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Zhang X, Norbäck D, Fan Q, Bai X, Li T, Zhang Y, Li B, Zhao Z, Huang C, Deng Q, Lu C, Qian H, Xu Y, Sun Y, Sundell J, Wang J. Dampness and mold in homes across China: Associations with rhinitis, ocular, throat and dermal symptoms, headache and fatigue among adults. INDOOR AIR 2019; 29:30-42. [PMID: 30379348 DOI: 10.1111/ina.12517] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 10/23/2018] [Accepted: 10/24/2018] [Indexed: 05/23/2023]
Abstract
We studied dampness and mold in China in relation to rhinitis, ocular, throat and dermal symptoms, headache and fatigue. A questionnaire study was performed in six cities including 36 541 randomized parents of young children. Seven self-reported signs of dampness were evaluated. Multilevel logistic regression models were used to calculate odds ratios (ORs). Totally, 3.1% had weekly rhinitis, 2.8% eye, 4.1% throat and 4.8% skin symptoms, 3.0% headache and 13.9% fatigue. Overall, 6.3% of the homes had mold, 11.1% damp stains, 35.3% damp bed clothing, 12.8% water damage, 45.4% window pane condensation, 11.1% mold odor, and 37.5% humid air. All dampness signs were associated with symptoms (ORs from 1.2 to 4.6; P < 0.001), including rhinitis (ORs from 1.4 to 3.2; P < 0.001), and ORs increased by number of dampness signs. The strongest associations were for mold odor (ORs from 2.3 to 4.6) and humid air (ORs from 2.8 to 4.8). Associations were stronger among men and stronger in Beijing as compared to south China. In conclusion, dampness and mold are common in Chinese homes and associated with rhinitis and ocular, throat and dermal symptoms, headache and fatigue. Men can be more sensitive to dampness and health effects of dampness can be stronger in northern China.
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Affiliation(s)
- Xin Zhang
- Institute of Environmental Science, Shanxi University, Taiyuan, China
| | - Dan Norbäck
- Institute of Environmental Science, Shanxi University, Taiyuan, China
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Qiannan Fan
- Institute of Environmental Science, Shanxi University, Taiyuan, China
| | - Xu Bai
- Institute of Environmental Science, Shanxi University, Taiyuan, China
| | - Tian Li
- Institute of Environmental Science, Shanxi University, Taiyuan, China
| | - Yinping Zhang
- School of Architecture, Tsinghua University, Beijing, China
| | - Baizhan Li
- Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Chongqing University, Chongqing, China
| | - Zhuohui Zhao
- Department of Environmental Health, Fudan University, Shanghai, China
| | - Chen Huang
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Qihong Deng
- XiangYa School of Public Health, Central South University, Changsha, China
- School of Energy Science and Engineering, Central South University, Changsha, China
| | - Chan Lu
- XiangYa School of Public Health, Central South University, Changsha, China
- School of Energy Science and Engineering, Central South University, Changsha, China
| | - Hua Qian
- School of Energy & Environment, Southeast University, Nanjing, China
| | - Yang Xu
- College of Life Sciences, Central China Normal University, Wuhan, China
| | - Yuexia Sun
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Jan Sundell
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Juan Wang
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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Wang YH, Su HH, Hsu L, Wang CY, Wu PH. Correlation between Novel Potential Indoor Risk Factors and Frequency of Doctor's Visit for Respiratory Problem in Taiwan's Tropical Environment. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2018; 9:10-22. [PMID: 29319051 PMCID: PMC6466971 DOI: 10.15171/ijoem.2018.1143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 11/25/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND With a global rising trend in prevalence of allergic diseases, more attention has been paid to investigation of environmental risk factors. Many risk factors have so far been identified. However, novel risk factors specific to Taiwanese environment and lifestyle were still relatively unknown. OBJECTIVE To investigate the potential effects of a number of little-known indoor risk factors on the frequency of doctor's visit for respiratory problems in context of Taiwanese environment and lifestyle. METHODS A cross-sectional, population-based study was performed on a 861 participants around Kaohsiung area, Taiwan. Survey investigation was employed to assess the household environment and the frequency of doctor's visit for respiratory problems. RESULTS Participants who performed "daily cleaning" was shown to have a significantly (p=0.007) higher mean number of doctor's visits in comparison to those who did not. Similar observation was made for participants who periodically took out beddings (p=0.042). Age had a significant positive correlation (linear regression β 0.089) with frequency of respiratory problems. CONCLUSION The habit of daily cleaning was implicated as a potential indoor risk factor due to the unique nature of Taiwanese cleaning habit and close contact with cleaning supplies, which could serve as chemical irritants. Bedding takeout was predicted to be an indicator of chronic allergies rather than an actual risk factor. However, both were controversial in their role as potential indoor risk factor, and required further examination.
