International Journal of Epidemiology, Vol 26, 120-125, Copyright © 1997 by International Epidemiological Association
RE Dales, D Miller and E McMullen
BACKGROUND: Questionnaire-based surveys from several countries have
consistently detected adverse health associated with home dampness and
mould growth. METHODS: To test the validity of questions commonly used to
indicate the presence of indoor mould, questionnaires were administered in
403 homes where dust samples were taken for viable fungi and air samples
for ergosterol. RESULTS: Geometric mean concentrations of the total viable
fungi were 255 (SE 116) x 10(3) CFU/g when mouldy odours were reported and
155 (SE 55) when odours were not reported (P = 0.01). Similarly, reported
water damage was associated with a 50% increase (P = 0.06). Geometric mean
concentrations of the predominantly indoor-source fungi, Aspergillus plus
Penicillium, were twice as high when mould or mildew was reported than when
not mentioned (P = 0.01). The presence of reported mould or water damage
was unrelated to the presence of detectable levels of ergosterol. There was
evidence for reporting bias: in the presence of low concentrations of
viable fungi in dust, respondents reporting allergies were more likely to
report visible mould growth (odds ratio [OR] = 1.8, 95% confidence interval
[CI]: 0.9-3.5, P = 0.10. In the presence of elevated concentrations of dust
fungi, respondents who smoked were less likely to report visible mould
growth, (OR = 0.4, 95% CI: 0.2-0.7, P = 0.005). CONCLUSIONS: Reported
mould, water damage, and mouldy odours were associated with elevated levels
of indoor fungi. However, inaccuracy was high and there was evidence of a
systematic reporting bias. Future research should concentrate on developing
accurate objective measures of exposure to fungi, and then use this
information to develop valid questionnaires. Currently, objective measures
not questionnaires, are recommended to clarify the health effects of indoor
fungi.
ARTICLES
Indoor air quality and health: validity and determinants of reported home dampness and moulds
Environmental Health Centre, Ottawa, Canada.
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