Effects of furniture polish on release of cat allergen-laden dust from wood surfaces

The purpose of this study was to evaluate the effects of furniture polish (FP) on the release of cat allergen (Fel d 1)-laden dust from wood surfaces and decay of Fel d 1 in dust over time. About 2 g of sieved (150 microm screen) allergen-laden dust was introduced as an aerosol into an experimental chamber by a Pitt-3 generator and allowed to settle onto two finished wood surfaces pre-treated with either distilled water (DW) or FP. After 24 h, each surface was vacuumed into separate plastic cassettes loaded with 37 mm diameter, 0.4 microm pore, polycarbonate filters. The recovered dust was weighed, extracted in phosphate-buffered saline, and assayed for Fel d 1 content using a two-site monoclonal antibody ELISA. After vacuuming, the remaining dust on the wood surfaces was wiped up with a water-moistened swab. The dusts were extracted from the swabs and assayed by ELISA for Fel d 1. More Fel d 1 was recovered by vacuuming from DW-pre-treated surfaces than from FP pre-treated surfaces (100% vs. 69 +/- 66%). On the contrary, more residual Fel d 1 (>99.9%) on the vacuumed surfaces was recovered from FP than from DW pre-treated surfaces by wet swabs. The concentration of Fel d 1 in dust did not change significantly at room temperature over 80 days. In conclusion, FP on wood surfaces makes dust stick to the surface, which likely reduces the release of allergen-laden dust from the wood surface. PRACTICAL IMPLICATIONS: Re-aerosolization of cat allergen-laden dusts from wood surfaces (e.g. wood floor or furniture) significantly increases the concentration of airborne cat allergens. Our study indicates that exposure to airborne cat allergens might be reduced by surface treatment with commercially available FP because cat allergen-laden dusts stuck more tightly to the wood surface treated with FP.     

House dust-mite allergen and cat allergen variability within carpeted living room floors in domestic dwellings

Exposure to allergens from house dust-mites (Der p 1) and domestic cats (Fel d 1) is associated with symptom severity in atopic subjects with asthma and rhinitis. Assessment of allergen exposure in the domestic environment is normally determined by measurement from a single floor site. We determined the variability of these allergens and protein throughout the whole living room floor area. Dust samples were collected from 1 m2 areas from 16 carpeted living room floors in Wellington, New Zealand, and analyzed for concentrations of Der p 1 and Fel d 1. Mean coefficients of variation for Der p 1 and Fel d 1 were 53.1% (range: 28.5-136.8) and 65.6% (range: 28.5-131), respectively. This study has demonstrated a large variation of house dust-mite and cat allergens within living room floors and thus a single sampling site may not be representative for assessment of an individual's exposure risk. House dust-mite and cat allergen levels from the center of the room, in front of a couch or chair, or from a corner of the room are similar to mean levels from the whole room, these sites may thus be representative of the whole living room floor in large-scale epidemiological studies.     

House dust-mite allergen and cat allergen variability within carpeted living room floors in domestic dwellings

Exposure to allergens from house dust-mites (Der p 1) and domestic cats (Fel d 1) is associated with symptom severity in atopic subjects with asthma and rhinitis. Assessment of allergen exposure in the domestic environment is normally determined by measurement from a single floor site. We determined the variability of these allergens and protein throughout the whole living room floor area. Dust samples were collected from 1 m2 areas from 16 carpeted living room floors in Wellington, New Zealand, and analyzed for concentrations of Der p 1 and Fel d 1. Mean coefficients of variation for Der p 1 and Fel d 1 were 53.1% (range: 28.5-136.8) and 65.6% (range: 28.5-131.0), respectively. This study has demonstrated a large variation of house dust-mite and cat allergens within living room floors and thus assessment of a single sampling site may not be representative of an individual's exposure risk. House dust-mite and cat allergen levels from the center of the room, in front of a couch or chair, or from a corner of the room are similar to mean levels from the whole room. These sites may thus be representative of the whole living room floor in large-scale epidemiological studies.     