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Affiliation(s)
- Yu-Hao Wang
- Department of Microbiology and Immunology, University of Rochester, NY 14642, USA
| | - Hsing-Hao Su
- Department of Otorhinolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan, ROC
| | - Lan Hsu
- Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan, ROC
| | | | - Pi-Hsiung Wu
- Department of Otorhinolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Pingtung Branch, Pingtung 91245, Taiwan, ROC.
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Fungal DNA in dust in Swedish day care centres: associations with respiratory symptoms, fractional exhaled nitrogen oxide (FeNO) and C-reactive protein (CRP) in serum among day care centre staff. Int Arch Occup Environ Health 2015; 89:331-40. [DOI: 10.1007/s00420-015-1076-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 07/07/2015] [Indexed: 10/23/2022]
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Lim FL, Hashim Z, Than LTL, Md Said S, Hisham Hashim J, Norbäck D. Asthma, Airway Symptoms and Rhinitis in Office Workers in Malaysia: Associations with House Dust Mite (HDM) Allergy, Cat Allergy and Levels of House Dust Mite Allergens in Office Dust. PLoS One 2015; 10:e0124905. [PMID: 25923543 PMCID: PMC4414577 DOI: 10.1371/journal.pone.0124905] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Accepted: 03/08/2015] [Indexed: 11/18/2022] Open
Abstract
A prevalence study was conducted among office workers in Malaysia (N= 695). The aim of this study was to examine associations between asthma, airway symptoms, rhinitis and house dust mites (HDM) and cat allergy and HDM levels in office dust. Medical data was collected by a questionnaire. Skin prick tests were performed for HDM allergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae) and cat allergen Felis domesticus. Indoor temperature and relative air humidity (RH) were measured in the offices and vacuumed dust samples were analyzed for HDM allergens. The prevalence of D. pteronyssinus, D. farinae and cat allergy were 50.3%, 49.0% and 25.5% respectively. Totally 9.6% had doctor-diagnosed asthma, 15.5% had current wheeze and 53.0% had current rhinitis. The Der p 1 (from D. pteronyssinus) and Der f 1 (from D. farinae) allergens levels in dust were 556 ng/g and 658 ng/g respectively. Statistical analysis was conducted by multilevel logistic regression, adjusting for age, gender, current smoking, HDM or cat allergy, home dampness and recent indoor painting at home. Office workers with HDM allergy had more wheeze (p= 0.035), any airway symptoms (p= 0.032), doctor-diagnosed asthma (p= 0.005), current asthma (p= 0.007), current rhinitis (p= 0.021) and rhinoconjuctivitis (p< 0.001). Cat allergy was associated with wheeze (p= 0.021), wheeze when not having a cold (p= 0.033), any airway symptoms (p= 0.034), doctor-diagnosed asthma (p= 0.010), current asthma (p= 0.020) and nasal allergy medication (p= 0.042). Der f 1 level in dust was associated with daytime breathlessness (p= 0.033) especially among those with HDM allergy. Der f 1 levels were correlated with indoor temperature (p< 0.001) and inversely correlated with RH (p< 0.001). In conclusion, HDM and cat allergies were common and independently associated with asthma, airway symptoms and rhinitis. Der f 1 allergen can be a risk factor for daytime breathlessness.
