EFFECTS OF DAMP AND MOLD IN THE HOME ON RESPIRATORY HEALTH - A REVIEWOF THE LITERATURE

This review examines whether there is a direct or indirect relation be tween damp or mould in the home and respiratory health. Home dampness is thought to have health consequences because it has the potential to increase the proliferation of house-dust mites and moulds, both of wh ich are allergenic. The results from the many studies conducted to inv estigate whether damp and mould are associated with health outcomes ar e difficult to compare because the methods of measuring exposures and health outcomes have not been standardized. However, the studies that have been conducted in children are probably the most reliable because the confounding effects of active smoking or occupational exposures a re absent, and because the presence of symptoms of cough and wheeze ha ve been consistently investigated in many studies. The increased risk of children having these symptoms if the home has damp or mould is fai rly small with an odds ratio that is generally in the range 1.5-3.5, t hese estimates being statistically significant when the sample size ha s been large enough. This range is consistent with the measured effect s of other environmental exposures which are considered important to h ealth, such as environmental tobacco smoke or outdoor air pollutants. The potential benefits of reducing mould in the home have not been inv estigated, and the few studies that have investigated health improveme nts as a result of increasing ventilation or reducing damp in order to reduce house-dust mite levels suggest that this intervention is expen sive, requires a large commitment, and is unlikely to be successful in the long term. This implies that houses need to be specifically desig ned for primary prevention of respiratory problems associated with ind oor allergen proliferation rather than using post hoc procedures to im prove indoor climate and reduce allergen load as a secondary or tertia ry preventive strategy.