A health and housing questionnaire was administered to the parents of 5,951 elementary school children as part of an air pollution cross-sectional study in nine Russian cities. Information about the child’s respiratory and medical history, along with questions about home characteristics, social status of the family, allergies and other relevant factors were collected. Logistic regression analysis examined the relationship between respiratory health conditions and housing factors. The health risks (expressed as relative odds) were controlled for gender, age, parental history of asthma or chronic lung disease, and pre-term birth. Respiratory allergy and eye irritation increased in association with traffic on street adjacent to apartment. A consistent positive association between all health conditions and two indicators of cigarette smoke exposure (lifetime exposure ever and maternal smoking during pregnancy) was observed but reached significance only for bronchitis ever and eye irritation. Water damage and molds were strongly associated with all health outcomes.

1C2o2 Moisture damage at home and childhood asthma - a case-control study

The aim of the study was to determine the association between moisture damage and indoor air microbial exposure and development of asthma among young children (1-7 yrs). The study consisted of 113 children with newly-diagnosed asthma and 217 controls. The homes were examined with a standardized protocol by civil engineers. Indoor air sampling of viable microbes was done with six-stage impactors in a subsample of 54 samples of 27 homes. Results suggest that a moisture damage in the living quarters of the home may increase the risk of asthma in early childhood.

In order to evaluate indoor air quality in houses of asthmatic and non-asthmatic children, a population based case-control study was carried out in Perth, Western Australia. Measurements of indoor formaldehyde, volatile organic compounds, particulate matter with size less then 10 microns in diameter (PM10 ), and house dust mite allergens exposure, were made on two occasions, winter and summer, over a one year period. Comparison of means for the two groups, asthmatic and non-asthmatic children, showed a tendency for significantly higher levels of indoor pollutants concentrations among cases compared to those in controls. A significant difference with season in the concentrations of formaldehyde, volatile organic compounds and allergen levels of house dust mite has been also identified. Indoor air pollutants may contribute to asthma in young children.

The occurrence of common respiratory infections were studied with self-reported questionnaires in 32 Finnish schools and the association between respiratory infections and moisture damage in different types of school buildings was estimated. Both old and new buildings with wooden and concrete/brick frame were included. An association was found between occurrence of common colds and moisture damage in all school buildings. In addition, sinusitis, tonsillitis and bronchitis were more common in concrete/brick buildings than in buildings with wooden frame irrespective with moisture observations. Occurrence of respiratory infection was also strongly correlated with background factors such as age, female gender, smoking, atopy and moisture damage in home environment.

In California, local and state agencies are facing an increasing demand for information, guidance, and enforcement on indoor environmental quality. This paper presents results from a survey of local (county and city) environmental health agencies of the types and magnitude of their services to the public regarding requests for assistance on mold complaints. While agency responses vary throughout the state, upon request most provide verbal or printed information on the potential health effects of mold and recommendations for its remediation. Queries to the State IAQ program, as indices of public concern, continue to rise; phone volume has increased nearly ten-fold since 1997, while Internet visitors have tripled in the past two years. New California regulations are pending on exposure limits, remediation guidelines, disclosure requirements, and enforcement for indoor mold.

The moisture accumulation, microbial ecology of the damage site and exposure to biological pollutants are all complex phenomena, and may result in various cases of indoor air pollution and health outcomes. Commonly reported are irritation symptoms, respiratory infections and general symptoms, but also diseases have been linked to mold, e.g., increased risk of asthma and clusters of hypersensitivity pneumonitis, pulmonary hemorrhage of infants and rheumatic diseases. Causal agents, still poorly known, may be linked to the complex interactions with the growth substrate and other microbes. Fungi and bacteria growing on building materials produce toxic secondary metabolites, and the material seems to have a critical effect on their production. Modern building technology has provided new ecological niches for microbes which readily exploit the faults in moisture control. In order to better describe the microbial exposures in buildings, current method development focuses on chemical markers of the biomass and PCR.

Several health studies have implicated mold as the cause of respiratory effects, asthma, central nervous system difficulties, and general malaise. Most of these studies have used self-reported data from questionnaires to obtain information on exposures and health outcomes Self-reported exposure is not well-correlated to airborne fungal concentrations, and self-reported symptoms or illnesses are limited in providing sufficient quality data for studying potential adverse health effects of mold. We reviewed those epidemiologic studies that attempted to use more objective measures for both exposure and health assessment. Among these studies, there appears to be a general consensus towards a positive association between mold exposure in indoor environments and respiratory effects. However, many of these studies are limited by small sample sizes, no demonstrations of dose-response relationships, exposure misclassification and other study limitations. Without better studies, a causal association cannot be confirmed at this time.

In hospitals, moisture damage and microbial growth pose a health risk not only to the personnel but also to patients. In this study, the microbial risks in two moisture damaged hospital wards and a reference ward were estimated with special reference in bathroom construction. The health effects associated with microbial growth among personnel of the wards were measured with a questionnaire. In moisture-damaged wards, cough, hoarseness, nose bleeding and eye symptoms were more common than among workers in a reference ward. Headache, tiredness and other non-specific symptoms were more often complained in the damaged wards. Common cold with fever and sickness absence was more often observed among the exposed. Also microbe specific IgG-antibodies were detected for those microbes cultivated in the constructions. Moisture damage abatement is crucial in decreasing work-related morbidity among hospital personnel.