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Affiliation(s)
- Fang Lee Lim
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang, Selangor, Malaysia
| | - Zailina Hashim
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang, Selangor, Malaysia
- * E-mail:
| | - Leslie Thian Lung Than
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang, Selangor, Malaysia
| | - Salmiah Md Said
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang, Selangor, Malaysia
| | - Jamal Hisham Hashim
- United Nations University-International Institute for Global Health (UNU-IIGH), Kuala Lumpur, Malaysia
- Department of Community Health, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Dan Norbäck
- Uppsala University, Department of Medical Science, Occupational and Environmental Medicine, University Hospital, Uppsala, Sweden
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Jones EK, Sumner KG, Gochfeld M. Residential Flood Damage After Hurricane Floyd, Mold, Household Remediation, and Respiratory Health. ACTA ACUST UNITED AC 2013. [DOI: 10.1002/rem.21381] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Larsson M, Hägerhed-Engman L, Moniruzzaman S, Janson S, Sundell J, Bornehag CG. Can we trust cross-sectional studies when studying the risk of moisture-related problems indoor for asthma in children? INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2011; 21:237-247. [PMID: 21745019 DOI: 10.1080/09603123.2010.533368] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Most studies studying dampness as a risk factor for asthma are of a cross-sectional design. The aim of this study was to investigate if the association between moisture-related problems indoor and asthma found in cross-sectional questionnaire data can be confirmed in longitudinal analyses. The Dampness in Building and Health (DBH) study started in 2000 in Värmland, Sweden, with a baseline questionnaire to all children aged 1-5 y (n = 14,077) and five years later a follow-up questionnaire was distributed to children aged 6-8 y (n = 7,509). Moisture-related problems that were associated with asthma in cross-sectional analysis decreased or disappeared in the longitudinal analysis. However, the association between reports of moldy odor in the homes at baseline and incident asthma remained and became stronger. Our results suggest that cross-sectional data showing associations between moisture-related problems in homes and asthma in children partly can be explained by reporting bias.
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Affiliation(s)
- Malin Larsson
- Public Health Sciences, Karlstad University, Sweden.
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7
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Sun Y, Zhang Y, Sundell J, Fan Z, Bao L. Dampness in dorm rooms and its associations with allergy and airways infections among college students in China: a cross-sectional study. INDOOR AIR 2009; 19:348-356. [PMID: 19627367 DOI: 10.1111/j.1600-0668.2009.00614.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
UNLABELLED A cross-sectional study was carried out at Tianjin University campus, China, from February 21 to June 10, 2006, to survey the association between dampness in dorms, and allergy and airways infections among college students. The health and dampness conditions were self-reported by 3436 students living in 1511 dorm rooms located in 13 buildings on the campus. The buildings were selected according to their positions, construction periods and occupant densities. The symptoms involved wheezing, dry cough during night, rhinitis, eczema, cold/flu, ear inflammation, pneumonia and tuberculosis. The indoor moisture signs were mould/damp spots on walls, ceilings and floors; suspected or ever happened water damage; condensation on windowpane in winter and odours perceived by subjects themselves. There was a significant positive association between condensation and dry cough. Eczema was often reported in rooms with moisture problem. Dampness was a significant risk factor for common cold. PRACTICAL IMPLICATIONS Dampness problems in dorms of Chinese students are a risk factor for allergic symptoms, and hence there is a need for dorm environment improvement. Health problems related to ventilation and microbiology problems in dorms should be further studied.
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Affiliation(s)
- Y Sun
- School of Environmental Science and Technology, Tianjin University, Nankai District 300072, Tianjin, China.