Current asthma and respiratory symptoms among pupils in relation to dietary factors and allergens in the school environment

The aim was to study asthma and allergy in relation to diet and the school environment. Pupils (5-14 years) in eight schools received a questionnaire, 1014 participated (68%). Settled dust was collected on ALK-filters and analyzed for allergens from cat (Fel d 1), dog (Can f 1), horse (Equ cx), house dust mites (Der p 1, Der f 1), and cockroach (Bla g 1) by ELISA. In total, 6.8% reported cat allergy, 4.8% dog allergy, 7.7% doctor's diagnosed asthma and 5.9% current asthma, and 7.8% reported wheeze. Current asthma was less common among those consuming more fresh milk (P < 0.05) and fish (P < 0.01). Poly-unsaturated fatty acids was associated with more wheeze (P < 0.05), olive oil was associated with less doctors' diagnosed asthma (P < 0.05). Totally, 74% of the classrooms had mean CO(2) <1000 ppm. The median concentration per gram dust was 860 ng/g Fel d 1, 750 ng/g Can f 1 and 954 U/g Equ cx. Horse allergen was associated with more wheeze (P < 0.05), daytime breathlessness (P < 0.05), current asthma (P < 0.05) and atopic sensitization (P < 0.05). Dog allergen was associated with wheeze (P < 0.05) and daytime breathlessness (P < 0.05). The associations between allergens and respiratory symptoms were more pronounced among those consuming margarine, not consuming butter, and with a low intake of milk. In conclusion, cat, dog and horse allergens in schools could be a risk factor for asthma and atopic sensitization, and dietary factors may interact with the allergen exposure. PRACTICAL IMPLICATIONS: Previous school studies performed by us in mid-Sweden, showed that most classrooms did not fulfill the ventilation standards. In this study, most of the classrooms fulfilled the ventilation standard, but despite that had widespread allergen contamination. Most previous studies have focused on cat allergen, but our study has shown that also dog and horse allergens can be risk factors for asthma and allergy in schools. As allergens are transported from other environments, mainly the home environment, the main prevention should be to minimize transfer of allergens. This could be achieved by reducing contacts with furry pets and horses, or using different clothes at home and at school (e.g. school uniforms). Increased cleaning in the schools may reduce allergen levels, but the efficiency of this measure must be evaluated in further intervention studies. Finally, our study supports the view that dietary habits among pupils should not be neglected and interaction between dietary factors and indoor allergen exposure needs to be further investigated.     

Social factors, allergen, endotoxin, and dust mass in mattress

Indoor environment has been associated with allergic disease. Further, it has been observed that the prevalences of allergic sensitization are different in different social groups. We therefore investigated the association between socioeconomic status (SES) and indoor bio-contaminants. House dust samples were collected from parents' and infants' mattress from 2166 families in Munich (62.2%) and Leipzig (37.8%), Germany. Major mite allergen Der p 1 and Der f 1, cat allergen Fel d 1, and endotoxin were extracted and quantified. Parental educational level and family equivalent income were used independently as socioeconomic indicators. Indoor endotoxin, mite allergen Der p 1, and the amount of sampled dust were not associated with the social factors. Mite allergen Der f 1 was slightly associated by family SES but without a consistent pattern. In families who are not cat owners, however, a negative association between the amount of cat allergen and family SES were observed. The observed negative association between cat allergen loads and concentrations in mattress and family SES in non-cat owners' homes indicated that community is an important source of cat allergen exposure. PRACTICAL IMPLICATIONS: The study indicated that community is a major source of cat allergen exposure especially in communities of low SES.     

Quantitative measurement of airborne cockroach allergen in New York City apartments

We designed and tested a sampling and analysis system for quantitative measurement of airborne cockroach allergen with sufficient sensitivity for residential exposure assessment. Integrated 1-week airborne particle samples were collected at 10-15 LPM in 19 New York City apartments in which an asthmatic child who was allergic to cockroach allergen resided. Four simultaneous air samples were collected in each home: at heights of 0.3 and 1 m in the child's bedroom and in the kitchen. Extracts of air samples were analyzed by ELISA for the cockroach allergen Bla g2, modified by amplifying the colorimetric signal generated via use of AMPLI-Q detection system (DAKO Corporation, Carpinteria, CA, USA). Settled dust samples were quantified by conventional ELISA. Of the homes where cockroach allergen was detected in settled dust, Bla g2 also was detected in 87% and 93% of air samples in the bedroom and kitchen, respectively. Airborne Bla g2 levels were highly correlated within and between the bedroom and kitchen locations (P < 0.001). Expressed as picogram per cubic meter, the room average geometric mean for Bla g2 concentrations was 1.9 pg/m3 (95% CI 0.63, 4.57) and 3.8 pg/m3 (95% CI 1.35, 9.25) in bedrooms and kitchens, respectively. This method offers an attractive supplement to settled dust sampling for cockroach allergen exposure health studies. PRACTICAL IMPLICATIONS: Until now, cockroach allergen exposures have usually been assessed by collection and analysis of settled dust, on the assumption that airborne cockroach allergen cannot be reliably measured. In this study, a sensitive and quantitative method for measuring indoor airborne exposures to cockroach allergens involving a 7-day integrated total suspended particulate (TSP) sample collected at approximately 10-15 l/min was developed. Investigators are now empowered with an alternative exposure assessment method to supplement their studies and the understanding of allergen aerodynamics in the homes of children with asthma. We report airborne cockroach allergen in apartments, suggesting an ongoing burden of inhalation exposure.     

