1
|
Walton L, Skillen E, Mosites E, Bures RM, Amah-Mbah C, Sandoval M, Thigpen Tart K, Berrigan D, Star C, Godette-Greer D, Kowtha B, Vogt E, Liggins C, Lloyd J. The intersection of health and housing: Analysis of the research portfolios of the National Institutes of Health, Centers for Disease Control and Prevention, and U.S. Department of Housing and Urban Development. PLoS One 2024; 19:e0296996. [PMID: 38285706 PMCID: PMC10824422 DOI: 10.1371/journal.pone.0296996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 12/20/2023] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Housing is a major social determinant of health that affects health status and outcomes across the lifespan. OBJECTIVES An interagency portfolio analysis assessed the level of funding invested in "health and housing research" from fiscal years (FY) 2016-2020 across the National Institutes of Health (NIH), the United States Department of Housing and Urban Development (HUD), and the Centers for Disease Control and Prevention (CDC) to characterize the existing health and housing portfolio and identify potential areas for additional research and collaboration. METHODS/RESULTS We identified NIH, HUD, and CDC research projects that were relevant to both health and housing and characterized them by housing theme, health topic, population, and study design. We organized the assessment of the individual housing themes by four overarching housing-to-health pathways. From FY 2016-2020, NIH, HUD, and CDC funded 565 health and housing projects combined. The Neighborhood pathway was most common, followed by studies of the Safety and Quality pathway. Studies of the Affordability and Stability pathways were least common. Health topics such as substance use, mental health, and cardiovascular disease were most often studied. Most studies were observational (66%); only a little over one fourth (27%) were intervention studies. DISCUSSION This review of the research grant portfolios of three major federal funders of health and housing research in the United States describes the diversity and substantial investment in research at the intersection between housing and health. Analysis of the combined portfolio points to gaps in studies on causal pathways linking housing to health outcomes. The findings highlight the need for research to better understand the causal pathways from housing to health and prevention intervention research, including rigorous evaluation of housing interventions and policies to improve health and well-being.
Collapse
Affiliation(s)
- Liberty Walton
- Office of Disease Prevention, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Elizabeth Skillen
- Policy Analysis and Engagement Office, Office of Policy, Performance & Evaluation, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Emily Mosites
- Office of the Deputy Director for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Regina M. Bures
- Population Dynamics Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, United States of America
| | - Chino Amah-Mbah
- Public Health and Epidemiology Practice, Westat, Rockville, Maryland, United States of America
| | - Maggie Sandoval
- Public Health and Epidemiology Practice, Westat, Rockville, Maryland, United States of America
| | - Kimberly Thigpen Tart
- Office of Science Coordination, Planning, and Evaluation, National Institute of Environmental Health Sciences, National Institutes of Health, Durham, North Carolina, United States of America
| | - David Berrigan
- Health Behaviors Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, United States of America
| | - Carol Star
- Office of Policy Development and Research, Program Evaluation Division, U.S. Department of Housing and Urban Development, Washington, DC, United States of America
| | - Dionne Godette-Greer
- Division of Extramural Science Programs, National Institute of Nursing Research, Rockville, Maryland, United States of America
| | - Bramaramba Kowtha
- Office of Disease Prevention, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Elizabeth Vogt
- Office of Disease Prevention, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Charlene Liggins
- Office of Disease Prevention, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Jacqueline Lloyd
- Office of Disease Prevention, National Institutes of Health, Bethesda, Maryland, United States of America
| |
Collapse
|
2
|
Denning DW, Pfavayi LT. Poorly controlled asthma - Easy wins and future prospects for addressing fungal allergy. Allergol Int 2023; 72:493-506. [PMID: 37544851 DOI: 10.1016/j.alit.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/25/2023] [Accepted: 06/28/2023] [Indexed: 08/08/2023] Open
Abstract
Poorly controlled asthma is especially common in low resource countries. Aside from lack of access to, or poor technique with, inhaled beta-2 agonists and corticosteroids, the most problematic forms of asthma are frequently associated with both fungal allergy and exposure, especially in adults leading to more asthma exacerbations and worse asthma. The umbrella term 'fungal asthma' describes many disorders linked to fungal exposure and/or allergy to fungi. One fungal asthma endotype, ABPA, is usually marked by a very high IgE and its differential diagnosis is reviewed. Both ABPA and fungal bronchitis in bronchiectasis are marked by thick excess airway mucus production. Dermatophyte skin infection can worsen asthma and eradication of the skin infection improves asthma. Exposure to fungi in the workplace, home and schools, often in damp or water-damaged buildings worsens asthma, and remediation improves symptom control and reduces exacerbations. Antifungal therapy is beneficial for fungal asthma as demonstrated in nine of 13 randomised controlled studies, reducing symptoms, corticosteroid need and exacerbations while improving lung function. Other useful therapies include azithromycin and some biologics approved for the treatment of severe asthma. If all individuals with poorly controlled and severe asthma could be 'relieved' of their fungal allergy and infection through antifungal therapy without systemic corticosteroids, the health benefits would be enormous and relatively inexpensive, improving the long term health of over 20 million adults and many children. Antifungal therapy carries some toxicity, drug interactions and triazole resistance risks, and data are incomplete. Here we summarise what is known and what remains uncertain about this complex topic.
Collapse
Affiliation(s)
- David W Denning
- Manchester Fungal Infection Group, The University of Manchester and Manchester Academic Health Science Centre, Manchester, UK.
| | - Lorraine T Pfavayi
- Institute of Immunology & Infection Research, Ashworth Laboratories, School of Biological Sciences, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
3
|
Grant TL, Wood RA, Chapman MD. Indoor Environmental Exposures and Their Relationship to Allergic Diseases. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:2963-2970. [PMID: 37652348 PMCID: PMC10927277 DOI: 10.1016/j.jaip.2023.08.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/23/2023] [Accepted: 08/23/2023] [Indexed: 09/02/2023]
Abstract
Cockroach, dust mite, cat, dog, mouse, and molds are major indoor allergens that have been associated with the development of allergic diseases and disease morbidity in allergen-sensitized individuals. Physical characteristics, such as allergen particle size, hydrophobicity, and charge, can determine an allergen's propensity to become airborne, location of respiratory tract penetration, and ability to elicit IgE responses in genetically predisposed individuals. Standardization and recent advancements in indoor allergen assessment serve to identify sources and distribution of allergens in a patient's home and public environment, inform public policy, and monitor the efficacy of allergen avoidance and therapeutics. Allergen exposure interventions have yielded mixed results with current US and international asthma guidelines differing on recommendations. A pragmatic, patient-centered approach to allergen avoidance includes: (1) tailoring intervention to the patient's sensitization and exposure status, (2) using a rigorous multifaceted intervention strategy to reduce allergen exposure as much as possible, and (3) beginning the intervention as soon as the patient is diagnosed. Further research into the risks/benefits of early allergen exposure, rapid and affordable in-home allergen assessment, and best practices for environmental control measures for asthma is needed.
Collapse
Affiliation(s)
- Torie L Grant
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Md.
