Dampness, Indoor Mould and Health

  • Dan NorbäckEmail author
Part of the Current Topics in Environmental Health and Preventive Medicine book series (CTEHPM)


Dampness is common in indoor environments and is related to indoor grown of mould and bacteria as well as chemical degradation of building materials. Dampness is a consistent risk factor for respiratory symptoms, asthma symptoms, onset of asthma, respiratory infections and rhinitis. Studies have found an increase of symptoms compatible with the sick building syndrome (SBS) in damp buildings. Moreover, there is some evidence that dampness is associated with lower lung function, dermatitis and non-respiratory symptoms (e.g. eye symptoms, headache, fatigue). The mechanism behind the health effects of dampness is not fully understood, but could include sensory effects, irritation of the mucous membranes, impaired tear film stability and neutrophilic or eosinophilic inflammation.


Dampness Mould Bacteria Chemical degradation Asthma Allergy Rhinitis Respiratory symptoms Sick building syndrome (SBS) Lung function 


  1. 1.
    WHO. Website for WHO Regional Office for Europe. WHO guidelines for indoor air quality: dampness and mould. Copenhagen and Bonn: WHO Regional Office for Europe; 2009. Scholar
  2. 2.
    Karvonen AM, Hyvärinen A, Roponen M, Hoffmann M, Korppi M, Remes S, von Mutius E, Nevalainen A, Pekkanen J. Confirmed moisture damage at home, respiratory symptoms and atopy in early life: a birth-cohort study. Pediatrics. 2009;124:e329–38.PubMedCrossRefGoogle Scholar
  3. 3.
    Norbäck D, Zock JP, Plana E, Heinrich J, Svanes C, Sunyer J, Künzli N, Villani S, Olivieri M, Soon A, Jarvis D. Mould and dampness in dwelling places, and onset of asthma: the population-based cohort ECRHS. Occup Environ Med. 2013;70:325–31.CrossRefGoogle Scholar
  4. 4.
    Mendell MJ, Macher JM, Kumagai K. Measured moisture in buildings and adverse health effects: a review. Indoor Air. 2018;28(4):488–99.PubMedCrossRefGoogle Scholar
  5. 5.
    Cai GH, Mälarstig B, Kumlin A, Johansson I, Norbäck D. Fungal DNA and pet allergen levels in Swedish day care centres and associations with building characteristics. J Environ Monit. 2011;13:2018–24.CrossRefGoogle Scholar
  6. 6.
    Wang J, Engvall K, Smedje G, Nilsson H, Norbäck D. Current wheeze, asthma, respiratory infections, and rhinitis among adults in relation to inspection data and indoor measurements in single-family houses in Sweden-the BETSI study. Indoor Air. 2017;27:725–36.CrossRefGoogle Scholar
  7. 7.
    WUFI and WUFI-BIO. Fraunhofer Institute for Building Physics IBP, Stuttgart, Germany.
  8. 8.
    Palmgren U, Ström G, Blomquist G, Malmberg P. Collection of airborne micro-organisms on Nucleopire filters, estimation and analysis- CAMNEA method. J Appl Bacteriol. 1986;61:401–6.PubMedCrossRefGoogle Scholar
  9. 9.
    Wålinder R, Norbäck D, Wessen B, Venge P. Nasal lavage biomarkers: effects of water damage and microbial growth in an office building. Arch Environ Health. 2001;56:30–6.PubMedCrossRefGoogle Scholar
  10. 10.
    Vesper S, McKinstry C, Cox D, Dewalt G. Correlation between ERMI values and other moisture and mold assessments of homes in the America Healthy Homes Survey. J Urban Health. 2009;86:850–60.PubMedPubMedCentralCrossRefGoogle Scholar
  11. 11.
    Wieslander G, Kumlin A, Norbäck D. Dampness and 2-etyl-1-hexanol in floor construction of rehabilitation center: health effects in staff. Arch Environ Occup Health. 2010;65:3–11.PubMedCrossRefGoogle Scholar
  12. 12.
    Norbäck D, Wieslander G, Nordström K, Wålinder R. Asthma symptoms in relation to measured building dampness in upper concrete floor construction, and 2-etyl-1-hexanol in indoor air. Int J Tuberc Lung Dis. 2000;11:16–25.Google Scholar
  13. 13.