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8
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Sun Y, Zhang Y, Sundell J, Fan Z, Bao L. Dampness at dorm and its associations with allergy and airways infection among college students in China: a cross-sectional study. INDOOR AIR 2009; 19:174-182. [PMID: 19191920 DOI: 10.1111/j.1600-0668.2008.00577.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
UNLABELLED A cross-sectional study was carried out at Tianjin University campus, China, from February 21 to June10, 2006, to survey the association between dampness in dorms and allergy and airways infection among college students. The health and dampness condition were self-reported by 3436 students living in 1511 dorm rooms located in 13 buildings on the campus. The buildings were selected according to their positions, construction periods and occupant densities. The allergy and airways infection symptoms involved wheezing, dry cough during night, rhinitis, eczema, cold/flu, ear inflammation, pneumonia and tuberculosis. The indoor moisture signs were mould/damp spots on walls, ceilings and floors; suspected or ever happened water damage; condensation on windowpane in winter and odours perceived by subjects themselves. This study showed there was significantly positive association between condensation and dry cough. Eczema was often reported in rooms with suspected moisture problem. Dampness was a significantly risk factor for common cold. PRACTICAL IMPLICATIONS This paper indicated that dampness problem at dorms of Chinese students was a risk factor in irritating allergic symptoms, and hence there is a need for dorm environment improvement. The ventilation and microbiology problems in dorm environment corresponding to dampness should be further studied, especially when it is associated to occupants' health.
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Affiliation(s)
- Y Sun
- School of Environmental Science and Technology, Tianjin University, Weijin Road 92, Tianjin City, China.
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9
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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. [PMID: 17257149 DOI: 10.1111/j.1600-0668.2006.00441.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
UNLABELLED The aim was to study health effects in office workers (N = 18) in a medical case book archive with dampness caused by flooding. They were first investigated in a building without dampness (exposure free for 10 days). Then all returned to the damp building, and were re-investigated after 2 days. We measured tear film break up time (BUT), nasal patency, biomarkers in nasal lavage (NAL), and dynamic spirometry. Both buildings had low CO(2) (380-600 ppm), low levels of respirable particles (8-10 microg/m(3)), and formaldehyde (5-7 microg/m(3)). The flooded building had slightly higher (149 ng/m(3) vs. 94 ng/m(3)) levels of microbial volatile organic compounds (MVOC). After 2 days of re-exposure, there was an increase of ocular (P < 0.001), nasal (P = 0.002), and throat symptoms (P < 0.001), dyspnea (P = 0.006), headache (P = 0.002), nausea (P = 0.04), and tiredness (P = 0.01). The median BUT decreased from 16 to 8 s (P = 0.003), and eosinophilic cationic protein (ECP) in NAL increased slightly (P = 0.04). A separate test of the weekday effect showed slight improvements, or no change of symptoms and signs from Monday to Wednesday. In conclusion, subjects previously exposed to building dampness had an increase of symptoms, reduced tear film stability, and signs of eosinophilic inflammation in the nasal mucosa after 2 days of re-exposure. PRACTICAL IMPLICATIONS The study is in agreement with previous cross-sectional studies, suggesting that building dampness may cause mucosal irritation, general symptoms such as headache and tiredness, impaired tear film stability, and eosinophilic inflammation in the airway mucosa. From a preventive point of view, health consequences of water leakage and flooding should not be neglected. The measurements of molds and microbial volatile organic compounds could not identify any obvious exposure contrast between the damp building and the dry control building. This illustrates the limitations of air measurements of microbial exposures in damp buildings.
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Affiliation(s)
- G Wieslander
- Department of Medical Sciences, Uppsala University and University Hospital, Uppsala, Sweden.
