Reuters: “Rooms with water damage may be linked to skin problem in children”

By Shereen Lehman

NEW YORK (Reuters Health) - Water damage in living rooms or children’s bedrooms, as confirmed by infrared cameras, could be associated with worse eczema in children, says a new study.

Eczema, or atopic dermatitis, results in itchy scaly skin. It often affects children, especially during the first year of life.

Moisture problems in the home can come from poor ventilation, high humidity or from wet weather and floods.

Water damage has long been associated with respiratory problems and asthma, but previous studies on water damage or mold growth on “atopic dermatitis” have shown mixed results.

Most of those previous studies have used questionnaires, interviews or visual inspection on-site to determine the presence of moisture problems at home, and those may not have been accurate, say the authors.

“In this study, we wanted to examine the association between AD severity and water damage by using a reliable method,” Dr. Kagmo Ahn told Reuters Health in an email.

Ahn is a pediatric allergist at the Samsung Medical Center, Seoul, Korea and was part of the study team.

Infrared cameras can be helpful to assess water damage in that situation, because they’re more reliable, Ahn said. They can detect surface temperature differences and are simple and easy to use for identifying and measuring water damage.

As reported in the Annals of Allergy, Asthma and Immunology, Ahn and colleagues examined the homes of 52 Korean children with atopic dermatitis.

The severity of the condition was classified as mild, moderate or severe based on a tool called Scoring Atopic Dermatitis (SCORAD).

The study team took air samples from the living room and from each child’s bedroom. In addition, they inspected those rooms for evidence of water damage, water stains or mold, both visually and with the use of an infrared camera.

A room was considered to be ‘water damaged’ if the researchers found more than two square feet of damage.

Water damage was found in 31 of the homes.

Concentrations of airborne mold were higher in homes with water damage – but there was no difference in airborne mold between homes with and without visible mold or water stains.

As for water damage and eczema severity, there was no association with visual inspections alone. Water damage and eczema severity were linked only when infrared inspections were used.

Ultimately, the authors estimated that kids living in homes with infrared-detected water damage were 15 times more likely to have moderate to severe eczema, rather than mild eczema. But they indicate in their paper that this finding might not be accurate, and additional studies in larger populations are needed to confirm it.

In the meantime, Ahn said, it’s necessary to find leakage of water, especially in the roof and around the windows, and to detect precipitation entering through the gap between the windows and the walls.

“Houses need to be repaired to prevent ongoing water leakage and to keep appropriate level of relative humidity with 40-50 percent,” Ahn said.

Dr. David Rosenstreich said it was an intriguing study but he was surprised there was such a strong association with infrared-detected water damage and atopic dermatitis, but not with visible mold.

Rosenstreich, who the Division of Allergy and Immunology at Montefiore Medical Center in Bronx, New York, wasn’t involved in the study.

“That’s a little surprising because if people can see water coming in or they can see mold growing you would think there would be an association as well,” he told Reuters Health in a phone call.

Rosenstreich also said their findings were a little different from what other researchers have reported about atopic dermatitis from mold in homes, in a sense that the magnitude of the effects was much greater.

“(The authors) raised the possibility that it may not be related to molds at all - it may be that more moisture translates to having more dust mites growing in the house,” he said.

Rosenstreich said dust mites need moisture to grow. If the house is moist, you have more dust mites, and dust mites are a risk factor for allergic children with atopic dermatitis.

Rosenstreich also said it was possible that taking measurements of the houses on different days might have resulted in different mold counts.

“It's very intriguing and some that makes sense but it probably needs to be confirmed,” he said.

SOURCE: http://bit.ly/1svraK5 Annals of Allergy, Asthma and Immunology, online September 10, 2014.