    Norbäck D, Zock JP, Plana E, et al. Building dampness and mould in European homes in relation to climate, building characteristics and socio-economic status: The European Community Respiratory Health Survey ECRHS II. Indoor Air. 2017;27:921–32.CrossRefGoogle Scholar
  14. 14.
    Haverinen-Shaughnessy U. Prevalence of dampness and mold in European housing stock. J Expo Sci Environ Epidemiol. 2012;22:461–7.PubMedCrossRefGoogle Scholar
  15. 15.
    Hägerhed-Engman L, Sigsgaard T, SamuelsonI SJ, Janson S, Bornehag CG. Low home ventilation rate in combination with mouldy odor from the building structure increase the risk for allergic symptoms in children. Indoor Air. 2009;19:194–2.CrossRefGoogle Scholar
  16. 16.
    Kanchongkittiphon W, Mendell MJ, Gaffin JM, Wang G, Phipatanakul W. Indoor environmental exposures and exacerbation of asthma: an update to the 2000 review by the Institute of Medicine. Environ Health Perspect. 2015;123:6–20.PubMedPubMedCentralCrossRefGoogle Scholar
  17. 17.
    Mendell MJ, Mirer AG, Cheung K, Tong M, Douwes J. Respiratory and allergic health effects of dampness, mold, and dampness-related agents: a review of the epidemiologic evidence. Environ Health Perspect. 2011;119:748–56.PubMedPubMedCentralCrossRefGoogle Scholar
  18. 18.
    Fisk WJ, Lei-Gomez Q, Mendell MJ. Meta-analysis of the associations of respiratory health effects with dampness and mold in homes. Indoor Air. 2007;17:284–96.CrossRefGoogle Scholar
  19. 19.
    Quansah R, Jaakkola MS, Hugg TT, Heikkinen SA, Jaakkola JJ. Residential dampness and molds and the risk of developing asthma: a systematic review and meta-analysis. PLoS One. 2012;7:e47526.PubMedPubMedCentralCrossRefGoogle Scholar
  20. 20.
    Jaakkola MS, Nordman H, Piipari R, Uitti J, Laitinen J, Karjalainen A, Hahtola P, Jaakkola JJ. Indoor dampness and mould and development of adult-onset asthma: a population-based incidence case-control study. Environ Health Perspect. 2002;1190:543–7.CrossRefGoogle Scholar
  21. 21.
    Gunnbjornsdottir MI, Franklin KA, Norback D, Bjornsson E, Gislason D, Lindberg E, Svanses C, Omenaas E, Norrman E, Jogi R, Jensen EJ, Dahlman-Hoglund A, Janson C. Prevalence and incidence of respiratory symptoms in relationship to indoor dampness: the RHINE study. Thorax. 2006;61:221–5.PubMedPubMedCentralCrossRefGoogle Scholar
  22. 22.
    Tischer CG, Hohmann C, Thiering E, Herbarth O, Müller A, Henderson J, et al. Meta-analysis of mould and dampness exposure on asthma and allergy in eight European birth cohorts: an ENRIECO initiative. Allergy. 2011;66:1570–9.PubMedCrossRefGoogle Scholar
  23. 23.
    Wang J, Pindus M, Janson C, Sigsgaard T, Kim JL, Holm M, Sommar J, Orru H, Gislason T, Johannessen A, Berthelsen RJ, Norbäck D. Dampness, mould, onset and remission of adult respiratory symptoms, asthma and rhinitis. Eur Respir J. 2019;53(5):1801921.PubMedCrossRefGoogle Scholar
  24. 24.
    Norbäck D, Björnsson E, Janson C, Palmgren U, Boman G. Current asthma and biochemical signs of inflammation in relation to building dampness in dwellings. Int J Tuberc Lung Dis. 1999;3:368–76.PubMedGoogle Scholar
  25. 25.
    Hagmolen of Ten Have W, van den Berg NJ, van der Palen J, van Aalderen WM, Bindels PJ. Residential exposure to mould and dampness is associated with adverse respiratory health. Clin Exp Allergy. 2007;37:1827–32.PubMedCrossRefGoogle Scholar
  26. 26.
