Asthma and respiratory symptoms in hospital workers related to dampness and biological contaminants

Abstract The National Institute for Occupational Safety and Health investigated respiratory symptoms and asthma in relation to damp indoor environments in employees of two hospitals. A cluster of six work‐related asthma cases from one hospital department, whose symptoms arose during a time of significant water incursions, led us to conduct a survey of respiratory health in 1171/1834 employees working in the sentinel cases hospital and a nearby hospital without known indoor environmental concerns. We carried out observational assessment of dampness, air, chair, and floor dust sampling for biological contaminants, and investigation of exposure‐response associations for about 500 participants. Many participants with post‐hire onset asthma reported diagnosis dates in a period of water incursions and renovations. Post‐hire asthma and work‐related lower respiratory symptoms were positively associated with the dampness score. Work‐related lower respiratory symptoms showed monotonically increasing odds ratios with ergosterol, a marker of fungal biomass. Other fungal and bacterial indices, particle counts, cat allergen and latex allergen were associated with respiratory symptoms. Our data imply new‐onset of asthma in relation to water damage, and indicate that work‐related respiratory symptoms in hospital workers may be associated with diverse biological contaminants.     

Building-related respiratory symptoms can be predicted with semi-quantitative indices of exposure to dampness and mold

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.     

Children's homes--determinants of moisture damage and asthma in Finnish residences

Certain housing characteristics increase the risk for moisture damage, which has been associated with increased risk for asthma in children. Modeling moisture damage as a function of these characteristics could therefore provide a simple tool to estimate building-related risk for asthma. This study aimed to find out specific associations between asthma case-control status of children and moisture damage and housing characteristics. The data consisted of information on 121 asthmatic children and predominately two age-, gender- and place of residence-matched control children for every case, and information on moisture damage and housing characteristics in the homes of the children. In a previous study, we found a statistically significant association between moisture damage observations in main living areas and asthma in children. Using logistic regression, five models were formulated to predict moisture damage status of the homes and moisture damage status of living areas. The models were able to classify the damage status correctly in 65.0-87.7% of the homes (kappa values 0.10-0.47) as functions of housing characteristics. None of the models qualified as a significant determinant of the case-control status of the children. PRACTICAL IMPLICATIONS: It can be hypothesized that building-related risk for asthma could be roughly estimated using models predicting moisture damage status of buildings as a function of easily obtainable housing characteristics. The results of this study indicated that, with a moderate certainty, it is possible to model moisture damage status of buildings using housing characteristics. However, the models developed did not associate with asthma in children. In conclusion, it was not possible to estimate the risk for asthma by studying housing characteristics only, but detailed information on moisture damage (e.g. location of damage) was crucial for such estimation.     

Meta-analyses of the associations of respiratory health effects with dampness and mold in homes

The Institute of Medicine (IOM) of the National Academy of Sciences recently completed a critical review of the scientific literature pertaining to the association of indoor dampness and mold contamination with adverse health effects. In this paper, we report the results of quantitative meta-analyses of the studies reviewed in the IOM report plus other related studies. We developed point estimates and confidence intervals (CIs) of odds ratios (ORs) that summarize the association of several respiratory and asthma-related health outcomes with the presence of dampness and mold in homes. The ORs and CIs from the original studies were transformed to the log scale and random effect models were applied to the log ORs and their variance. Models accounted for the correlation between multiple results within the studies analyzed. Central estimates of ORs for the health outcomes ranged from 1.34 to 1.75. CIs (95%) excluded unity in nine of 10 instances, and in most cases the lower bound of the CI exceeded 1.2. Based on the results of the meta-analyses, building dampness and mold are associated with approximately 30-50% increases in a variety of respiratory and asthma-related health outcomes. PRACTICAL IMPLICATIONS: The results of these meta-analyses reinforce the IOM's recommendation that actions be taken to prevent and reduce building dampness problems, and also allow estimation of the magnitude of adverse public health impacts associated with failure to do so.     

