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Salonen H, Salthammer T, Morawska L. Human exposure to NO 2 in school and office indoor environments. ENVIRONMENT INTERNATIONAL 2019; 130:104887. [PMID: 31195224 DOI: 10.1016/j.envint.2019.05.081] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 05/28/2019] [Accepted: 05/31/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Although nitrogen dioxide (NO2) is one of the most common air pollutants encountered indoors, and extensive literature has examined the link between NO2 exposure and duration causing adverse respiratory effects in susceptible populations, information about global and local exposure to NO2 in different indoor environments is limited. To synthesize the existing knowledge, this review analyzes the magnitude of and the trends in global and local exposure to NO2 in schools and offices, and the factors that control exposure. METHODS For the literature review, Web of Science, SCOPUS, Google Scholar, and PubMed were searched using 42 search terms and their combinations to identify manuscripts, reports, and directives published between 1971 and 2019. The search was then extended to the reference lists of relevant articles. RESULTS The calculated median, as well as the mean, concentration of NO2 in school (median 21.1 μg/m3; mean 29.4 μg/m3) and office settings (median 22.7 μg/m3; mean 25.1 μg/m3) was well below the World Health Organization (WHO) guideline of 40 μg/m3 for the annual mean NO2 concentration. However, a large range of average concentrations of NO2 were reported, from 6.00 to 68.5 μg/m3 and from 3.40 to 56.5 μg/m3 for school and office environments, respectively, indicating situations where the WHO guidelines are exceeded. Outdoor levels of NO2 are a reliable predictor of indoor NO2 levels across seasons, with mean and median Indoor/Outdoor (I/O) ratios of 0.9 and 0.7 in school and 0.9 and 0.8 in office environments, respectively. The absence of major indoor NO2 emission sources and NO2 sinks, including chemical reactions and deposition, are the reasons for lower indoor NO2 concentrations. During the winter, outdoor NO2 concentrations are generally higher than during the summer. In addition, various building and indoor environment characteristics, such as type of ventilation, air exchange rates, airtightness of the envelope, furnishing and surface characteristics of the building, location of the building (urban versus suburban and proximity to traffic routes), as well as occupants' behavior (such as opening windows), have been statistically significantly associated with indoor NO2 levels in school and office environments. CONCLUSIONS Indoor exposure to NO2 from the infiltration of ambient air can be significant in urban areas, and in the case of high traffic volume. Although reducing transportation emissions is challenging, there are several easier means to reduce indoor NO2 concentrations, including a ventilation strategy with suitable filters; location planning of new schools, classrooms, and ventilating windows or intakes; traffic planning (location and density); and reducing the use of NO2-releasing indoor sources.
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Affiliation(s)
- Heidi Salonen
- Aalto University, Department of Civil Engineering, PO Box 12100, FI-00076 Aalto, Finland; Queensland University of Technology, International Laboratory for Air Quality and Health, 2 George Street, Brisbane Q 4001, Australia.
| | - Tunga Salthammer
- Queensland University of Technology, International Laboratory for Air Quality and Health, 2 George Street, Brisbane Q 4001, Australia; Fraunhofer WKI, Department of Material Analysis and Indoor Chemistry, 38108 Braunschweig, Germany.
| | - Lidia Morawska
- Queensland University of Technology, International Laboratory for Air Quality and Health, 2 George Street, Brisbane Q 4001, Australia
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Chaiear N, Saejiw N, Dithisawatwet S, Polpila P, Paratako K, Chuntum K. The Discovery of an Unusual Cause of Indoor Radiation Pollution. Asia Pac J Public Health 2016; 18:46-50. [PMID: 16883970 DOI: 10.1177/10105395060180020801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The objective of our study is to investigate the reasons why 21 persons suffered erythema and other skin changes, and conjunctivae infection after staying in a closed room for three hours. A multi-disciplinary case study including interviews, building and ventilation inspections, was performed by a multidisciplinary team comprising a medical epidemiologist, and an industrial hygienist. A self-administered questionnaire was designed to determine the magnitude of the health problem of the affected students. By a process of investigative elimination, we deduced that the symptoms were caused by accidental exposure to ultraviolet C radiation where it was radiated from the germicidal ultraviolet lamps. The most common symptoms and signed presented were erythema of skin and conjunctivae infection. The erythema of skin and conjunctivae infection arose from exposure to ultraviolet C radiation and that safeguards are needed to ensure ultraviolet germicidal lamps are not accidentally switched on while a room is occupied.
