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Increased occurrence of respiratory symptoms is associated with indoor climate risk indicators: a cross-sectional study in a Swedish population
Örebro University, Department of Health Sciences.
Statistical and Epidemiological Unit, Center for Clinical Research, Örebro University Hospital.
Department of Respiratory Medicine, Örebro University Hospital.
Örebro University, Department of Health Sciences.
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2007 (English)In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 101, no 9, p. 2031-2035Article in journal (Refereed) Published
Abstract [en]

A basic assumption was that exposure to the indoor environment would increase the manifestation of respiratory symptoms in predisposed individuals. The aim was to investigate the proportion of perceived respiratory symptoms attributed to specific environmental exposures, and associations related to indoor climate risk indicators, i.e. occurrence of damp or mould, insufficient ventilation and condensation on windows.

Method

A questionnaire was mailed to a random sample of 8008 individuals, stratified for gender and age. The response rate was 84% (n=6732). Established criteria for current asthma were used to classify subjects into three subgroups: asthmatics, healthy and symptomatics (but without current asthma).

Results

The proportion of symptoms attributed to specific environmental exposures increased in the total sample and in the three subgroups when indoor climate risk indicators, particularly damp or mould, were reported. Generally, the lowest proportions were found for healthy and the highest for asthmatics. Univariate analyses presented as relative risks (RR) (95% CI) showed significantly increased risks for perceived overall influence on airways for all groups, with RR ranging from 4.3 to 6.8. Although respiratory symptoms attributed to dust, environmental tobacco smoke (ETS) and strong scents increased when risk indicators were reported, RR were generally lower in all groups.

Conclusion

The high frequency of respiratory symptoms among asthmatics increased when occurrences of risk indicators were reported. Similarly, increased symptoms were found for healthy indicating that indoor climate risk indicators may affect both healthy and unhealthy individuals.

Place, publisher, year, edition, pages
2007. Vol. 101, no 9, p. 2031-2035
Keyword [en]
asthma, airway symptoms, housing environment, risk indicators
National Category
Nursing Public Health, Global Health, Social Medicine and Epidemiology Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Nursing Science w. Occupational Therapy Focus
Identifiers
URN: urn:nbn:se:oru:diva-2832DOI: 10.1016/j.rmed.2007.05.002OAI: oai:DiVA.org:oru-2832DiVA, id: diva2:134757
Available from: 2007-05-03 Created: 2007-05-03 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Asthma and respiratory symptoms related to the housing environment
Open this publication in new window or tab >>Asthma and respiratory symptoms related to the housing environment
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this dissertation was to study the housing environment with a focus on indoor climate factors which may maintain or worsen respiratory symptoms among persons with asthma.

Quasi-experimental and cross-sectional designs and a case-control approach were used. In Study I data was collected from a consecutive series of patients with asthma (n=21) and in the three other studies from a randomly selected sample, representative of the general population (n=6732). This sample was classified into subgroups (Study II): persons with asthma (n=261), healthy persons (n=5266) and persons with symptoms (n=1205). In Study III persons with asthma (n=49) were compared to persons without asthma (n=48), and the same group, persons with asthma (n=49) was also included in Study IV. Data were gathered using subjective information from diaries and questionnaires as well as objective measurements of medical and environmental factors.

Lung function was improved and there was a tendency for the indoor climate to improve after the removal of textile wall-to-wall carpets or the increase of air exchange rate. No statistically significant differences were found in the housing environment when persons with and without asthma were compared. However in some individual homes, environmental factors at levels that could increase symptoms were identified. In single-family houses higher levels of humidity, insufficient ventilation and the occurrence of house dust mites indicated a less favorable indoor climate compared to multi-family houses. Respiratory symptoms attributed to specific environmental exposures increased in both healthy and unhealthy persons when they reported occurrence of indoor climate risk indicators. No statistically significant associations were found between separate risk indicators, identified by a ‘Housing Environmental-index’, or the frequency of indicators and clinical tests. The lack of significant associations may show that the chosen cut-off levels in the index were too high in reference to persons with asthma and further research is needed to establish relevant cut-off levels.

In some of the investigated houses there was a need for secondary preventive interventions to improve the indoor climate in order to decrease the exposure of allergens and airway irritants. In this dissertation one aspect of the complex relationship between the person and the environment, i.e. accessibility, has been studied. Further research is needed to address the aspect of usability, i.e. the person’s own evaluation of the degree to which they can be in and use the environment.

Place, publisher, year, edition, pages
Örebro: Örebro universitetsbibliotek, 2007. p. 63
Series
Örebro Studies in Care Sciences, ISSN 1652-1153 ; 15
Keyword
Accessibility, adaptation, asthma, housing environment, risk indicators, index, occupational therapy, prevention, respiratory symptoms.
National Category
Nursing
Research subject
Nursing Science; Nursing Science w. Occupational Therapy Focus
Identifiers
urn:nbn:se:oru:diva-1195 (URN)978-91-7668-540-2 (ISBN)
Public defence
2007-05-25, Wilandersalen, M-huset, Universitetssjukhuset, Örebro, 13:00 (English)
Opponent
Supervisors
Available from: 2007-05-03 Created: 2007-05-02 Last updated: 2017-10-18Bibliographically approved

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Frisk, Margot L. A.Ivarsson, Ann-BrittKamwendo, Kitty

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