Nasal Hyperreactivity among Teachers in a School with a Long History of Moisture Problems

Abstract

Upper airway symptoms have frequently been reported in people working or residing in damp buildings. However, little information has been available on objective pathophysiologic findings in relation to these environments. Twenty-eight teachers, who had worked for at least five years in a recently renovated school that had had severe moisture problems for years, were randomly selected for this study. Eighteen teachers, who had worked in another school that had no moisture problems, were randomly selected to serve as the control group. Although remedial measures had been taken, an increase in the prevalence of mucous membrane irritations was still reported by the teachers in the target school. We used a nasal challenge test with three concentrations of histamine (1, 2 and 4 mg/mL). Recordings of swelling of the nasal mucosa were made with rhinostereometry, a very accurate optical non-invasive method. The growth curves of mucosal swelling induced by the three concentrations of histamine differed significantly between the two groups (p < 0.01). The frequencies of atopy, evaluated with the skin-prick test, were almost identical in both groups. The study indicates that long-term exposure to indoor environments with moisture problems may contribute to mucosal hyperreactivity, of the upper airways. Such hyperreactivity also seems to persist for at least one year after remedial measures have been taken.

Nasal mucosal histamine reactivity among teachers six years after working in a moisture-damaged school

“…This phenomenon may have something to do with the difficulty to maintain a uniform temperature in a single-story building, and this lack of uniformity then leading to a significantly higher prevalence of complaints of varying and low room temperature among the target school teachers. Uniformity of temperature and welladapted ventilation are important for comfort and seem to be associated with a lower incidence of perceived air dryness (21), which was a dominating complaint in the perception of poor indoor air climate among the target school teachers (8,9).…”

“…In 1997, 26 and 18 teachers from the target and control schools, respectively, participated (9). All the teachers from the study in 1995 (8), except one from the target school and one from the control school who had died, were invited in 2000 to participate (27 and 17 from the target and control schools, respectively). Twenty-four teachers from the target school and sixteen from the control school agreed to participate and formed the two study groups who participated on all three occasions.…”

“…Twenty-eight and eighteen teachers, respectively, gave their informed consent and formed the two study groups (8). In 1997, 26 and 18 teachers from the target and control schools, respectively, participated (9).…”

“…In 1995 all teachers underwent a standardized skin-prick test (8,13). Skin-prick test positivity (SPT+) was defined as the formation of a wheal with a diameter of at least 3 millimeters in response to any of the allergens used.…”

“…In 1995 (ie, 1 year after extensive remedial measures had been taken in a water-damaged school) a random sample of the teachers (N=28) who had worked in the water-damaged school for at least 5 years before the renovation were exposed to a nasal histamine provocation test and compared with teachers (N=18) from a control school with previous ventilation problems but without moisture problems (8).…”