Background: The indoor home environment has been shown to be associated with the presence of respiratory symptoms and atopic disease. Methods: Two cross-sectional surveys (1995–2000) were conducted, using data from the ISAAC phase I and III surveys, collected in Münster, Germany (n = 6,996, response 81.8%). We analyzed the prevalence ratio (PR) for several indoor exposures and asthma-related outcomes in 6- to 7-year-old children, adjusting for potential confounders. Results: Positive associations were observed regarding exposure to molds, environmental tobacco smoke, cooking with gas and space heating with fossil fuels, but most associations were not statistically significant. Surprisingly, presence of a carpet was negatively associated with most respiratory conditions. When restricting the analysis to participants without avoidance of a carpet due to a history of atopic disease, the protective associations disappeared. Mostly, present pet ownership did not show positive associations with respiratory symptoms. However, ownership at different times in life revealed positive associations, particularly in regard to birds owned in the first year of life (PR 1.51, 95% CI 1.11–2.06, for sleep disturbance due to wheeze and PR 1.28, 95% CI 1.01–1.63, for wheeze during the last 12 months, respectively). Conclusions: Only few indoor factors were positively associated with the studied outcomes. The change of associations in participants that reported allergy-related avoidance of carpets suggests that the observed effects are a result of asthmatics’ changed behavior. The effect of allergy-related change in behavior and the results observed concerning the ownership of pets at different ages underline the need of establishing a precise temporal relationship between disease and exposure.

1.
Maziak W: Asthma and the exposure-disease tenet. J Clin Epidemiol 2002;55:737–740.
2.
Jones AP: Asthma and the home environment. J Asthma 2000;37:103–124.
3.
Bardana EJ Jr: Indoor pollution and its impact on respiratory health. Ann Allergy Asthma Immunol 2001;87(suppl 3):33–40.
4.
Wright AL: The epidemiology of the atopic child: Who is at risk for what? J Allergy Clin Immunol 2004;113(suppl):S2–S7.
5.
Strachan DP, Carey IM: Home environment and severe asthma in adolescence: A population based case-control study. BMJ 1995;311:1053–1056.
6.
McConnell R, Berhane K, Gilliland F, Islam T, Gauderman WJ, London SJ, Avol E, Rappaport EB, Margolis HG, Peters JM: Indoor risk factors for asthma in a prospective study of adolescents. Epidemiology 2002;13:288–295.
7.
Lau S, Illi S, Sommerfeld C, Niggemann B, Bergmann R, von Mutius E, Wahn U: Early exposure to house-dust mite and cat allergens and development of childhood asthma: A cohort study. Multicentre Allergy Study Group. Lancet 2000;356:1392–1397.
8.
Apelberg BJ, Aoki Y, Jaakkola JJ: Systematic review: Exposure to pets and risk of asthma and asthma-like symptoms. J Allergy Clin Immunol 2001;107:455–460.
9.
Roost HP, Kunzli N, Schindler C, Jarvis D, Chinn S, Perruchoud AP, Ackermann-Liebrich U, Burney P, Wuthrich B: Role of current and childhood exposure to cat and atopic sensitization. European Community Respiratory Health Survey. J Allergy Clin Immunol 1999;104:941–947.
10.
Hesselmar B, Aberg N, Aberg B, Eriksson B, Bjorksten B: Does early exposure to cat or dog protect against later allergy development? Clin Exp Allergy 1999;29:611–617.
11.
de Meer G, Toelle BG, Ng K, Tovey E, Marks GB: Presence and timing of cat ownership by age 18 and the effect on atopy and asthma at age 28. J Allergy Clin Immunol 2004;113:433–438.
12.
Maziak W, Behrens T, Brasky TM, Duhme H, Rzehak P, Weiland SK, Keil U: Are asthma and allergies in children and adolescents increasing? Results from ISAAC phase I and phase III surveys in Munster, Germany. Allergy 2003;58:572–579.
13.
The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee: Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. Lancet 1998;351:1225–1232.
14.
Zocchetti C, Consonni D, Bertazzi PA: Relationship between prevalence rate ratios and odds ratios in cross-sectional studies. Int J Epidemiol 1997;26:220–223.
15.
