Home Dampness and Molds, Parental Atopy, and Asthma in Childhood: A Six-Year Population-Based Cohort Study

Previous studies of how parental atopy and exposure to dampness and molds contribute to the risk of asthma have been mainly cross-sectional or prevalent case–control studies, where selection and information bias and temporality constitute problems. We assessed longitudinally the independent and joint effects of parental atopy and exposure to molds in dwellings on the development of asthma in childhood. We conducted a population-based, 6-year prospective cohort study of 1,984 children 1–7 years of age at the baseline in 1991 (follow-up rate, 77%). The study population included 1,916 children without asthma at baseline and complete outcome information. The data collection included a baseline and follow-up survey. The outcome of interest was development of asthma during the study period. The studied determinants were parental allergic diseases and four indicators of exposure at baseline: histories of water damage, presence of moisture and visible molds, and perceived mold odor in the home. A total of 138 (7.2%) children developed asthma during the study period, resulting in an incidence rate of 125 cases per 10,000 person-years [95% confidence interval (CI), 104–146]. In Poisson regression adjusting for confounding, parental atopy [adjusted incidence rate ratio (IRR) 1.52; 95% CI, 1.08–2.13] and the presence of mold odor in the home reported at baseline (adjusted IRR 2.44; 95% CI, 1.07–5.60) were independent determinants of asthma incidence, but no apparent interaction was observed. The results of this cohort study with assessment of exposure before the onset of asthma strengthen the evidence on the independent effects of parental atopy and exposure to molds on the development of asthma

Subtypes of Adult-Onset Asthma at the Time of Diagnosis: A Latent Class Analysis

Introduction: Only a few previous studies have investigated the subtypes of adult-onset asthma. No previous study has assessed whether these subtypes are different between men and women, or whether these subtypes have different risk factors. Methods: We applied latent class analyses to the Finnish Environment and Asthma Study population, including 520 new cases of adult-onset asthma. We formed subtypes separately between women and men and analyzed the following determinants as potential predictors for these subtypes: age, body mass index, smoking, and parental asthma. Results: Among women, the subtypes identified were: 1. Moderate asthma, 2. Cough-variant asthma, 3. Eosinophilic asthma, 4. Allergic asthma, and 5. Difficult asthma. Among men, the subtypes were: 1. Mild asthma, 2. Moderate asthma, 3. Allergic asthma, and 4. Difficult asthma. Three of the subtypes were similar among women and men: Moderate, Allergic, and Difficult asthma. In addition, women had two distinct subtypes: Cough-variant asthma, and Eosinophilic asthma. These subtypes had different risk factor profiles, e.g., heredity was important for Eosinophilic and Allergic asthma (RR for Both parents having asthma in Eosinophilic 3.55 (1.09 to 11.62)). Furthermore, smoking increased the risk of Moderate asthma among women (RR for former smoking 2.21 (1.19 to 4.11)) and Difficult asthma among men but had little influence on Allergic or Cough-variant asthma. Conclusion: This is an original investigation of the subtypes of adult-onset asthma identified at the time of diagnosis. These subtypes differ between women and men, and these subtypes have different risk factor profiles. These findings have both clinical and public health importance for the etiology, prognosis, and treatment of adult-onset asthma

The effect of sampling height on grass pollen concentrations in different urban environments in the Helsinki Metropolitan Area, Finland