Building environmental assessment methods: applications and development trends

The construction and property sector has seen the development of a number of methods for evaluating the 'greenness' of buildings in the 1990s - both for new designs and existing buildings. These range from very detailed life cycle assessment methods, which account for all the embodied and operational environmental impacts of building materials, to higher level environmental impact assessment methods, which evaluate the broader implications of the building's impact on the environment. In between these two are environmental assessment methods such as BREEAM, BEPAC, LEED, and GBA. In this paper, we discuss the potential market applications of these systems and compare and contrast several of the major environmental assessment methods. Le secteur de la construction et de l'immobilier a ete le temoin du developpement d'un certain nombre de methodes permettant d'evaluer les performances ecologiques des batiments dans les annees 1990, tant sur le plan des nouveaux concepts que des batiments existants. Ces methodes vont de l'evaluation tres detailee du cycle de vie, qui tient compte de l'impact specifique et des incidences operationnelles des materiaux de construction sur l'environnement, jusqu'a une evaluation de l'impact environnemental a un niveau plus eleve. Entre ces deux extremes, on trouve des methodes d'evaluation environnementale telles que BREEAM, BEPAC, LEED et GBA. Dans cet article, nous examinons les applications commerciales potentielles des ces systemes; nous comparons, en les opposant, plusieurs methodes majeures d'evaluation environnementale.     

健康建筑评价标准比较分析与认知框架

基于“健康中国”战略和提升建筑健康性能的需求,本文以健康建筑及其评价标准为研究对象,回顾了健康建筑内涵认知的改变,以及国内外健康建筑评价的研究进展,在此基础上提出了健康建筑评价的认知框架,将健康建筑评价要素分为“健康建筑环境品质要素”“引导健康行为的建筑空间与设施要素”“健康建筑设计要素”和“健康建筑运营服务要素”四大类。其次,梳理了国内外建立健康建筑评价标准的探索,选择美国WELL建筑标准、新加坡Green Mark健康工作场所认证和我国《健康建筑评价标准》,从与绿色建筑评价体系关系、评价对象和阶段、评价内容、评价方法等四方面进行比较分析,归纳总结出这三个评价标准的特征与问题。最后,结合我国的国情,从评价理念转变、评价认证推广、评价对象分类指导、评价指标动态调整、评价方法优化等五个角度,对我国健康建筑评价标准的进一步完善提出了建议,为推动健康建筑的建设提供参考。     

我国绿色建筑评估标准的发展演变

随着全球环境污染、温室效应和能源短缺等问题日益突出,绿色建筑成为建筑行业可持续发展理念的具体体现。绿色建筑评价系统是评价一个建筑是否符合绿色标准的指标体系,同时对绿色建筑的发展方向和绿色建筑的设计、建造管理具有指导、规范的作用。本文结合国外先进评价体系分析了我国绿色建筑标准的发展过程,提出了现行绿色建筑评估标准的优点与不足,探讨了我国绿色建筑标准应行的科学、自主的创新之路,并提出了绿色建筑评估标准应着重发展的几个方面。     

基于新版《绿色建筑评价标准》的建筑设计策略研究

绿色建筑工作的推进依赖于相关专业人员对《绿色建筑评价标准》的执行,根据评价标准制定建筑设计策略可以有效控制绿色建筑的实施效果。通过对传统建筑设计流程的梳理,分析绿色建筑设计各阶段的过程文件,结合新版《绿色建筑评价标准》的条款要求,对绿色建筑的前期设计、方案设计、技术设计、施工图设计四个阶段的具体工作进行了分解研究,探讨每个阶段的具体设计原则及策略,提出绿色建筑设计具有各专业在统一流程框架内互相配合协同完成工作的特点。     

Impacts of climate change on building performance in New Zealand

Climate change is expected to impact on many aspects of building performance, with much of the existing and future building stock likely to be affected. Potential impacts of climate change on buildings are identified, evaluated as to how serious they might be, and actions are considered to ensure that future building performance is not compromised. Climate change scenarios for New Zealand defined the scale of climate changes considered for building performance. For each climate variable, relevant aspects of building performance were examined to determine if there is likely to be a significant impact. Where significant impacts were indicated, they were studied in detail and quantified where possible. A risk-profiling tool was formulated to cover the risk/severity of the most significant climate change impacts, which include flooding, tropical cyclones and overheating. Adaptation strategies were developed for each climate change impact, with different responses appropriate for each impact. Mitigation of greenhouse emissions is also addressed. For those risks where delaying action has serious consequences, it may be appropriate to consider changes in building or zoning regulations to anticipate the future impacts of climate change. Some implications for future building performance, design, standards and regulation are discussed.