Respiratory symptoms, asthma and allergen levels in schools--comparison between Korea and Sweden

We studied reports on respiratory symptoms, asthma and atopic sensitisation in relation to allergen contamination in Korean schools and compared with data from a previous Swedish study performed in eight primary schools. Korean pupils (n = 2365) in 12 primary schools first completed a questionnaire. Then airborne and settled dust were collected from 34 classrooms and analyzed for allergens by ELISA. In both countries, boys reported more symptoms. The prevalence of wheeze was similar, while daytime [odds ratio (OR) = 14.0, 95% confidence interval (CI) = 9.0-21.9] and nocturnal breathlessness (OR = 3.1, 95% CI = 1.5-6.4) were much higher among Korean students. In Korean schools, dog allergen (Can f 1) was the most common followed by mite allergen (Der f 1), while cat (Fel d 1), dog, and horse allergen (Equ cx) were abundant in Sweden. Moreover, CO(2) levels were high in most Korean schools (range 907-4113 ppm). There was an association between allergen levels in dust and air samples, and number of pet-keepers in the classrooms. In conclusion, allergen contamination in Korean schools may be an important public issue. PRACTICAL IMPLICATIONS: This study showed that furry pet allergen contamination was common in both Korean and Swedish schools. In addition, house dust-mite (Der f 1) allergen contamination was common in Korean schools, probably because of transport of allergen from other environments. Transfer should therefore be minimized. Korean schools had high CO(2) levels and the concept of mechanical ventilation should be introduced. Measurement of airborne allergen levels is quite new and seems to be a more convenient and correct way to monitor allergen exposure in classrooms.     

Relationships between mite allergen levels, mold concentrations, and sick building syndrome symptoms in newly built dwellings in Japan

This study investigated the possible relationships between exposures to mite allergen and airborne fungi with sick building syndrome (SBS) symptoms for residents living in newly built dwellings. We randomly sampled 5709 newly built dwellings in six prefectures from northern to southern Japan. A total of 1479 residents in 425 households participated in the study by completing questionnaire surveys and agreeing to environmental monitoring for mite allergen (Der 1), airborne fungi, aldehydes, and volatile organic compounds. Stepwise logistic regression analyses adjusted for confounders were used to obtain odds ratios (OR) of mite allergen and fungi for SBS symptoms. Der 1 had a significantly high OR for nose symptoms. Rhodotorula had a significantly high OR for any symptoms, and Aspergillus had significantly high OR for eye symptoms. However, the total colony-forming units had a significantly low OR for throat and respiratory symptoms. Eurotium had a significantly low OR for skin symptoms. In conclusion, dust-mite allergen levels and indoor airborne Rhodotorula and Aspergillus concentrations may result in SBS symptoms in newly built dwellings. PRACTICAL IMPLICATIONS: Various factors can cause sick building syndrome symptoms. This study focused on biologic factors such as dust-mite allergen and airborne fungi in newly built dwellings in Japan. Dust-mite allergen levels were significantly associated with higher rates of nose symptoms, airborne Rhodotorula concentrations were significantly associated with higher rates of any symptoms, and Aspergillus concentrations were significantly associated with higher rates of eye symptoms. Measures should be taken to reduce mite allergen levels and fungal concentrations in these dwellings.     

