Damp mouldy housing and early childhood hospital admissions for acute respiratory infection: a case control study

Introduction A gap exists in the literature regarding dose–response associations of objectively assessed housing quality measures, particularly dampness and mould, with hospitalisation for acute respiratory infection (ARI) among children. Methods A prospective, unmatched case–control study was conducted in two paediatric wards and five general practice clinics in Wellington, New Zealand, over winter/spring 2011–2013. Children aged Results 188 cases and 454 controls were studied. Higher levels of RHI were associated with elevated odds of hospitalisation (OR 1.11/unit increase (95% CI 1.01 to 1.21)), which weakened after adjustment for season, housing tenure, socioeconomic status and crowding (aOR 1.04/unit increase (95% CI 0.94 to 1.15)). The damp–mould index had a significant, adjusted dose–response relationship with ARI admission (aOR 1.15/unit increase (95% CI 1.02 to 1.30)). By addressing these harmful housing exposures, the rate of admission for ARI would be reduced by 19% or 1700 fewer admissions annually. Conclusions A dose–response relationship exists between housing quality measures, particularly dampness–mould, and young children’s ARI hospitalisation rates. Initiatives to improve housing quality and to reduce dampness–mould would have a large impact on ARI hospitalisation.