Environmental risk factors and work‐related lower respiratory symptoms in 80 office buildings: An exploratory analysis of NIOSH data

Mendell, Mark J.; Naco, Gina M.; Wilcox, T.G.; Sieber, William K.

doi:10.1002/ajim.10211

Cited by 39 publications

(40 citation statements)

References 24 publications

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“…While several HVAC factors related to moisture and related contamination have been associated with increased symptoms in prior analyses of these or other data (e.g., poorly draining condensate drain pans, residue in drain pans, dirt and contamination at outdoor air intakes, infrequently cleaned coils and pans) (Sieber, Stayner et al 1996;Mendell, Naco et al 2003;Mendell, Cozen et al 2006), predicted associations of symptoms with most other aspects of HVAC systems investigated here were conjectural, based on engineering judgement. Thus, the analyses reported here were primarily to explore previously untested hypotheses.…”

Section: Introductionmentioning

confidence: 81%

“…Nevertheless, HVAC systems are necessary in buildings to maintain thermal comfort, control humidity, and provide outdoor air in order to maintain good indoor environmental quality. Prior available evidence suggests either production of contaminants (Mendell, Naco et al 2003) or less effective ventilation by some HVAC systems as the most likely explanation. However, little epidemiologic investigation of this question has occurred.…”

Section: Discussionmentioning

confidence: 99%

“…Prior analyses of the BASE study data, using slightly different definitions for symptom outcomes and risk factor categories, found similarly elevated risks for less frequently cleaned condensate drain pans and coils (Mendell, Cozen et al 2006). Prior analyses of other data, from office buildings investigated for health complaints by occupants, found elevated lower respiratory symptoms associated with several aspects of poor HVAC maintenance, including poorly draining condensate drain pans and debris in air intakes (Mendell, Naco et al 2003). Similarly increased odds ratios for these risk factors were not found in the present analyses, in initial crude models with specific HVAC condition variables; these variables were then combined into composite variables in the current analyses.…”

Section: Comparison With Prior Findings and Predictionsmentioning

confidence: 99%

“…Researchers have, however, identified a number of environmental "risk factors" that are correlated with higher prevalence of symptoms in buildings selected without regard to occupant complaints, and thus may indicate as yet unidentified causal exposures. These risk factors include the presence of air-conditioning systems (Seppanen and Fisk 2002), contaminated components of heating, ventilating, and air-conditioning (HVAC) systems (Sieber, Stayner et al 1996;Mendell, Naco et al 2003), low ventilation rates (Seppanen, Fisk et al 1999), higher temperatures , and dampness/visible mold in buildings (Park, Schleiff et al 2004;Mendell, Cozen et al 2006). …”

Section: Introductionmentioning

confidence: 99%

“…Current causal hypotheses focus on aspects of HVAC that may influence production, dissemination, or concentration of indoor biological and chemical contaminants. Regarding these hypotheses, much epidemiologic evidence is available related to low ventilation rates as risk factors (Seppanen, Fisk et al 1999) and limited evidence is available related to moisture in HVAC systems (Mendell, Cozen et al 2006) and poor condition and maintenance of HVAC systems (Mendell, Naco et al 2003). …”

Section: Introductionmentioning

confidence: 99%

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Risk Factors in Heating, Ventilating, and Air-Conditioning Systemsfor Occupant Symptoms in U.S. Office Buildings: the EPA BASE Study

Mendell¹,

Lei-Gomez²,

Mirer³

et al. 2006

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Background: Nonspecific building-related symptoms among occupants of modern office buildings worldwide are common and may be associated with important reductions in work performance, but their etiology remains uncertain. Characteristics of heating, ventilating, and air-conditioning (HVAC) systems in office buildings that increase risk of indoor contaminants or reduce effectiveness of ventilation may cause adverse exposures and subsequent increase in these symptoms among occupants.Methods: We analyzed data collected by the U.S. Environmental Protection Agency (EPA) from a representative sample of 100 large U.S. office buildings -the Building Assessment and Survey Evaluation (BASE) study -using multivariate-adjusted logistic regression models with generalized estimating equations. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) for associations between seven building-related symptom outcomes and selected HVAC system characteristics (excluding ventilation rate, analyzed elsewhere) in the 97 airconditioned study buildings.Results: Among factors of HVAC design or configuration: Outdoor air intakes less than 60 m above the ground were associated with substantially increased odds of most symptoms assessed (ORs up to 2.7). Among factors of HVAC condition, maintenance, or operation: the presence of humidification systems in good condition was associated with reduction in skin symptoms (OR=0.5), whereas the presence of humidification systems in poor condition was associated with increases in upper respiratory symptoms, eye symptoms, fatigue/difficulty concentrating, and skin symptoms (ORs=1.5 to 1.7). Lack of regularly scheduled inspections for HVAC components was associated with increased eye and upper respiratory symptoms (ORs=2.2, 1.6). Less frequent cleaning of cooling coils or condensate drain pans was associated with increased headache and eye symptoms (ORs=1.5, 1.5). Ventilation for 10-12 hours per day (relative to more) was associated with a general slight increase in symptoms, especially fatigue/difficulty concentrating (OR=1.3). Several specific associations opposite of predicted were found, such as with cleanliness of air handler components and operational condition of air handling components. Discussion: Most of the many potential risk factors assessed here had not been investigated previously, and associations found with single symptom groups may have been by chance, including some that were the reverse of expected. Risk factors newly identified in these analyses that deserve attention include outdoor air intakes less than 60 m above the ground (which were correlated with higher levels of some outdoor vehicle-emitted pollutants), poorly maintained humidification systems, and lack of scheduled inspection for HVAC systems. Infrequent cleaning of cooling coils and drain pans were associated with increases in several symptoms in these as well as prior analyses of BASE data. Replication of these findings is needed, using more objective measurements of both exposure and health response. Co...