Study on dielectrophoretic deposition of airborne particles in a vertical micro channel

Airborne particles significantly contribute to the toxicity of environmental pollution. A mathematical model is developed and analyzed to study the dielectrophoretic deposition of airborne particles in a vertical micro channel. Finite element programs are utilized to calculate the air flow and potential distribution in the vertical micro channel. The electric field in the numerical solution space is obtained by employing a potential gradient in the x and y directions. The dielectrophoretic force and sedimentation motion of a spherical particle are achieved. The simulated results show that the dielectrophoretic force is maximal at the tips of the shorter electrode. The initial position of the particle, initial direction of the particle, radius of the particle, electrode dimension, applied voltage and air flow velocity are the main factors affecting the trajectories of airborne particles in a micro channel. Modification of the particle size distribution using the technology as a dielectrophoretic filter is more feasible in practice. Sedimentation micro channels in series with the shorter electrode on an alternating side will be beneficial to improve particle sedimentation efficiency.     

House dust mites (Der p 1, Der f 1), cat (Fel d 1) and cockroach (Bla g 2) allergens in indoor work-places (offices and archives)

BACKGROUND: Exposure to indoor allergens has already been shown to occur in many public places, including workplaces, in several countries. Aim of this study was to measure the levels of house dust mites, cat and cockroach allergens in indoor workplaces (offices and archives) in Italy and to evaluate the possible relationships between allergen levels and building characteristics, type of ventilation, indoor relative humidity and temperature. METHODS: Der f 1 and Der p 1, Fel d 1, Bla g 2 were measured by ELISA in dust samples collected from floors or upholstered seats of 160 workplaces. RESULTS: Detectable Der p 1 levels were found in 86 (54%) workplaces Der f 1 in 87 (55%), Fel d 1 in 86 (54%) and Bla g 2 in 3 (1.9%). Der p 1 allergen concentrations expressed per weight were higher than the proposed sensitization thresholds in 7 samples, Der f 1 in 5, Fel d 1 in 6 and Bla g 2 in 3. The highest allergen levels were detected in samples from upholstered seats. A significant correlation was found between Der f 1 level on floors, expressed per surface, and indoor temperature (r = 0.39; P < 0.01). CONCLUSIONS: In our study we found that upholstered seats in workplaces in Italy may constitute a significant reservoir both of house dust mites and cat allergens. Exposure to these allergens in workplaces may represent a risk factor for elicitation of symptoms and/or induction/maintenance of inflammation in allergic individuals and might also constitute a risk factor for sensitization.     

Diurnal distribution of airborne bacteria and fungi in the atmosphere of Helwan area, Egypt

Airborne bacterial and fungal composition in an industrial town of Helwan, Egypt, was studied using a slit impactor sampler during the period from March 2006 to February 2007. Airborne bacterial concentrations were usually higher than fungi. Bacteria and fungi had similar diurnal variation patterns. Airborne microorganisms reached their concentration peaks in the evening and gradually decreased during the night time. The hourly concentration peaks of the bacteria and fungi appeared at 20:00 h. A significant difference (P ≤ 0.05) was found between the hourly mean concentrations of airborne fungi in winter compared to other seasons. Fungi concentrations were significantly higher (P ≤ 0.05) on working weekdays than weekends. Aspergillus, Penicillium, Alternaria and Cladosporium were the most predominant airborne fungal genera. Aspergillus showed double peak patterns whereas Penicillium, Alternaria and Cladosporium showed one peak pattern. The diurnal variations of the bacteria and fungi could be divided into four periods: 1) the morning maximum concentration (6:00 h-10:00 h), 2) midday to afternoon pattern (10:00 h-16:00 h), 3) the evening concentration peak (18:00 h-20:00 h) and 4) the gradual decrease of night time concentration (22:00 h-24:00 h). Geographical location, human activity, growth cycle of organisms and meteorological factors were the main criteria controlling the temporal variations of the air microorganisms in the Wadi Hof area.     

