Background

Multiple reviews have been conducted on the associations between residential mold and dampness and respiratory outcomes in children, with few specifically investigating respiratory tract infections (RTIs).

Objective

We aimed to review and synthesize the available epidemiological literature on mold and dampness and risk of RTIs and respiratory symptoms compatible with RTIs in children living in high-income countries.

Method

We performed a systematic search of literature available from MEDLINE, Embase, and Web of Science for observational studies. We conducted meta-analyses using two-level random effects (RE) and multi-level random effects (ML) models for contrasts of three exposure and three outcome categories, including multiple estimates reported by single studies. We report central estimates for pooled odds ratios (OR) and 95 % confidence intervals (CI).We conducted a risk of bias assessment using the Joanna Briggs Initiative (JBI) checklists for cross-sectional, case-control, and cohort studies. We additionally report on cumulative meta-analyses, leave-one-out analyses of single estimates, subgroup analyses by study quality and study design and inclusion of all effect estimates.

Results

Of the 932 studies initially screened by title and abstract, we included 30 studies with 267 effect estimates that met the inclusion criteria. Most were cross-sectional (n = 22), with fewer cohort (n = 5) and case-control (n = 3) studies. Most of the studies were according to the bias assessment of poor or fair quality (n = 24). The main meta-analyses generally provided similar results regardless of statistical model and central estimates ranged from OR 1.28 (95 % CI; 1.08, 1.53) for dampness and RTIs to OR 1.76 (95 % CI; 1.64, 1.88) for mold and respiratory symptoms. Most analyses were of moderate heterogeneity. Funnel plots did not indicate strong publication bias.

Conclusion

Our results are compatible with a weak to moderate effect of residential mold and or dampness on risk of RTIs in children in high-income countries. However, these results are based primarily on cross-sectional studies.

中文翻译：

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高收入国家儿童接触住宅霉菌和潮湿以及与呼吸道感染及其症状的关联：流行病学研究的系统回顾和荟萃分析

背景

针对居住霉菌和潮湿与儿童呼吸道疾病之间的关系，已经进行了多项综述，但很少有专门调查呼吸道感染 (RTI) 的研究。

客观的

我们的目的是回顾和综合现有的流行病学文献，涉及生活在高收入国家的儿童中的霉菌和潮湿以及 RTI 风险以及与 RTI 相关的呼吸道症状。

方法

我们系统地检索了 MEDLINE、Embase 和 Web of Science 的观察性研究文献。我们使用二级随机效应（RE）和多级随机效应（ML）模型进行荟萃分析，以对比三种暴露和三种结果类别，包括单个研究报告的多个估计值。我们报告了汇总比值比 (OR) 和 95% 置信区间 (CI) 的中心估计值。我们使用 Joanna Briggs Initiative (JBI) 检查表进行横断面、病例对照和队列研究的偏倚风险评估。我们还报告了累积荟萃分析、单一估计的留一分析、按研究质量和研究设计进行的亚组分析以及所有效果估计的纳入。

结果

在最初按标题和摘要筛选的 932 项研究中，我们纳入了 30 项研究，其中 267 项效果估计符合纳入标准。大多数是横断面研究 (n = 22)，队列研究 (n = 5) 和病例对照研究 (n = 3) 较少。大多数研究都是根据质量较差或一般的偏倚评估进行的（n = 24）。无论统计模型如何，主要的荟萃分析通常都提供相似的结果，并且中心估计范围从潮湿和 RTI 的 OR 1.28 (95 % CI; 1.08, 1.53) 到霉菌和呼吸道症状的 OR 1.76 (95 % CI; 1.64, 1.88) 。大多数分析具有中等异质性。漏斗图并未表明存在强烈的发表偏倚。

结论

我们的结果与住宅霉菌和/或潮湿对高收入国家儿童呼吸道感染风险的弱至中度影响相一致。然而，这些结果主要基于横断面研究。