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10
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Lee YL, Hsiue TR, Lee CH, Su HJJ, Leon Guo Y. Home exposures, parental atopy, and occurrence of asthma symptoms in adulthood in southern Taiwan. Chest 2006; 129:300-308. [PMID: 16478845 DOI: 10.1378/chest.129.2.300] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
OBJECTIVE Parental atopy and environmental exposures at home have been recognized risk factors for adulthood asthma. However, the relative contributions of specific risk factors and the overall contributions of heredity or home exposure remain unexplored. The purpose of this study was to identify predictors and estimate the population attributable risk (PAR) of each exposure for typical asthma symptoms among 26- to 50-year-old Taiwanese. We also investigated whether an interactive effect existed between parental atopy and home exposures on the occurrence of asthma symptoms in adulthood. DESIGN A cross-sectional study with retrospective components. SETTING Elementary and middle schools in Southern Taiwan. SUBJECTS Between March and October 2004, we conducted a cross-sectional survey among schoolchildren's parents from 94 elementary and middle schools in Southern Taiwan. The main outcome measure was typical asthma-like symptoms occurring within the preceding 5 years. Information on hereditary and home exposures was collected by using a self-administered questionnaire. RESULTS After excluding unqualified questionnaires, data from 24,784 subjects were left for analysis. New-onset asthma was reported for 0.83% of male (n = 80 of 9,662) and 1.36% of female subjects (n = 206 of 15,122). Besides parental atopic factors, environmental tobacco smoke or pet avoidance and visible mold on walls at home were independently associated with the occurrence of asthma symptoms. Mutually adjusted models produced statistically significant associations between any home exposure (odds ratio [OR], 1.80; 95% confidence interval [CI], 1.08 to 3.23; PAR, 28.04%), parental atopy (OR, 4.47; 95% CI, 3.47 to 5.75; PAR, 31.38%), and new-onset asthma. However, there was no interaction between parental atopy and home exposures. CONCLUSIONS Home exposures and parental atopy both increased the risks of new-onset asthma in adulthood but did not show an interactive effect. These two exposure categories approximately contributed equally to the adulthood asthma.
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Affiliation(s)
- Yung-Ling Lee
- Department of Occupational and Environmental Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tzuen-Ren Hsiue
- Department of Internal Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Cheng-Hung Lee
- Department of Internal Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Huey-Jen Jenny Su
- Graduate Institute of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yueliang Leon Guo
- Department of Occupational and Environmental Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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11
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Mendell MJ, Heath GA. Do indoor pollutants and thermal conditions in schools influence student performance? A critical review of the literature. INDOOR AIR 2005; 15:27-52. [PMID: 15660567 DOI: 10.1111/j.1600-0668.2004.00320.x] [Citation(s) in RCA: 141] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
UNLABELLED To assess whether school environments can adversely affect academic performance, we review scientific evidence relating indoor pollutants and thermal conditions, in schools or other indoor environments, to human performance or attendance. We critically review evidence for direct associations between these aspects of indoor environmental quality (IEQ) and performance or attendance. Secondarily, we summarize, without critique, evidence on indirect connections potentially linking IEQ to performance or attendance. Regarding direct associations, little strongly designed research was available. Persuasive evidence links higher indoor concentrations of NO(2) to reduced school attendance, and suggestive evidence links low ventilation rates to reduced performance. Regarding indirect associations, many studies link indoor dampness and microbiologic pollutants (primarily in homes) to asthma exacerbations and respiratory infections, which in turn have been related to reduced performance and attendance. Also, much evidence links poor IEQ (e.g. low ventilation rate, excess moisture, or formaldehyde) with adverse health effects in children and adults and documents dampness problems and inadequate ventilation as common in schools. Overall, evidence suggests that poor IEQ in schools is common and adversely influences the performance and attendance of students, primarily through health effects from indoor pollutants. Evidence is available to justify (i) immediate actions to assess and improve IEQ in schools and (ii) focused research to guide IEQ improvements in schools. PRACTICAL IMPLICATIONS There is more justification now for improving IEQ in schools to reduce health risks to students than to reduce performance or attendance risks. However, as IEQ-performance links are likely to operate largely through effects of IEQ on health, IEQ improvements that benefit the health of students are likely to have performance and attendance benefits as well. Immediate actions are warranted in schools to prevent dampness problems, inadequate ventilation, and excess indoor exposures to substances such as NO(2) and formaldehyde. Also, siting of new schools in areas with lower outdoor pollutant levels is preferable.
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Affiliation(s)
- M J Mendell
- Lawrence Berkeley National Laboratory, Environmental Energy Technologies Division, Indoor Environment Department, Berkeley, CA 94720, USA.
