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We studied dampness and mold in China in relation to rhinitis, ocular, throat and dermal symptoms, headache and fatigue. Multilevel logistic regression models were used to calculate odds ratios ORs. Totally, 3. Overall, 6.
All dampness signs were associated with symptoms ORs from 1. The strongest associations were for mold odor ORs from 2.
Associations were stronger among men and stronger in Beijing as compared to south China. In conclusion, dampness and mold are common in Chinese homes and associated with rhinitis and ocular, throat and dermal symptoms, headache and fatigue. Men can be more sensitive to dampness and health effects of dampness can be stronger in northern China.
Practical Implications There is an obvious need for improvements of dampness conditions in Chinese homes. Since there are mostly weak correlations between different signs of dampness, it is important to assess different types of dampness indicators in indoor epidemiology to cover all aspects of dampness.
More detailed technical investigations are needed in China to identify underlying causes of dampness in homes in China to be able to improve the home environment and to build homes with less dampness in the future.
Many epidemiological studies have been published, linking dampness to an increased risk of asthma, 2 asthmatic symptoms, 3 , 4 respiratory infections, 3 , 5 and rhinitis. Parents of preschool children in the city of Taiyuan in northern China reported that China is divided into northern and southern China with the Yangze River as the border.
Buildings in northern China including Beijing have a central heating system. Residential buildings in southern China have no central heating system installed but the residents may use their air conditioner or electric radiators to heat the home in winter. The wall construction in modern buildings in southern China consists of a frame of reinforced concrete with bricks as the wall material. Recently, mineral insulation on the outside of the walls has started to be used.
The wall has an inside layer and an outside layer of waterproof cement mortar as dampness barriers. Two cities within the CCHH study Chongqing and Changsha have reported associations between dampness and rhinitis, eye, nose, throat and dermal symptoms, headache and fatigue among parents of young children. Our hypothesis is that there are positive associations between the seven signs of dampness and the medical symptoms including three merged symptom categories.
Consents were obtained from parents or guardians of participating children before the study. The present article is based on merged data from six cities from the CCHH study performed in 10 Chinese cities from December to January The study population consisted of the parents of children attending randomly selected day care centers in the six cities Beijing, Shanghai, Nanjing, Wuhan, Chongqing, and Changsha.
The questionnaires were mostly completed by the child's parents, but in some cases by grandparents or other persons. The current study was restricted to the parents in order to get a more homogenous population with respect to age range and home environment exposure.
Grandparents and other persons who answered the questionnaire may not live permanently in the dwelling. The questionnaire included questions on the current home environment, health information on the child and demographics and health among the adults answering the questionnaire. There were three possible responses: weekly; sometimes; and never. For some statistical analysis, we combined the symptoms into three groups as in previous publications.
Mucosal symptoms included itching, burning, or irritation of the eyes; irritating stuffy or runny nose; hoarse throat, dry throat, and cough. Rhinitis, eye symptoms, throat symptoms, headache, and fatigue were considered as core symptoms and were analyzed as single items as well.
Information on the current home used in this article included the following:. Size of the home has been demonstrated to be a good socioeconomic indicator related to family income 36 and has been used previously in China as an indicator of socioeconomic status SES. In all statistical analysis, sometimes symptoms or never symptoms were coded 0 and weekly symptoms were coded 1. Factor analysis was applied to the seven signs of indoor dampness and mold, size of the home, construction year of the building, and ownership of the home, using principal component analysis and varimax rotation.
Kendal Tau beta rank correlation test was used to measure correlations. Moreover, we used multilevel logistic regression two levels: individual level and city level to evaluate the associations between dichotomous dampness indicators dependent variable and city level exposure indicators outdoor temperature and GDP per capita. Finally, we used multilevel logistic regression two levels: individual level and city level to evaluate associations between symptoms dependent variable and indoor dampness and mold.
Models were adjusted for gender, asthma or allergy, smoking and house size.
