damage and moisture damage or mold in the child's main living areas were significantly associated with increased FeNO levels (>75th percentile) at the age of 6 years (adjusted odds ratios, 95% confidence intervals, aOR (95% CI): 3.10 (1.35-7.07) and 3.16 (1.43-6.98), respectively. Effects were more pronounced in those who did not change residential address throughout the study period. For lung function, major structural damage within the whole home was associated with reduced FEV1 and FVC, but not with FEV1/FVC. No association with lung function was observed with early moisture damage or mold in the child's main living areas. CONCLUSION: These results underline the importance of prevention and remediation efforts of moisture and mold-damaged buildings in order to avoid harmful effects within the vulnerable phase of the infants and children's immunologic development.