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Correspondence |

Lung Function Is Reduced Among Subjects With Asthma Exposed to Mold OdorReduced Lung Function After Mold Odor Exposure FREE TO VIEW

Samu Hernberg, MD; Penpatra Sripaiboonkij, PhD; Reginald Quansah, PhD; Jouni J. K. Jaakkola, MD, DSc, PhD; Maritta S. Jaakkola, MD, PhD
Author and Funding Information

From the Center for Environmental and Respiratory Health Research (Drs Hernberg, Sripaiboonkij, Quansah, J. J. K. Jaakkola, and M. S. Jaakkola), Respiratory Medicine Unit (Drs Hernberg, J. J. K. Jaakkola, and M. S. Jaakkola), Institute of Clinical Medicine, and Public Health (Dr J. J. K. Jaakkola), Institute of Health Sciences, University of Oulu; Medical Research Center Oulu (Drs Hernberg, J. J. K. Jaakkola, and M. S. Jaakkola); Respiratory Medicine Unit (Drs Hernberg, J. J. K. Jaakkola, and M. S. Jaakkola), Oulu University Hospital; and Faculty of Public Health (Dr Sripaiboonkij), Thammasat University, Pathum Thani, Thailand.

Correspondence to: Jouni J. K. Jaakkola, MD, DSc, PhD, Center for Environmental and Respiratory Health Research, University of Oulu, PO Box 5000, 90014 Oulu, Finland; e-mail: jouni.jaakkola@oulu.fi


Editor’s Note: Authors are invited to respond to Correspondence that cites their previously published work. Those responses appear after the related letter. In cases where there is no response, the author of the original article declined to respond or did not reply to our invitation.

Funding/Support: Dr J. J. K. Jaakkola received grants for this work from the Academy of Finland [Grant 266314 and Grant 129419 of the SALVE research program]. Dr M.S. Jaakkola received grants for this work from the Academy of Finland [Grant 138691], the Ministry of Social Affairs and Health [Grant STM/1523/2012], and the Foundation of the Finnish Anti-Tuberculosis Association.

Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts of interest: Dr Hernberg received travel and accommodation costs from GlaxoSmithKline and Boehringer Ingelheim GmbH during 2013 and 2014. Dr M. S. Jaakkola received the following grants: GlaxoSmithKline (2011-2013), Filha (Finnish Lung Health Association) (2011), Väinö and Laina Kivi Foundation (2011), Filha (Finnish Lung Health Association) (2012), and Mundipharma International (2013). Drs Sripaiboonkij, Quansah, and J. J. K. Jaakkola have reported that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;146(1):e28-e29. doi:10.1378/chest.14-0582
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Published online
To the Editor:

At least 20% of the buildings in North America and Europe have one or more signs of dampness; indoor dampness and molds are common worldwide.1 Only one previous study (from Scotland) has addressed and shown the effects of such at-home exposure on lung function in adults with asthma, even though adults with asthma may form a susceptible group.2 We investigated the effect of dampness and mold exposure at home and at work on lung function among adults with new asthma and also elaborated on the importance of different exposure indicators including water damage, dampness, visible mold, and mold odor.

In our population-based study, 521 working-aged adults (response rate, 86%) from South Finland with clinically defined new asthma answered a questionnaire on (1) indoor dampness and mold exposures at home, at work, or both and (2) other factors potentially influencing lung function; 487 subjects performed spirometry. The study population and methods have been elaborated in detail elsewhere.3

Our main finding was that, among people with asthma, mold odor at home, at work, or both was related to a significantly reduced FEV1 level, which was on average 240 mL lower in those exposed compared with those with no exposure (Table 1). For FVC, we detected a similar, but statistically nonsignificant association. An association was detected mostly in men whose FEV1 was on average 480 mL lower in relation to mold odor. Among women, the corresponding reduction in FEV1 was smaller at 90 mL. Among men also, a dose-response pattern was seen. The other dampness-related exposure did not show consistent associations with lung function.

Table Graphic Jump Location
Table 1 —Exposure to Dampness and Molds and Lung Function (n = 487)
a 

Linear regression analysis adjusted for age, sex, height, education, smoking (current, ex), and secondhand smoke exposure.

This study provides new evidence that among working-aged adults with new asthma, mold odor at home or at work is related to reduced FEV1 level. Men seem to be more susceptible to the adverse effect of mold odor on lung function. A lower FEV1 related to mold odor is consistent with the results from the systematic review of dampness and mold exposure and development of new asthma and allergic rhinitis risk.4,5 Together, these data suggest that indoor environmental microbial contamination could be an important causal agent. Being able to smell odor indicates that there is a connection between the damaged area and the breathing zone of people occupying that space, which is of importance when investigating effects on airways. It also usually reflects long-term exposure to dampness because it takes some time until there is enough microbial growth to produce enough chemical compounds to be sensed as odor.

Acknowledgments

Role of sponsors: The funding agency had no influence on the interpretation or publication of the results.

World Health Organization (WHO) Regional Office for Europe. Guidelines for Indoor Air Quality: Dampness and Mould. Copenhagen, Denmark: World Health Organization; 2009.
 
Williamson IJ, Martin CJ, McGill G, Monie RD, Fennerty AG. Damp housing and asthma: a case-control study. Thorax. 1997;52(3):229-234. [CrossRef] [PubMed]
 
Jaakkola MS, Nordman H, Piipari R, et al. Indoor dampness and molds and development of adult-onset asthma: a population-based incident case-control study. Environ Health Perspect. 2002;110(5):543-547. [CrossRef] [PubMed]
 
Quansah R, Jaakkola MS, Hugg TT, Heikkinen SA, Jaakkola JJ. Residential dampness and molds and the risk of developing asthma: a systematic review and meta-analysis. PLoS ONE. 2012;7(11):e47526. [CrossRef] [PubMed]
 
Jaakkola MS, Quansah R, Hugg TT, Heikkinen SA, Jaakkola JJ. Association of indoor dampness and molds with rhinitis risk: a systematic review and meta-analysis. J Allergy Clin Immunol. 2013;132(5):1099-1110.e18. [CrossRef] [PubMed]
 

Figures

Tables

Table Graphic Jump Location
Table 1 —Exposure to Dampness and Molds and Lung Function (n = 487)
a 

Linear regression analysis adjusted for age, sex, height, education, smoking (current, ex), and secondhand smoke exposure.

References

World Health Organization (WHO) Regional Office for Europe. Guidelines for Indoor Air Quality: Dampness and Mould. Copenhagen, Denmark: World Health Organization; 2009.
 
Williamson IJ, Martin CJ, McGill G, Monie RD, Fennerty AG. Damp housing and asthma: a case-control study. Thorax. 1997;52(3):229-234. [CrossRef] [PubMed]
 
Jaakkola MS, Nordman H, Piipari R, et al. Indoor dampness and molds and development of adult-onset asthma: a population-based incident case-control study. Environ Health Perspect. 2002;110(5):543-547. [CrossRef] [PubMed]
 
Quansah R, Jaakkola MS, Hugg TT, Heikkinen SA, Jaakkola JJ. Residential dampness and molds and the risk of developing asthma: a systematic review and meta-analysis. PLoS ONE. 2012;7(11):e47526. [CrossRef] [PubMed]
 
Jaakkola MS, Quansah R, Hugg TT, Heikkinen SA, Jaakkola JJ. Association of indoor dampness and molds with rhinitis risk: a systematic review and meta-analysis. J Allergy Clin Immunol. 2013;132(5):1099-1110.e18. [CrossRef] [PubMed]
 
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