    Holst GJ, Høst A, Doekes G, Meyer HW, Madsen AM, Plesner KB, Sigsgaard T. Allergy and respiratory health effects of dampness and dampness-related agents in schools and homes: a cross-sectional study in Danish pupils. Indoor Air. 2016;26:880–91.PubMedCrossRefGoogle Scholar
  27. 27.
    Hernberg S, Sripaiboonkij P, Quansah R, Jaakkola JJ, Jaakkola MSD. Indoor molds and lung function in healthy adults. Respir Med. 2014;108:677–84.PubMedCrossRefGoogle Scholar
  28. 28.
    Norbäck D, Zock JP, Plana E, Heinrich J, Svanes C, Sunyer J, Kunzli N, Villani S, Olivieri M, Soon A, Jarvis D. Lung function decline in relation to mould and dampness in the home: the longitudinal European Community Respiratory Health Survey ECRHSII. Thorax. 2011;66:396–401.PubMedCrossRefGoogle Scholar
  29. 29.
    Tischer C, Chen CM, Heinrich J. Association between domestic mould and mould components, and asthma and allergy in children: a systematic review. Eur Respir J. 2011;38:812–24.PubMedCrossRefGoogle Scholar
  30. 30.
    Jaakkola MS, Quansah R, Hugg TT, Heikkinen SA, Jaakkola JJ. Association of indoor dampness and molds with rhinitis risk: a systematic review and meta-analysis. J Allergy Clin Immunol. 2013;132:1099–110.CrossRefGoogle Scholar
  31. 31.
    Zhang X, Sahlberg B, Wieslander G, Janson C, Gislason T, Norback D. Dampness and moulds in workplace buildings: associations with incidence and remission of sick building syndrome (SBS) and biomarkers of inflammation in a 10 year follow-up study. Sci Total Environ. 2012;430:75–81.PubMedCrossRefGoogle Scholar
  32. 32.
    Norbäck D, Hashim JH, Hashim Z, Cai G-H, Sooria V, Ismail SA, Wieslander G. Respiratory symptoms and fractional exhaled nitric oxide (FeNO) among students in Penang, Malaysia in relation to signs of dampness at school and fungal DNA in school dust. Sci Total Environ. 2017;577:148–54.CrossRefGoogle Scholar
  33. 33.
    Janson C, Kalm-Stephens P, Foucard T, Norbäck D, Alving K, Nordvall SL. Exhaled nitric oxide levels in school children in relation to IgE sensitisation and window pane condensation. Respir Med. 2005;99:1015–21.PubMedCrossRefGoogle Scholar
  34. 34.
    Bakke JV, Norbäck D, Wieslander G, Hollund BE, Moen BE. Pet keeping and dampness in the dwelling: associations with airway infections, symptoms, and physiological signs from the ocular and nasal mucosa. Indoor Air. 2007;17:60–9.PubMedCrossRefGoogle Scholar
  35. 35.
    Wålinder R, Norbäck DF, Wieslander G, Smedje G, Erwall C, Venge P. Acoustic rhinometry and lavage biomarkers in relation to some building characteristics in Swedish schools. Indoor Air. 2001b;11:2–9.PubMedPubMedCentralCrossRefGoogle Scholar
  36. 36.
    Wieslander G, Norbäck D, Nordström K, Wålinder R, Venge P. Nasal and ocular symptoms, tear film stability and biomarkers in nasal lavage, in relation to building-dampness and building design in hospitals. Int Arch Occup Environ Health. 1999;72:451–61.PubMedCrossRefPubMedCentralGoogle Scholar
  37. 37.
    Wieslander G, Norbäck D, Venge P. Changes of symptoms, tear film stability and eosinophilic cationic protein in nasal lavage fluid after re-exposure to a damp office building with a history of flooding. Indoor Air. 2007;17:19–27.PubMedCrossRefGoogle Scholar
  38. 38.
    Hirvonen MR, Ruotsalainen M, Roponen M, Hyvärinen A, Husman T, Kosma VM, Komulainen H, Savolainen K, Nevalainen A. Nitric oxide and proinflammatory cytokines in nasal lavage fluid associated with symptoms and exposure to mouldy building microbes. Am J Respir Crit Care Med. 1999;1760:1043–946.Google Scholar
  39. 39.