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Affiliation(s)
- N Chaiear
- Department of Community Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
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Byber K, Flatz A, Norbäck D, Hitzke C, Imo D, Schwenkglenks M, Puhan MA, Dressel H, Mutsch M. Humidification of indoor air for preventing or reducing dryness symptoms or upper respiratory infections in educational settings and at the workplace. Hippokratia 2016. [DOI: 10.1002/14651858.cd012219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Katarzyna Byber
- University of Zurich and University Hospital Zurich; Division of Occupational and Environmental Medicine; Rämistrasse 100 Zurich Switzerland 8091
| | - Aline Flatz
- Lausanne University Hospital; Cochrane Switzerland, Institute of Social and Preventive Medicine; Route de la Corniche 10 Lausanne Switzerland CH-1010
| | - Dan Norbäck
- Uppsala University; Department of Medical Science; Uppsala Sweden
| | - Christine Hitzke
- University of Zurich and University Hospital Zurich; Division of Occupational and Environmental Medicine; Rämistrasse 100 Zurich Switzerland 8091
| | - David Imo
- University of Zurich; Division of Occupational and Environmental Medicine; Hirschengraben 84 Zurich Switzerland 8001
| | - Matthias Schwenkglenks
- University of Zurich; Epidemiology, Biostatistics and Prevention Institute; Hirschengraben 84 Zurich Switzerland
| | - Milo A Puhan
- University of Zurich; Epidemiology, Biostatistics and Prevention Institute; Hirschengraben 84 Zurich Switzerland
| | - Holger Dressel
- University of Zurich and University Hospital Zurich; Division of Occupational and Environmental Medicine; Rämistrasse 100 Zurich Switzerland 8091
| | - Margot Mutsch
- University of Zurich; Epidemiology, Biostatistics and Prevention Institute; Hirschengraben 84 Zurich Switzerland
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Hori H, Ishimatsu S, Fueta Y, Ishidao T. Evaluation of a real-time method for monitoring volatile organic compounds in indoor air in a Japanese university. Environ Health Prev Med 2013; 18:285-292. [PMID: 23184473 PMCID: PMC3709044 DOI: 10.1007/s12199-012-0319-1 10.1016/j.atmosenv.2013.11.061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Accepted: 11/06/2012] [Indexed: 06/14/2023] Open
Abstract
OBJECTIVE Real time monitoring of total volatile organic compounds (TVOC) in rooms of Japanese university buildings was carried out to understand the temporal changes in actual indoor air quality. METHODS The TVOC concentrations in seven different rooms, consisting of a lecture room, a seminar room, three laboratories, a computer room and a library, were monitored continuously for 24 h via a personal VOC monitor equipped with a semiconductor gas sensor. An active sampling-thermal desorption method using stainless steel tubes packed with Tenax-TA was also carried out simultaneously to verify the usability of the monitor. RESULTS The TVOC concentrations measured by the personal VOC monitor were closely correlated with those measured by the active sampling method. The TVOC concentration in all rooms was generally low during the day and increased during the night. This concentration change corresponded to the ventilation cycle in the building. During the day, the TVOC concentration was generally lower than the provisional target criterion (advisable value) of indoor air quality in Japan (400 μg/m³). During the night, however, it exceeded this criterion in several rooms, especially during the summer season. CONCLUSION The real-time monitor using a semiconductor gas sensor can provide useful data on changes in the TVOC concentration in indoor air with high sensitivity.
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Affiliation(s)
- Hajime Hori
- Department of Environmental Management, School of Health Sciences, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan.
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Hori H, Ishimatsu S, Fueta Y, Ishidao T. Evaluation of a real-time method for monitoring volatile organic compounds in indoor air in a Japanese university. Environ Health Prev Med 2012. [PMID: 23184473 DOI: 10.1007/s12199-012-0319-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Real time monitoring of total volatile organic compounds (TVOC) in rooms of Japanese university buildings was carried out to understand the temporal changes in actual indoor air quality. METHODS The TVOC concentrations in seven different rooms, consisting of a lecture room, a seminar room, three laboratories, a computer room and a library, were monitored continuously for 24 h via a personal VOC monitor equipped with a semiconductor gas sensor. An active sampling-thermal desorption method using stainless steel tubes packed with Tenax-TA was also carried out simultaneously to verify the usability of the monitor. RESULTS The TVOC concentrations measured by the personal VOC monitor were closely correlated with those measured by the active sampling method. The TVOC concentration in all rooms was generally low during the day and increased during the night. This concentration change corresponded to the ventilation cycle in the building. During the day, the TVOC concentration was generally lower than the provisional target criterion (advisable value) of indoor air quality in Japan (400 μg/m³). During the night, however, it exceeded this criterion in several rooms, especially during the summer season. CONCLUSION The real-time monitor using a semiconductor gas sensor can provide useful data on changes in the TVOC concentration in indoor air with high sensitivity.
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Affiliation(s)
- Hajime Hori
- Department of Environmental Management, School of Health Sciences, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan.