| | - Robert A Wood
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Md
| | | |
Collapse
|
4
|
Howden-Chapman P, Crane J, Keall M, Pierse N, Baker MG, Cunningham C, Amore K, Aspinall C, Bennett J, Bierre S, Boulic M, Chapman R, Chisholm E, Davies C, Fougere G, Fraser B, Fyfe C, Grant L, Grimes A, Halley C, Logan-Riley A, Nathan K, Olin C, Ombler J, O’Sullivan K, Pehi T, Penny G, Phipps R, Plagman M, Randal E, Riggs L, Robson B, Ruru J, Shaw C, Schrader B, Teariki MA, Telfar Barnard L, Tiatia R, Toy-Cronin B, Tupara H, Viggers H, Wall T, Wilkie M, Woodward A, Zhang W. He Kāinga Oranga: reflections on 25 years of measuring the improved health, wellbeing and sustainability of healthier housing. J R Soc N Z 2023. [DOI: 10.1080/03036758.2023.2170427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- Philippa Howden-Chapman
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Julian Crane
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Michael Keall
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Nevil Pierse
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Michael G. Baker
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Chris Cunningham
- Research Centre for Hauora & Health, Massey University, Wellington, New Zealand
| | - Kate Amore
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Clare Aspinall
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Julie Bennett
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Sarah Bierre
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Mikael Boulic
- School of the Built Environment, Massey University, Auckland, New Zealand
| | - Ralph Chapman
- School of Geography, Environment and Earth Sciences, Te Herenga Waka, Victoria University of Wellington, New Zealand
| | - Elinor Chisholm
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Cheryl Davies
- Tu Kotahi Māori Asthma Trust, Wainuiomata, Lower Hutt, New Zealand
| | - Geoff Fougere
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Brodie Fraser
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Caro Fyfe
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Libby Grant
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Arthur Grimes
- Motu Economic and Public Policy Research, Wellington, New Zealand
| | - Caroline Halley
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Amber Logan-Riley
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Kim Nathan
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Crystal Olin
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Jenny Ombler
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Kimberley O’Sullivan
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Tiria Pehi
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Guy Penny
- EMPlan Services Ltd, Wellington, New Zealand
| | - Robyn Phipps
- Faculty of Architecture and Design Innovation, Te Herenga Waka, Victoria University of Wellington, Wellington, New Zealand
| | - Manfred Plagman
- Building Research Association of New Zealand, Porirua, New Zealand
| | - Edward Randal
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Lynn Riggs
- Motu Economic and Public Policy Research, Wellington, New Zealand
| | - Bridget Robson
- Eru Pomare Māori Health Research Centre, University of Otago, Wellington, New Zealand
| | - Jacinta Ruru
- Faculty of Law, University of Otago, Dunedin, New Zealand
| | - Caroline Shaw
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Ben Schrader
- Stout Research Centre, Te Herenga Waka, Victoria University of Wellington, Wellington, New Zealand
| | - Mary Anne Teariki
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Lucy Telfar Barnard
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Ramona Tiatia
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | | | - Hope Tupara
- Research Centre for Hauora & Health, Massey University, Wellington, New Zealand
| | - Helen Viggers
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | | | - Marg Wilkie
- Research Centre for Hauora & Health, Massey University, Wellington, New Zealand
| | - Alistair Woodward
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Wei Zhang
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| |
Collapse
|
5
|
Fyfe C, Barnard LT, Douwes J, Howden‐Chapman P, Crane J. Retrofitting home insulation reduces incidence and severity of chronic respiratory disease. INDOOR AIR 2022; 32:e13101. [PMID: 36040274 PMCID: PMC9545372 DOI: 10.1111/ina.13101] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/31/2022] [Accepted: 08/05/2022] [Indexed: 09/13/2023]
Abstract
To assess whether retrofitting home insulation can reduce the risk of respiratory disease incidence and exacerbation, a retrospective cohort study was undertaken using linked data from a national intervention program. The study population was made up of 1 004 795 residents from 205 001 New Zealand houses that received an insulation subsidy though a national Energy Efficiency and Conservation Authority program. A difference-in-difference model compared changes in the number of prescriptions dispensed for respiratory illness post- insulation to a control population over the same timeframe. New prescribing of chronic respiratory disease medication at follow-up was used to compare incidence risk ratios between intervention and control groups. Chronic respiratory disease incidence was significantly lower in the intervention group at follow-up: odds ratio 0.90 (95% CI: 0.86-0.94). There was also a 4% reduction in medication dispensed for treating exacerbations of chronic respiratory disease symptoms in the intervention group compared with the control group: relative rate ratio (RRR) 0.96 (95% CI: 0.96-0.97). There was no change in medication dispensed to prevent symptoms of chronic respiratory disease RRR: 1,00 (95% CI: 0.99-1.00). These findings support home insulation interventions as a means of improving respiratory health outcomes.
Collapse
Affiliation(s)
- Caroline Fyfe
- He Kāinga Oranga, Department of Public HealthUniversity of Otago WellingtonWellingtonNew Zealand
| | - Lucy Telfar Barnard
- He Kāinga Oranga, Department of Public HealthUniversity of Otago WellingtonWellingtonNew Zealand
| | - Jeroen Douwes
- Research Centre for Hauora and HealthMassey University WellingtonWellingtonNew Zealand
| | - Philippa Howden‐Chapman
- He Kāinga Oranga, Department of Public HealthUniversity of Otago WellingtonWellingtonNew Zealand
| | - Julian Crane
- Wellington Asthma Research Group, Department of MedicineUniversity of Otago WellingtonWellingtonNew Zealand
| |
Collapse
|
6
|
Grant TL, Wood RA. The influence of urban exposures and residence on childhood asthma. Pediatr Allergy Immunol 2022; 33:e13784. [PMID: 35616896 PMCID: PMC9288815 DOI: 10.1111/pai.13784] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 12/19/2022]
Abstract
Children with asthma who live in urban neighborhoods experience a disproportionately high asthma burden, with increased incident asthma and increased asthma symptoms, exacerbations, and acute visits and hospitalizations for asthma. There are multiple urban exposures that contribute to pediatric asthma morbidity, including exposure to pest allergens, mold, endotoxin, and indoor and outdoor air pollution. Children living in urban neighborhoods also experience inequities in social determinants of health, such as increased poverty, substandard housing quality, increased rates of obesity, and increased chronic stress. These disparities then in turn can increase the risk of urban exposures and compound asthma morbidity as poor housing repair is a risk factor for pest infestation and mold exposure and poverty is a risk factor for exposure to air pollution. Environmental interventions to reduce in-home allergen concentrations have yielded inconsistent results. Population-level interventions including smoking bans in public places and legislation to decrease traffic-related air pollution have been successful at reducing asthma morbidity and improving lung function growth. Given the interface and synergy between urban exposures and social determinants of health, it is likely population and community-level changes will be needed to decrease the excess asthma burden in children living in urban neighborhoods.
Collapse
Affiliation(s)
- Torie L Grant
- Division of Pediatric Allergy, Immunology, and Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Robert A Wood
- Division of Pediatric Allergy, Immunology, and Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| |
Collapse
|
7
|
Deng YT, Li XM, Liu EM, Xiong WK, Wang S, Zhu R, Ding YB, Zhong ZH. Associations of early-life factors and indoor environmental exposure with asthma among children: a case-control study in Chongqing, China. World J Pediatr 2022; 18:186-195. [PMID: 35018606 DOI: 10.1007/s12519-021-00506-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 12/16/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Childhood asthma has substantial effects on children's health. It is important to identify influencing factors in early life in the development of childhood asthma. We aim to evaluate the effects of early-life factors and indoor environmental exposure on childhood asthma in Chongqing, China. METHOD We designed a case-control study to enrol children with asthma aged 3 to < 14 years old and controls in Chongqing, China. The "Children's Early Life and Indoor Environment Survey" was used to collect the early-life factors and indoor environmental exposure of foetuses in utero and of infants during the first 3 years of life. A multivariate logistic regression model was used to evaluate the association between independent variables and childhood asthma and the interaction of early-life factors and environmental exposure. RESULTS A total of 160 asthma cases and 247 controls were included in this study. The mean ages of the cases and controls were 5.53 ± 1.88 and 5.72 ± 2.34 years, respectively (P = 0.192). Early-life factors and indoor environmental exposure were independently associated with childhood asthma. Infectious diseases of the respiratory system in children under 3 years old [adjusted odds ratio (OR) = 5.76, 95% confidence interval (CI) 2.49-13.30], bedroom air conditioner use (adjusted OR = 4.61, 95% CI 1.45-14.64), and bedroom dampness/mould (adjusted OR = 2.98, 95% CI 1.54-5.75) ranked as the three most significant exposures associated with the risk of childhood asthma. Other factors associated with an increased risk of childhood asthma included second-hand smoke exposure in early life (adjusted OR = 1.93, 95% CI 1.24-3.00), neonatal pneumonia (adjusted OR = 1.90, 95% CI 1.05-3.42) and maternal allergic diseases during pregnancy (adjusted OR = 2.13, 95% CI 1.10-4.10). The interaction effects of child second-hand smoke exposure with other covariates were not found to be statistically significant. CONCLUSIONS Early-life factors and indoor environmental exposure are closely related to childhood asthma in Chongqing, China. Further interventions and management in the early life of children should be considered to prevent and control childhood asthma in Chongqing and similar cities.
Collapse
Affiliation(s)
- Yun-Tian Deng
- The First Clinical College, Chongqing Medical University, Chongqing, China
| | - Xue-Mei Li
- Pediatric Outpatient, Chongqing Health Center for Women and Children, Chongqing, China
| | - En-Mei Liu
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.,Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Wen-Kui Xiong
- The First Clinical College, Chongqing Medical University, Chongqing, China
| | - Shuo Wang
- The First Clinical College, Chongqing Medical University, Chongqing, China
| | - Rui Zhu
- The First Clinical College, Chongqing Medical University, Chongqing, China
| | - Yu-Bin Ding
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Zhao-Hui Zhong
- School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, No. 1, Medical School Road, Yu zhong District, Chongqing, China.
| |
Collapse
|
8
|
Grant T, Croce E, Matsui EC. Asthma and the social determinants of health. Ann Allergy Asthma Immunol 2022; 128:5-11. [PMID: 34673220 PMCID: PMC8671352 DOI: 10.1016/j.anai.2021.10.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/30/2021] [Accepted: 10/04/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To synthesize the growing body of literature on the role of social determinants of health (SDoH) in asthma and asthma disparities. DATA SOURCES A pubmed.gov search was performed to identify published literature on SDoH, asthma, asthma disparities, and race and ethnicity. Current asthma statistics of the Centers for Disease Control and Prevention were reviewed. STUDY SELECTIONS Relevant articles on SDoH, asthma, asthma disparities, and race and ethnicity were reviewed in detail. RESULTS Black and Latinx Americans have a higher asthma prevalence and greater asthma morbidity than White Americans and also bear a disproportionate burden of SDoH. Inequities in SDoH are rooted in structural racism and population-level injustices that affect the socioeconomic status, physical environment, and health care access/quality of Black and Latinx Americans. There is evidence that racial/ethnic inequities in SDoH, such as socioeconomic status, neighborhood environment, housing, environmental exposures, and health care access/quality, contribute to excess burden of asthma prevalence/incidence, morbidity, exacerbations, and abnormal lung function among certain racial/ethnic populations. In addition, Black and Latinx communities experience high levels of long-term stress, which may increase asthma risk through direct effects on the immune system and hypothalamic-pituitary-adrenocortical activation. Long-term stress may also mediate the effects of SDoH on asthma. CONCLUSION Although there is clear evidence linking SDoH to excess asthma risk and implicating SDoH in asthma disparities, the extent to which asthma disparities are explained by inequities in SDoH and the relative contributions of each of these SDoH to asthma disparities remain unclear. This knowledge is needed to effectively develop and test systems-level interventions targeting SDoH, with the ultimate goal of meaningfully reducing racial/ethnic asthma disparities.