Role of ventilation in airborne transmission of infectious agents in the built environment - a multidisciplinary systematic review

There have been few recent studies demonstrating a definitive association between the transmission of airborne infections and the ventilation of buildings. The severe acute respiratory syndrome (SARS) epidemic in 2003 and current concerns about the risk of an avian influenza (H5N1) pandemic, have made a review of this area timely. We searched the major literature databases between 1960 and 2005, and then screened titles and abstracts, and finally selected 40 original studies based on a set of criteria. We established a review panel comprising medical and engineering experts in the fields of microbiology, medicine, epidemiology, indoor air quality, building ventilation, etc. Most panel members had experience with research into the 2003 SARS epidemic. The panel systematically assessed 40 original studies through both individual assessment and a 2-day face-to-face consensus meeting. Ten of 40 studies reviewed were considered to be conclusive with regard to the association between building ventilation and the transmission of airborne infection. There is strong and sufficient evidence to demonstrate the association between ventilation, air movements in buildings and the transmission/spread of infectious diseases such as measles, tuberculosis, chickenpox, influenza, smallpox and SARS. There is insufficient data to specify and quantify the minimum ventilation requirements in hospitals, schools, offices, homes and isolation rooms in relation to spread of infectious diseases via the airborne route. PRACTICAL IMPLICATION: The strong and sufficient evidence of the association between ventilation, the control of airflow direction in buildings, and the transmission and spread of infectious diseases supports the use of negatively pressurized isolation rooms for patients with these diseases in hospitals, in addition to the use of other engineering control methods. However, the lack of sufficient data on the specification and quantification of the minimum ventilation requirements in hospitals, schools and offices in relation to the spread of airborne infectious diseases, suggest the existence of a knowledge gap. Our study reveals a strong need for a multidisciplinary study in investigating disease outbreaks, and the impact of indoor air environments on the spread of airborne infectious diseases.     

Predictions and measurements of the stack effect on indoor airborne virus transmission in a high-rise hospital building

As the viral diseases such as Severe Acute Respiratory Syndrome (SARS) and Influenza A (H1N1) occur in many countries recently, the epidemic of those influenza viruses causes many human casualties. Moreover, the second infection from infected patients particularly within general hospitals frequently takes places due to improperly hospitalized and/or quarantined patients. Accordingly, it becomes a great concern to accommodate safer ventilation system in general hospital wards against such airborne transmitted viruses. It is also a recent trend that many urban general hospitals are designed and constructed as high-rises. If a virus is transmitted through uncontrolled air movement within a hospital and then infected other patients or healthy visitors, it might be impossible to control the spread of the disease. Thus research has been preceded scrutinizing stack effect on the indoor airborne virus transmission in large hospitals by conducting both the field measurement and numerical analysis according to the outdoor temperature and the releasing vertical points of the tracer gas assumed as a viral contaminant. In the field measurement of a high-rise hospital, the indoor airflow was affected by the stack effect of vertical chute of the building. The numerical simulation was verified by comparing its prediction results and the field measurement data. In result, very high possibility has witnessed that the airborne contaminant emitted from the infected patients in the lower floors could be transported to the higher floors through the airflow driven by the stack effect.     

Large-scale radon hazard evaluation in the Oslofjord region of Norway utilizing indoor radon concentrations, airborne gamma ray spectrometry and geological mapping

We test whether airborne gamma ray spectrometer measurements can be used to estimate levels of radon hazard in the Oslofjord region of Norway. We compile 43,000 line kilometres of gamma ray spectrometer data from 8 airborne surveys covering 10,000 km² and compare them with 6326 indoor radon measurements. We find a clear spatial correlation between areas with elevated concentrations of uranium daughters in the near surface of the ground and regions with high incidence of elevated radon concentrations in dwellings. This correlation permits cautious use of the airborne data in radon hazard evaluation where direct measurements of indoor radon concentrations are few or absent. In radon hazard evaluation there is a natural synergy between the mapping of radon in indoor air, bedrock and drift geology mapping and airborne gamma ray surveying. We produce radon hazard forecast maps for the Oslofjord region based on a spatial union of hazard indicators from all four of these data sources. Indication of elevated radon hazard in any one of the data sets leads to the classification of a region as having an elevated radon hazard potential. This approach is inclusive in nature and we find that the majority of actual radon hazards lie in the assumed elevated risk regions.     

