The Burden of Respiratory Disease from Formaldehyde, Damp and Mould in English Housing
Abstract
:1. Introduction
1.1. Formaldehyde
1.2. Damp and Mould
1.3. Study Aim
2. Materials & Methods
2.1. Overview of Estimation Approach
2.2. Study Population
2.3. Exposures
2.3.1. Formaldehyde
2.3.2. Damp and Mould
- Rising damp: where the surveyor has noted the presence of rising damp in at least one of the rooms surveyed during the physical survey. Rising damp occurs when water from the ground rises up into the walls or floors because damp-proof courses in walls or damp-proof membranes in floors are either not present or faulty.
- Penetrating damp: where the surveyor has noted the presence of penetrating damp in at least one of the rooms surveyed during the physical survey. Penetrating damp is caused by leaks from faulty components of the external fabric, e.g., roof covering, gutters etc. or leaks from internal plumbing, e.g., water pipes, radiators etc.
- Condensation or mould: caused by water vapour generated by activities like cooking and bathing condensing on cold surfaces like windows and walls. Virtually all dwellings have some level of condensation. Only serious levels of condensation or mould are considered in the EHS, namely where there are extensive patches of mould growth on walls and ceilings and/or mildew on soft furnishings.
2.4. Epidemiological Relationships
- Study design: Meta-analysis; large/pooled prospective cohort studies
- Age group: Any
- Geography: Any
- Exposure assessment:
- ∘
- Formaldehyde: Residential formaldehyde (airborne), although we did consider meta-analyses that pooled studies from residential and school settings for children
- ∘
- Damp and mould: Residential damp and/or mould assessed via a survey (inspector/surveyor or occupant self-report)
- Effect estimate: Statistically significant and adjusted for confounders
2.5. Health Data
2.6. Attributable Burden of Disease Calculations and Analyses
3. Results
3.1. Formaldehyde Burden of Disease
3.2. Damp and Mould Burden of Disease
4. Discussion
4.1. Formaldehyde
4.2. Damp and Mould
4.3. Inequalities and Trends over Time
4.4. Interpretation and Comparison of Environmental Burden of Disease Estimates
4.5. Uncertainties and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Exposure | Health Outcome | Source | Type of Study | Number of Studies/ Cohorts | ERF (e.g., RR, OR) [95% CI] | ERF Lower | ERF Upper | Ages (yrs) |
---|---|---|---|---|---|---|---|---|
Main (primary) estimates | ||||||||
Formaldehyde (μg/m3) | Asthma | Liu et al., 2023 [42] | Meta-analysis | 22 | 1.20 [1.11–1.31] per 10 μg/m3 Meta-analysis by Lam et al., 2021 [20] (n = 9 studies) produced the same central effect estimate | 50 μg/m3 * (primary) 20 μg/m3 (sensitivity); 60 μg/m3 (sensitivity) | 100 μg/m3 ** | 0–14 |
Damp and/or mould (% of dwellings) | Asthma | Quansah et al., 2012 [73] | Meta-analysis | 16 | 1.50 [1.25–1.80] | - | - | 0–14 |
Damp and/or mould (% of dwellings) | Asthma | Wang et al., 2019 [96] | Longitudinal cohort study | Large cohort pooling data across 5 Scandinavian countries | 1.43 [1.12–1.83] | - | - | 15–49 |
