Air Conditioning Systems as Non-Infectious Health Hazards Inducing Acute Respiratory Symptoms

Abstract

The risk of air conditioners as potential sources of contaminated aerosols is known for a long time. Recently, the appearance of the severe acute respiratory syndrome caused by a novel SARS coronavirus (SARS-CoV) highlighted the dangers of airborne infectious agents [1][2][3] In this respect, the legionella pneumophila associated pneumonia 4) , even in large public places such as the Picadilly Circus in London 5) or lethal pulmonary aspergillosis 6) have been reported. Therefore, to protect patients from air condition-transmitted nosocomial infections at intensive care units, operating theatres and other medical wards, air-filters should be checked and disinfected regularly. However, air conditioning systems are currently not considered as common distributors of non-infectious toxic aerosols leading to the induction of acute airway diseases. Here we report a case of a bank manager presenting with acute airway reactions caused by exposure to toxic substances.A 35 year old male Caucasian bank-manager with a history of bronchial asthma from the age of 14 presented with an acute asthma attack. The current asthma medication was 2 puffs of fenoterol and 2 2 puffs budesonide daily. He had not had any exacerbations of asthma or severe respiratory symptoms for the last year but had shown bronchial hyperresponsiveness in methacholine challenge in 2002.History talking revealed that the patient had sensed a slight smell of solvents at noon in his office, followed by a general unwellness with irritation of the conjunctivae and later shortness of breath, cough and dyspnoe. The attack was treated successfully with a standard therapeutic regimen and there were no further complaints noticed in the following 4 months. The blood and biochemical parameters were within normal limits beside an increased eosinophil count and elevated cholesterol.A direct origin of toxic substances could not be detected at his office, but exploration of the whole bank building revealed that in the upper floors, painters had been using a special sealing for two days to seal the floors. The sealing consisted of a mixture of the dissolved substances 2,4-and 2,6-diisocyanate and the organic solvents light naphta, n-butyl acetate, 2-methoxy-1-methylacetate, propylbenzene, and mesitylene (1,2,4-trimethylbenzene).The painters did not complain about any disorders as they carried safety suits and masks, but apparently aerosols developed from the volatile substances which were then transmitted via air-condition to the office of the

Adverse Health Effects of Particulate Air Pollution

“…Some health hazards may be transmitted through AC systems, especially if the systems are poorly maintained. 27–29 …”

Impact of air conditioners on sick building syndrome, sickness absenteeism, and lung functions

“…[ 16 17 ] The higher prevalence of respiratory symptoms in our study is in line with the results of other studies. [ 18 19 ] Cold dry air from the ACs causes activation of the epithelium to generate pro-inflammatory substances and engorgement of venous sinuses in the submucosa which leads to congestion, sneezing, and rhinorrhea. Repeated cooling and desiccation of peripheral airways can cause airway remodeling similar to that seen in asthma.…”

“…There is a potential for transmission of toxic volatile substances via an air conditioning system. In a study done by Gerber et al .,[ 19 20 ] low dose exposure to volatile chemicals by the air conditioning system induced an acute asthma attack and suggested that air conditioning can lead to incidents of inhalation occupational exposure/intoxication to other employees in the same building.…”