The impact of indoor pollution on asthma‐related outcomes: A systematic review for the EAACI guidelines on environmental science for allergic diseases and asthma

Author:

Agache Ioana1ORCID,Canelo‐Aybar Carlos23,Annesi‐Maesano Isabella4ORCID,Cecchi Lorenzo5ORCID,Biagioni Benedetta6,Chung Fan7ORCID,D'Amato Gennaro89ORCID,Damialis Athanasios10ORCID,Del Giacco Stefano11ORCID,De las Vecillas Leticia12ORCID,Dominguez‐Ortega Javier12,Galàn Carmen13ORCID,Gilles Stefanie14ORCID,Giovannini Mattia1516,Holgate Stephen17,Jeebhay Mohamed18ORCID,Nadeau Kari19ORCID,Papadopoulos Nikolaos2021ORCID,Quirce Santiago12,Sastre Joaquin22,Traidl‐Hoffmann Claudia232425ORCID,Walusiak‐Skorupa Jolanta26,Sousa‐Pinto Bernardo27,Salazar Josefina23,Rodríguez‐Tanta L. Yesenia23,Cantero Yahveth23,Montesinos‐Guevara Camila2328,Song Yang23,Alvarado‐Gamarra Giancarlo23ORCID,Sola Ivan23,Alonso‐Coello Pablo2329,Nieto‐Gutierrez Wendy23,Jutel Marek30ORCID,Akdis Cezmi A.31ORCID

Affiliation:

1. Faculty of Medicine Transylvania University Brasov Romania

2. Institut de Recerca Sant Pau (IR SANT PAU) Barcelona Spain

3. Centro Cochrane Iberoamericano, Sant Antoni Maria Claret Barcelona Spain

4. Institute Desbrest of Epidemiology and Public Health University of Montpellier and INSERM Montpellier France

5. Centre of Bioclimatology University of Florence Florence Italy

6. Allergy and Clinical Immunology Unit San Giovanni di Dio Hospital Florence Italy

7. Imperial College London UK

8. Respiratory Disease Department Hospital Cardarelli Naples Italy

9. Medical School of Respiratory Allergy University of Naples Federico II Naples Italy

10. Department of Ecology, School of Biology, Faculty of Sciences Aristotle University of Thessaloniki Thessaloniki Greece

11. Department of Medical Sciences and Public Health University of Cagliari Monserrato Italy

12. Department of Allergy Hospital La Paz Institute for Health Research (IdiPAZ) Madrid Spain

13. Department of Botany, Ecology and Plant Physiology, International Campus of Excellence on Agrifood (ceiA3) University of Córdoba Córdoba Spain

14. Environmental Medicine, Faculty of Medicine University of Augsburg Augsburg Germany

15. Allergy Unit Meyer Children's Hospital IRCCS Florence Italy

16. Department of Health Sciences University of Florence Florence Italy

17. Faculty of Medicine University of Southampton Southampton UK

18. Occupational Medicine Division and Centre for Environmental & Occupational Health Research University of Cape Town Cape Town South Africa

19. Department of Environmental Health, Center for Climate, Health, and the Global Environment Climate and Population Studies, Harvard T.H. Chan School of Public Health Boston USA

20. Allergy and Clinical Immunology Unit, Second Pediatric Clinic National and Kapodistrian University of Athens Athens Greece

21. University of Manchester Manchester UK

22. Allergy Service, Fundación Jiménez Díaz Faculty of Medicine Universidad Autónoma de Madrid and CIBERES, Instituto Carlos III, Ministry of Science and Innovation Madrid Spain

23. Department of Environmental Medicine, Faculty of Medicine University of Augsburg Augsburg Germany

24. Institute of Environmental Medicine Helmholtz Center Munich ‐German Research Center for Environmental Health Augsburg Germany

25. Christine Kühne Center for Allergy Research and Education Davos Switzerland

26. Department of Occupational Diseases and Environmental Health Nofer Institute of Occupational Medicine Lodz Poland

27. MEDCIDS ‐ Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine University of Porto Porto Portugal

28. Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo Universidad UTE Quito Ecuador

29. Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP) Madrid Spain

30. Department of Clinical Immunology Wrocław Medical University, and ALL‐MED Medical Research Institute Wroclaw Poland

31. Swiss Institute of Allergy and Asthma Research (SIAF) University Zurich Davos Switzerland

Abstract

AbstractSystematic review using GRADE of the impact of exposure to volatile organic compounds (VOCs), cleaning agents, mould/damp, pesticides on the risk of (i) new‐onset asthma (incidence) and (ii) adverse asthma‐related outcomes (impact). MEDLINE, EMBASE and Web of Science were searched for indoor pollutant exposure studies reporting on new‐onset asthma and critical and important asthma‐related outcomes. Ninety four studies were included: 11 for VOCs (7 for incidenceand 4 for impact), 25 for cleaning agents (7 for incidenceand 8 for impact), 48 for damp/mould (26 for incidence and 22 for impact) and 10 for pesticides (8 for incidence and 2 for impact). Exposure to damp/mould increases the risk of new‐onset wheeze (moderate certainty evidence). Exposure to cleaning agents may be associated with a higher risk of new‐onset asthma and with asthma severity (low level of certainty). Exposure to pesticides and VOCs may increase the risk of new‐onset asthma (very low certainty evidence). The impact on asthma‐related outcomes of all major indoor pollutants is uncertain. As the level of certainty is low or very low for most of the available evidence on the impact of indoor pollutants on asthma‐related outcomes more rigorous research in the field is warranted.

Publisher

Wiley

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