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Saijo Y, Sata F, Mizuno S, Yamaguchi K, Sunagawa H, Kishi R. Indoor airborne mold spores in newly built dwellings. Environ Health Prev Med 2012; 10:157-61. [PMID: 21432155 DOI: 10.1007/bf02900809] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2004] [Accepted: 01/05/2005] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To investigate the relationships between sick building syndrome and mold in newly-built dwellings. METHODS Symptoms of 61 residents in 18 dwellings were surveyed by standardized questionnaires. Mold sampling was done by gravity sampling using an open Petri dish. Potato dextrose agar (PDA) and dichloran-18% glycerol agar (DG-18) were used as the culture medium. RESULTS There were 6 dwellings in which at least one inhabitant complained of one or more symptoms and 12 dwellings in which none of the inhabitants complained of symptoms. There was a tendency for the dwellings with inhabitants reporting symptoms to have larger colony forming units (CFU) on PDA than those without inhabitants reporting symptoms (p=0.1), but there was no difference in DG-18 result. There was a tendency for the dwellings with inhabitants reporting symptoms to have larger CFU ofCladosporium on PDA than those without (p=0.08), but there was no difference in DG-18 result. Significantly moreUlocladium sp. was detected in the dwellings with inhabitants reporting symptoms than in those without (p=0.03).Cladosporium cladosporioides was detected in all the dwellings with inhabitants reporting symptoms and 75% of the dwellings without.Cladosporium macrocarpum andCladosporium herbarum were detected in 33% of the dwellings with inhabitants reporting e symptoms and none of the dwellings without (p=0.1). CONCLUSION Cladosporium was dominant in the Japanese newly-built dwellings studied, andCladosporium andUlocladium were probably associated with the residents' symptoms in these newly-built dwellings.
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Affiliation(s)
- Yasuaki Saijo
- Department of Public Health, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, 060-8638, Sapporo, Japan,
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Wong SK, Wai-Chung Lai L, Ho DCW, Chau KW, Lo-Kuen Lam C, Hung-Fai Ng C. Sick building syndrome and perceived indoor environmental quality: A survey of apartment buildings in Hong Kong. HABITAT INTERNATIONAL 2009; 33:463-471. [PMID: 32287695 PMCID: PMC7124323 DOI: 10.1016/j.habitatint.2009.03.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The outbreak of a highly communicable disease, SARS, in Asia in 2003 has revealed the health risk of living in a high-density environment. To show the important connection between human health and environmental quality, this study surveys the prevalence of sick building syndrome (SBS) among apartment residents and their evaluation of indoor environmental quality (IEQ). Based on a sample of 748 households living in Hong Kong, two interesting findings are revealed: (1) nasal discomfort was the commonest home-related SBS symptom despite the absence of any central ventilation system in apartment buildings; (2) noise, rather than ventilation, was the major IEQ problem perceived by residents. Our statistical analysis further showed that residents with SBS symptoms were less satisfied with their IEQ than those without. That is, despite a positive evaluation of specific IEQ criteria with respect to the building residents lived in, if they reported feeling SBS related symptoms, the overall IEQ evaluation of their building could still be negative. This perception bias gives rise to a sample selection problem in measuring perceived IEQ, which has implications on housing management practices and the formulation of a healthy housing policy.
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Affiliation(s)
- Siu-Kei Wong
- Department of Real Estate and Construction, The University of Hong Kong, Pokfulam Road, Hong Kong
| | - Lawrence Wai-Chung Lai
- Department of Real Estate and Construction, The University of Hong Kong, Pokfulam Road, Hong Kong
| | - Daniel Chi-Wing Ho
- Department of Real Estate and Construction, The University of Hong Kong, Pokfulam Road, Hong Kong
| | - Kwong-Wing Chau
- Department of Real Estate and Construction, The University of Hong Kong, Pokfulam Road, Hong Kong
| | - Cindy Lo-Kuen Lam
- Family Medicine Unit, Department of Medicine, The University of Hong Kong, Hong Kong
| | - Chris Hung-Fai Ng
- Development Bureau, Hong Kong Special Administrative Region Government, Hong Kong
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Takigawa T, Wang BL, Sakano N, Wang DH, Ogino K, Kishi R. A longitudinal study of environmental risk factors for subjective symptoms associated with sick building syndrome in new dwellings. THE SCIENCE OF THE TOTAL ENVIRONMENT 2009; 407:5223-5228. [PMID: 19608217 DOI: 10.1016/j.scitotenv.2009.06.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2009] [Revised: 05/27/2009] [Accepted: 06/23/2009] [Indexed: 05/28/2023]
Abstract
This study was performed to explore possible environmental risk factors, including indoor chemicals, mold, and dust mite allergens, which could cause sick building syndrome (SBS)-type symptoms in new houses. The study was conducted in 2004 and 2005 and the final study population consisted of 86 men and 84 women residing in Okayama, Japan. The indoor concentrations of indoor aldehydes, volatile organic compounds, airborne fungi, and dust mite allergens in their living rooms were measured and the longitudinal changes in two consecutive years were calculated. A standardized questionnaire was used concomitantly to gather information on frequency of SBS-type symptoms and lifestyle habits. About 10% of the subjects suffered from SBS in the both years. Crude analyses indicated tendencies for aldehyde levels to increase frequently and markedly in the newly diseased and ongoing SBS groups. Among the chemical factors and molds examined, increases in benzene and in Aspergillus contributed to the occurrence of SBS in the logistic regression model. Indoor chemicals were the main contributors to subjective symptoms associated with SBS. A preventive strategy designed to lower exposure to indoor chemicals may be able to counter the occurrence of SBS.