Collapse
Affiliation(s)
- Torie Grant
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Emily Croce
- The University of Texas at Austin Dell Medical School, Austin, Texas
| | | |
Collapse
|
9
|
Haines SR, Hall EC, Marciniak K, Misztal PK, Goldstein AH, Adams RI, Dannemiller KC. Microbial growth and volatile organic compound (VOC) emissions from carpet and drywall under elevated relative humidity conditions. MICROBIOME 2021; 9:209. [PMID: 34666813 PMCID: PMC8524935 DOI: 10.1186/s40168-021-01158-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 08/27/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Microbes can grow in indoor environments if moisture is available, and we need an improved understanding of how this growth contributes to emissions of microbial volatile organic compounds (mVOCs). The goal of this study was to measure how moisture levels, building material type, collection site, and microbial species composition impact microbial growth and emissions of mVOCs. We subjected two common building materials, drywall, and carpet, to treatments with varying moisture availability and measured microbial communities and mVOC emissions. RESULTS Fungal growth occurred in samples at >75% equilibrium relative humidity (ERH) for carpet with dust and >85% ERH for inoculated painted drywall. In addition to incubated relative humidity level, dust sample collection site (adonis p=0.001) and material type (drywall, carpet, adonis p=0.001) drove fungal and bacterial species composition. Increased relative humidity was associated with decreased microbial species diversity in samples of carpet with dust (adonis p= 0.005). Abundant volatile organic compounds (VOCs) that accounted for >1% emissions were likely released from building materials and the dust itself. However, certain mVOCs were associated with microbial growth from carpet with dust such as C10H16H+ (monoterpenes) and C2H6SH+ (dimethyl sulfide and ethanethiol). CO2 production from samples of carpet with dust at 95% ERH averaged 5.92 mg hr-1 kg-1, while the average for carpet without dust at 95% ERH was 2.55 mg hr-1 kg-1. CONCLUSION Microbial growth and mVOC emissions occur at lower relative humidity in carpet and floor dust compared to drywall, which has important implications for human exposure. Even under elevated relative humidity conditions, the VOC emissions profile is dominated by non-microbial VOCs, although potential mVOCs may dominate odor production. Video Abstract.
Collapse
Affiliation(s)
- Sarah R. Haines
- Department of Civil & Mineral Engineering, University of Toronto, Toronto, Ontario M5S 1A4 Canada
| | - Emma C. Hall
- Department of Civil, Architectural and Environmental Engineering, University of Texas at Austin, Austin, TX 78712 USA
| | | | - Pawel K. Misztal
- Department of Civil, Architectural and Environmental Engineering, University of Texas at Austin, Austin, TX 78712 USA
| | - Allen H. Goldstein
- Department of Environmental Science, Policy and Management, University of California, Berkeley, CA 94720 USA
| | - Rachel I. Adams
- Department of Plant and Microbial Biology, University of California, Berkeley, CA 94720 USA
| | - Karen C. Dannemiller
- Department of Civil, Environmental & Geodetic Engineering, College of Engineering, Ohio State University, Columbus, OH 43210 USA
- Division of Environmental Health Sciences, College of Public Health, Ohio State University, Columbus, OH 43210 USA
- Sustainability Institute, Ohio State University, Columbus, OH 43210 USA
- Department of Civil, Environmental & Geodetic Engineering, Environmental Health Sciences, Ohio State University, 470 Hitchcock Hall, 2070 Neil Ave, Columbus, OH 43210 USA
| |
Collapse
|
10
|
Vesper S, Wymer L, Cox D, Dewalt G, Pinzer E, Friedman W, Ashley PJ. Comparison of ERMI results for dust collected from homes by an electrostatic cloth and by the standard vacuum method. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2021; 18:423-429. [PMID: 34170214 PMCID: PMC8543091 DOI: 10.1080/15459624.2021.1946254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The Environmental Relative Moldiness Index (ERMI) is a scale used to compare mold contamination levels in U.S. homes. To create the ERMI scale, a nationally representative set of U.S. homes was selected (n = 1,096). From each of these homes, a standard vacuum-dust sample was collected and then 36 common molds, the 26 Group 1 and 10 Group 2 molds, as grouped for forming the ERMI metric, were quantified using quantitative PCR assays. However, in investigations of mold in homes, it is not always practical or even possible to collect dust using the standard vacuum method. Therefore, we performed a comparative study of dust samples collected in the same homes (n = 151) by the standard vacuum method and by an electrostatic cloth (EC) method. First, floor dust was collected by vacuuming a 2 m2 area in the living room and a 2 m2 area in a bedroom, directly adjacent to the sofa or bed, for 5 min each with a Mitest sampler-fitted vacuum. Second, immediately after the collection of the vacuum dust sample, an EC dust sample was collected by wiping above-floor horizontal surfaces in the living room and bedroom. Then, the ERMI analysis of each sample was performed by a commercial laboratory. The results showed the average concentrations of 33 of the 36 ERMI molds were not significantly different in the vacuum and EC samples. Also, the average summed logs of the Group 1 molds, Group 2, or ERMI values were significantly (p < 0.001) correlated between the vacuum and EC samples. Logistic regression indicated that an EC sample could identify homes in the highest ERMI quartile 96% of the time by using the same ERMI value cutoff as vacuum sample ERMI value cutoff and 35% of samples proved to be false positives. When it is not practical to obtain the standard vacuum-dust sample, an EC sample can provide a useful practical alternative for ERMI analyses.
Collapse
Affiliation(s)
- Stephen Vesper
- United States Environmental Protection Agency, Center for Environmental Measurement and Modeling, Cincinnati, Ohio
| | - Larry Wymer
- United States Environmental Protection Agency, Center for Environmental Measurement and Modeling, Cincinnati, Ohio
| | | | | | - Eugene Pinzer
- United States Department of Housing and Urban Development, Office of Lead Hazard Control and Healthy Homes, Washington, District of Columbia
| | - Warren Friedman
- United States Department of Housing and Urban Development, Office of Lead Hazard Control and Healthy Homes, Washington, District of Columbia
| | - Peter J. Ashley
- United States Department of Housing and Urban Development, Office of Lead Hazard Control and Healthy Homes, Washington, District of Columbia
| |
Collapse
|
11
|
Bentley R, Simons K, Kvelsvig A, Milne B, Blakely T. Short-run effects of poverty on asthma, ear infections and health service use: analysis of the Longitudinal Study of Australian Children. Int J Epidemiol 2021; 50:1526-1539. [PMID: 33880535 DOI: 10.1093/ije/dyab059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Many studies have reported an inferred causal association of income poverty with physical health among children; but making causal inference is challenging due to multiple potential sources of systematic error. We quantified the short-run effect of changes in household poverty status on children's health (asthma and ear infections) and service use (visits to the doctor and parent-reported hospital admissions), using a national longitudinal study of Australian children, with particular attention to potential residual confounding and selection bias due to study attrition. METHODS We use four modelling approaches differing in their capacity to reduce residual confounding (generalized linear, random effects (RE), hybrid and fixed effects (FE) regression modelling) to model the effect of income poverty (<60% of median income) on health for 10 090 children surveyed every 2nd year since 2004. For each method, we simulate the potential impact of selection bias arising due to attrition related to children's health status. RESULTS Of the 10 090 children included, 20% were in families in poverty at survey baseline (2004). Across subsequent years, ∼25% experienced intermittent and <2% persistent poverty. No substantial associations between poverty and child physical health and service use were observed in the FE models least prone to residual confounding [odds ratio (OR) 0.94, 95% confidence interval (CI) 0.81-1.10 for wheeze], in contrast to RE models that were positive (consistent with previous studies). Selection bias causing null findings was unlikely. CONCLUSIONS While poverty has deleterious causal effects on children's socio-behavioural and educational outcomes, we find little evidence of a short-run causal effect of poverty on asthma, ear infections and health service use in Australia.
Collapse
Affiliation(s)
- Rebecca Bentley
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Koen Simons
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Amanda Kvelsvig
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Barry Milne
- Department of Statistics, University of Auckland, Auckland, New Zealand
| | - Tony Blakely
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
12
|
Indoor Microbial Exposures and Chronic Lung Disease: From Microbial Toxins to the Microbiome. Clin Chest Med 2021; 41:777-796. [PMID: 33153695 DOI: 10.1016/j.ccm.2020.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Effects of environmental microbial exposures on human health have long been of interest. Microbes were historically assumed to be harmful, but data have suggested that microbial exposures can modulate the immune system. We focus on the effects of indoor environmental microbial exposure on chronic lung diseases. We found contradictory data in bacterial studies using endotoxin as a surrogate for bacterial exposure. Contradictory data also exist in studies of fungal exposure. Many factors may modulate the effect of environmental microbial exposures on lung health, including coexposures. Future studies need to clarify which method of assessing environmental microbial exposures is most relevant.