Objective: To review current data on the health effects of indoor fungal bioaerosol exposure based on published studies. Methods: We conducted MEDLINE search and reviewed all English language studies on indoor mold exposure (visible survey or objective sampling) and human health effects published from 1966 to January 2002. Main findings of the studies are analyzed in conjunction with plausible association of health effects and fungal exposure. Results: Five case control studies, 16 cross-sectional surveys and 7 case reports met the selection criteria. Current evidence suggests that excessive moisture promotes mold growth and is associated with an increased prevalence of symptoms due to irritation, allergy, and infection. However, specific toxicity due to inhaled fungal toxins has not been scientifically established. Conclusions: Methods for assessing indoor bioaerosol exposure and health effects are not well standardized, making interpretation of existing data difficult. Additional studies are needed to document human exposure-disease and dose-response relationships.

We have found (papers sent for publication) two cases of mould-damaged buildings with clusters of different inflammatory rheumatic diseases, various rheumatic symptoms and signs. So far, we have an association of these disease clusters with exposure in mouldy buildings with no causal link. In this paper we shortly describe the cases and discuss the possible causal mechanisms, which should be addressed in the further

The association between serum mold-specific IgG levels of 181 primary schoolchildren with asthma or wheezing or cough symptoms and the microbial exposure were determined. The study was conducted in a school with mold damage and in another without such damage. Microbial exposure was characterized with environmental sampling. Serum IgG antibody concentrations to 20 microbial strains were determined with ELISA. There was an association between elevated serum IgG levels to

This intervention study was designed to show the effects of the renovation of moisture and mold damaged school building on the schoolchildren’s health and exposure. Microbial sampling from indoor air of the school and a health questionnaire study were performed before and after renovation. The results were compared to those from non-damaged reference school. The effect of a thorough renovation in the damaged school was seen as decreased concentrations of airborne fungi and decreased diversity of mycoflora. There was a significant decrease in the prevalence of the respiratory symptoms among schoolchildren after the renovation. The results show that the symptoms are associated with the moisture damage and that the increased symptom levels can be normalized with proper repair measures.

This study tested if respiratory symptoms in 7-9 year old school children were associated with mould growth in schools. Eight "wet" and seven "dry" schools including 330 children were studied by means of an interview, spirometry, skin prick test and a "free running test". At each classroom a dust collector was placed for collection of dust for 140 days at app. 1.5 meters height. When dividing the classrooms into quartiles of dust concentration a positive trend was found with increasing quartiles of dust for "sensitisation to moulds" and "nasal symptoms" (Kendal’s Tau b [KT]; p < .05). For mould exposure we found a positive association between increasing number of moulds and "headache at least once a week" (KT; p < .05). These results indicate that the dust collector method for collection of dust is probably a reasonable tool for exposure measurements that are related to health

Symptom questionnaire responses were collected from upper secondary and high school students (n=245) before comprehensive repairs of moisture damage in the school unit. The questionnaire study was repeated one year (n=227) and three years (n=256) after the repairs. The data was analyzed both cross-sectionally including all respondents, and longitudinally including paired observations for those individuals who had responded both before and after the repairs. Compared to the situation before the repairs, the situation after the repairs was significantly improved in most of the 20 symptoms studied among the whole population. However, the improvement was not so clear in the paired analysis and regression analysis among the students who had responded to all three questionnaires. The results indicate that the repairs succeeded in terms of that new cases of symptomatic students were no longer expected. However, the situation of the group of exposed individuals may need to be considered separately.

Although the causes for rheumatoid arthritis and autoimmune diseases remain obscure, previous epidemiological studies have shown that rheumatoid arthritis is associated with age, female sex, smoking and certain occupational exposures. A few unusual clusters of autoimmune diseases have been found in association with moisture damaged buildings. In this paper, clustering of joint symptoms is described in a school building and a day care center in a rural Finnish town. Both buildings have prolonged indoor air problems associated with moisture damage, microbial growth in construction, insufficient ventilation and unpleasant odors of sewer gases. In microbial samples, high concentrations of moisture damage indicative microbes were detected in material samples and additionally, atypical mycobacteria were found in indoor air and material samples. A questionnaire study showed a high proportion of workers with muscle and joint pain and relatively high number of workers with doctor diagnosed rheumatoid arthritis or other type of

The National Institute for Occupational Safety and Health (NIOSH) investigated 13 college buildings to examine whether a semi-quantitative mold exposure index (EI) could efficiently predict work-related respiratory symptoms. We collected work-related symptom data and room locations/time fractions through questionnaires. Industrial hygienists classified rooms for factors including extent of water stain, visible mold, mold odor, and dampness. We estimated 323 individual EIs based on each factor or a combination of the factors weighted by time fraction in particular rooms. In logistic regression models adjusting for age, gender, job position, hire years, smoking, allergies, and use of latex gloves, we found a significant exposure-response relationship for wheeze (Odds Ratio(OR)=2.3) with stain-based EI. EI based on the combined factors showed significant exposure-response relationships for chest tightness (OR=2.2) and shortness of breath (OR=2.7). Our findings suggest that an observational semi-quantitative exposure index can support public health action to prevent risk of building-related respiratory disease.

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