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Affiliation(s)
- Tomoko Takigawa
- Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558 Okayama, Japan.
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Graudenz GS, Oliveira CH, Tribess A, Landgraf RG, Jancar IS, Kalil J. Sudden temperature changes and respiratory symptoms--an experimental approach. ACTA ACUST UNITED AC 2007; 21:383-7. [PMID: 17621828 DOI: 10.2500/ajr.2007.21.3023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Exposure to air-conditioning systems and allergic phenotypes are consistent risk factors to develop indoor air quality (IAQ) respiratory complaints. The aim of this study was to compare the role of allergic rhinitis on respiratory complaints in individuals exposed to sudden temperature changes. METHODS To address this question, a case-control challenge study was performed in a laboratory of thermal comfort evaluation with twin isolated chambers set at 14 degrees C/57.2 degrees F (cold) and 26 degrees C/78.8 degrees F (hot) temperatures. A groups of 32 patients with persistent allergic rhinitis (rhinitis group) and 16 control subjects (control group) were exposed for 30 minutes, three times alternately in the chambers. Symptoms were reported using an analog visual scale and nasal and pulmonary peak flow measurements were taken during baseline at hot and cold temperatures and after the challenge. RESULTS The rhinitis group reported increased itching and stinging eyes when compared with the baseline during exposure to hot and cold temperatures and they also reported increased breathlessness during hot air exposure. In addition, there was a significant decrease in expiratory flow rates in this group during exposure to hot and cold temperatures that persisted for 24 hours after challenge. CONCLUSION This study suggests that individuals with allergic rhinitis have a lower threshold than controls to develop respiratory and ocular symptoms after air-conditioning-induced sudden temperature changes.
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Affiliation(s)
- Gustavo Silveira Graudenz
- Division of Allergy and Clinical Immunology, Internal Medicine Department, School of Medicine, Millennium Institute, University of Sao Paulo, Sao Paulo- SP, Brazil.
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Graudenz GS, Latorre MRDO, Tribess A, Oliveira CH, Kalil J. Persistent allergic rhinitis and indoor air quality perception--an experimental approach. INDOOR AIR 2006; 16:313-9. [PMID: 16842611 DOI: 10.1111/j.1600-0668.2006.00428.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: 05/10/2023]
Abstract
In order to compare patterns of indoor air perception, including perceptions of temperature, air movement, indoor air quality (IAQ), mental concentration, and comfort, 33 subjects either with persistent allergic rhinitis or controls were exposed to different temperatures and constant relative humidity in an experimental office environment. Results were obtained by means of a self-administered visual analogue scale, analyzed using mean score comparisons and principal component analysis. At 14 degrees C, the rhinitis group reported higher scores for sensations of air dryness than controls. At 18 degrees C, in the rhinitis group, there was a correlation between dry, stagnant air, and difficult mental concentration. This group also correlated heat, dry air, and poor IAQ, in contrast to the control group, which correlated comfort, easy mental concentration, and freshness. At 22 degrees C, the rhinitis group correlated heat, dryness, stagnant air, and overall discomfort. This group also correlated non-dry air, freshness, and comfort, whereas the control group correlated heat, humidity, good indoor air, freshness, and comfort. This study suggests that the rhinitis group perceives indoor temperatures of 14 degrees C as dryer than controls do, and that at 18 and 22 degrees C this group positively correlates different adverse perceptions of IAQ. By means of a self-administered questionnaire in an experimental condition, the present study compares subjective patterns of indoor air perception from individuals with respiratory allergy (allergic rhinitis) to control individuals. It reports different patterns of perception of indoor air quality (IAQ) between the two groups, suggesting that allergic individuals could have different IAQ perception.