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Section: Introductionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Comparison With Prior Findings and Predictionsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Risk Factors in Heating, Ventilating, and Air-Conditioning Systemsfor Occupant Symptoms in U.S. Office Buildings: the EPA BASE Study

Mendell¹,

Lei-Gomez²,

Mirer³

et al. 2006

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Sick Building Syndrome and Other Building-Related Illnesses

Nag

2018

Design Science and Innovation

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Outbreaks of building-related illnesses, collectively termed as sick building syndrome (SBS) among building occupants reported in the recent decades, draw remarkable resemblance to early events of epidemic hysteria. Tarantism, the dancing mania of peasant women (animal-like squealing, obscene shouting, laughing, or weeping) during the fifteenth to seventeenth century, St. John's or St. Vitus' dances in Northern Europe, the hysterical fits of women due to smells from hemp steeped in water (Ramazzini 1713), industrial outbreak among workers in a cotton mill in the eighteenth century England (Gentleman's Magazine 1787), are historically recorded events. Many other early psychogenic illnesses reported from schools, hospitals, prisons, and in warfare, exemplify the results of various reasons, like prominent social concerns and exposure to physical, biological, or chemical agents (Bartholomew and Wessely 2002; Sirois 2013). The SBS manifests as the complex spectrum of ill health symptoms, such as mucous membrane irritation (rhinorrhea, nasal congestion, sore throat, eye irritation), asthma symptoms (chest tightness, wheezing), neurotoxic effects (a headache, fatigue, irritability), gastrointestinal disturbance, skin dryness, sensitivity to odours. These symptoms may appear among occupants in office buildings, schools, public buildings, hospitals, and recreational facilities. The rapid spread of symptoms often leads to the virtual closure of the facility, and resolution of the illness also takes place within a short time after leaving the facility (Laumbach 2008; Takeda et al. 2009). Building-related illnesses have been viewed as ubiquitous in modern high-rise buildings. These are designed to be airtight on energy-saving considerationwindows remain sealed, deprived of natural ventilation and daylighting, and HVAC system re-circulates the air in the building, with the minimal replacement of fresh air. Concerns about human health due to deteriorating indoor environmental quality are steadily increasing with a public outcry among the building occupants and also

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Evaluation of microbiological air quality and of microclimate in university classrooms

Grisoli

Rodolfi

Chiara

et al. 2011

Environ Monit Assess

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The proliferation of air-diffused microorganisms inside public buildings such as schools, hospitals, and universities, is often indicated as a possible health risk. In this research, we have illustrated the results of an investigation realized to determine the health of the air in some university classrooms, both from a microbiological and a microclimatic viewpoint, during the normal didactic activity of direct lessons. The results obtained have been expressed by means of contamination indices, already used in previous works. Very little contamination was recorded in the different phases of air treatment, which underlines the efficiency of the system and of the maintenance protocols. The Global Index of Microbial Contamination (GIMC per cubic meter) showed a value greater than the mean during the heating period (290), while the highest values (95th percentile 1,138.45) were recorded in the period using air conditioning. The index of mesophilic bacterial contamination, though it did not show any significant differences in the various modes of air treatment, showed a mean value (1.34) and the 95th percentile value (4.14), which was greater in the air-conditioning phase. Finally, the mean value of the amplification index underlined a decrease in the microbial contamination in comparison to the outside, while showing situations of increased microbial amplification during the period of simple ventilation (95th percentile 4.27). The 95th percentile values found for GICM in the three sampling periods, however, permitted us to identify the value of GIMC per cubic meter equal to 1,000 as a guide to provide a means of self-monitoring the quality of the air inside the classrooms. From a microclimatic viewpoint, two periods of the year manifested discomfort situations: during the heating phase (winter) and during the simple ventilation phase (spring). The results obtained indicate, therefore, a need to intervene on the environmental parameters, not being able, in this particular case, to intervene on other aspects that influence the microclimate.

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Environmental risk factors and work‐related lower respiratory symptoms in 80 office buildings: An exploratory analysis of NIOSH data

Cited by 39 publications

References 24 publications

Risk Factors in Heating, Ventilating, and Air-Conditioning Systemsfor Occupant Symptoms in U.S. Office Buildings: the EPA BASE Study

Risk Factors in Heating, Ventilating, and Air-Conditioning Systemsfor Occupant Symptoms in U.S. Office Buildings: the EPA BASE Study

Sick Building Syndrome and Other Building-Related Illnesses

Evaluation of microbiological air quality and of microclimate in university classrooms

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