    Fisk WJ, Eliseeva EA, Mendell MJ. Association of residential dampness and mold with respiratory tract infections and bronchitis: a meta-analysis. Environ Health. 2010;9:72.PubMedPubMedCentralCrossRefGoogle Scholar
  40. 40.
    Zhuge Y, Qian H, Zheng X, Huang C, Zhang Y, Zhang M, Li B, Zhao Z, Deng Q, Yang X, Sun Y, Wang T, Zhang X, Sundell J. Residential risk factors for childhood pneumonia. A cross-sectional study in eight cities of China. Environ Int. 2018;116:83–91.PubMedCrossRefGoogle Scholar
  41. 41.
    Norbäck D, Lu C, Zhang YP, Li BZ, Zhao ZH, Huang C, Zhang X, Qian H, Sundell J, Deng QH. Common cold among pre-school children in China- associations with ambient PM10 and dampness, mould, cats, dogs, rats and cockroaches in the home environment. Environ Int. 2017c;193:13–22.CrossRefGoogle Scholar
  42. 42.
    McNally NJ, Williams HC, Phillips DR. Atopic eczema and the home environment. Br J Dermatol. 2001;145:730–6.CrossRefGoogle Scholar
  43. 43.
    Shpakou A, Brozek G, Stryzhak A, Neviartovich T, Zejda J. Allergic diseases and respiratory symptoms in urban and rural children in Grodno region (Belarus). Pediatr Allergy Immunol. 2012;23:339–46.CrossRefGoogle Scholar
  44. 44.
    Cai J, Liu W, Hu Y, Zou Z, Shen L, Huang C. Household environment, lifestyle behaviours, and dietary habits in relation to childhood atopic eczema in Shanghai, China. Int Arch Occup Environ Health. 2017;90:141–59.PubMedCrossRefGoogle Scholar
  45. 45.
    Xu F, Yan S, Zheng Q, Li F, Chai W, Wu M, Kan H, Norback D, Xu J, Zhao Z. Residential risk factors for atopic dermatitis in 3- to 6-year old children: a cross-sectional study in Shanghai. China Int J Environ Res Public Health. 2016;13:E537.PubMedCrossRefGoogle Scholar
  46. 46.
    Deng Q, Lu C, Ou C, Chen L, Yuan H. Preconceptional, prenatal and postnatal exposure to outdoor and indoor environmental factors on allergic diseases/symptoms in preschool children. Chemosphere. 2016;152:459–67.PubMedCrossRefGoogle Scholar
  47. 47.
    Lin Z, Norback D, Wang T, Zhang X, Shi J, Kan H, Zhao Z. The first 2-year home environment in relation to the new onset and remission of asthmatic and allergic symptoms in 4246 preschool children. Sci Total Environ. 2016;553:204–10.CrossRefGoogle Scholar
  48. 48.
    Sharpe RA, Thornton CR, Tyrrell J, Nikolaou V, Osborne NJ. Variable risk of atopic disease due to indoor fungal exposure in NHANES 2005-2006. Clin Exp Allergy. 2015;45:1566–78.CrossRefGoogle Scholar
  49. 49.
    Norbäck D, Lampa E, Engvall K. Asthma, allergy and eczema among adults in multifamily houses in Stockholm (3HE-study)-associations with building characteristics, home environment and energy use for heating. PLoS One. 2014;9:e112960.PubMedPubMedCentralCrossRefGoogle Scholar
  50. 50.
    Norbäck D. An update on sick building syndrome. Curr Opin Allergy Clin Immunol. 2009;9:55–9.PubMedCrossRefGoogle Scholar
  51. 51.
    Engvall K, Norrby C, Norbäck D. Sick building syndrome in relation to building dampness in multi-family residential buildings in Stockholm. Int Arch Occup Environ Health. 2001;74:270–8.PubMedCrossRefGoogle Scholar
  52. 52.
    Pirhonen I, Nevalainen A, Husman T, Pekkanen J. Home dampness, moulds and their influence on respiratory infections and symptoms in adults in Finland. Eur Respir J. 1996;9:2618–22.CrossRefGoogle Scholar
  53. 53.
