Background: Indoor environmental exposures such as mold and pesticide use are increasingly recognized as potential contributors to adverse child health outcomes, but their relationship to pediatric heart conditions remains underexplored. Methods: Data from the 2016–2019 National Survey of Children’s Health (NSCH; n = 131,367) were analyzed using survey-weighted descriptive and logistic regression models. The primary outcome was parent-reported heart condition in a child. Key exposures included household mold presence, any indoor pesticide use in the past 12 months, and housing status (renter vs. owner). Models were adjusted for child age, sex, race, ethnicity, and family poverty ratio. Independent effects of race and ethnicity were examined in fully adjusted models to assess disparities in the odds of heart conditions across population subgroups. Results: The weighted prevalence of heart conditions was 2.2%. Children in homes with mold had a higher prevalence of heart conditions (3.0%) than those without mold (2.0%) ( p = 0.0006). Similarly, households with indoor pesticide use reported more heart conditions (2.4%) than those without use (1.9%) ( p = 0.013). In unadjusted analyses, mold (OR 1.50, 95% CI 1.19–1.89) and pesticide use (OR 1.24, 95% CI 1.05–1.48) were significantly associated with heart conditions, while housing status was not. After multivariable adjustment, associations remained significant: mold (aOR 1.67, 95% CI 1.27–2.21, p <0.001) and pesticide use (aOR 1.22, 95% CI 1.00–1.47, p = 0.045). Race and ethnicity showed independent effects, with non-Hispanic (aOR 1.61, p = 0.002) and Asian (aOR 0.45, p = 0.003) children differing in risk. Conclusions: Indoor environmental exposures, i.e., visible mold and indoor pesticide use, were associated with higher odds of heart conditions among U.S. children, independent of sociodemographic factors. These findings highlight the potential cardiovascular relevance of indoor environmental quality and underscore the need for targeted prevention and remediation strategies.
Patel et al. (2026) studied this question.