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Affiliation(s)
- G S Graudenz
- Internal Medicine Department, Division of Allergy and Clinical Immunology, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
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Microbial Contamination in Airplane Cabins:Health Effects and Remediation. THE HANDBOOK OF ENVIRONMENTAL CHEMISTRY 2005. [PMCID: PMC7120199 DOI: 10.1007/b107242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Microorganisms that affect human health are found in all indoor environments, including cabins
of commercial aircraft. Those that arise from human sources can be transmitted by direct contact,
droplets, or the airborne route. Infections from human sources include Influenza, Rhinovirus, SARS
and tuberculosis. Transmission by the airborne route can be reduced by sterilizing the air with ultraviolet
germicidal irradiation, or by diluting the contaminated air with outdoor air through ventilation.
Microbes arising from environmental sources include bacteria, fungi and other organisms such as protozoa.
These usually have very simple requirements for growth – water and a simple substrate such
as dust. They cause health effects through direct infection rarely (one example is Legionnella),
but more commonly cause immune reactions resulting in hypersensitivity or allergy mediated diseases.
Environmental sources of microbial contamination are best prevented, but can be remediated through
cleaning, germicidal chemicals, or ultraviolet germicidal irradiation. Airborne microbial substances
including toxins, antigens and viable organisms can be removed by outdoor air ventilation or filtration.
In aircraft cabins transmission of pathogens from human sources is difficult to control, but airborne
transmission can be reduced through increased outdoor air ventilation or filtration. Environmental
microbial contamination can, and does occur in aircraft cabins. These microbial sources are best
prevented but, if detected, can be removed through cleaning or disinfection. Ultraviolet germicidal
irradiation is an under-utilized technology that may be useful for sterilizing air as well as potential
environmental sources.
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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. [PMID: 15558298 DOI: 10.1007/s00420-004-0535-0] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2003] [Accepted: 04/02/2004] [Indexed: 10/26/2022]
Abstract
OBJECTIVES As the airtightness of dwellings has recently increased, problems associated with indoor air pollution and dampness have become important environmental health issues. The aim of this study was to clarify whether symptoms in residents living in newly built dwellings were related to chemicals and dampness. METHODS Symptoms of 317 residents were surveyed by standardized questionnaires, and the concentrations of formaldehyde, acetaldehyde, and 17 volatile organic compounds (VOCs) in their homes were measured. Dampness (condensation on window panes and/or walls, and mold growth) was identified by questionnaires given to the householders or their partners. RESULTS Some VOCs (toluene, butyl acetate, ethylbenzene, alpha-pinene, p-dichlorobenzene, nonanal, and xylene) were significantly related to the symptoms, and the sum of all VOCs (all identified VOCs) was significantly related to throat and respiratory symptoms [odds ratio (OR) for eye symptoms =2.4; 95% confidence interval (CI) 1.0-5.5], although the concentrations of VOCs were relatively low. As for the dampness index, condensation on window panes and/or walls was related to all symptoms, and mold growth was related to all symptoms except skin, throat and respiratory and general symptoms. As the number of dampness signs increased, the ORs increased for the symptoms except general symptoms (OR for nose symptoms = 4.4, 95% CI 1.6-11.9). CONCLUSION Both VOCs and dampness were significantly related to symptoms. We should take measures to reduce the concentrations of VOCs, dampness and microbial growth in dwellings.
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Affiliation(s)
- Y Saijo
- Department of Public Heath, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
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Menzies D, Popa J, Hanley JA, Rand T, Milton DK. Effect of ultraviolet germicidal lights installed in office ventilation systems on workers' health and wellbeing: double-blind multiple crossover trial. Lancet 2003; 362:1785-91. [PMID: 14654316 DOI: 10.1016/s0140-6736(03)14897-0] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Workers in modern office buildings frequently have unexplained work-related symptoms or combinations of symptoms. We assessed whether ultraviolet germicidal irradiation (UVGI) of drip pans and cooling coils within ventilation systems of office buildings would reduce microbial contamination, and thus occupants' work-related symptoms. METHODS We undertook a double blind, multiple crossover trial of 771 participants. In office buildings in Montreal, Canada, UVGI was alternately off for 12 weeks, then turned on for 4 weeks. We did this three times with UVGI on and three times with it off, for 48 consecutive weeks. Primary outcomes of self-reported work-related symptoms, and secondary outcomes of endotoxin and viable microbial concentrations in air and on surfaces, and other environmental covariates were measured six times. FINDINGS Operation of UVGI resulted in 99% (95% CI 67-100) reduction of microbial and endotoxin concentrations on irradiated surfaces within the ventilation systems. 771 participants appeared to remain masked, and reported no adverse effects. On the basis of within-person estimates, use of UVGI was associated with significantly fewer work-related symptoms overall (adjusted odds ratio 0.8 [95% CI 0.7-0.99]), as well as respiratory (0.6 [0.4-0.9]) and mucosal (0.7 [0.6-0.9]) symptoms than was non-use. Reduction of work-related mucosal symptoms was greatest among atopic workers (0.6 [0.5-0.8]), and never-smokers (0.7 [0.5-0.9]). With UVGI on, never-smokers also had large reduction of work-related respiratory (0.4 [0.2-0.9]), and musculoskeletal symptoms (0.5 [0.3-0.9]). INTERPRETATION Installation of UGVI in most North American offices could resolve work-related symptoms in about 4 million employees, caused by microbial contamination of heating, ventilation, and air-conditioning systems. The cost of UVGI installation could in the long run prove cost-effective compared with the yearly losses from absence because of building-related illness.
