Indoor Environmental Exposures and Exacerbation of Asthma
Indoor Environmental Exposures and Exacerbation of Asthma
In this review we have revised prior evidence-based conclusions about relationships between specific indoor exposures and exacerbation of asthma. Exposures to indoor dampness and dampness-related agents have a causal relationship with exacerbation of asthma (in children). Exposures to dampness-related agents (in adults), ETS (in preschool-age children), and endotoxin are associated with exacerbation of asthma. Exposures to indoor culturable Penicillium and total fungi, rodents (nonoccupational exposure), and NO2 have limited or suggestive evidence for an association with exacerbation of asthma, and limited data suggest that exposures to feather/down pillows may have a protective association relative to synthetic bedding. Exposures to dust mite, cockroach, dog, fungi, and dampness-related agents also have limited or suggestive evidence for an association with exacerbation of asthma even in nonsensitized individuals, suggesting proinflammatory effects. Prospective or intervention studies are needed to confirm hypothesized associations, and rigorous real-world environmental intervention trials are needed to demonstrate effective remediation and resulting reductions in exacerbation of asthma.
Conclusions
In this review we have revised prior evidence-based conclusions about relationships between specific indoor exposures and exacerbation of asthma. Exposures to indoor dampness and dampness-related agents have a causal relationship with exacerbation of asthma (in children). Exposures to dampness-related agents (in adults), ETS (in preschool-age children), and endotoxin are associated with exacerbation of asthma. Exposures to indoor culturable Penicillium and total fungi, rodents (nonoccupational exposure), and NO2 have limited or suggestive evidence for an association with exacerbation of asthma, and limited data suggest that exposures to feather/down pillows may have a protective association relative to synthetic bedding. Exposures to dust mite, cockroach, dog, fungi, and dampness-related agents also have limited or suggestive evidence for an association with exacerbation of asthma even in nonsensitized individuals, suggesting proinflammatory effects. Prospective or intervention studies are needed to confirm hypothesized associations, and rigorous real-world environmental intervention trials are needed to demonstrate effective remediation and resulting reductions in exacerbation of asthma.
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