Sensitivity analysis was performed, stratifying for gender, asthma or allergy and city Beijing vs southern cities. Data analysis was conducted with SPSS All symptoms were more common among subjects with allergic asthma or rhinitis.
Main causes of dampness in building
All signs of dampness and mold were more common in the southern cities. In the total material from the six cities, window pane condensation in winter A total of 6. Most More than half of buildings Factor analysis was performed to understand to what degree different dampness signs were related to each other and to other building characteristics construction year, size of the home, type of ownership. Factor 1 consisted of construction year, size of the home, and ownership of the home.
Factor 2 consisted of mold spots and damp stains. Mold spots and damp stains were positively associated Kendal Tau beta 0. Factor 3 consisted of damp bed clothing and perception of humid air. Damp bed clothing and perception of humid air were positively associated Kendal Tau beta 0.
Water damage, window pane condensation in winter, and mold odor did not belong to any factor. Data on annual mean outdoor temperature and annual mean GDP per capita in each city from to were collected, and mean values for the three year period were calculated. The mean outdoor temperature was A higher outdoor temperature was associated with a higher prevalence of mold spots OR 1.
Causes of dampness in buildings pdf viewer
The highest ORs were found for mold spots, weekly mold odor, and weekly perception of humid indoor air. The ORs for rhinitis ranged from 1. Similar ORs were found for the other symptoms. Due to low prevalence of higher scores, scores higher than 2 were combined. We performed sensitivity analysis, stratifying by gender. Associations between mold odor and health were stronger among men. For general symptoms and weekly weekly mold odor, OR was 3.
For mucosal symptoms and weekly mold odor, OR was Most other ORs were similar among men and women. ORs for mold odor were higher in Beijing.
Meta‐analyses of the associations of respiratory health effects with dampness and mold in homes
For mucosal symptoms and weekly mold odor, OR was 4. For skin symptoms and weekly mold odor, OR was Finally, we performed sensitivity analysis, stratified by atopy defined as allergic asthma or allergic rhinitis.
Most associations were similar, but associations between mold odor and general and dermal symptoms were stronger in the atopy group. For general symptoms and weekly mold odor, OR was 3.
For skin symptoms and weekly mold odor, OR was 6. In contrast, associations between mold odor and mucosal symptoms were stronger in the nonatopy group. For mucosal symptoms and weekly mold odor, OR was 2. Finally, window pane condensation was a significant risk factor for general and dermal symptoms mainly in the nonatopic group Table S3.
Signs of dampness and indoor mold were common in homes in China, especially in southern China. We found associations between seven different signs of dampness or mold at home and rhinitis, throat symptoms, cough, and nonrespiratory symptoms eye and skin symptoms, headache, and fatigue.
The strongest health associations were found for mold spots, mold odor, and perception of humid air. Health associations for mold odor and water damage were stronger among males. Health associations for water damage and moldy odor were stronger among subject with atopy while health associations for window pane condensation in winter were stronger in the nonatopic group.
Association between dampness indicators and health were stronger in Beijing as compared to the southern cities, especially for mold odor. To our knowledge, this is one of the largest studies on rhinitis and nonrespiratory symptoms among adults in relation to dampness and mold in the home environment.
Selection bias can be a problem in epidemiological studies. Our study is based on parents one per child of preschool children recruited from randomly selected day care centers in six cities across China. All parents in the selected day care centers were invited. The one child policy was still valid when the study was performed, and thus, most of the children had no siblings. The study subjects were young parents and more mothers than fathers answered the questionnaire. This could have caused a selection bias related to gender, with symptomatic fathers tending to participate in the study.
On the contrary, we found that most symptoms were more common among females, and none of the symptoms were more common among men.
The higher prevalence of symptoms among women agrees with previous studies. Another problem in epidemiological studies can be reporting bias. In China, the main concern is health risks of outdoor air pollution.