Impact of moisture / mould exposure on asthma control in children: the CHAMPIASTHMA study

Abstract

Introduction: Deleterious environmental exposures are known risk factors for poor asthma control, with unclear contribution of mould.

Objectives: To assess the impact of moisture/mould exposure on asthma control in children.

Methods: Multicenter, cross-sectional, observational study. Home environment questionnaires were administered to parents of asthmatic children aged 1-17y. Moisture/mould exposure (E+) was retained in case of positive answer to any of 4 previously described indicators (Jaakkola J, et al. Environ Health Perspect 2005). Asthma control was scored according to GINA and Childhood Asthma Control Test (ACT or pACT). Results are expressed as median [IQR] or number (%).

Results: 424 patients [112(27%) 1-5y, 182(43%) 6-11y, 126(30%) 12-17y] were included. 146(34%) were E+. There was no significant difference in demographics apart from a lower parental educational level in the E+ children (p=0.024). Among E+ children, more patients were uncontrolled according to GINA (64(45%) vs 90(33%), p=0,021), ACT scores were lower (22[19-25] vs 24[21-25], p=0.015), with a stronger impact on adolescents (12-17y) in age-subgroup analyses. A higher use of oral corticosteroids [53(37%) vs 74(27%), p=0,046] and more frequent unscheduled visits in the past year [65(45%) vs 86(32%), p=0,007] were observed. Parents’ estimated impact of indoor environment on health was more frequently reported (36(25%) vs 13(5%), p<0,001). There was no significant association between exposure and mean daily ICS dose (p=0.11), and hospitalisation in the past year (p=0.13).

Conclusion: The CHAMPIASTHMA study highlights the negative association between home exposure to moisture/mould and asthma control in children.