Exposure to indoor mould and children’s respiratory health in the PATY study

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Journal of Epidemiology and Community Health 2008;62:708-714;

doi:10.1136/jech.2007.065896

RESEARCH REPORTS

Exposure to indoor mould and children's respiratory health in the

PATY study

T Antova1, S Pattenden2, B Brunekreef3, J Heinrich4, P Rudnai5, F

Forastiere6, H Luttmann-Gibson7, L Grize8, B Katsnelson9, H

Moshammer10, B Nikiforov11, H Slachtova12, K Slotova13, R

Zlotkowska14, T Fletcher2

http://jech.bmj.com/cgi/content/abstract/62/8/708

1 Environmental Health Unit, NCPHP, Sofia, Bulgaria

2 LSHTM, London, UK

3 IRAS, Utrecht, The Netherlands

4 Institute of Epidemiology, Neuherberg, Germany

5 " Jozsef Fodor " National Center of Public Health, Budapest, Hungary

6 ASL RME, Rome, Italy

7 Department of Environmental Health, Harvard School of Public

Health, Boston, MA, USA

8 University of Basel, Basel, Switzerland

9 Ural Regional Centre for Environmental Epidemiology,

Yekaterinburg, Russia

10 Medical University of Vienna, Vienna, Austria

11 Environmental Health Unit, NCHMEN, Sofia, Bulgaria

12 Regional Institute of Hygiene, Ostrava, Czech Republic

13 Regional Authority of Public Health, Banska Bystrica, Slovakia

14 Institute of Occupational Medicine and Environmental Health,

Sosnowiec, Poland

Correspondence to:

Dr S Pattenden, London School of Hygiene & Tropical Medicine, Keppel

Street, London WC1E 7HT, UK; sam.pattenden@...

Background: Living in a damp or mouldy home reportedly damages

children's respiratory health, yet mould appears not to be a

prominent risk factor in the public's perception. Analyses of data

on over 58 000 children from the Pollution and the Young (PATY)

study are presented. In this collaboration, researchers from 12

cross-sectional studies pooled their data to assess the effects of

air quality on a spectrum of children's respiratory disorders.

Method: Original studies were conducted in Russia, North America and

10 countries in Eastern and Western Europe. Pooled analyses were

restricted to children aged 6–12 years. Associations between visible

mould reported in the household and a spectrum of eight respiratory

and allergic symptoms were estimated within each study. Logistic

regressions were used, controlling for individual risk factors and

for study area. Heterogeneity between study-specific results and

mean effects (allowing for heterogeneity) were estimated using meta-

analysis.

Results: Visible mould was reported by 13.9% of respondents in

Russia, increasing to 39.1% in North America. Positive associations

between exposure to mould and children's respiratory health were

seen with considerable consistency across studies and across

outcomes. Confounder-adjusted combined ORs ranged from 1.30 (95% CI

1.22 to 1.39) for " nocturnal cough " to 1.50 (1.31 to 1.73)

for " morning cough " . Evidence of stronger effects in more crowded

households was statistically significant for only asthma and

sensitivity to inhaled allergens. No consistent interactions between

mould and age, sex or parental smoking were found.

Conclusion: Indoor mould exposure was consistently associated with

adverse respiratory health outcomes in children living in these

diverse countries.

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