Indoor Air Quality Section, Environmental Health Laboratory Branch, California Department of Public Health, Richmond, California 94804, USA.
Environ Health Perspect. 2011 Jun;119(6):748-56. doi: 10.1289/ehp.1002410. Epub 2011 Jan 26.
Many studies have shown consistent associations between evident indoor dampness or mold and respiratory or allergic health effects, but causal links remain unclear. Findings on measured microbiologic factors have received little review. We conducted an updated, comprehensive review on these topics.
We reviewed eligible peer-reviewed epidemiologic studies or quantitative meta-analyses, up to late 2009, on dampness, mold, or other microbiologic agents and respiratory or allergic effects.
We evaluated evidence for causation or association between qualitative/subjective assessments of dampness or mold (considered together) and specific health outcomes. We separately considered evidence for associations between specific quantitative measurements of microbiologic factors and each health outcome.
Evidence from epidemiologic studies and meta-analyses showed indoor dampness or mold to be associated consistently with increased asthma development and exacerbation, current and ever diagnosis of asthma, dyspnea, wheeze, cough, respiratory infections, bronchitis, allergic rhinitis, eczema, and upper respiratory tract symptoms. Associations were found in allergic and nonallergic individuals. Evidence strongly suggested causation of asthma exacerbation in children. Suggestive evidence was available for only a few specific measured microbiologic factors and was in part equivocal, suggesting both adverse and protective associations with health.
Evident dampness or mold had consistent positive associations with multiple allergic and respiratory effects. Measured microbiologic agents in dust had limited suggestive associations, including both positive and negative associations for some agents. Thus, prevention and remediation of indoor dampness and mold are likely to reduce health risks, but current evidence does not support measuring specific indoor microbiologic factors to guide health-protective actions.
许多研究表明，明显的室内潮湿或霉菌与呼吸道或过敏健康影响之间存在一致的关联，但因果关系仍不清楚。对测量微生物因素的研究结果很少受到审查。我们对这些主题进行了一次更新的、全面的综述。
我们回顾了截止到 2009 年底的关于潮湿、霉菌或其他微生物制剂与呼吸道或过敏影响相关的合格同行评审的流行病学研究或定量荟萃分析。
我们评估了潮湿或霉菌（综合考虑）的定性/主观评估与特定健康结果之间的因果关系或关联的证据。我们分别考虑了特定微生物因素的定量测量与每个健康结果之间的关联的证据。
来自流行病学研究和荟萃分析的证据表明，室内潮湿或霉菌与哮喘的发展和恶化、当前和曾经诊断出的哮喘、呼吸困难、喘息、咳嗽、呼吸道感染、支气管炎、过敏性鼻炎、湿疹和上呼吸道症状的增加一致相关。在过敏和非过敏个体中都发现了这些关联。有证据强烈表明儿童哮喘恶化的原因。只有少数特定的测量微生物因素有提示性证据，而且部分证据存在争议，表明与健康有关的不利和保护关联。
明显的潮湿或霉菌与多种过敏和呼吸道影响有一致的积极关联。灰尘中测量的微生物制剂与健康只有有限的提示性关联，包括一些制剂的阳性和阴性关联。因此，预防和纠正室内潮湿和霉菌可能会降低健康风险，但目前的证据并不支持测量特定的室内微生物因素来指导健康保护措施。
