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Indoor Environmental Factors and its Associations with Asthma and Allergy Among Swedish Pre-School Children

Hägerhed Engman, Linda LU (2006) In Report TVBH 1015.
Abstract
It has been shown in a large number of scientific studies that living or working in a building with mould and moisture damage increases the risk for asthmatic and allergic symptoms. However, there is a need to establish more valid methods to obtain a more nuanced picture of the wide range of different types of moisture related problems. Furthermore, the causal relationships and the biological mechanisms between moisture damage and health have to be shown.



The study Dampness in Buildings and Health (DBH) was started in the year 2000. Results from the first two phases of the study (a cross sectional questionnaire study on 10,851 children and a nested case control study on 198+202 children) are included in the thesis The... (More)
It has been shown in a large number of scientific studies that living or working in a building with mould and moisture damage increases the risk for asthmatic and allergic symptoms. However, there is a need to establish more valid methods to obtain a more nuanced picture of the wide range of different types of moisture related problems. Furthermore, the causal relationships and the biological mechanisms between moisture damage and health have to be shown.



The study Dampness in Buildings and Health (DBH) was started in the year 2000. Results from the first two phases of the study (a cross sectional questionnaire study on 10,851 children and a nested case control study on 198+202 children) are included in the thesis The overall aim of this work has been to study the impact of moisture related problems in homes on asthmatic and allergic diseases among children.



A dose response relationship was observed, in the case control study, between doctor diagnosed asthma/allergy among the children and inspectors perception of a mouldy odour along the skirting board i.e. a probably sign of hidden mould damage inside the building structure. Inspectors observations of visible damp stains or mould odour in a room were not associated with studied health effects.



The ventilation rate in more than 80% of the single family houses and around 60% of the multi family houses did not fulfil the Swedish building code requirement. It was found that children with asthma and allergy more often lived in homes with a low ventilation rate and a dose response relationship was indicated for this association in single family houses.



Validation of the used questionnaire showed that parental reports were in good agreement with the inspectors observations regarding building characteristics, such as type of house and type of foundation and to a lower degree for type of ventilation system and flooring material. However, the concordance for mould odour and visible signs of dampness was poor. Day care attendance was shown to increase the risk for infectious diseases e.g. common colds, as expected, but also for asthmatic and allergic symptoms among children.



In conclusion, 'dampness' in buildings is a major risk factor for health effects among children, such as asthma and allergies. Parental questionnaire reports on 'dampness' were more valid from a health point of view than observations from inspectors. (Less)
Abstract (Swedish)
Popular Abstract in Swedish

En mängd epidemiologiska studier har visat att fuktskador i bostaden eller på arbetsplatsen ökar risken för olika typer av hälsobesvär, t.ex. astmatiska och allergiska besvär. Exakt vad som emitteras och orsakar dessa symptom i fuktskadade byggnader är inte känt, men både kemiska och mikrobiologiska agens är misstänkta. Vidare finns behov av bättre metoder för att identifiera hälsorelevanta fuktproblem i byggnader.



År 2000 startade den epidemiologiska studien Bostad-Barn-Hälsa, (Dampness in Buildings and Health, DBH). I den första fasen genomfördes en enkät-undersökning där hälsa och bostadsmiljö kartlades för alla barn mellan ett och sex år i Värmland, (n=14 077). I den andra... (More)
Popular Abstract in Swedish

En mängd epidemiologiska studier har visat att fuktskador i bostaden eller på arbetsplatsen ökar risken för olika typer av hälsobesvär, t.ex. astmatiska och allergiska besvär. Exakt vad som emitteras och orsakar dessa symptom i fuktskadade byggnader är inte känt, men både kemiska och mikrobiologiska agens är misstänkta. Vidare finns behov av bättre metoder för att identifiera hälsorelevanta fuktproblem i byggnader.



År 2000 startade den epidemiologiska studien Bostad-Barn-Hälsa, (Dampness in Buildings and Health, DBH). I den första fasen genomfördes en enkät-undersökning där hälsa och bostadsmiljö kartlades för alla barn mellan ett och sex år i Värmland, (n=14 077). I den andra fasen fördjupades undersökningarna i en fall-kontroll studie där 198 barn med allergiska besvär och 202 friska kontroller ingick. Barnen läkarundersöktes och tekniska mätningar och besiktningar genomfördes i deras bostäder.



Resultat från fall-kontroll studien visade att i hus där inspektörerna observerade en mögellukt i golvvinkeln i något rum, var risken för astma och allergiska besvär hos barnen större. Ju starkare lukt desto större risk för besvär av typen rinit och eksem. Mögellukt i golvvinkeln kan vara ett tecken på en fukt- och mögelskada inuti konstruktionen, t.ex. i grunden eller i ytterväggen. Hus byggda mellan 1960-1983, småhus med betongplatta på mark samt hus med frånluftssystem hade i högre grad mögellukt i golvvinkeln än andra. Andra fuktindikationer som observerades av inspektörerna var inte associerade till hälsobesvär hos barnen.