Behrens T, Taeger D, Wellmann J, Keil U: Different methods to calculate effect estimates in cross-sectional studies. A comparison between prevalence odds ratio and prevalence ratio. Methods Inf Med 2004;43:505–509.
16.
Butland BK, Strachan DP, Anderson HR: The home environment and asthma symptoms in childhood: Two population based case-control studies 13 years apart. Thorax 1997;52:618–624.
17.
Garrett MH, Hooper MA, Hooper BM, Abramson MJ: Respiratory symptoms in children and indoor exposure to nitrogen dioxide and gas stoves. Am J Respir Crit Care Med 1998;158:891–895.
18.
Jarvis D, Chinn S, Luczynska C, Burney P: Association of respiratory symptoms and lung function in young adults with use of domestic gas appliances. Lancet 1996;347:426–431.
19.
Ponsonby AL, Couper D, Dwyer T, Carmichael A, Kemp A, Cochrane J: The relation between infant indoor environment and subsequent asthma. Epidemiology 2000;11:128– 135.
20.
Zacharasiewicz A, Zidek T, Haidinger G, Waldhor T, Suess G, Vutuc C: Indoor factors and their association to respiratory symptoms suggestive of asthma in Austrian children aged 6–9 years. Wien Klin Wochenschr 1999;111:882–886.
21.
von Mutius E, Illi S, Nicolai T, Martinez FD: Relation of indoor heating with asthma, allergic sensitisation, and bronchial responsiveness: Survey of children in south Bavaria. BMJ 1996;312:1448–1450.
22.
Chapman RS, Hadden WC, Perlin SA: Influences of asthma and household environment on lung function in children and adolescents: The third national health and nutrition examination survey. Am J Epidemiol 2003;158:175–189.
23.
von Mutius E: The environmental predictors of allergic disease. J Allergy Clin Immunol 2000;105:9–19.
24.
Maziak W: Asthma and farming. Lancet 2002;359:623–624.
25.
Cook DG, Strachan DP: Summary of effects of parental smoking on the respiratory health of children and implications for research. Thorax 1999;54:357–365.
26.
Peat JK, Dickerson J, Li J: Effects of damp and mould in the home on respiratory health: A review of the literature. Allergy 1998;53:120–128.
27.
Maziak W, von Mutius E, Keil U, Hirsch T, Leupold W, Rzehak P, Behrens T, Weiland SK: Predictors of health care utilization of children with asthma in the community. Pediatr Allergy Immunol 2004;15:166–171.
28.
Kolstad HA, Brauer C, Iversen M, Sigsgaard T, Mikkelsen S: Do indoor molds in nonindustrial environments threaten workers’ health? A review of the epidemiologic evidence. Epidemiol Rev 2002;24:203–217.
29.
Belanger K, Beckett W, Triche E, Bracken MB, Holford T, Ren P, McSharry JE, Gold DR, Platts-Mills TA, Leaderer BP: Symptoms of wheeze and persistent cough in the first year of life: Associations with indoor allergens, air contaminants, and maternal history of asthma. Am J Epidemiol 2003;158:195–202.
30.
Li CS, Wan GH, Hsieh KH, Chua KY, Lin RH: Seasonal variation of house dust mite allergen (Der pI) in a subtropical climate. J Allergy Clin Immunol 1994;94:131–134.
31.
Behrens T, Maziak W, Weiland SK, Siebert E, Rzehak P, Keil U: The use of synthetic bedding in children. Do strategies of change influence associations with asthma? J Asthma, in press.
32.
Oryszczyn MP, Annesi-Maesano I, Charpin D, Kauffmann F: Allergy markers in adults in relation to the timing of pet exposure: The EGEA study. Allergy 2003;58:1136–1143.
33.
Platts-Mills T, Vaughan J, Squillace S, Woodfolk J, Sporik R: Sensitisation, asthma, and a modified Th2 response in children exposed to cat allergen: A population-based cross-sectional study. Lancet 2001;357:752–756.
34.
Corbo GM, Forastiere F, Agabiti N, Dell’Orco V, Pistelli R, Aebischer ML, Valente S, Perucci CA: Effect of gas cooking on lung function in adolescents: Modifying role of sex and immunoglobulin E. Thorax 2001;56:536–540.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.