The Phase Two Study Group is listed in Appendix.
Dampness and moulds in relation to respiratory and allergic symptoms in children: results from Phase Two of the International Study of Asthma and Allergies in Childhood (ISAAC Phase Two)
Article first published online: 21 JUN 2013
© 2013 John Wiley & Sons Ltd
Clinical & Experimental Allergy
Volume 43, Issue 7, pages 762–774, July 2013
How to Cite
the ISAAC Phase Two Study Group Clinical & Experimental Allergy2013; (43) 762–774., , , , , , , , , and
- Issue published online: 21 JUN 2013
- Article first published online: 21 JUN 2013
- Accepted manuscript online: 4 MAR 2013 11:45AM EST
- Manuscript Accepted: 24 JAN 2013
- Manuscript Revised: 21 JAN 2013
- Manuscript Received: 26 SEP 2012
- house dust mite;
- respiratory and allergic symptoms;
Many studies report that damp housing conditions are associated with respiratory symptoms. Less is known about mechanisms and possible effect modifiers. Studies of dampness in relation to allergic sensitization and eczema are scarce.
We study the influence of damp housing conditions world-wide on symptoms and objective outcomes.
Cross-sectional studies of 8–12-year-old children in 20 countries used standardized methodology from Phase Two of the International Study of Asthma and Allergies in Childhood (ISAAC). Symptoms of asthma, rhinitis and eczema, plus residential exposure to dampness and moulds, were ascertained by parental questionnaires (n = 46 051). Skin examination, skin prick tests (n = 26 967) and hypertonic saline bronchial challenge (n = 5713) were performed. In subsamples stratified by wheeze (n = 1175), dust was sampled and analysed for house dust mite (HDM) allergens and endotoxin.
Current exposure to dampness was more common for wheezy children (pooled odds ratio 1.58, 95% CI 1.40–1.79) and was associated with greater symptom severity among wheezers, irrespective of atopy. A significant (P < 0.01) adverse effect of dampness was also seen for cough and phlegm, rhinitis and reported eczema, but not for examined eczema, nor bronchial hyperresponsiveness. HDM sensitization was more common in damp homes (OR 1.16, 1.03–1.32). HDM-allergen levels were higher in damp homes and were positively associated with HDM-sensitization, but not wheeze.
A consistent association of dampness with respiratory and other symptoms was found in both affluent and non-affluent countries, among both atopic and non-atopic children. HDM exposure and sensitization may contribute, but the link seems to be related principally to non-atopic mechanisms.