On peut s'attendre à ce que les changements aient des incidences sur de nombreux aspects des performances des bâtiments et que la majorité des bâtiments existants et futurs soit touchée. Cet article recense les conséquences potentielles des changements climatiques sur les bâtiments, les évalue quant à leur gravité et étudie les mesures à prendre pour que les performances des futurs bâtiments ne soient pas compromises. La Nouvelle-Zélande a étudié des scénarios de changements climatiques pour définir leur échelle en fonction des performances des bâtiments. Pour chaque variable climatique, on a examiné les aspects pertinents des performances des bâtiments afin de déterminer si elle est susceptible d'avoir un impact significatif. Lorsque c'est le cas, ces impacts ont été étudiés en détail et, dans la mesure du possible, quantifiés. On a conçu un outil de profil des risques pour couvrir les risques et la gravité des conséquences les plus importantes des changements climatiques, ce qui inclut les inondations, les cyclones tropicaux et les vagues de chaleur. Pour chaque conséquence des changements climatiques, on a formulé des stratégies d'adaptation, avec différentes réponses appropriées à chaque impact. On a également étudié l'atténuation des émissions de gaz à effet de serre. Quant aux risques pour lesquels tout retard dans les mesures à prendre aurait des conséquences sérieuses, il pourrait être judicieux d'envisager de modi? er la réglementation concernant les bâtiments ou le zonage afin d'anticiper les conséquences futures des changements climatiques. Cet article traite également de certaines implications pour les futures performances des bâtiments, conceptions, normes et réglementations.     

Ventilation and dampness in dorms and their associations with allergy among college students in China: a case-control study

To study the associations between dorm environment and occupants' health, a nested case-control study on 348 college students was carried out in 2006-2007 at Tianjin University, China. Two hundred and twenty-three dorm rooms where the 'cases' and 'controls' resided were inspected. Measured variables were ventilation rate, air temperature, and relative humidity indoors. Allergic symptoms in the last 12 months were self-reported by occupants. Adjusted odds ratios (AORs) of a 'localized moldy smell/moisture indicator' in 'special places' (e.g., in a room corner or close to the radiator under the window) for wheezing was 3.56 [95% Confident Interval (CI): 1.56-8.14] and for rhinitis 2.81 (95% CI: 1.32-5.97). The AOR of a low air change rate (below the median value of 0.7/h) for wheezing was 2.28 (95% CI: 1.38-3.75) and for dry cough 2.26 (95% CI: 1.08-4.75). The prevalence of students with allergic symptoms in dorm rooms decreased with increasing ventilation rate. The combination of a 'localized moldy/moisture indicator' and a low air change rate significantly increased the AOR of case status to 13.35 (95% CI: 3.73-47.83), compared to the reference condition with no-dampness and high ventilation rate (above the median). This supports the hypothesis that ventilation rate is an effect modifier for moisture problems and indoor pollutants.     

基于IFC与gbXML标准的绿色建筑信息模型数据标准及应用研究

BIM技术是一种全新的信息技术,是建筑业实现绿色节能、可持续发展以及建筑业信息化的重要途径之一,但是缺乏统一的BIM数据存储和传输标准是影响其发展的主要因素。IFC标准和gbXML标准都是解决BIM建模软件和绿色建筑分析软件之间互操作性问题的重要BIM标准。本文通过分析基于IFC标准和gbXML标准的绿色建筑信息模型的内容和不同标准的适用性,提出了基于IFC标准和gbXML标准的绿色建筑性能分析流程,探索了不同软件间信息共享的途径,对解决BIM模型在信息交换过程中的“信息孤岛”问题提出了参考性建议。     

Postscript: Green Building Challenge 2000

The next stage of the Green Building Challenge process incorporating the revised goals for Green Building Challenge and GBTool are reported. This will culminate in a conference in October 2000, Sustainable Building 2000. The critical analysis and feedback from GBC '98 have been incorporated into the revised goals and agenda which are presented in this paper. Cet article rend compte de la prochaine etape du projet Green Building Challenge, notamment de ses objectifs revises et de ceux du GBTool. Ces travaux s'acheveront a l'occasion de la conference d'octobre 2000 intitulee "Sustainable Building 2000" (batiments durables 2000). L'analyse critique et les informations recues de GBC 98 ont ete integrees dans les objectifs revises et dans l'ordre du jour qui sont presentes dans cet article.