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12
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Jaakkola MS, Jaakkola JJK. Indoor molds and asthma in adults. ADVANCES IN APPLIED MICROBIOLOGY 2004; 55:309-38. [PMID: 15350800 DOI: 10.1016/s0065-2164(04)55012-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Maritta S Jaakkola
- Institute of Occupational and Environmental Medicine, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom
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13
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Park JH, Schleiff PL, Attfield MD, Cox-Ganser JM, Kreiss K. Building-related respiratory symptoms can be predicted with semi-quantitative indices of exposure to dampness and mold. INDOOR AIR 2004; 14:425-433. [PMID: 15500636 DOI: 10.1111/j.1600-0668.2004.00291.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
UNLABELLED Using a semi-quantitative mold exposure index, the National Institute for Occupational Safety and Health (NIOSH) investigated 13 college buildings to examine whether building-related respiratory symptoms among employees are associated with environmental exposure to mold and dampness in buildings. We collected data on upper and lower respiratory symptoms and their building-relatedness, and time spent in specific rooms with a self-administered questionnaires. Trained NIOSH industrial hygienists classified rooms for water stains, visible mold, mold odor, and moisture using semi-quantitative scales and then estimated individual exposure indices weighted by the time spent in specific rooms. The semi-quantitative exposure indices significantly predicted building-related respiratory symptoms, including wheeze [odds ratio (OR) = 2.3; 95% confidence interval (CI) = 1.1-4.5], chest tightness (OR = 2.2; 95% CI = 1.1-4.6), shortness of breath (OR = 2.7; 95% CI = 1.2-6.1), nasal (OR = 2.5; 95% CI = 1.3-4.7) and sinus (OR = 2.2; 95% CI = 1.2-4.1) symptoms, with exposure-response relationships. We found that conditions suggestive of indoor mold exposure at work were associated with building-related respiratory symptoms. Our findings suggest that observational semi-quantitative indices of exposure to dampness and mold can support action to prevent building-related respiratory diseases. PRACTICAL IMPLICATIONS Current air sampling methods have major limitations in assessing exposure to mold and other biological agents that may prevent the demonstration of associations of bioaerosol exposure with health. Our study demonstrates that semi-quantitative dampness/mold exposure indices, based solely on visual and olfactory observation and weighted by time spent in specific rooms, can predict existence of excessive building-related respiratory symptoms and diseases. Relative extent of water stains, visible mold, mold odor, or moisture can be used to prioritize remediation to reduce potential risk of building-related respiratory diseases. From a public health perspective, these observational findings justify action to correct water leaks and repair water damage in order to prevent building-related respiratory diseases. This approach can also be a basis for developing practical building-diagnostic tools for water-incursion.
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Affiliation(s)
- J-H Park
- National Institute for Occupational Safety and Health, Division of Respiratory Disease Studies, Field Studies Branch, Morgantown, WV 26505, USA.
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14
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Shendell DG, Barnett C, Boese S. Science-based recommendations to prevent or reduce potential exposure to biological, chemical, and physical agents in schools. THE JOURNAL OF SCHOOL HEALTH 2004; 74:390-396. [PMID: 15724565 DOI: 10.1111/j.1746-1561.2004.tb06603.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The U.S. General Accounting Office (GAO) documented generally poor conditions of school facilities in the early 1990s. Previous papers examined, for time intervals ending before 2002, relationships between education facility indoor air and environmental quality (IEQ), including adequate ventilation, and occupant health and productivity. Research on IEQ related specifically to new or refurbished traditional school construction, or portable classrooms, is limited. A review of school IEQ literature through fall 2003 was conducted. Then, acknowledging the limited resources and competing priorities facing American schools, practical science-based, best practices recommendations to promote IEQ and hence prevent or reduce potential occupant exposure to biological, chemical, and physical agents of concern were proposed. Electronic search engines, conference proceedings, the Internet, and reference lists of peer-reviewed papers and reports were used. Eighteen best practices based on scientific references are presented.