Collapse
|
13
|
Riggs L, Keall M, Howden-Chapman P, Baker MG. Environmental burden of disease from unsafe and substandard housing, New Zealand, 2010-2017. Bull World Health Organ 2021; 99:259-270. [PMID: 33953443 PMCID: PMC8085632 DOI: 10.2471/blt.20.263285] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 11/05/2020] [Accepted: 11/18/2020] [Indexed: 11/27/2022] Open
Abstract
Objective To assess the burden of disease related to unsafe and substandard housing conditions in New Zealand from 2010 to 2017. Methods We focused on substandard housing conditions most relevant for New Zealand homes: crowding, cold, damp or mould, and injury hazards linked to falls. We estimated the population attributable fraction using existing estimates of the population exposed and exposure–response relationships of health disorders associated with each housing condition. We used government hospitalization data, no-fault accident insurance claims and mortality data to estimate the annual disease burden from the most severe cases, as well as the resulting costs to the public sector in New Zealand dollars (NZ$). Using value of a statistical life measures, we estimated the indirect cost of deaths. Findings We estimated that illnesses attributable to household crowding accounted for 806 nights in hospital annually; cold homes for 1834 hospital nights; and dampness and mould for 36 649 hospital nights. Home injury hazards resulted in 115 555 annual accident claims. We estimated that direct public sector costs attributable to these housing conditions were approximately NZ$ 141 million (100 million United States dollars, US$) annually. We also estimated a total of 229 deaths annually attributable to adverse housing and the costs to society from these deaths at around NZ$ 1 billion (US$ 715 million). Conclusion Of the conditions assessed in this study, damp and mouldy housing accounted for a substantial proportion of the burden of disease in New Zealand. Improving people’s living conditions could substantially reduce total hospitalization costs and potentially improve quality of life.
Collapse
Affiliation(s)
- Lynn Riggs
- Motu Economic and Public Policy Research, 97 Cuba Street, Wellington 6011, New Zealand
| | - Michael Keall
- Department of Public Health, University of Otago, Dunedin, New Zealand
| | | | - Michael G Baker
- Department of Public Health, University of Otago, Dunedin, New Zealand
| |
Collapse
|
14
|
Fyfe C, Telfar L, Barnard, Howden-Chapman P, Douwes J. Association between home insulation and hospital admission rates: retrospective cohort study using linked data from a national intervention programme. BMJ 2020; 371:m4571. [PMID: 33376083 PMCID: PMC7770561 DOI: 10.1136/bmj.m4571] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To investigate whether retrofitting insulation into homes can reduce cold associated hospital admission rates among residents and to identify whether the effect varies between different groups within the population and by type of insulation. DESIGN A quasi-experimental retrospective cohort study using linked datasets to evaluate a national intervention programme. PARTICIPANTS 994 317 residents of 204 405 houses who received an insulation subsidy through the Energy Efficiency and Conservation Authority Warm-up New Zealand: Heat Smart retrofit programme between July 2009 and June 2014. MAIN OUTCOME MEASURE A difference-in-difference approach was used to compare the change in hospital admissions of the study population post-insulation with the change in hospital admissions of the control population that did not receive the intervention over the same two timeframes. Relative rate ratios were used to compare the two groups. RESULTS 234 873 hospital admissions occurred during the study period. Hospital admission rates after the intervention increased in the intervention and control groups for all population categories and conditions with the exception of acute hospital admissions among Pacific Peoples (rate ratio 0.94, 95% confidence interval 0.90 to 0.98), asthma (0.92, 0.86 to 0.99), cardiovascular disease (0.90, 0.88 to 0.93), and ischaemic heart disease for adults older than 65 years (0.79, 0.74 to 0.84). Post-intervention increases were, however, significantly lower (11%) in the intervention group compared with the control group (relative rate ratio 0.89, 95% confidence interval 0.88 to 0.90), representing 9.26 (95% confidence interval 9.05 to 9.47) fewer hospital admissions per 1000 in the intervention population. Effects were more pronounced for respiratory disease (0.85, 0.81 to 0.90), asthma in all age groups (0.80, 0.70 to 0.90), and ischaemic heart disease in those older than 65 years (0.75, 0.66 to 0.83). CONCLUSION This study showed that a national home insulation intervention was associated with reduced hospital admissions, supporting previous research, which found an improvement in self-reported health.
Collapse
Affiliation(s)
- Caroline Fyfe
- He Kianga Oranga, Department of Public Health, University of Otago Wellington, PO Box 7343, Wellington South 6242, New Zealand
| | | | - Barnard
- He Kianga Oranga, Department of Public Health, University of Otago Wellington, PO Box 7343, Wellington South 6242, New Zealand
| | - Philippa Howden-Chapman
- He Kianga Oranga, Department of Public Health, University of Otago Wellington, PO Box 7343, Wellington South 6242, New Zealand
| | - Jeroen Douwes
- Centre for Public Health Research, Massey University Wellington, New Zealand
| |
Collapse
|
15
|
Taptiklis P, Phipps R, Jones M, Douwes J. House characteristics and condition as determinants of visible mold and musty odor: Results from three New Zealand House Condition Surveys in 2005, 2010, and 2015. INDOOR AIR 2020; 31:832-847. [PMID: 33350507 DOI: 10.1111/ina.12774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 11/30/2020] [Indexed: 06/12/2023]
Abstract
This study assessed associations between house characteristics and mold and musty odor, using data from three consecutive (2005, 2010, and 2015) New Zealand House Condition Surveys, involving a total of 1616 timber-framed houses. Mold, musty odor, and house characteristics were assessed by independent building inspectors. We used multivariate logistic regression analyses mutually adjusted for other house characteristics for each survey separately. Positive and independent associations were found with tenure, ventilation, insulation, and envelope condition for both mold in living and bedrooms and musty odor. In particular, we found significant dose-response associations with envelope condition, ventilation, and insulation. Odds of mold increased 2.4-15.9 times (across surveys) in houses with the worst building envelope condition (BEC; p < 0.05-0.001 for trend); optimal ventilation reduced the risk of mold by 60% and the risk of musty odor by 70%-90% (p < 0.01 for trend). Other factors associated with mold and musty odor included: tenure, with an approximate doubling of odds of mold across surveys; and insulation with consistent dose-response patterns in all outcomes and surveys tested (p < 0.05 for trend in two surveys with mold and one survey for odor). In conclusion, this study showed the importance of BEC, ventilation, and insulation to avoiding harmful damp-related exposures.
Collapse
Affiliation(s)
- Phoebe Taptiklis
- School of Built Environment, Massey University, Albany Campus, Auckland, New Zealand
| | - Robyn Phipps
- School of Built Environment, Massey University, Albany Campus, Auckland, New Zealand
| | | | - Jeroen Douwes
- Centre for Public Health Research, Massey University, Wellington Campus, Wellington, New Zealand
| |
Collapse
|
16
|
Cox J, Ryan P, Burkle J, Jandarov R, Mendell MJ, Hershey GK, LeMasters G, Reponen T. Quantitative and semiquantitative estimates of mold exposure in infancy and childhood respiratory health. Environ Epidemiol 2020; 4:e101. [PMID: 32832840 PMCID: PMC7423528 DOI: 10.1097/ee9.0000000000000101] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 05/18/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Previous epidemiologic studies of dampness and mold relied on metrics that did not fully assess exposure-response relationships. Our objective was to examine quantitative metrics of dampness and mold during infancy and respiratory health outcomes during childhood. METHODS In-home visits were conducted before age 1 for children in the Cincinnati Childhood Allergy and Air Pollution Study. Respiratory outcomes included age 3 wheeze and age 7 asthma and wheeze. The associations between home exposure and respiratory outcomes were evaluated for 779 children using logistic regression adjusting for household income, neighborhood socioeconomic status, and the presence of pests. RESULTS Children residing in homes with ≥0.29 m2 of moisture damage were significantly more likely to have wheezing at age 3 and persistent wheeze through age 7 (adjusted odds ratio [aOR] = 2.2; 95% confidence interval [CI] = 1.0, 4.3 and aOR = 3.2; CI = 1.3, 7.5, respectively). Additionally, homes having ≥0.19 m2 of mold damage were associated with wheezing at age 3 and early transient wheeze assessed at age 7 (aOR = 2.9; CI = 1.3, 6.4 and aOR = 3.5; CI = 1.5, 8.2, respectively). Mold damage <0.19 m2 and moisture damage <0.29 m2 were not associated with health outcomes. Mold and moisture damage were also not associated with asthma. CONCLUSION Our data indicate that only the highest categories analyzed for mold (≥0.19 m2) and moisture damage (≥0.29 m2) in homes at age 1 were significantly associated with wheeze at ages 3 and 7; however, data below these levels were too sparse to assess the shape of the relationship or explore potential health-relevant thresholds.