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Affiliation(s)
- Dick Menzies
- Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, Montreal, Quebec, Canada.
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Piccoli B. A critical appraisal of current knowledge and future directions of ergophthalmology: consensus document of the ICOH Committee on 'Work and Vision'. ERGONOMICS 2003; 46:384-406. [PMID: 12637175 DOI: 10.1080/0014013031000067473] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
In the past, occupational health gave scant attention to the visual apparatus. Studies on issues relating to 'work and vision' have predominantly addressed industrial accidents and the toxic effects of exposure to chemical and physical agents, with secondary prevention being more common than primary prevention. In recent years, the huge transformations implemented in workplaces, mainly due to computer-based technologies, demand a progressively higher efficiency of the eye and the related nervous system components that co-ordinate eye movements and accommodation. At the moment these aspects are managed by medical, psychosocial and a variety of technical disciplines, without any shared criteria, terminology and method. Objectives of the Committee are: to investigate holistically the many possible hazards associated to the occupational visual performance; to come to a consensus on terminology, risk assessment and health surveillance procedures. The present status of research and practice in ergophthalmology does not allow for clear-cut decision about health risk and nor is there a clear direction on the prevention of work-related ocular and visual disturbances and disorders. Specifically, at least three determinants must be objectively considered, namely: (a) visual effort; (b) environmental agents; (c) individual characteristics. Although criteria exist for the evaluation of some of these determinants, a greater refinement is necessary 'for a good working life' of the visual apparatus. The ICOH Scientific Committee on 'Work and Vision' is seeking to systematically develop this matter, yielding a more rational and complete approach to the relationship between work and vision.
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Affiliation(s)
- Bruno Piccoli
- Department of Occupational Health, University of Milan-ICO Hospital Via San Barnaba, Italy.
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Schneider T, Sundell J, Bischof W, Bohgard M, Cherrie JW, Clausen PA, Dreborg S, Kildesø J, Kaergaard SK, Løvik M, Pasanen P, Skyberg K. 'EUROPART'. Airborne particles in the indoor environment. A European interdisciplinary review of scientific evidence on associations between exposure to particles in buildings and health effects. INDOOR AIR 2003; 13:38-48. [PMID: 12608924 DOI: 10.1034/j.1600-0668.2003.02025.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The relevance of particle mass, surface area or number concentration as risk indicators for health effects in non-industrial buildings has been assessed by a European interdisciplinary group of researchers (called EUROPART) by reviewing papers identified in Medline, Toxline, and OSH. Studies dealing with dermal effects or cancer or specifically addressing environmental tobacco smoke, house dust-mite, cockroach or animal allergens, microorganisms and pesticides were excluded. A total of 70 papers were reviewed, and eight were identified for the final review: Five experimental studies involving mainly healthy subjects, two cross-sectional office studies and one longitudinal study among elderly on cardiovascular effects. From most studies, no definite conclusions could be drawn. Overall, the group concluded that there is inadequate scientific evidence that airborne, indoor particulate mass or number concentrations can be used as generally applicable risk indicators of health effects in non-industrial buildings and consequently that there is inadequate scientific evidence for establishing limit values or guidelines for particulate mass or number concentrations.
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Affiliation(s)
- T Schneider
- National Institute of Occupational Health, Copenhagen, Denmark.
