title: Low home ventilation rate in combination with moldy odor from the building structure increase the risk for allergic symptoms in children.
abstract: There are consistent findings on associations between asthma and allergy symptoms and residential mold and moisture. However, definitions of 'dampness' in studies are diverse because of differences in climate and building construction. Few studies have estimated mold problems inside the building structure by odor assessments. In a nested case-control study of 400 Swedish children, observations and measurements were performed in their homes by inspectors, and the children were examined by physicians for diagnoses of asthma, eczema, and rhinitis. In conclusion, we found an association between moldy odor along the skirting board and allergic symptoms among children, mainly rhinitis. No associations with any of the allergic symptoms were found for discoloured stains, 'floor dampness' or a general mold odor in the room. A moldy odor along the skirting board can be a proxy for hidden moisture problem inside the outer wall construction or in the foundation construction. There are indications that such dampness problems increase the risk for sensitization but the interpretation of data in respect of sensitization is difficult as about 80% of the children with rhinitis were sensitized. Furthermore, low ventilation rate in combination with moldy odor along the skirting board further increased the risk for three out of four studied outcomes, indicating that the ventilation rate is an effect modifier for indoor pollutants.
  
  
  CONCLUSIONS
  This study showed that mold odor at the skirting board level is strongly associated with allergic symptoms among children. Such odor at that specific place can be seen as a proxy for some kind of hidden moisture or mold problem in the building structure, such as the foundation or wooden ground beam. In houses with odor along the skirting board, dismantling of the structure is required for an investigation of possible moisture damage, measurements, and choice of actions. In homes with low ventilation in combination with mold odor along the skirting board, there was even a higher risk of health effects. This emphasizes the need for the appropriate remediation as this is an ever increasing problem in poorly ventilated houses that are damp.
authors.affiliation: Department of Building Physics and Indoor Environment, SP Technical Research Institute of Sweden, Borås, Sweden. linda.hagerhed-engman@sp.se
authors.forename: L
authors.initials: L
authors.lastname: Hägerhed-Engman
authors.forename: T
authors.initials: T
authors.lastname: Sigsgaard
authors.forename: I
authors.initials: I
authors.lastname: Samuelson
authors.forename: J
authors.initials: J
authors.lastname: Sundell
authors.forename: S
authors.initials: S
authors.lastname: Janson
authors.forename: C-G
authors.initials: CG
authors.lastname: Bornehag
mesh_terms: D016902:Air Pollution, Indoor / Q000009:adverse effects*; D001249:Asthma / Q000209:etiology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005658:Fungi; D006798:Housing; D006801:Humans; D006813:Humidity; D006967:Hypersensitivity / Q000209:etiology*; D008297:Male; D009812:Odorants; D012307:Risk Factors; D013548:Sweden; D014691:Ventilation