Table 5. Meta analyses of associations of dampness and mold in homes with health

Population(s);  Number of Studies

Risk Factors

Control for confounding

Health Outcomes and Estimate of Association with Dampness or Mold Expressed as Odds ratio or Effect Estimate (95% confidence interval)

Reference

Adults and children; Number of studies in analysis ranged from 4  for asthma development to 22 for wheeze

Dampness, mold (visible mold or mold odor), or dampness and mold, in housing

Required that  individual studies controlled for confounding by age, gender, smoking, socio-economic status;

Age > 3 for asthma development

Upper respiratory symptom    1.70 (1.44 – 2.00)

Cough, all ages    1.67 (1.49 – 1.86)

Cough, Adults      1.52 (1.18 – 1.96)

Cough, Children   1.75 (1.56 – 1.96)

Wheeze, all ages  1.50 (1.38 – 1.64)

Wheeze, adults    1.39 (1.04 – 1.85)

Wheeze, children 1.53 (1.39 – 1.68)

Ever diagnosed with asthma 1.37 (1.23 – 1.53)

Asthma development  1.34 (0.86 – 2.10)

Fisk et al 2007 [46]

58,000 children age 6 -12; 12 studies in Russia, North America, Europe

Visible mold in home

Controlled for age, sex, maternal education, paternal education, nationality, crowding, unvented combustion heating, smoker in house, birth order, ever had a pet

Wheeze in past 12 months  1.43 (1.36 – 1.49)

Ever asthma 1.35 (1.20 – 1.51)

Bronchitis in past 12 months   1.38 ( 1.29 – 1.47)

Nocturnal dry cough in past 12 months 1.30 (1.22 – 1.39)

Morning cough 1.50 (1.31 – 1.73)

Sensitivity to inhaled allergens 1.33 (1.23 – 1.44)

Ever hay fever  1.35 (1.18 – 1.53)

Woken by wheeze in past 12 months  1.49 (1.28 – 1.74)

Antova et al. 2008 [51]

Children and adults; 13 to 19 studies with 57 to 20,059 subjects per study

Any of dampness, water damage, visible mold, mold odor, history of flooding in home

For results reported in this table, individual studies controlled for age, gender, smoking, socio-economic status

 

Acute or chronic bronchitis  1.45 (1.32 – 1.59)

Respiratory infection

   All ages  1.44 (1.31 – 1.59)

   Children  1.48 (1.33 – 1.65)

   Adults  1.49 (1.14 – 1.95)

Respiratory infection excluding otitis media  1.40 (1.29 – 1.52)

Respiratory infection excluding common cold and non-specific infections  1.50 (1.32 – 1.70)

Common cold or acute upper respiratory infection  1.38 (1.13 – 1.65)

Fisk et al. 2010 [49]

Children; 21 studies for asthma, 19 studies for wheeze, 10 studies for allergic rhinitis

Visible mold, mold concentrations in air or dust; concentrations markers of mold; all at home

*

For visible mold:

Doctor-diagnosed asthma  1.49 (1.28 – 1.72)

Wheeze  1.68 (1.48 – 1.90)

Allergic rhinitis 1.39 ( 1.28 – 1.51)

For concentrations of mold spores or of markers of mold in air or dust, there were fewer significant findings. Higher mold spore levels were associated with increased wheeze and asthma in young children; however, there was a tendency for lower risks of allergic health outcomes with higher concentrations on markers of molds, such as glucans.

Tischer et al. 2011a [42]

31,742 children; 8 birth cohorts in Europe

Visible dampness or mold in home during first 2 years of life

Controlled for gender, parental atopy, parental education, maternal smoking during pregnancy, smoke at home in 1st two years of life, breast feeding, day care

Asthma during age 0 – 2     1.39 (1.05 – 1.95)

Asthma during age 6 – 8     1.09 (0.90 – 1.32)

Asthma ever during age 3 – 10     1.10 (0.90 – 1.34)

Allergic rhinitis during age 6 – 8    1.12 (1.02 – 1.23)

Allergic rhinitis during age 3 – 10     1.18 (1.09 – 1.28)

Sensitization to airborne allergens during age 6 – 8   1.05 (0.89 – 1.24)

Tischer et al 2011b [47]

Children or adults; 8 to 16 studies depending upon analysis

Combinations of water damage, damp stains or other dampness indicators, visible mold, mold odor

Not described

For onset of asthma:

   Any dampness or mold indicator  1.50 (1.25 – 1.80)

   Water damage:1.12 (0.98 – 1.27)

   Dampness indicators 1.32 (1.12 – 1.57)

   Visible mold 1.29 (1.04 – 1.60)

   Mold odor 1.73 (1.19 – 2.50)

Jaakkola et al. 2013 [52]

Children or adults; 31 studies

Any of water damage, damp stains or other dampness indicators, visible mold, mold odor in home

*

Rhinitis

   Any risk factor  2.08 (1.56 – 2.76)

   Water damage 1.71 (0.69 – 4.22)

   Damp stains  1.82 (1.34 – 2.46)

   Visible mold  1.82 (1.56 – 2.12)

   Mold odor  2.18 (1.76 – 2.71)

Allergic rhinitis  

   Any risk factor  1.52 (1.29 – 1.80)

   Water damage  1.46 (0.98 – 2.19)

   Damp stains  1.50 (1.38 – 1.62)

   Visible mold 1.51 (1.39 – 1.64)

   Mold odor  1.87 (0.95 – 3.68)

Rhinoconjunctivitis

   Damp stains or visible mold  1.68 (1.41 – 2.00)

   Damp stains  1.67 (1.41 – 1.98)

   Visible mold  1.66 (1.27 – 2.18)

Jaakkola et al 2013 [53]

Children and adults in buildings that received dampness remediation; 12 total studies but as few as 2 studies per analysis

 

 Dampness remediations

 Intervention study designs control for personal/demographic factors and many building characteristics

Reported results are too numerous for replication in this table.  The main findings were:

  • For adults, dampness remediation in homes was associated with reduced respiratory and asthma outcomes, including asthma medication use, often with odds ratios of approximately 0.6 and many of the findings were statistically significant
  • There was low quality evidence that a dampness remediation in an office building reduced asthma and other respiratory symptoms.
  • Dampness remediation in schools had an inconsistent association with respiratory symptoms in children, although there was evidence that remediation decreased students’ visits to doctors for common colds

Sauni et al. 2015 [50]