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Association of indoor dampness and molds with rhinitis risk: A systematic review and meta-analysis - 30/10/13

Doi : 10.1016/j.jaci.2013.07.028 
Maritta S. Jaakkola, MD, PhD a, b, c, , Reginald Quansah, PhD a, Timo T. Hugg, PhD a, d, Sirpa A.M. Heikkinen, BSc a, b, c, Jouni J.K. Jaakkola, MD, PhD a, c, d
a Center for Environmental and Respiratory Health Research, University of Oulu, Oulu, Finland 
b Respiratory Medicine Unit, Institute of Clinical Medicine, University of Oulu, Oulu, Finland 
d Public Health, Institute of Health Sciences, University of Oulu, Oulu, Finland 
c Respiratory Medicine Unit, Department of Medicine, Oulu University Hospital, Oulu, Finland 

Corresponding author: Maritta S. Jaakkola, MD, PhD, Center for Environmental and Respiratory Health Research, University of Oulu, PO Box 5000, FI-90014 Oulu, Finland.

Abstract

Background

A substantial proportion of the world’s population is exposed to indoor dampness-related exposures. Since the 1990s, studies have assessed the relation between indoor dampness and mold and rhinitis, but the evidence has been inconclusive. No previous meta-analysis has been reported on this topic.

Objective

We conducted a systematic review and meta-analysis of studies on the relations between indoor dampness and mold and the risk of different types of rhinitis and investigated whether these relations differ according to the type of exposure.

Methods

A systematic search of the Ovid MEDLINE and EMBASE databases was conducted (1950 through August 2012), and reference lists of relevant articles were reviewed. Cross-sectional, case-control, and cohort studies in children or adults were selected according to a priori criteria and evaluated by 3 authors independently.

Results

Thirty-one studies on rhinitis, allergic rhinitis (AR), or rhinoconjunctivitis were included. In meta-analyses the largest risk was observed in relation to mold odor (rhinitis: 2.18 [95% CI, 1.76-2.71]; AR: 1.87 [95% CI, 0.95-3.68]). The risk related to visible mold was also consistently increased (rhinitis: 1.82 [95% CI, 1.56-2.12]; AR: 1.51 [95% CI, 1.39-1.64]; rhinoconjunctivitis: 1.66 [95% CI, 1.27-2.18]). In addition, exposure to dampness was related to increased risk of all types of rhinitis.

Conclusion

This meta-analysis provides new evidence that dampness and molds at home are determinants of rhinitis and its subcategories. The associations were strongest with mold odor, suggesting the importance of microbial causal agents. Our results provide evidence that justifies prevention and remediation of indoor dampness and mold problems, and such actions are likely to reduce rhinitis.

El texto completo de este artículo está disponible en PDF.

Key words : Rhinitis, mold, dampness, case-control, longitudinal, cross-sectional, meta-analysis

Abbreviations used : AR, EE


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 Supported by the Research Council for Health, the Academy of Finland (grants no. 129419 [SALVE Research Program] and 138691), the Ministry of Social Affairs and Health of Finland (grant no. STM/1523/2012), and the Finnish Lung Health Association.
 Disclosure of potential conflict of interest: The authors declare that they have no relevant conflicts of interest.


© 2013  American Academy of Allergy, Asthma & Immunology. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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Vol 132 - N° 5

P. 1099 - novembre 2013 Regresar al número
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