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The presence of mould as a source of perennial allergens and bacteria products has been related to the appearance of respiratory symptoms in several studies. Yet, its role in eczema has not been elucidated. The aim of this study was to investigate the association between exposure to indoor visible molds/dampness and the manifestation of eczema in children. Methods: The study is part of the Greek contribution to ISAAC IΙ that includes 2023 students of randomly selected public primary schools in Athens and Thessaloniki, aged 9 - 10 years old. The children represented a general population sample and were evaluated according to ISAAC II questionnaire, validated for Greek language. Additionally, skin prick tests to aero-allergens were performed and children were examined for active skin lesions. Results: 13% had suffered from eczema in the past, 9% had current and 2% had atopic eczema (positive at least one skin prick test). Out of the children examined, half reported that eczema first appeared after the age of five years old whereas 70% mentioned persistence of eczema. Dampness was reported in 10.8% and visible mould in 6.4% of all cases during infancy, while continued exposure until the age of 10 years old was reported in 38% and 33% out of them respectively. 10.8% of the sensitized children were positive to house dust mites and Alternaria, however, sensitization was not related to indoor exposure. In logistic regression analysis evaluating 20 environmental risk factors, a significant association was noted between the presence of indoor visible mold and dampness in infancy, and the presence of current eczema OR 1, 89 (95%CI 1.18 - 3.03). This association remained significant irrespective of the family history of eczema and sensitization. Conclusions: Frequently eczema first appears at early school age. The presence of visible mold and dampness at home during infancy appears to be an initial enhancing risk factor for the development but also for the persistence of the disease throughout school age.

open journal of pediatrics

Indoor Exposure to Mould and Dampness in Infancy and Its Association to Persistent Atopic Dermatitis in School Age: Results from the Greek ISAAC II Study