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Affiliation(s)
- Derek G Shendell
- Healthy Schools Network, Inc., 1839 Holland Drive, Walnut Creek, CA 94597-2242, USA.
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15
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Affiliation(s)
- P S Burge
- Occupational Lung Disease Unit, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham B9 5SS, UK.
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16
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Nieminen SM, Kärki R, Auriola S, Toivola M, Laatsch H, Laatikainen R, Hyvärinen A, Von Wright A. Isolation and identification of Aspergillus fumigatus mycotoxins on growth medium and some building materials. Appl Environ Microbiol 2002; 68:4871-5. [PMID: 12324333 PMCID: PMC126391 DOI: 10.1128/aem.68.10.4871-4875.2002] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Genotoxic and cytotoxic compounds were isolated and purified from the culture medium of an indoor air mold, Aspergillus fumigatus. One of these compounds was identified as gliotoxin, a known fungal secondary metabolite. Growth of A. fumigatus and gliotoxin production on some building materials were also studied. Strong growth of the mold and the presence of gliotoxin were detected on spruce wood, gypsum board, and chipboard under saturation conditions.
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Affiliation(s)
- Susanna M Nieminen
- Department of Pharmaceutical Chemistry, University of Kuopio, 70211 Kuopio, Finland.
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Graudenz GS, Kalil J, Saldiva PH, Gambale W, Latorre MDRDO, Morato-Castro FF. Upper respiratory symptoms associated with aging of the ventilation system in artificially ventilated offices in São Paulo, Brazil. Chest 2002; 122:729-35. [PMID: 12171858 DOI: 10.1378/chest.122.2.729] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND The increase of work-related respiratory complaints in artificially ventilated buildings has multiple causes, and the role of allergen exposure and symptoms is still controversial. STUDY OBJECTIVES To analyze the risk factors and the association of work-related symptoms with allergen exposure and different conditions of the same air conditioning system in São Paulo, Brazil. DESIGN Workers were classified according to characteristics of the air conditioning system: the first group (group 1) with ventilation machinery and ducts with > 20 years of use, the second group (group 2) with ventilation machinery with > 20 years of use and ventilation ducts with < 2 years of use, and the third group (group 3) with ventilation machinery and ducts with < 2 years of use. Logistic regression was performed to check the associations between air conditioning groups, allergen exposure (fungi, mites, animal dander, and cockroach), and symptoms. RESULTS There was a higher prevalence of building-related worsening of respiratory symptoms (p = 0.004; odds ratio [OR], 8.53) and symptoms of rhinoconjunctivitis (p = 0.01; OR, 8.49) in group 1. There was a lower relative humidity (p = 0.05) and nonsignificant lower temperature in group 1, when compared to the other groups. The viable mold spores totals were higher outdoors than in the indoor samples (n = 45, p = 0.017). There were higher levels of Der p 1 in group 2 (p = 0.032). All allergen levels were considered low. CONCLUSION There was a strong association of building-related upper-airway symptoms with places having ventilation systems with > 20 years of use.
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Affiliation(s)
- Gustavo S Graudenz
- Division of Allergy and Clinical Immunology, Internal Medicine Department, School of Medicine, University of São Paulo, Brazil.
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Wan GH, Li CS. Indoor endotoxin and glucan in association with airway inflammation and systemic symptoms. ARCHIVES OF ENVIRONMENTAL HEALTH 1999; 54:172-9. [PMID: 10444038 DOI: 10.1080/00039899909602256] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Indoor bioaerosols (i.e., bacteria, fungi, endotoxin, and beta-1,3-glucan) were determined in daycare centers, office buildings, and domestic environments in the Taipei area. In addition, we used a questionnaire survey to determine associations between indoor dampness, bioaerosols, and airway inflammation and systemic symptoms. We demonstrated that the median levels of indoor bacteria and fungi were the highest in daycare centers, followed by those in homes and office buildings. Similar patterns were observed for endotoxin and beta-1,3-glucan. The prevalences of airway inflammation and systemic symptoms were higher for females in office buildings than for employees in daycare centers; all symptoms were more prevalent in females than males. With respect to the relationship between bioaerosol exposure and airway inflammation and systemic symptoms, we found a strong association between beta-1,3-glucan and lethargy/fatigue.