    Sahlberg B, Wieslander G, Norbäck D. Sick building syndrome (SBS) in relation to domestic exposure in Sweden - a cohort study from 1991 to 2001. Scand J Public Health. 2010;38:232–8.PubMedCrossRefGoogle Scholar
  54. 54.
    Sahlberg B, Norbäck D, Wieslander G, Gislason T, Janson C. Onset of mucosal, dermal, and general symptoms in relation to biomarkers and exposures in the dwelling: a cohort study from 1992 to 2002. Indoor Air. 2012;22:331–8.PubMedCrossRefGoogle Scholar
  55. 55.
    Sahlberg B, Gunnbjörnsdottir M, Soon A, Jogi R, Gislason T, Wieslander G, Janson C, Norback D. Airborne moulds and bacteria, microbial volatile organic compounds (MVOC), plasticizers and formaldehyde in dwellings in three North European cities in relation to sick building syndrome (SBS). Sci Total Environ. 2013;444:433–40.CrossRefGoogle Scholar
  56. 56.
    Smedje G, Wang J, Norbäck D, Nilsson H, Engvall K. SBS symptoms in relation to dampness and ventilation in inspected single-family houses in Sweden. Int Arch Occup Environ Health. 2017;90:703–11.PubMedPubMedCentralCrossRefGoogle Scholar
  57. 57.
    Koskinen OM, Husman TM, Meklin TM, Nevalainen AI. The relationship between moisture or mould observations in houses and the state of health of their occupants. Eur Respir J. 1999;14:1363–7.CrossRefGoogle Scholar
  58. 58.
    Lu C, Deng Q, Li Y, Sundell J, Norbäck D. Outdoor air pollution, meteorological conditions and indoor factors in dwellings in relation to sick building syndrome (SBS) among adults in China. Sci Total Environ. 2016;560–561:186–96.PubMedCrossRefGoogle Scholar
  59. 59.
    Kanazawa A, Saijo Y, Tanaka M, Yoshimura T, Chikara H, Takigawa T, Morimoto K, Nakayama K, Shibata E, Kishi R. Nationwide study of sick house syndrome: comparison of indoor environment of newly built dwellings between Sapporo city and southern areas including those in Honshu and Kyushu. Nihon Eiseigaku Zasshi. 2010;65:447–58.PubMedCrossRefGoogle Scholar
  60. 60.
    Kishi R, Saijo Y, Kanazawa A, Tanaka M, Yoshimura T, Chikara H, Takigawa T, Morimoto K, Nakayama K, Shibata E. Regional differences in residential environments and the association of dwellings and residential factors with the sick house syndrome: a nationwide cross-sectional questionnaire study in Japan. Indoor Air. 2009;19:243–54.CrossRefGoogle Scholar
  61. 61.
    Saijo Y, Kishi R, Sata F, Katakura Y, Urashima Y, Hatakeyama A, Kobayashi S, Jin K, Kurahashi N, Kondo T, Gong YY, Umemura T. Symptoms in relation to chemicals and dampness in newly built dwellings. Int Arch Occup Environ Health. 2004;77:461–70.CrossRefGoogle Scholar
  62. 62.
    Saijo Y, Nakagi Y, It OT, Sugioka Y, Endo H, Yoshida T. Relation of dampness to sick building syndrome in Japanese public apartment houses. Environ Health Prev Med. 2009;14:26–35.CrossRefGoogle Scholar
  63. 63.
    Takaoka M, Suzuki K, Norbäck D. Sick building syndrome among junior high school students in Japan in relation to the home and school environment. Glob J Health Sci. 2015;8:165–77.PubMedPubMedCentralCrossRefGoogle Scholar
  64. 64.
    Takeda M, Saijo Y, Yuasa M, Kanazawa A, Araki A, Kishi R. Relationship between sick building syndrome and indoor environmental factors in newly built Japanese dwellings. Int Arch Occup Environ Health. 2009;82:583–93.CrossRefGoogle Scholar
  65. 65.
    Li CS, Hsu CW, Lu CH. Dampness and respiratory symptoms among workers in daycare centers in a subtropical climate. Arch Environ Health. 1997;52:68–71.CrossRefGoogle Scholar
  66. 66.
