Gary Adamkiewicz and John D. Spengler are with the Department of Environmental Health and Glorian Sorensen is with the Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA. Amy E. Harley is with the Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee. Anne Stoddard and May Yang are with the New England Research Institutes, Watertown, MA. Marty Alvarez-Reeves is with the Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA.
Am J Public Health. 2014 Sep;104(9):1650-6. doi: 10.2105/AJPH.2013.301253. Epub 2013 Sep 12.
We explored prevalence and clustering of key environmental conditions in low-income housing and associations with self-reported health.
The Health in Common Study, conducted between 2005 and 2009, recruited participants (n = 828) from 20 low-income housing developments in the Boston area. We interviewed 1 participant per household and conducted a brief inspection of the unit (apartment). We created binary indexes and a summed index for household exposures: mold, combustion by-products, secondhand smoke, chemicals, pests, and inadequate ventilation. We used multivariable logistic regression to examine the associations between each index and household characteristics and between each index and self-reported health.
Environmental problems were common; more than half of homes had 3 or more exposure-related problems (median summed index = 3). After adjustment for household-level demographics, we found clustering of problems in site (P < .01) for pests, combustion byproducts, mold, and ventilation. Higher summed index values were associated with higher adjusted odds of reporting fair-poor health (odds ratio = 2.7 for highest category; P < .008 for trend).
We found evidence that indoor environmental conditions in multifamily housing cluster by site and that cumulative exposures may be associated with poor health.
我们探讨了低收入住房中关键环境条件的流行程度和聚集情况，以及它们与自我报告健康状况的关联。
健康共享研究于 2005 年至 2009 年期间在波士顿地区的 20 个低收入住房开发项目中招募了参与者（n=828）。我们对每个家庭中的 1 名参与者进行了访谈，并对其居住单元（公寓）进行了简要检查。我们创建了家庭暴露的二进制索引和总和指数：霉菌、燃烧副产物、二手烟、化学物质、害虫和通风不足。我们使用多变量逻辑回归来检验每个指数与家庭特征之间以及每个指数与自我报告健康状况之间的关联。
环境问题很常见；超过一半的家庭有 3 种或更多与暴露相关的问题（中位数总和指数=3）。在调整家庭层面的人口统计学因素后，我们发现虫害、燃烧副产物、霉菌和通风问题在现场存在聚集（P<.01）。更高的总和指数值与更高的报告健康状况不佳的调整比值比相关（最高类别为 2.7；趋势 P<.008）。
我们发现证据表明，多户住房中的室内环境条件会因地点而聚集，累积暴露可能与健康状况不佳有关。