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Affiliation(s)
- G H Wan
- Graduate Institute of Public Health, National Taiwan University, Taipei, Republic of China
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Wan GH, Li CS. Dampness and airway inflammation and systemic symptoms in office building workers. ARCHIVES OF ENVIRONMENTAL HEALTH 1999; 54:58-63. [PMID: 10025418 DOI: 10.1080/00039899909602238] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
To evaluate dose-response relationships between airway inflammation/systemic symptoms and dampness exposure, we conducted a self-reported questionnaire study on risk factors among 1237 employees in 19 air-conditioned office buildings in the Taipei area. The odds ratio for eye irritation was 1.34 when either stuffy odor or mold was present in the buildings. The odds ratio increased to 1.72 when both stuffy odor and mold were present, to 3.14 when water damage was also present, and to 5.03 when four dampness exposure factors were present. Dampness in the building had a dose-response effect on eye irritation, cough, and lethargy/fatigue.
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Affiliation(s)
- G H Wan
- Graduate Institute of Public Health, College of Public Health, National Taiwan University, Taipei, Republic of China
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Wilkins CK, Larsen ST, Hammer M, Poulsen OM, Wolkoff P, Nielsen GD. Respiratory effects in mice exposed to airborne emissions from Stachybotrys chartarum and implications for risk assessment. PHARMACOLOGY & TOXICOLOGY 1998; 83:112-9. [PMID: 9783329 DOI: 10.1111/j.1600-0773.1998.tb01453.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Stachybotrys chartarum, a mycotoxin producing mould found in some damp buildings, was grown in aluminum dishes in closed exposure chambers. The loading factor, 5.12 m2/m3, corresponded to 2.8 times the loading in a normal room with all surfaces covered by mould. Sensory irritation, bronchoconstriction and pulmonary irritation effects were investigated using a sensitive mouse bioassay in which the airway reactions were measured plethysmographically. Little effect was seen from the vapours in agreement with the predicted effects of the low concentrations of volatile organic compounds measured. Even under the influence of an airflow about four times that measured in normal buildings, the concentration of liberated spores and other particles was very low, corresponding to the biological effects observed, and probably reflecting the high water content of the substrate. These results demonstrate that many factors are important for the transport of biologically active mould metabolites from building material to occupants and that no direct relationship may exist between immediate biological effects and surface area covered with mould. Therefore, risk assessments should be based on estimated effects of emitted vapours, effects of liberated particles, e.g. sensitization potentials of the mould spores and effects of the generated metabolites (mycotoxins).
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Affiliation(s)
- C K Wilkins
- National Institute of Occupational Health, Copenhagen, Denmark
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Abstract
A study was undertaken in a number of rowhouses, some of which had had previous problems related to dampness and water leakage. The aim of the study was to assess the relation between exposure to airborne (1--> 3)-beta-D-glucan, a cell-wall substance in molds, and airways inflammation. The study involved 75 houses with indoor (1--> 3)-beta-D-glucan levels ranging from 0 to 19 ng/m3. Of 170 invited tenants, 129 (76%) participated in the study. A questionnaire relating to symptoms was used, and measurements were made of lung function and airway responsiveness. Myeloperoxidase (MPO), eosinophilic cationic protein (ECP), and C-reactive protein (CRP) were measured in serum. Atopy was determined with the Phadiatop test. The major findings were a relation between exposure to (1--> 3)- beta-D-glucan and an increased prevalence of atopy, a slightly increased amount of MPO, and a decrease in FEV1 over the number of years lived in the house. The results suggests the hypothesis that exposure to (1--> 3)-beta-D-glucan or molds indoors could be associated with signs of a non-specific inflammation.
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Affiliation(s)
- J Thorn
- Department of Environmental Medicine, University of Gothenburg, Gothenburg, Sweden
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