Introduction It is important to study potential differences in pollen concentrations between sampling heights because of diverse outdoor and indoor activity of humans (exposure) at different height levels in urban environments. Previous studies have investigated the effect of height on pollen concentrations based on just one or a few sampling points. We studied the effect of sampling height on grass pollen concentrations in several urban environments with different levels of urbanity. Methods This study was conducted in the Helsinki Metropolitan Area, Finland, in 2013 during the pollen season of grasses. Pollen grains were monitored in eight different points in the morning and afternoon. Rotorod-type samplers were attached on sampling poles at the heights of 1.5 meters and 4 meters. Results Grass pollen concentrations were on average higher at the height of 1.5 meters (Helsinki mean 5.24 grains / m3; Espoo mean 75.71 grains / m3) compared to the height of 4 meters (Helsinki mean 3.84 grains / m3; Espoo mean 37.42 grains / m3) with a difference of 1.40 grains / m3 (95% CI -0.21 to 3.01) in Helsinki, and 38.29 grains / m3 (7.52 to 69.07) in Espoo, although not always statistically significant. This was detected both in the morning and in the afternoon. However, in the most urban sites the levels were lower at 1.5 meters compared to 4 meters, whereas in the least urban sites the concentrations were higher at 1.5 meters. In linear regression models with interaction terms, the modifying effect of urbanity on concentration-height relation was statistically significant in both cities. The effect of urbanity on pollen concentrations at both heights was stronger in less urban Espoo. Conclusions The present study provides evidence that height affects the abundance and distribution of grass pollen in urban environments, but this effect depends on the level of urbanity.Peer reviewe

Indoor dampness and molds and development of adult-onset asthma: a population-based incident case-control study.

Previous cross-sectional and prevalent case-control studies have suggested increased risk of asthma in adults related to dampness problems and molds in homes. We conducted a population-based incident case-control study to assess the effects of indoor dampness problems and molds at work and at home on development of asthma in adults. We recruited systematically all new cases of asthma during a 2.5-year study period (1997-2000) and randomly selected controls from a source population consisting of adults 21-63 years old living in the Pirkanmaa Hospital district, South Finland. The clinically diagnosed case series consisted of 521 adults with newly diagnosed asthma and the control series of 932 controls, after we excluded 76 (7.5%) controls with a history of asthma. In logistic regression analysis adjusting for confounders, the risk of asthma was related to the presence of visible mold and/or mold odor in the workplace (odds ratio, 1.54; 95% confidence interval, 1.01-2.32) but not to water damage or damp stains alone. We estimated the fraction of asthma attributable to workplace mold exposure to be 35.1% (95% confidence interval, 1.0-56.9%) among the exposed. Present results provide new evidence of the relation between workplace exposure to indoor molds and adult-onset asthma

Self-Assessed Threshold Temperature for Cold among Poultry Industry Workers in Thailand

The self-assessed threshold temperature for cold in the workplace is not well known. We asked 392 chicken industry workers in Thailand what they regard as the cold threshold (CT) and compared subgroups of workers using linear and quantile regressions by CT sextiles (percentiles P17, P33, P50, P67, and P83, from warmest to coldest). The variables of interest were sex, office work, and sedentary work, with age, clothing thermal insulation, and alcohol consumption as adjustment factors. The mean CT was 14.6 ◦C. Office workers had a 6.8 ◦C higher mean CT than other workers, but the difference ranged from 3.8 ◦C to 10.0 ◦C from P17 to P83. Sedentary workers had a 2.0 ◦C higher mean CT than others, but the difference increased from 0.5 ◦C to 3.0 ◦C through P17–P83. The mean CT did not differ between sexes, but men had a 1.6–5.0 ◦C higher CT at P17–P50 (>20 ◦C) and a 5.0 ◦C lower CT at P83 ( 0.35 m/s) worksites. We conclude that office, sedentary, and female workers and those working at warm, dry, and draughty sites are sensitive to the coldest temperatures, whereas male workers are sensitive even to moderate temperatures