    Park JH, Cho SJ, White SK, Cox-Ganser JM. Changes in respiratory and non-respiratory symptoms in occupants of a large office building over a period of moisture damage remediation attempts. PLoS One. 2018;13:e0191165.PubMedPubMedCentralCrossRefGoogle Scholar
  67. 67.
    Wan GH, Li CS. Dampness and airway inflammation and systemic symptoms in office building workers. Arch Environ Health. 1999;54:58–63.PubMedCrossRefGoogle Scholar
  68. 68.
    Kishi R, Ketema RM, Ait Bamai Y, Araki A, Kawai T, Tsuboi T, Saito T, Yoshioka E, Saito T. Indoor environmental pollutants and their association with sick house syndrome among adults and children in elementary school. Build Environ. 2018;136:293–301.CrossRefGoogle Scholar
  69. 69.
    Ahlroth Pind C, Gunnbjörnsdottir M, Bjerg A, Järvholm B, Lundbäck B, Malinovschi A, Midelveld R, Sommar JN, Norbäck D, Janson C. Patient-reported signs of dampness at home may be a risk factor for chronic sinusitis: a cross-sectional study. Clin Exp Allergy. 2017;47:1383–9.PubMedCrossRefGoogle Scholar
  70. 70.
    Tiesler CM, Thiering E, Tischer C, Lehmann I, Schaaf B, von Berg A, Heinrich J. Exposure to visible mould or dampness at home and sleep problems in children: results from the LISAplus study. Environ Res. 2015;1378:357–63.CrossRefGoogle Scholar
  71. 71.
    Janson C, Norbäck D, Omenaas E, Gislason T, Nyström L, Jogi R, Lindberg E, Gunnbjörnsdottir M, Norrman E, Wentzel-Larsen T, Svanes C, Jensen EJ, Toren K, RHINE Study Group. Insomnia is more common among subjects living in damp buildings. Occup Environ Med. 2005;62:113–8.PubMedPubMedCentralCrossRefGoogle Scholar
  72. 72.
    Karvala K, Uitti J, Luukkonen R, Nordman H. Quality of life of patients with asthma related to damp and mouldy work environments. Scand J Work Environ Health. 2013;39:96–105.PubMedCrossRefGoogle Scholar
  73. 73.
    Karvala K, Nordman H, Luukkonen R, Uitti J. Asthma related to workplace dampness and impaired work ability. Int Arch Occup Environ Health. 2014;87:1–11.PubMedCrossRefGoogle Scholar
  74. 74.
    Sauni R, Verbeek JH, Jauhiainen M, Kreiss K, Sigsgaard T. Remediating buildings damaged by dampness and mouild for preventing or reducing respiratory tract symptoms, infections and asthma. Cochrane Database Syst Rev. 2015;2:CD007897.Google Scholar
  75. 75.
    Rennie D, Chen Y, Lawson J, Dosman J. Differential effect of damp housing on respiratory health in women. J Am Med Womens Assoc (1972). 2005;60:46–51.Google Scholar
  76. 76.
    Meyer HW, Würtz H, Suadicani P, Valbjørn O, Sigsgaard T, Gyntelberg F, Members of a Working Group under the Danish Mold in Buildings Program (DAMIB). Mold in floor dust and building-related symptoms among adolescent school children: a problem for boys only? Indoor Air. 2005;15(Suppl 10):17–24.PubMedCrossRefGoogle Scholar
  77. 77.
    Su MW, Tung KY, Liang PH, Tsai CH, Kuo NW, Lee YL. Gene-gene and gene-environmental interactions of childhood asthma: a multifactor dimension reduction approach. PLos One. 2012;7:e30694.PubMedPubMedCentralCrossRefGoogle Scholar
  78. 78.
    Tsai CH, Tung KY, Chen CH, Lee YL. Tumour necrosis factor G-308A polymorphism modifies the effect of home dampness on childhood asthma. Occup Environ Med. 2011;68:771–6.PubMedPubMedCentralCrossRefGoogle Scholar
  79. 79.
    Wang IJ, Tsai CH, Kuo NW, Chiang BL, Tung KY, Lee YL. Home dampness, beta-2 adrenergic reception genetic polymorphism, and asthma phenotypes in children. Environ Res. 2012;118:72–8.CrossRefGoogle Scholar

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© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  1. 1.Department of Medical SciencesUppsala UniversityUppsalaSweden

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