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Kuhn DM, Ghannoum MA. Indoor mold, toxigenic fungi, and Stachybotrys chartarum: infectious disease perspective. Clin Microbiol Rev 2003; 16:144-72. [PMID: 12525430 PMCID: PMC145304 DOI: 10.1128/cmr.16.1.144-172.2003] [Citation(s) in RCA: 180] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Damp buildings often have a moldy smell or obvious mold growth; some molds are human pathogens. This has caused concern regarding health effects of moldy indoor environments and has resulted in many studies of moisture- and mold-damaged buildings. Recently, there have been reports of severe illness as a result of indoor mold exposure, particularly due to Stachybotrys chartarum. While many authors describe a direct relationship between fungal contamination and illness, close examination of the literature reveals a confusing picture. Here, we review the evidence regarding indoor mold exposure and mycotoxicosis, with an emphasis on S. chartarum. We also examine possible end-organ effects, including pulmonary, immunologic, neurologic, and oncologic disorders. We discuss the Cleveland infant idiopathic pulmonary hemorrhage reports in detail, since they provided important impetus for concerns about Stachybotrys. Some valid concerns exist regarding the relationship between indoor mold exposure and human disease. Review of the literature reveals certain fungus-disease associations in humans, including ergotism (Claviceps species), alimentary toxic aleukia (Fusarium), and liver disease (Aspergillys). While many papers suggest a similar relationship between Stachybotrys and human disease, the studies nearly uniformly suffer from significant methodological flaws, making their findings inconclusive. As a result, we have not found well-substantiated supportive evidence of serious illness due to Stachybotrys exposure in the contemporary environment. To address issues of indoor mold-related illness, there is an urgent need for studies using objective markers of illness, relevant animal models, proper epidemiologic techniques, and examination of confounding factors.
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Affiliation(s)
- D M Kuhn
- Division of Infectious Diseases, Department of Medicine, University Hospitals of Cleveland, and Case Western Reserve University, Cleveland, Ohio 44106, USA
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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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Wargocki P, Sundell J, Bischof W, Brundrett G, Fanger PO, Gyntelberg F, Hanssen SO, Harrison P, Pickering A, Seppänen O, Wouters P. Ventilation and health in non-industrial indoor environments: report from a European multidisciplinary scientific consensus meeting (EUROVEN). INDOOR AIR 2002; 12:113-128. [PMID: 12216467 DOI: 10.1034/j.1600-0668.2002.01145.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Scientific literature on the effects of ventilation on health, comfort, and productivity in non-industrial indoor environments (offices, schools, homes, etc.) has been reviewed by a multidisciplinary group of European scientists, called EUROVEN, with expertise in medicine, epidemiology, toxicology, and engineering. The group reviewed 105 papers published in peer-reviewed scientific journals and judged 30 as conclusive, providing sufficient information on ventilation, health effects, data processing, and reporting, 14 as providing relevant background information on the issue, 43 as relevant but non-informative or inconclusive, and 18 as irrelevant for the issue discussed. Based on the data in papers judged conclusive, the group agreed that ventilation is strongly associated with comfort (perceived air quality) and health [Sick Building Syndrome (SBS) symptoms, inflammation, infections, asthma, allergy, short-term sick leave], and that an association between ventilation and productivity (performance of office work) is indicated. The group also concluded that increasing outdoor air supply rates in non-industrial environments improves perceived air quality; that outdoor air supply rates below 25 l/s per person increase the risk of SBS symptoms, increase short-term sick leave, and decrease productivity among occupants of office buildings; and that ventilation rates above 0.5 air changes per hour (h-1) in homes reduce infestation of house dust mites in Nordic countries. The group concluded additionally that the literature indicates that in buildings with air-conditioning systems there may be an increased risk of SBS symptoms compared with naturally or mechanically ventilated buildings, and that improper maintenance, design, and functioning of air-conditioning systems contributes to increased prevalence of SBS symptoms.
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Affiliation(s)
- P Wargocki
- Technical University of Denmark, Kongens Lyngby, Denmark.
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Doughty MJ, Blades KA, Ibrahim N. Assessment of the number of eye symptoms and the impact of some confounding variables for office staff in non-air-conditioned buildings. Ophthalmic Physiol Opt 2002; 22:143-55. [PMID: 12014488 DOI: 10.1046/j.1475-1313.2002.00013.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE The goal of this study was both to assess the frequency of self-reported eye symptoms for employees in a non-air-conditioned office building complex, and to specifically assess whether confounding variables (contact lens wear, medicines use, and provoking stimuli) had a discernible impact on the characteristics of this reporting. METHODS A questionnaire was distributed, in the winter months, to office employees in a building complex within a city-located University site, consisting of non-air-conditioned rooms with some mechanical ventilation. The questionnaire asked respondents to identify any eye symptoms experienced (foreign body sensation, soreness, dryness, grittiness, itchiness, stinging, intense burning), the frequency of their occurrence, details of any conditions provoking eye symptoms (such as changes in the microenvironment), their medication use and if they were contact lens wearers. RESULTS The proportion of respondents for various categories was calculated, along with the total number of symptoms. If 'eye irritation' is considered as reporting any symptoms experienced at any time, then 63% of 292 respondents (median age 42.5 years) reported an average of 1.83 symptoms. However, the identification of contact lens wearers, medication use (especially for seasonal allergies) and provoking stimuli reduced this prevalence to just 29% (with the average number of symptoms being 1.51). If the frequency of experiencing symptoms was also taken into account (never, sometimes, often, and constantly), then only 12.3% of the respondents indicated symptoms often or constantly, i.e. could be considered to have significant symptoms. In all categories, men were more likely to report eye symptoms compared with women. CONCLUSIONS The results confirm that office employees are likely to have some ocular symptoms, but that even a simple consideration of possible confounding variables can greatly change the reported prevalence of eye irritation that might be specifically associated with the workplace environment.
