Prediction of wheezing at ages 3 and 7 and asthma at age 7 using quantified observational exposure data collected at age 1

摘要

Although the association of observed dampness and mold with asthma is well established, most epidemiologic studies have used dichotomous metrics of observed mold that cannot assess exposure-response relationships. This study investigated specific exposure-response relationships within an ongoing birth cohort, the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS) (n=762). The primary exposure variable was the maximum damaged surface in a home from water damage or mold. Potential confounding variables were identified with directed acyclic graphs. Logistic regression models were used to estimate odds ratios (ORs) between year 1 exposure and year-3 wheeze, year-7 asthma, and three wheeze outcomes at year-7: early transient (ETW), late onset (LOW), and persistent (PW) wheeze. Analyses were adjusted for income, race, presence of cockroach antigen, and reported presence of mice or rats. Potential interactions of exposure variables with water damage history and moldy odor were assessed. The upper quartile of individuals with any damage from water or mold had increased odds for year-7 asthma (OR=1.9, p<0.1), year-3 wheeze (OR=2.0, p=0.05) and year-7 PW (OR=3.3, p<0.01). Several significant interactions (p<0.05) were identified. The upper quartile of individuals with any damage from water or mold, when water damage history was absent, had increased odds for year-3 wheeze and year-7 ETW, and when moldy smell was absent, had increased odds for year-7 PW. Our data suggested that moldy odor and water damage history may be more important when there is little to no visible mold or water damage than in cases of higher levels of observed dampness or mold.