Collapse
Affiliation(s)
- Jennie Cox
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | - Patrick Ryan
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
- Division of Biostatistics and Epidemiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Jeff Burkle
- Division of Biostatistics and Epidemiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Roman Jandarov
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | | | - Gurjit Khurana Hershey
- Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Grace LeMasters
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | - Tiina Reponen
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| |
Collapse
|
17
|
Cai J, Li B, Yu W, Yao Y, Wang L, Li B, Wang Y, Du C, Xiong J. Associations of household dampness with asthma, allergies, and airway diseases among preschoolers in two cross-sectional studies in Chongqing, China: Repeated surveys in 2010 and 2019. ENVIRONMENT INTERNATIONAL 2020; 140:105752. [PMID: 32371306 DOI: 10.1016/j.envint.2020.105752] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 04/12/2020] [Accepted: 04/18/2020] [Indexed: 06/11/2023]
Abstract
Many studies have investigated the associations between household damp indicators, and allergies and respiratory diseases in childhood. However, the findings are rather inconsistent. In 2010, we conducted a cross-sectional study of preschoolers aged three-six years in three urban districts of Chongqing, China. In 2019, we repeated this cross-sectional study with preschoolers of the same ages and districts. Here, we selected data for 2935 and 2717 preschoolers who did not change residences since birth in the 2010 and 2019 studies, respectively. We investigated associations of household damp indicators with asthma, allergic rhinitis, pneumonia, eczema, wheeze, and rhinitis in childhood in the two studies. The proportions of residences with household damp indicators and the prevalence of the studied diseases (except for allergic rhinitis) were significantly lower in 2019 than in 2010. In the two-level (district-child) logistic regression analyses, household damp exposures that showed by different indicators were significantly associated with the increased odds of lifetime-ever asthma (range of adjusted odds ratio (AOR): 1.69-3.50 in 2019; 1.13-1.90 in 2010), allergic rhinitis (1.14-2.39; 0.67-1.61), pneumonia (1.09-1.64; 1.21-1.59), eczema (0.96-1.83; 0.99-1.56), wheeze (1.64-2.79; 1.18-1.91), rhinitis (1.43-2.71; 1.08-1.58), and current (in the past 12 months before the survey) eczema (0.46-2.08; 0.99-1.48), wheeze (0.97-2.86; 1.26-2.07) and rhinitis (1.34-2.25; 1.09-1.56) in most cases. The increased odds ratios (ORs) of most diseases had exposure-response relationships with the cumulative number (n) of household damp indicators in the current and early residences. Our results indicated household damp exposure could be a risk factor for childhood allergic and respiratory diseases, although the magnitudes of these effects could be different in different studies.
Collapse
Affiliation(s)
- Jiao Cai
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Baizhan Li
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China.
| | - Wei Yu
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Yinghui Yao
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Lexiang Wang
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Bicheng Li
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Yujue Wang
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Chenqiu Du
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Jie Xiong
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| |
Collapse
|
18
|
Coulby G, Clear A, Jones O, Godfrey A. A Scoping Review of Technological Approaches to Environmental Monitoring. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113995. [PMID: 32512865 PMCID: PMC7312086 DOI: 10.3390/ijerph17113995] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/29/2020] [Accepted: 06/02/2020] [Indexed: 11/16/2022]
Abstract
Indoor environment quality (IEQ) can negatively affect occupant health and wellbeing. Air quality, as well as thermal, visual and auditory conditions, can determine how comfortable occupants feel within buildings. Some can be measured objectively, but many are assessed by interpreting qualitative responses. Continuous monitoring by passive sensors may be useful to identify links between environmental and physiological changes. Few studies localise measurements to an occupant level perhaps due to many environmental monitoring solutions being large and expensive. Traditional models for occupant comfort analysis often exacerbate this by not differentiating between individual building occupants. This scoping review aims to understand IEQ and explore approaches as to how it is measured with various sensing technologies, identifying trends for monitoring occupant health and wellbeing. Twenty-seven studies were reviewed, and more than 60 state-of-the-art and low-cost IEQ sensors identified. Studies were found to focus on the home or workplace, but not both. This review also found how wearable technology could be used to augment IEQ measurements, creating personalised approaches to health and wellbeing. Opportunities exist to make individuals the primary unit of analysis. Future research should explore holistic personalised approaches to health monitoring in buildings that analyse the individual as they move between environments.
Collapse
Affiliation(s)
- Graham Coulby
- Department of Computer and Information Sciences, Faculty of Engineering and Environment, Northumbria University, Newcastle Upon Tyne NE1 8ST, UK; (G.C.); (A.C.)
| | - Adrian Clear
- Department of Computer and Information Sciences, Faculty of Engineering and Environment, Northumbria University, Newcastle Upon Tyne NE1 8ST, UK; (G.C.); (A.C.)
| | - Oliver Jones
- Department of Technologies, Ryder Architecture, Newcastle Upon Tyne NE1 3NN, UK;
| | - Alan Godfrey
- Department of Computer and Information Sciences, Faculty of Engineering and Environment, Northumbria University, Newcastle Upon Tyne NE1 8ST, UK; (G.C.); (A.C.)
- Correspondence: ; Tel.: +44-(0)191-227-3642
| |
Collapse
|
19
|
Baker MG, Gurney J, Oliver J, Moreland NJ, Williamson DA, Pierse N, Wilson N, Merriman TR, Percival T, Murray C, Jackson C, Edwards R, Foster Page L, Chan Mow F, Chong A, Gribben B, Lennon D. Risk Factors for Acute Rheumatic Fever: Literature Review and Protocol for a Case-Control Study in New Zealand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4515. [PMID: 31731673 PMCID: PMC6888501 DOI: 10.3390/ijerph16224515] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 11/06/2019] [Accepted: 11/08/2019] [Indexed: 02/06/2023]
Abstract
Acute rheumatic fever (ARF) and its sequela, rheumatic heart disease (RHD), have largely disappeared from high-income countries. However, in New Zealand (NZ), rates remain unacceptably high in indigenous Māori and Pacific populations. The goal of this study is to identify potentially modifiable risk factors for ARF to support effective disease prevention policies and programmes. A case-control design is used. Cases are those meeting the standard NZ case-definition for ARF, recruited within four weeks of hospitalisation for a first episode of ARF, aged less than 20 years, and residing in the North Island of NZ. This study aims to recruit at least 120 cases and 360 controls matched by age, ethnicity, gender, deprivation, district, and time period. For data collection, a comprehensive pre-tested questionnaire focussed on exposures during the four weeks prior to illness or interview will be used. Linked data include previous hospitalisations, dental records, and school characteristics. Specimen collection includes a throat swab (Group A Streptococcus), a nasal swab (Staphylococcus aureus), blood (vitamin D, ferritin, DNA for genetic testing, immune-profiling), and head hair (nicotine). A major strength of this study is its comprehensive focus covering organism, host and environmental factors. Having closely matched controls enables the examination of a wide range of specific environmental risk factors.
Collapse
Affiliation(s)
- Michael G Baker
- Department of Public Health, University of Otago, Wellington 6021, New Zealand; (J.G.); (J.O.); (N.P.); (R.E.)
| | - Jason Gurney
- Department of Public Health, University of Otago, Wellington 6021, New Zealand; (J.G.); (J.O.); (N.P.); (R.E.)
| | - Jane Oliver
- Department of Public Health, University of Otago, Wellington 6021, New Zealand; (J.G.); (J.O.); (N.P.); (R.E.)
| | - Nicole J Moreland
- School of Medical Sciences, University of Auckland, Auckland 1010, New Zealand;
| | - Deborah A Williamson
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology & Immunology, University of Melbourne at The Doherty Institute for Infection and Immunity, Melbourne 3010, Australia;
| | - Nevil Pierse
- Department of Public Health, University of Otago, Wellington 6021, New Zealand; (J.G.); (J.O.); (N.P.); (R.E.)
| | - Nigel Wilson
- Green Lane Paediatric and Congenital Cardiac Services, Starship Children’s Hospital, Auckland District Health Board, Auckland 1023; New Zealand;
- Department of Paediatrics, University of Auckland, Auckland 1142, New Zealand;
| | - Tony R Merriman
- Biochemistry Department, University of Otago, Dunedin 9054, New Zealand;
| | - Teuila Percival
- School of Population Health, University of Auckland, Auckland 1142, New Zealand;
- KidzFirst Children’s Hospital, Auckland 1640, New Zealand;
| | - Colleen Murray
- Faculty of Dentistry, University of Otago, Dunedin 9054, New Zealand (L.F.P.)
| | - Catherine Jackson
- Auckland Regional Public Health Service, Auckland District Health Board, Auckland 0622, New Zealand;
| | - Richard Edwards
- Department of Public Health, University of Otago, Wellington 6021, New Zealand; (J.G.); (J.O.); (N.P.); (R.E.)
| | - Lyndie Foster Page
- Faculty of Dentistry, University of Otago, Dunedin 9054, New Zealand (L.F.P.)
| | | | - Angela Chong
- CBG Health Research Ltd, Auckland 0651, New Zealand; (A.C.); (B.G.)
| | - Barry Gribben
- CBG Health Research Ltd, Auckland 0651, New Zealand; (A.C.); (B.G.)