Damp and/or mould (% of dwellings) | LRI *** | Fisk et al., 2010 [70] | Meta-analysis | 15 | 1.50 [1.32–1.70] Respiratory infections excluding common cold and nonspecific upper respiratory infections *** | - | - | 0–14 15–49 |
Secondary estimates | ||||||||
Damp and/or mould (% of dwellings) | Allergic Rhinitis | Jaakkola et al., 2013 [72] **** | Meta-analysis | 19 ***** | 1.43 [1.34–1.53] | - | - | 0–14 |
Damp and/or mould (% of dwellings) | Allergic Rhinitis | Wang et al., 2019 [96] | Longitudinal cohort study | Large cohort pooling data across 5 Scandinavian countries | 1.28 [1.08–1.52] | - | - | 15-49 |
Damp and/or mould (% of dwellings) | Bronchitis | Fisk et al., 2010 [70] | Meta-analysis | 13 | 1.45 [1.32–1.59] Acute or chronic bronchitis | - | - | 0–14 15–49 |
Health Outcome | Age Group (Yrs) | Exposure Distribution | PAF [95% CI] | Disease Incidence [95% CI] | Disease Incidence per 100,000 People [95% CI] | DALYs Lost [95% CI] | DALYs Lost per 100,000 People [95% CI] |
---|---|---|---|---|---|---|---|
Formaldehyde | μg/m3 | ||||||
Asthma * | 0–14 | GM: 22.8 GSD: 2.0 ** | 0.025 [0.013–0.039] | 4038 [1423–9184] | 40 [14–91] | 777 [246–2021] | 8 [2–20] |
Damp and/or mould | % of dwellings (EHS) | ||||||
Asthma | 0–14 | 4.2% | 0.021 [0.010–0.033] | 3389 [1120–7654] | 34 [11–76] | 652 [193–1684] | 6 [2–17] |
LRI | 0–14 | 4.2% | 0.021 [0.013–0.029] | 3902 [1998–6624] | 39 [20–66] | 193 [104–314] | 2 [1–3] |
Asthma | 15–49 | 3.4% | 0.014 [0.004–0.027] | 1632 [330–4086] | 6 [1–16] | 1520 [274–4299] | 6 [1–17] |
LRI | 15–49 | 3.4% | 0.017 [0.011–0.023] | 4554 [2588–7239] | 18 [10–28] | 397 [247–571] | 2 [1–2] |
Health Outcome | Source of Exposure Information | % of Dwellings with Damp and/or Mould * | PAF | Disease Incidence (per 100,000 People) | DALY Rate (per 100,000 People) |
---|---|---|---|---|---|
Children (0–14) | |||||
Asthma | Healthy Homes Barometer Report [94]—Western Europe | 14% | 0.065 | 106 | 20 |
LRI | Healthy Homes Barometer Report [94]—Western Europe | 14% | 0.065 | 122 | 6 |
Asthma | Energy Follow Up Survey [66]—England | 39% | 0.163 | 265 | 51 |
LRI | Energy Follow Up Survey [66]—England | 39% | 0.163 | 305 | 15 |
Adults (15–49) | |||||
Asthma | Healthy Homes Barometer Report [94]—Western Europe | 14% | 0.057 | 25 | 24 |
LRI | Healthy Homes Barometer Report [94]—Western Europe | 14% | 0.065 | 70 | 6 |
Asthma | Energy Follow Up Survey [66]—England | 27% | 0.104 | 46 | 43 |
LRI | Energy Follow Up Survey [66]—England | 27% | 0.119 | 127 | 11 |
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Clark, S.N.; Lam, H.C.Y.; Goode, E.-J.; Marczylo, E.L.; Exley, K.S.; Dimitroulopoulou, S. The Burden of Respiratory Disease from Formaldehyde, Damp and Mould in English Housing. Environments 2023, 10, 136. https://doi.org/10.3390/environments10080136
Clark SN, Lam HCY, Goode E-J, Marczylo EL, Exley KS, Dimitroulopoulou S. The Burden of Respiratory Disease from Formaldehyde, Damp and Mould in English Housing. Environments. 2023; 10(8):136. https://doi.org/10.3390/environments10080136
Chicago/Turabian StyleClark, Sierra N., Holly C. Y. Lam, Emma-Jane Goode, Emma L. Marczylo, Karen S. Exley, and Sani Dimitroulopoulou. 2023. "The Burden of Respiratory Disease from Formaldehyde, Damp and Mould in English Housing" Environments 10, no. 8: 136. https://doi.org/10.3390/environments10080136