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Inspection confirmed mold damage in schools and new use of drugs for airway obstruction: A cohort study
Juha Pekkanen1,2, Martin Täubel2,3, Lauri Lehtimäki4,5
1Department of Public Health, University of Helsinki, Helsinki, Finland.
Objective:
To test if extent and severity of mold damage in school buildings increases the risk of new use of drugs for airway obstruction among students with a dose-response.
Methods:
Extent of mold damage in 110 Finnish primary and secondary school buildings in 2004 was estimated based on all technical inspections done by 2021. New asthma (n = 1,035) and use of drugs for obstructive airway diseases (n = 3,162) among 30,418 students by 2019 was defined based on drug purchases. Multilevel Cox models were adjusted for confounders obtained from Medical Birth Register.
Results:
Extensive mold damage was common. Nine buildings had no or small mold damage, 19 buildings limited, 44 wide and 38 very wide damage in 2004. No association with onset of asthma was observed neither in all students nor in students with previous obstructive airway problems. Among primary school students, there was some suggestion for an association with new use of drugs for obstructive airway diseases, but with highest risk in buildings with limited damage.
Conclusions:
The results from this unique and large follow-up study suggest that assessment of the extent and severity of mold damage inside building structures in Finnish schools do not identify buildings, in which students are at increased risk of developing asthma.
Insights
Mold damage in Finnish schools did not increase asthma risk in students. Some limited evidence suggested a link to obstructive airway disease drug use in primary students, but not asthma development.
Area of Science:
- Environmental Health
- Pediatric Respiratory Health
- Building Science
Background:
- Indoor mold exposure in schools is a public health concern.
- Previous studies suggest links between mold and respiratory issues, but evidence on dose-response relationships and specific outcomes like asthma onset is inconsistent.
- Understanding environmental factors in schools is crucial for student health.
Purpose of the Study:
- To investigate the association between the extent and severity of mold damage in Finnish school buildings and the risk of new-onset asthma and new use of drugs for obstructive airway diseases among students.
- To determine if a dose-response relationship exists between mold damage levels and these health outcomes.
Main Methods:
- A cohort of 30,418 Finnish students from 110 schools was followed.
- Mold damage in school buildings was assessed based on technical inspections up to 2021.
- New asthma cases (1,035) and drug use for obstructive airway diseases (3,162) were identified through drug purchases by 2019.
- Multilevel Cox models were used, adjusting for confounders from the Medical Birth Register.
Main Results:
- Extensive mold damage was prevalent, with varying degrees across the 110 schools.
- No significant association was found between mold damage and new-onset asthma in the general student population or those with pre-existing airway problems.
- A potential association was observed among primary school students for new drug use for obstructive airway diseases, with the highest risk noted in buildings with limited mold damage.
Conclusions:
- The study's findings suggest that assessing the extent and severity of mold damage within school building structures does not reliably identify buildings posing an increased risk for students developing asthma.
- Further research may be needed to explore potential links between specific types of mold, other indoor environmental factors, and respiratory health outcomes in school settings.
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