| | - Diana Lennon
- Department of Paediatrics, University of Auckland, Auckland 1142, New Zealand;
- KidzFirst Children’s Hospital, Auckland 1640, New Zealand;
- Starship Children’s Hospital, Auckland District Health Board, Auckland 1023, New Zealand
| |
Collapse
|
20
|
Ingham T, Keall M, Jones B, Aldridge DRT, Dowell AC, Davies C, Crane J, Draper JB, Bailey LO, Viggers H, Stanley TV, Leadbitter P, Latimer M, Howden-Chapman P. Damp mouldy housing and early childhood hospital admissions for acute respiratory infection: a case control study. Thorax 2019; 74:849-857. [PMID: 31413146 PMCID: PMC6824607 DOI: 10.1136/thoraxjnl-2018-212979] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 06/17/2019] [Accepted: 06/24/2019] [Indexed: 11/11/2022]
Abstract
INTRODUCTION A gap exists in the literature regarding dose-response associations of objectively assessed housing quality measures, particularly dampness and mould, with hospitalisation for acute respiratory infection (ARI) among children. METHODS A prospective, unmatched case-control study was conducted in two paediatric wards and five general practice clinics in Wellington, New Zealand, over winter/spring 2011-2013. Children aged <2 years who were hospitalised for ARI (cases), and either seen in general practice with ARI not requiring admission or for routine immunisation (controls) were included in the study. Objective housing quality was assessed by independent building assessors, with the assessors blinded to outcome status, using the Respiratory Hazard Index (RHI), a 13-item scale of household quality factors, including an 8-item damp-mould subscale. The main outcome was case-control status. Adjusted ORs (aORs) of the association of housing quality measures with case-control status were estimated, along with the population attributable risk of eliminating dampness-mould on hospitalisation for ARI among New Zealand children. RESULTS 188 cases and 454 controls were studied. Higher levels of RHI were associated with elevated odds of hospitalisation (OR 1.11/unit increase (95% CI 1.01 to 1.21)), which weakened after adjustment for season, housing tenure, socioeconomic status and crowding (aOR 1.04/unit increase (95% CI 0.94 to 1.15)). The damp-mould index had a significant, adjusted dose-response relationship with ARI admission (aOR 1.15/unit increase (95% CI 1.02 to 1.30)). By addressing these harmful housing exposures, the rate of admission for ARI would be reduced by 19% or 1700 fewer admissions annually. CONCLUSIONS A dose-response relationship exists between housing quality measures, particularly dampness-mould, and young children's ARI hospitalisation rates. Initiatives to improve housing quality and to reduce dampness-mould would have a large impact on ARI hospitalisation.
Collapse
Affiliation(s)
- Tristram Ingham
- Department of Medicine, University of Otago Wellington, Wellington, New Zealand
| | - Michael Keall
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Bernadette Jones
- Department of Medicine, University of Otago Wellington, Wellington, New Zealand
| | - Daniel R T Aldridge
- Department of Medicine, University of Otago Wellington, Wellington, New Zealand
| | - Anthony C Dowell
- Department of Obstetrics and Gynaecology, University of Otago Wellington, Wellington, New Zealand
| | - Cheryl Davies
- Tu Kotahi Māori Asthma Trust, Lower Hutt, New Zealand
| | - Julian Crane
- Department of Medicine, University of Otago Wellington, Wellington, New Zealand
| | - Jessica Barbara Draper
- Department of Medicine, University of Otago Wellington, Wellington, New Zealand
- Tu Kotahi Māori Asthma Trust, Lower Hutt, New Zealand
| | | | - Helen Viggers
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Thorsten Villiers Stanley
- Department of Paediatrics, University of Otago Wellington, Wellington, New Zealand
- Department of Paediatrics, Capital and Coast District Health Board, Wellington, New Zealand
| | - Philip Leadbitter
- Department of Paediatrics, Hutt Valley District Health Board, Lower Hutt, New Zealand
| | | | | |
Collapse
|
21
|
Mendell MJ, Adams RI. The challenge for microbial measurements in buildings. INDOOR AIR 2019; 29:523-526. [PMID: 31190428 DOI: 10.1111/ina.12550] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 02/26/2019] [Indexed: 06/09/2023]
Affiliation(s)
- Mark J Mendell
- IAQS/EHLB, California Department of Public Health, Richmond, California
| | - Rachel I Adams
- Plant & Microbial Biology, University of California, Berkeley, California
| |
Collapse
|
22
|
Cai J, Li B, Yu W, Wang H, Du C, Zhang Y, Huang C, Zhao Z, Deng Q, Yang X, Zhang X, Qian H, Sun Y, Liu W, Wang J, Yang Q, Zeng F, Norbäck D, Sundell J. Household dampness-related exposures in relation to childhood asthma and rhinitis in China: A multicentre observational study. ENVIRONMENT INTERNATIONAL 2019; 126:735-746. [PMID: 30878869 DOI: 10.1016/j.envint.2019.03.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 03/05/2019] [Accepted: 03/06/2019] [Indexed: 06/09/2023]
Abstract
During 2010-2012, we conducted an observational study on household environment and health outcomes among 40,010 preschool children from seven cities of China. Here we examined associations of six dampness-related indicators (visible mold spots, visible damp stains, damp clothing and/or bedding, water damage, condensation on windowpane, moldy odor) in the current residence and three dampness-related indicators (visible mold spots, condensation on windowpane, moldy odor) in the early residence with childhood asthma and rhinitis. In the multi-level logistic regression analyses, visible mold spots and visible damp stains in the current residence were significantly associated with the increased odds of doctor-diagnosed asthma and allergic rhinitis during lifetime-ever (adjusted odd ratios (AORs) range: 1.18-1.35). All dampness-related indicators were significantly associated with increased odds of wheeze and rhinitis during lifetime-ever and in the past 12 months (AORs range: 1.16-2.64). The cumulative numbers of damp indicators had positively dose-response relationships with the increased odds of the studied diseases. These associations for wheeze and rhinitis were similar between northern children and southern children. Similar results were found in the sensitive analyses among children without a family history of allergies and among children without asthma and allergic rhinitis. For 3-6 years-old children in mainland of China in 2011, we speculated that about 90,000 (2.02%) children with asthma and about 59,000 (1.09%) children with allergic rhinitis could be attributable to exposing to visible mold spots in the current residence. Our results suggested that early and lifetime exposures to household dampness indicators are risk factors for childhood asthma and rhinitis.
Collapse
Affiliation(s)
- Jiao Cai
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Baizhan Li
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China.
| | - Wei Yu
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Han Wang
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Chenqiu Du
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Yinping Zhang
- School of Architecture, Tsinghua University, Beijing, China
| | - Chen Huang
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Zhuohui Zhao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Key Lab of Health Technology Assessment, National Health and Family Planning Commission of the People's Republic of China, Fudan University, Shanghai, China
| | - Qihong Deng
- School of Public Health, Central South University, Changsha, Hunan, China
| | - Xu Yang
- College of Life Sciences, Central China Normal University, Wuhan, China
| | - Xin Zhang
- Research Center for Environmental Science and Engineering, Shanxi University, Taiyuan, China
| | - Hua Qian
- School of Energy and Environment, Southeast University, Nanjing, China
| | - Yuexia Sun
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Wei Liu
- School of Architecture, Tsinghua University, Beijing, China
| | - Juan Wang
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala SE-751, Sweden
| | - Qin Yang
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Fanbin Zeng
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Dan Norbäck
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala SE-751, Sweden
| | - Jan Sundell
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| |
Collapse
|
23
|
Walker GJ, Stelzer-Braid S, Shorter C, Honeywill C, Wynn M, Willenborg C, Barnes P, Kang J, Pierse N, Crane J, Howden-Chapman P, Rawlinson WD. Viruses associated with acute respiratory infection in a community-based cohort of healthy New Zealand children. J Med Virol 2019; 94:454-460. [PMID: 31017663 PMCID: PMC7228279 DOI: 10.1002/jmv.25493] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 04/15/2019] [Accepted: 04/18/2019] [Indexed: 12/16/2022]
Abstract
Acute respiratory infections (ARIs) are a major cause of morbidity among children. Respiratory viruses are commonly detected in both symptomatic and asymptomatic periods. The rates of infection and community epidemiology of respiratory viruses in healthy children needs further definition to assist interpretation of molecular diagnostic assays in this population. Children otherwise healthy aged 1 to 8 years were prospectively enrolled in the study during two consecutive winters, when ARIs peak in New Zealand. Parents completed a daily symptom diary for 8 weeks, during which time they collected a nasal swab from the child for each clinical ARI episode. A further nasal swab was collected by research staff during a clinic visit at the conclusion of the study. All samples were tested for 15 respiratory viruses commonly causing ARI using molecular multiplex polymerase chain reaction assays. There were 575 ARIs identified from 301 children completing the study, at a rate of 1.04 per child‐month. Swabs collected during an ARI were positive for a respiratory virus in 76.8% (307 of 400), compared with 37.3% (79 of 212) of swabs collected during asymptomatic periods. The most common viruses detected were human rhinovirus, coronavirus, parainfluenza viruses, influenzavirus, respiratory syncytial virus, and human metapneumovirus. All of these were significantly more likely to be detected during ARIs than asymptomatic periods. Parent‐administered surveillance is a useful mechanism for understanding infectious disease in healthy children in the community. Interpretation of molecular diagnostic assays for viruses must be informed by understanding of local rates of asymptomatic infection by such viruses. During winter, children experienced acute respiratory infections at a rate of 1.04/month. A virus was detected in 76.8% of acute respiratory infections. Specific viruses are more likely to be associated with respiratory symptoms.
