Indoor Damp and Asthma Exacerbation: A Causal Relationship in Young Children
A recent review by the Institute of Medicine on the impact the indoor environment has on asthma has upgraded some of its conclusions. The updates reflect a firming up of scientific evidence.
The report grades evidence according to three categories of relationship:
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A causal relationship is one where the authors consider the available evidence is strong enough to suggest that we have found something that causes the health outcome – this is the strongest relationship and strongly suggests that an intervention is needed.
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If they do not yet consider that there is enough evidence to suggest a causal relationship then they can opt for an association between environmental factor and health impact.
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Finally if evidence is found that there is no relationship between an environmental factor and a health outcome then the conclusion is that there is evidence of no association.
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Major changes since 2000
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There is now a causal relationship with exacerbation for indoor dampness or dampness-related agents (in children)
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There are now associations with exacerbation for dampness or dampness-related agents (in adults), endotoxin, and environmental tobacco smoke (in preschool children)
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There is limited or suggestive evidence for association with exacerbation for indoor culturable Penicillium or total fungi, nitrogen dioxide, rodents (non-occupational), feather/down pillows (protective relative to synthetic bedding), and (regardless of specific sensitization) dust mite, cockroach, dog, and dampness-related agents.
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It is clear that those with asthma should avoid living in damp homes, especially if they have children.