Profiles and seasonal distribution of airborne fungi in indoor and outdoor environments at a French hospital

A one-year prospective survey of fungal air contamination was conducted in outdoor air and inside two haematological units of a French hospital. Air was sampled with a portable Air System Impactor. During this period of survey, the mean viable fungal load was 122.1 cfu/m³ in outdoor air samples, and 4.1 and 3.9 cfu/m³ in samples from adult and pediatric haematology units, respectively. In outdoor samples, Cladosporium was the dominant genus (55%) while in the clinical units, Penicillium sp. (23 to 25%), Aspergillus sp. (15 to 23%) and Bjerkandera adusta (11 to 13%) were the most frequently recovered airborne fungi. The outdoor fungal load was far higher in autumn (168 cfu/m³), spring (110 cfu/m³) and summer (138 cfu/m³) than in winter (49 cfu/m³). In indoor air, fungal concentrations were significantly lower in winter (2.7 to 3.1 cfu/m³) than in summer (4.2 to 5.0 cfu/m³) in both haematology units. In the outdoor environment, Penicillium sp. and Aspergillus sp. were more abundant in winter while the levels of Cladosporium were lowest during this season. In the haematological units, the presence of Aspergillus sp. was stable during the year (close to 20%), Bjerkandera sp. was particularly abundant in winter (close to 30%); levels of Penicillium sp. were highest in autumn while levels of Cladosporium sp. were highest in spring and summer.     

The physicochemical characterisation of microscopic airborne particles in south Wales: a review of the locations and methodologies

As part of the NERC-URGENT thematic programme, research was undertaken into the physicochemistry and bioreactivity of microscopic airborne particulate matter in south Wales. This paper reviews the collecting and characterisation methods used in the research; some of the results obtained are shown as examples. Four main collecting locations were chosen: Cardiff (urban); Port Talbot (urban/industrial); Park Slip West coal opencast pit (industrial/rural); the Black Mountains (rural/background). Collections initially used a 30-l/min Negretti PM10 filter collection system, however in the later stages of the project increased use was made of a 1100-l/min impaction system (nicknamed the super-sucker). This latter device was developed at Harvard University USA, however was adapted and optimised at Cardiff University. Methods for the extraction of PM10 off polycarbonate filters and polyurethane substrates were developed, with particular attention being paid to minimise physical or chemical changes during the extraction, and the extracts being in an appropriate state for bioreactivity assessment. Physicochemical characterisation of the PM10 included the empirical measurement of shape and size using electron microscopy and semi-automated image analysis. The determinations of the water-soluble and -insoluble chemical components were undertaken by ion chromatography and inductive coupled plasma-mass spectrometry. The bioreactivity of south Wales airborne particles is not covered by this review.     

A comparative study of asthma, pollen, cat and dog allergy among pupils and allergen levels in schools in Taiyuan city, China, and Uppsala, Sweden

We compared the school environment, asthma and allergy in 10 schools in Taiyuan, China, with eight schools in Uppsala, Sweden. In total 2193 pupils (mean age 13 years) participated. Chinese pupils had more respiratory symptoms, particularly daytime breathlessness after exercise (29.8% vs. 7.1%; P < 0.001), while cat allergy (1.2% vs. 6.6%; P < 0.001) and dog allergy (1.3% vs. 4.0%; P < 0.01) was less common. Cumulative incidence of asthma (1.8% vs. 9.5%; P < 0.001) and doctor's diagnosed asthma (1.2% vs. 9.0%; P < 0.001) were less common in China, indicating an under-diagnosis of asthma. Chinese classrooms were colder (mean 14.7 vs. 21.4 degrees C), more humid (mean 42% vs. 31% RH) and had higher CO2-levels (mean 2211 vs. 761 ppm). Levels of cat (Fel d1), dog (Can f1) allergens were low in settled dust from China (< 200 ng/g dust), but high in airborne dust on Petri-dishes (GM 16.8 ng/m2/day for Fel d1 and 17.7 for Can f1). The Swedish settled dust contained cat, dog and horse allergens in high levels (median 1300 ng/g, 1650 ng/g, 1250 U/g dust, respectively). In conclusion, there were large differences in the school environment, and in respiratory symptom and allergy. Allergen measurements in settled dust only may largely underestimate the classroom exposure. Practical Implications There is a need to improve the school environment, both in China and Sweden. The Swedish schools contained high levels of cat, dog and horse allergens and more amounts of open shelves and textiles that can accumulate dust and allergens. The air measurements indicated that Chinese schools may contain significant amounts of cat and dog allergen, and analysis of settled dust only may not reflect the true allergen exposure. Since the Chinese schools had no mechanical ventilation, they could not fulfill the ventilation standard in winter, and hence there is a need for improving the ventilation. The great discrepancy between respiratory symptoms and reports on asthma, and the high prevalence of attacks of breathlessness without wheeze, may have implication for future questionnaire studies on asthma in China.