Collapse
Affiliation(s)
- Gregory J Walker
- Virology Research Laboratory, Prince of Wales Hospital, Sydney, New South Wales, Australia.,School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Sacha Stelzer-Braid
- Virology Research Laboratory, Prince of Wales Hospital, Sydney, New South Wales, Australia.,School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Caroline Shorter
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Claire Honeywill
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Matthew Wynn
- Virology Research Laboratory, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Christiana Willenborg
- Virology Research Laboratory, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Phillipa Barnes
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Janice Kang
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Nevil Pierse
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Julian Crane
- Department of Medicine, University of Otago, Wellington, New Zealand
| | | | - William D Rawlinson
- Virology Research Laboratory, Prince of Wales Hospital, Sydney, New South Wales, Australia.,School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.,Serology and Virology Division, South Eastern Area Laboratory Services Microbiology, Prince of Wales Hospital, Sydney, Australia.,School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| |
Collapse
|
24
|
Chisholm E, Pierse N, Davies C, Howden-Chapman P. Promoting health through housing improvements, education and advocacy: Lessons from staff involved in Wellington's Healthy Housing Initiative. Health Promot J Austr 2019; 31:7-15. [PMID: 30920685 DOI: 10.1002/hpja.247] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 03/23/2019] [Indexed: 11/07/2022] Open
Abstract
ISSUE ADDRESSED Improving the conditions of housing through programs that trigger when children are hospitalised has the potential to prevent further ill-health and re-hospitalisations. Exploring the attitudes and beliefs of staff involved in such a program assists in understanding the advantages and challenges of this approach. METHODS We interviewed 21 people involved in a regional initiative to improve the health outcomes of children through referral to a housing program. Interviews were recorded and transcribed. Transcripts were subsequently subjected to qualitative thematic analysis. RESULTS Participants identified a number of factors that were key to the success of the program, such as: visiting the home, having health and energy organisations work together, and an integrated approach that includes interventions as well as education and advocacy. Key challenges to the program's aim of improving health outcomes for children were landlords' reluctance to implement improvements, homeowners' inability to afford improvements, limitations to staff resources, and client stress and income constraints, which meant that some interventions did not necessarily lead to housing improvements. CONCLUSIONS Efforts to improve health outcomes through housing interventions should be supported by funding and regulatory initiatives that encourage property owners to implement recommended interventions. SO WHAT?: This program represents an encouraging step towards health promotion through housing interventions and education. However, the initiative cannot fully counter structural challenges such as poor quality housing, and lack of housing and energy affordability. This study highlights the potential for a holistic approach to health promotion in housing, which integrates health initiatives with advocacy for regulatory support.
Collapse
Affiliation(s)
- Elinor Chisholm
- He Kainga Oranga, The Housing and Health Research Programme, Department of Public Health, University of Otago, Wellington, New Zealand
| | - Nevil Pierse
- He Kainga Oranga, The Housing and Health Research Programme, Department of Public Health, University of Otago, Wellington, New Zealand
| | - Cheryl Davies
- Tū Kotahi Māori Asthma Trust, Wellington, New Zealand
| | - Philippa Howden-Chapman
- He Kainga Oranga, The Housing and Health Research Programme, Department of Public Health, University of Otago, Wellington, New Zealand
| |
Collapse
|
25
|
Chisholm E, Keall M, Bennett J, Marshall A, Telfar-Barnard L, Thornley L, Howden-Chapman P. Why don't owners improve their homes? Results from a survey following a housing warrant-of-fitness assessment for health and safety. Aust N Z J Public Health 2019; 43:221-227. [PMID: 30958630 DOI: 10.1111/1753-6405.12895] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 02/01/2019] [Accepted: 03/01/2019] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To assess homeowners' intentions to make voluntary improvements to their homes following a warrant-of-fitness (WOF) assessment to highlight health and safety issues. METHODS We recruited 83 homeowners, including nine landlords, in Taranaki, New Zealand, who agreed to have a WOF assessment carried out on their homes. We interviewed 40 of the homeowners to ascertain what improvements they planned to make, and barriers to improving their homes. RESULTS Of the 83 properties, 76 (92%) failed the WOF. Of the 40 interview participants, 31 (76%) had addressed or planned to address at least one of the identified issues with the home. Participants were least likely to address identified issues with security stays on windows, and absence of ground vapour barrier. Reasons for not addressing identified issues included cost, and a belief that making the improvement would not benefit health and safety. CONCLUSIONS Information about housing defects appears insufficient to encourage people to make improvements to their homes to meet a specified health and safety standard. Implications for public health: Better understanding of how particular housing defects pose a risk for health and safety, and provision of funding support in some cases, may encourage people to invest in safer, healthier homes.
Collapse
Affiliation(s)
- Elinor Chisholm
- He Kainga Oranga, the Housing and Health Research Programme, Department of Public Health, University of Otago, New Zealand
| | - Michael Keall
- He Kainga Oranga, the Housing and Health Research Programme, Department of Public Health, University of Otago, New Zealand
| | - Julie Bennett
- He Kainga Oranga, the Housing and Health Research Programme, Department of Public Health, University of Otago, New Zealand
| | | | - Lucy Telfar-Barnard
- He Kainga Oranga, the Housing and Health Research Programme, Department of Public Health, University of Otago, New Zealand
| | - Louise Thornley
- Department of Public Health, University of Otago, New Zealand
| | - Philippa Howden-Chapman
- He Kainga Oranga, the Housing and Health Research Programme, Department of Public Health, University of Otago, New Zealand
| |
Collapse
|
26
|
Telfar-Barnard L, Bennett J, Robinson A, Hailes A, Ombler J, Howden-Chapman P. Evidence base for a housing warrant of fitness. SAGE Open Med 2019; 7:2050312119843028. [PMID: 31001424 PMCID: PMC6454639 DOI: 10.1177/2050312119843028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 03/19/2019] [Indexed: 11/23/2022] Open
Abstract
Substandard housing is a major public health issue in New Zealand. Approximately,
two-thirds of the housing stock is uninsulated and many homes are inadequately
heated, with an average indoor temperature of 14.5°C. Cold, damp, and mouldy
housing results in poor health; each year, respiratory hospital admissions are
74% higher during winter, and excess winter mortality is 20% higher than other
seasons. The relationship between injury and housing conditions is also well
established. Each year, 500,000 New Zealanders suffer falls requiring medical
treatment in their homes. As a step towards improving the quality of existing
housing, an evidence-based warrant of fitness has been developed. This article
outlines the evidence base to each criterion in the warrant of fitness. We
conclude that introducing and properly enforcing a housing warrant of fitness
will ensure that basic minimum standards are met, which could mitigate the
disease burdens and injuries associated with, or caused, by poorer quality
housing. In addition, there are potential fiscal and economic advantages of the
scheme, including reduced hospitalisations and increased productivity.
Collapse
Affiliation(s)
| | - Julie Bennett
- University of Otago, Wellington, Wellington, New Zealand
| | | | - Albert Hailes
- University of Otago, Wellington, Wellington, New Zealand
| | - Jenny Ombler
- University of Otago, Wellington, Wellington, New Zealand
| | | |
Collapse
|
27
|
Sasso F, Izard M, Beneteau T, Rakotozandry T, Ramadour M, Annesi-Maesano I, Robin D, Charpin D. 18-year evolution of asthma and allergic diseases in French urban schoolchildren in relation to indoor air pollutant levels. Respir Med 2019; 148:31-36. [PMID: 30827471 DOI: 10.1016/j.rmed.2019.01.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 01/07/2019] [Accepted: 01/08/2019] [Indexed: 01/27/2023]
Abstract
BACKGROUND An initial epidemiological study carried out 18 years ago in Marseilles indicated that the air quality in schools was poor and that there was an association between the level of fine particulates and the occurrence of asthma in children. The aim of the present study was to evaluate the change in the prevalence of childhood asthma and allergic diseases and their link with the levels of air pollutants and other factors of potential risk. METHODS In 2016, using a questionnaire identical to the one used for the 1st survey in 1998-1999, we collected information regarding the symptoms, the diagnosis, and the potential confounding factors. We measured the main indoor and outdoor pollutants at the schools. RESULTS Overall, the prevalence of asthma and of allergic diseases exhibited an increasing trend in the time interval between the two studies, significant only for dry cough and pollen allergy. The level of air pollutants decreased significantly indoors. In spite of this, we found a correlation and a dose-effect relationship between the level of PM2.5 and the prevalence of asthma. A family history of asthma and allergies, the insalubrity of the place of residence, and a non-Mediterranean diet were also associated with the risk of these diseases. CONCLUSION In the time interval between the two studies, which were 18 years apart, despite a reduction in the level of air pollutants in classrooms, asthma was still related to PM2.5. Other potentially causative or contributing environmental factors were also related to asthma and allergies.
Collapse
Affiliation(s)
- Fabien Sasso
- Pulmonology Unit, La Timone Hospital, Marseille and Aix-Marseille University, France
| | | | - Thomas Beneteau
- EPAR, IPLESP, UMR S, 1136, INSERM & UPMC Paris 6, Sorbonne University, Medical School Saint-Antoine, France
| | - Thierry Rakotozandry
- Pulmonology Unit, La Timone Hospital, Marseille and Aix-Marseille University, France
| | | | - Isabella Annesi-Maesano
- EPAR, IPLESP, UMR S, 1136, INSERM & UPMC Paris 6, Sorbonne University, Medical School Saint-Antoine, France
| | | | - Denis Charpin
- Pulmonology Unit, La Timone Hospital, Marseille and Aix-Marseille University, France.
| |
Collapse
|
28
|
Horsley A, Thaler DS. Microwave detection and quantification of water hidden in and on building materials: implications for healthy buildings and microbiome studies. BMC Infect Dis 2019; 19:67. [PMID: 30658591 PMCID: PMC6339348 DOI: 10.1186/s12879-019-3720-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 01/11/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Excess water in all its forms (moisture, dampness, hidden water) in buildings negatively impacts occupant health but is hard to reliably detect and quantify. Recent advances in through-wall imaging recommend microwaves as a tool with a high potential to noninvasively detect and quantify water throughout buildings. METHODS Microwaves in both transmission and reflection (radar) modes were used to perform a simple demonstration of the detection of water both on and hidden within building materials. RESULTS We used both transmission and reflection modes to detect as little as 1 mL of water between two 7 cm thicknesses of concrete. The reflection mode was also used to detect 1 mL of water on a metal surface. We observed oscillations in transmitted and reflected microwave amplitude as a function of microwave wavelength and water layer thickness, which we attribute to thin-film interference effects. CONCLUSIONS Improving the detection of water in buildings could help design, maintenance, and remediation become more efficient and effective and perhaps increase the value of microbiome sequence data. Microwave characterization of all forms of water throughout buildings is possible; its practical development would require new collaborations among microwave physicists or engineers, architects, building engineers, remediation practitioners, epidemiologists, and microbiologists.