Assessment of public health impact of work-related asthma

<p>Abstract</p> <p>Background</p> <p>Asthma is among the most common chronic diseases in working-aged populations and occupational exposures are important causal agents. Our aims were to evaluate the best methods to assess occurrence, public health impact, and burden to society related to occupational or work-related asthma and to achieve comparable estimates for different populations.</p> <p>Methods</p> <p>We addressed three central questions: <b>1: What is the best method to assess the occurrence of occupational asthma? </b>We evaluated: 1) assessment of the occurrence of occupational asthma <it>per se</it>, and 2) assessment of adult-onset asthma and the population attributable fractions due to specific occupational exposures. <b>2: What are the best methods to assess public health impact and burden to society related to occupational or work-related asthma? </b>We evaluated methods based on assessment of excess burden of disease due to specific occupational exposures. <b>3: How to achieve comparable estimates for different populations? </b>We evaluated comparability of estimates of occurrence and burden attributable to occupational asthma based on different methods.</p> <p>Results</p> <p>Assessment of the occurrence of occupational asthma <it>per se </it>can be used in countries with good coverage of the identification system for occupational asthma, i.e. countries with well-functioning occupational health services. Assessment based on adult-onset asthma and population attributable fractions due to specific occupational exposures is a good approach to estimate the occurrence of occupational asthma at the population level. For assessment of public health impact from work-related asthma we recommend assessing excess burden of disease due to specific occupational exposures, including excess incidence of asthma complemented by an assessment of disability from it. International comparability of estimates can be best achieved by methods based on population attributable fractions.</p> <p>Conclusions</p> <p>Public health impact assessment for occupational asthma is central in prevention and health policy planning and could be improved by purposeful development of methods for assessing health benefits from preventive actions. Registry-based methods are suitable for evaluating time-trends of occurrence at a given population but for international comparisons they face serious limitations. Assessment of excess burden of disease due to specific occupational exposure is a useful measure, when there is valid information on population exposure and attributable fractions.</p

Respiratory Infections Precede Adult-Onset Asthma

BACKGROUND: Respiratory infections in early life are associated with an increased risk of developing asthma but there is little evidence on the role of infections for onset of asthma in adults. The objective of this study was to assess the relation of the occurrence of respiratory infections in the past 12 months to adult-onset asthma in a population-based incident case-control study of adults 21-63 years of age. METHODS/PRINCIPAL FINDINGS: We recruited all new clinically diagnosed cases of asthma (n = 521) during a 2.5-year study period and randomly selected controls (n = 932) in a geographically defined area in South Finland. Information on respiratory infections was collected by a self-administered questionnaire. The diagnosis of asthma was based on symptoms and reversible airflow obstruction in lung function measurements. The risk of asthma onset was strongly increased in subjects who had experienced in the preceding 12 months lower respiratory tract infections (including acute bronchitis and pneumonia) with an adjusted odds ratio (OR) 7.18 (95% confidence interval [CI] 5.16-9.99), or upper respiratory tract infections (including common cold, sinusitis, tonsillitis, and otitis media) with an adjusted OR 2.26 (95% CI 1.72-2.97). Individuals with personal atopy and/or parental atopy were more susceptible to the effects of respiratory infections on asthma onset than non-atopic persons. CONCLUSIONS/SIGNIFICANCE: This study provides new evidence that recently experienced respiratory infections are a strong determinant for adult-onset asthma. Reducing such infections might prevent onset of asthma in adulthood, especially in individuals with atopy or hereditary propensity to it

Identifying the gaps regarding exposure to aeroallergens in schools: systematic review

This research was funded by the Instituto Politécnico de Lisboa, Lisboa, Portugal for funding Project IPL/2023/FoodAIIEU_ESTeSL. H&TRC authors gratefully acknowledge the FCT/MCTES national support through the 2023.01366.BD and IPL/2022/InChildhealth/BI/12M.Background: Allergic diseases are a major concern in high-income countries, and their occurrence continues to increase worldwide. Despite previous studies reporting the health effects of exposure to both chemical and (micro)biological agents, aeroallergens have been less well studied. Most studies have focused on exposure to indoor allergens at home. However, exposure can happen in other environments, including in schools where children spend much of their time. Review questions: What are the most common indoor allergens in schools? What methods (sampling and assays) are applied to measure the levels of indoor allergens in schools? What are the levels of indoor allergens in schools? What are the determinants of indoor allergens in schools? Which areas of schools have the highest levels of allergens (e.g., wet areas/bathrooms)? What are the effects of exposure to indoor allergens on asthma, asthma-like symptoms, asthma control, allergic sensitization, and allergic diseases?info:eu-repo/semantics/publishedVersio