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Niven RM, Fletcher AM, Pickering CA, Faragher EB, Potter IN, Booth WB, Jones TJ, Potter PD. Building sickness syndrome in healthy and unhealthy buildings: an epidemiological and environmental assessment with cluster analysis. Occup Environ Med 2000; 57:627-34. [PMID: 10935944 PMCID: PMC1740017 DOI: 10.1136/oem.57.9.627] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Building sickness syndrome remains poorly understood. Aetiological factors range from temperature, humidity, and air movement to internal pollutants, dust, lighting, and noise factors. The reported study was designed to investigate whether relations between symptoms of sick building syndrome and measured environmental factors existed within state of the art air conditioned buildings with satisfactory maintenance programmes expected to provide a healthy indoor environment. METHODS Five buildings were studied, three of which were state of the art air conditioned buildings. One was a naturally ventilated control building and one a previously studied and known sick building. A questionnaire was administered to the study population to measure the presence of building related symptoms. This was followed by a detailed environmental survey in identified high and low symptom areas within each building. These areas were compared for their environmental performance. RESULTS Two of the air conditioned buildings performed well with a low prevalence of building related symptoms. Both of these buildings out performed the naturally ventilated building for the low number of symptoms and in many of the environmental measures. One building (C), expected to perform well from a design viewpoint had a high prevalence of symptoms and behaved in a similar manner to the known sick building. Environmental indices associated with symptoms varied from building to building. Consistent associations between environmental variables were found for particulates (itchy eyes, dry throat, headache, and lethargy) across all buildings. There were persisting relations between particulates and symptoms (headache, lethargy, and dry skin) even in the building with the lowest level of symptoms and of measured airborne particulates (building B). There were also consistent findings for noise variables with low frequency noise being directly associated with symptoms (stuffy nose, itchy eyes, and dry skin) and higher frequency noise being relatively protective across all buildings. CONCLUSIONS This is the first epidemiological study of expected state of the art, air conditioned buildings. These buildings can produce an internal environment better than that of naturally ventilated buildings for both reported symptoms and environmental variables. The factors associated with symptoms varied widely across the different buildings studied although consistent associations for symptoms were found with increased exposure to particulates and low frequency noise.
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Affiliation(s)
- R M Niven
- North West Lung Centre, Wythenshawe Hospital, Southmoor Road, Manchester M23 9LT, UK.
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Menzies D, Comtois P, Pasztor J, Nunes F, Hanley JA. Aeroallergens and work-related respiratory symptoms among office workers. J Allergy Clin Immunol 1998; 101:38-44. [PMID: 9449499 DOI: 10.1016/s0091-6749(98)70191-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE We sought to determine the association between office workers' respiratory tract symptoms and immediate skin test reactions with exposure to fungal and house dust mite aeroallergens at their work sites. METHODS An initial prevalence survey was conducted among 1102 full-time workers in six mechanically ventilated, air-conditioned, nonindustrial buildings in downtown Montreal. Detailed environmental measures of 214 subjects' work sites were determined. Half of the workers reported frequent work-related respiratory tract symptoms on the initial survey. Participants simultaneously underwent allergy skin prick testing and completed a second self-administered questionnaire. RESULTS Contaminant levels were low and not associated with symptoms in the great majority of workers. For approximately 17% of workers, symptoms were associated with exposure to total concentrations of house dust mite allergen greater than 1 microg/gm floor dust (odds ratio [OR], 5.0; 95% confidence interval [CI], 1.3, 19.5]) or to detectable airborne Alternaria allergens in their offices (OR, 3.3; 95% CI, 1.2, 9.4 and in the ventilation system supplying their offices (OR, 3.9; 95% CI, 1.6, 9.6). Workers with positive skin test reactions to Alternaria extract were exposed at their work site to airborne Alternaria allergen (OR, 4.4; 95% CI, 1.4, 14.5) and cited significantly more respiratory symptoms on both questionnaires. Detection of airborne Alternaria allergen at work sites was significantly associated with detection in the ventilation system (OR, 4.0; 95% CI, 1.4,10.9); this was in turn associated with lower efficiency filters. CONCLUSIONS Potentially avoidable exposure to aeroallergens accounted for symptoms in a small subgroup of office workers with frequent work-related respiratory tract symptoms.
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Affiliation(s)
- D Menzies
- Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada
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Affiliation(s)
- D Menzies
- Department of Medicine, McGill University, Montreal, QC, Canada
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