Collapse
Affiliation(s)
- Andrew Horsley
- Department of Physics, University of Basel, Klingelbergstrasse 82, CH-4056, Basel, Switzerland. .,Research School of Physics and Engineering, The Australian National University, Mills Rd., ACT 2601, Canberra, Australia.
| | - David S Thaler
- Research School of Physics and Engineering, The Australian National University, Mills Rd., ACT 2601, Canberra, Australia.,Biozentrum, University of Basel, Klingelbergstrasse 50/70, CH-4056, Basel, Switzerland
| |
Collapse
|
29
|
Kristono GA, Shorter C, Pierse N, Crane J, Siebers R. Endotoxin, cat, and house dust mite allergens in electrostatic cloths and bedroom dust. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2019; 16:89-96. [PMID: 30325697 DOI: 10.1080/15459624.2018.1536827] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Environmental exposure to endotoxin, Fel d I (cat) allergen and Der p I (house dust mite) allergen have been associated with asthma symptoms and have been measured in the environment using various sampling methods, including the electrostatic dust collector. The objectives of this study were to investigate whether levels of endotoxin and allergens were detectable in electrostatic dust collectors and to examine the correlation of allergen and endotoxin levels between electrostatic dust collectors and vacuum sampling methods (floor dust and mattress dust). Electrostatic cloths, bedroom floor dust and mattress dust samples from a subset of 60 homes were randomly selected from the Health of Occupants of Mouldy Homes study for allergen and endotoxin analysis. Fel d I and Der p I allergens were analyzed by double monoclonal antibody ELISA and endotoxin by the kinetic Limulus amoebocyte lysate assay. An enhanced ELISA method was used to analyze Der p I in the electrostatic cloths. Endotoxin was detected in all samples, however Fel d I and Der p I were not detected in all electrostatic dust collector samples (detection in 53% and 15% of cloths respectively). No correlations were found between cloth and dust samples for endotoxin or Der p I, but moderate-to-strong correlations were found between all three sampling methods for Fel d I (rs = 0.612-0.715, p < 0.001). Poor correlation was found between floor dust and mattress dust samples for Der p I (rs = 0.256, p = 0.048). Electrostatic dust collectors may provide a way to measure airborne dust and allergen. Given the moderate-to-low correlations with vacuum dust sampling, this may present a unique measurement system which, when collected alongside traditional vacuum dust sampling, could provide additional exposure measures. Further studies are required to correlate endotoxin and allergen levels measured by electrostatic dust collector with air sampling and to explore the relationships between these bioaerosols, environmental factors and asthma.
Collapse
Affiliation(s)
- Gisela A Kristono
- a Wellington Asthma Research Group, Department of Medicine , University of Otago , Wellington , New Zealand
| | - Caroline Shorter
- a Wellington Asthma Research Group, Department of Medicine , University of Otago , Wellington , New Zealand
| | - Nevil Pierse
- b Department of Public Health , University of Otago , Wellington , New Zealand
| | - Julian Crane
- a Wellington Asthma Research Group, Department of Medicine , University of Otago , Wellington , New Zealand
| | - Robert Siebers
- a Wellington Asthma Research Group, Department of Medicine , University of Otago , Wellington , New Zealand
| |
Collapse
|
30
|
Reboux G, Rocchi S, Laboissière A, Ammari H, Bochaton M, Gardin G, Rame JM, Millon L. Survey of 1012 moldy dwellings by culture fungal analysis: Threshold proposal for asthmatic patient management. INDOOR AIR 2019; 29:5-16. [PMID: 30368912 DOI: 10.1111/ina.12516] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 09/12/2018] [Accepted: 10/21/2018] [Indexed: 06/08/2023]
Abstract
Different countries have tried to define guidelines to quantify what levels of fungi are considered as inappropriate for housing. This retrospective study analyzes indoor fungi by cultures of airborne samples from 1012 dwellings. Altogether, 908 patients suffering from rhinitis, conjunctivitis, and asthma were compared to 104 controls free of allergies. Portuguese decree law no 118/2013 (PDL118), ANSES (a French environmental and health agency) recommendations, and health regulations of Besançon University Hospital were applied to determine the rates of non-conforming dwellings, which were respectively 55.2%, 5.2%, and 19%. Environmental microbiological results and medical data were compared. The whole number of colonies per cubic meter of air was correlated with asthma (P < 0.001) and rhinitis (P = 0.002). Sixty-seven genera and species were detected in bedrooms. Asthma was correlated to Aspergillus versicolor (P = 0.004) and Cladosporium spp. (P = 0.02). Thresholds of 300 cfu/m3 for A. versicolor or 495 cfu/m3 for Cladosporium spp. are able to discriminate 90% of the asthmatic dwellings. We propose a new protocol to obtain an optimal cost for indoor fungi surveys, excluding surface analyses, and a new guideline to interpret the results based on >1000 cfu/m3 of whole colonies and/or above threshold levels for A. versicolor or Cladosporium spp.
Collapse
Affiliation(s)
- Gabriel Reboux
- University of Bourgogne-Franche-Comté, Besançon, France
- Jean Minjoz University Hospital, Besançon, France
| | - Steffi Rocchi
- University of Bourgogne-Franche-Comté, Besançon, France
- Jean Minjoz University Hospital, Besançon, France
| | | | - Habiba Ammari
- Réseaux d'Allergologie de Franche-Comté (RAFT), Besançon, France
| | | | | | - Jean-Marc Rame
- Réseaux d'Allergologie de Franche-Comté (RAFT), Besançon, France
| | - Laurence Millon
- University of Bourgogne-Franche-Comté, Besançon, France
- Jean Minjoz University Hospital, Besançon, France
| |
Collapse
|
31
|
Mendell MJ, Macher JM, Kumagai K. Measured moisture in buildings and adverse health effects: A review. INDOOR AIR 2018; 28:488-499. [PMID: 29683210 DOI: 10.1111/ina.12464] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Accepted: 04/13/2018] [Indexed: 06/08/2023]
Abstract
It has not yet been possible to quantify dose-related health risks attributable to indoor dampness or mold (D/M), to support setting specific health-related limits for D/M. An overlooked target for assessing D/M is moisture in building materials, the critical factor allowing microbial growth. A search for studies of quantified building moisture and occupant health effects identified 3 eligible studies. Two studies assessed associations between measured wall moisture content and respiratory health in the UK. Both reported dose-related increases in asthma exacerbation with higher measured moisture, with 1 study reporting an adjusted odds ratio of 7.0 for night-time asthma symptoms with higher bedroom moisture. The third study assessed relationships between infrared camera-determined wall moisture and atopic dermatitis in South Korea, reporting an adjusted odds ratio of 14.5 for water-damaged homes and moderate or severe atopic dermatitis. Measuring building moisture has, despite extremely limited available findings, potential promise for detecting unhealthy D/M in homes and merits more research attention. Further research to validate these findings should include measured "water activity," which directly assesses moisture availability for microbial growth. Ultimately, evidence-based, health-related thresholds for building moisture, across specific materials and measurement devices, could better guide assessment and remediation of D/M in buildings.
Collapse
Affiliation(s)
- M J Mendell
- Indoor Air Quality Section, California Department of Public Health, Richmond, CA, USA
| | - J M Macher
- Indoor Air Quality Section, California Department of Public Health, Richmond, CA, USA
| | - K Kumagai
- Indoor Air Quality Section, California Department of Public Health, Richmond, CA, USA
| |
Collapse
|
32
|
Using Twitter to Explore (un)Healthy Housing: Learning from the #Characterbuildings Campaign in New Zealand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14111424. [PMID: 29160814 PMCID: PMC5708063 DOI: 10.3390/ijerph14111424] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 11/05/2017] [Accepted: 11/17/2017] [Indexed: 11/17/2022]
Abstract
While increasingly used for research, Twitter remains largely untapped as a source of data about housing. We explore the growth of social media and use of Twitter in health and social research, and question why housing researchers have avoided using Twitter to explore housing issues to date. We use the #characterbuildings campaign, initiated by an online media platform in New Zealand in 2014 to illustrate that Twitter can provide insights into housing as a public health and social problem. We find that Twitter users share details of problems with past and present homes on this public platform, and that this readily available data can contribute to the case for improving building quality as a means of promoting public health. Moreover, the way people responded to the request to share details about their housing experiences provides insight into how New Zealanders conceive of housing problems.
Collapse
|