Mer än 80 % av småhusen och runt 60 % av lägenheterna i flerbostadshusen hade en lägre ventilationsgrad än vad som föreskrivs i den svenska byggnormen. Vidare visade det sig att barn med besvär hade lägre ventilation hemma än friska barn.



För att validera enkäten jämfördes föräldrarnas enkätsvar med observationer från besiktningen. Det var mycket god överensstämmelse för olika byggnads-tekniska parametrar som exempelvis typ av hus eller typ av grundläggning, och relativt god för typ av ventilationssystem och golvmaterial. Däremot stämde föräldrarnas rapportering av olika typer av fuktindikationer och mögellukt dåligt överens med inspektörernas uppfattning.



Slutligen visades att daghemsvistelse innebär en ökad risk för luftvägs-infektioner, vilket var väntat, men även att risken för astmatiska och allergiska symptom var större.



Sammanfattningsvis visade undersökningarna att fuktskador i byggnaden är en riskfaktor för hälsobesvär såsom astma och allergi bland barn.



Fuktindikationer som rapporterades av föräldrarna var i större utsträckning associerade till astma och allergiska besvär hos barnen, jämfört med de observationer som gjordes vid besiktningen. (Less)
Please use this url to cite or link to this publication:
author
supervisor
opponent
  • Dr Nevalainen, Aino, Laboratory of Environmental Microbiology, National Public Health Institute, Kuopio, Finland
organization
publishing date
type
Thesis
publication status
published
subject
keywords
epidemiology, Public health, children, validation, inspections, dampness, moisture problem, questionnaire, allergy, asthma, Folkhälsa, epidemiologi, health
in
Report TVBH
volume
1015
pages
188 pages
publisher
Byggnadsfysik LTH, Lunds Tekniska Högskola
defense location
Room C, V-building, John Ericssons väg 1, Lund Institute of Technology
defense date
2006-05-12 13:15:00
external identifiers
  • other:TVBH-1015
ISSN
0349-4950
ISBN
91-88722-35-X
language
English
LU publication?
yes
id
83a04e2b-ad07-4168-8249-67400cbee186 (old id 546631)
date added to LUP
2016-04-01 17:10:47
date last changed
2019-05-23 17:24:25
@phdthesis{83a04e2b-ad07-4168-8249-67400cbee186,
  abstract     = {It has been shown in a large number of scientific studies that living or working in a building with mould and moisture damage increases the risk for asthmatic and allergic symptoms. However, there is a need to establish more valid methods to obtain a more nuanced picture of the wide range of different types of moisture related problems. Furthermore, the causal relationships and the biological mechanisms between moisture damage and health have to be shown.<br/><br>
<br/><br>
The study Dampness in Buildings and Health (DBH) was started in the year 2000. Results from the first two phases of the study (a cross sectional questionnaire study on 10,851 children and a nested case control study on 198+202 children) are included in the thesis The overall aim of this work has been to study the impact of moisture related problems in homes on asthmatic and allergic diseases among children.<br/><br>
<br/><br>
A dose response relationship was observed, in the case control study, between doctor diagnosed asthma/allergy among the children and inspectors perception of a mouldy odour along the skirting board i.e. a probably sign of hidden mould damage inside the building structure. Inspectors observations of visible damp stains or mould odour in a room were not associated with studied health effects.<br/><br>
<br/><br>
The ventilation rate in more than 80% of the single family houses and around 60% of the multi family houses did not fulfil the Swedish building code requirement. It was found that children with asthma and allergy more often lived in homes with a low ventilation rate and a dose response relationship was indicated for this association in single family houses.<br/><br>
<br/><br>
Validation of the used questionnaire showed that parental reports were in good agreement with the inspectors observations regarding building characteristics, such as type of house and type of foundation and to a lower degree for type of ventilation system and flooring material. However, the concordance for mould odour and visible signs of dampness was poor. Day care attendance was shown to increase the risk for infectious diseases e.g. common colds, as expected, but also for asthmatic and allergic symptoms among children.<br/><br>
<br/><br>
In conclusion, 'dampness' in buildings is a major risk factor for health effects among children, such as asthma and allergies. Parental questionnaire reports on 'dampness' were more valid from a health point of view than observations from inspectors.},
  author       = {Hägerhed Engman, Linda},
  isbn         = {91-88722-35-X},
  issn         = {0349-4950},
  language     = {eng},
  publisher    = {Byggnadsfysik LTH, Lunds Tekniska Högskola},
  school       = {Lund University},
  series       = {Report TVBH},
  title        = {Indoor Environmental Factors and its Associations with Asthma and Allergy Among Swedish Pre-School Children},
  url          = {https://lup.lub.lu.se/search/ws/files/4899148/8168560},
  volume       = {1015},
  year         = {2006},
}