Respiratory Symptoms and Infections in Children and Employees at a Water-Damaged Kindergarten
DOI:
https://doi.org/10.12974/2312-5470.2016.03.3Keywords:
Molds, kindergarten, health effects.Abstract
Objectives: Several studies have shown an increased risk of infections and respiratory symptoms among people exposed to molds. Here, we report the morbidity of children and staff exposed to several toxic molds at a kindergarten.
Methods: Prevalence of symptoms and the incidence of infections were followed up and compared between children and staff exposed in a day-care center affected by mold and those in a reference day-care center. At both day-care centers, parents (mostly mothers) filled out a questionnaire. Staff members with more severe symptoms were examined at the Clinic for Indoor Air Health Problems of the Skin and Allergy Hospital, Helsinki University Hospital.
Results: Children and staff exposed to mold had more frequent symptoms and illnesses such as hoarseness, bronchitis than the nonexposed reference group. Symptoms in the exposed group were reduced following remedial building work and the avoidance of exposure. In addition, the acute care visits of the children to the local health care center were less frequent after remediation. One of the employees of a water-damaged kindergarten was diagnosed with allergic alveolitis and asthma, one had epipharyngitis, and two had mixed cell inflammation of the eye.
Conclusions: Our study supports the results in which moisture and mold problems have been noted to increase disease rates of children and staff in day-care facilities. The study also suggest that detrimental health effects can be diminished by decreasing or stopping the exposure.
References
Ruotsalainen R, Jaakkola N and Jaakkola JJK. Dampness and molds in day-care centers as an occupational health problem. Int Arch Occup Environ Health 1995; 66(6): 369-374. http://dx.doi.org/10.1007/BF00383142
Park JH and Cox-Ganser JM. Mold exposure and respiratory health in damp indoor environments. Review. Front Biosci (elite Ed.) 2011; 1(3): 757-771. http://dx.doi.org/10.2741/e284
Bornehag CG, Sundell J, Bonini S, Custovic A, Malmberg P, Skerfving S, et al. Dampness in buildings as a risk factor for health effects, EUROEXPO: a multidisciplinary review of the literature (1998-2000) on dampness and mite exposure in buildings and health effects, Indoor Air 2004; 14(4): 243-257. http://dx.doi.org/10.1111/j.1600-0668.2004.00240.x
Fisk WJ, Lei-Gomez Q and Mendell MJ. Meta-analyses of the associations of respiratory health effects with dampness and mold in homes. Indoor Air 2007; 17(4): 284-296. http://dx.doi.org/10.1111/j.1600-0668.2007.00475.x
WHO Guidelines for indoor air quality: dampness and mould. Copenhagen: WHO Regional Office for Europe 2009.
Bornehag CG, Blomquist G, Gyntelberg F, Jarvholm B, Malmberg P, Nordvall L, et al. Dampness in buildings and health. Nordic interdisciplinary review of the scientific evidence on associations between exposure to 'dampness' in buildings and health effects (NORDDAMP). Indoor Air 2001; 11(2): 72-86. http://dx.doi.org/10.1034/j.1600-0668.2001.110202.x
Louhiala PJ, Jaakkola N, Ruotsalainen R and Jaakkola JJ. Form of day care and respiratory infections among Finnish children. Am J Public Health 1995; 85(8): 1109-1112. http://dx.doi.org/10.2105/AJPH.85.8_Pt_1.1109
Pönkä A, Nurmi T, Salminen E and Nykyri E. Infections and other illnesses of children in day-care centers in Helsinki I: Incidences and effects of home and day-care center variables. Infection 1991; 19(4): 230-236. http://dx.doi.org/10.1007/BF01644951
Ruotsalainen R, Jaakkola N and Jaakkola JJK. Ventilation and indoor air quality in Finnish daycare centers. Environ Int 1993; 19: 109-119. http://dx.doi.org/10.1016/0160-4120(93)90362-L
Wald ER, Guerra N and Byers C. Frequency and severity of infections in day care: three-year follow-up. J Pediatr 1991; 118(4): 509-514. http://dx.doi.org/10.1016/S0022-3476(05)83370-0
Mussalo-Rauhamaa H, Nikulin M, Koukila-Kähkölä P, Hintikka E-L, Malmberg M and Haahtela T. Health effects of residents exposed to Stachybotrys in water-damaged houses in Finland. Indoor and Built Environ 2010; 19(4): 478-485. http://dx.doi.org/10.1177/1420326X10367290
Fisk WJ, Eliseeva EA and Mendell MJ. Association of residential dampness and mold with respiratory tract infections and bronchitis: a meta-analysis. Environ Health 2010; 9: 72. http://dx.doi.org/10.1186/1476-069X-9-72
Antova T, Pattenden S, Brunekreef B, Heinrich J, Rudnai P, Forastiere F, et al. Exposure to indoor mould and children’s respiratory health in the PATY study. J Epidemiol Community Health 2008; 62(8): 708-714. http://dx.doi.org/10.1136/jech.2007.065896
Dales RE, Zwanenburg H, Burnett R and Franklin CA. Respiratory health effects of home dampness and molds among Canadian children. Am J Epidemiol 1991; 134: 196-203.
Levetin E, Shaughnessy R, Fisher E, Ligman B, Harrison J and Brennan T. Indoor air quality in school: exposure to fungal allergens. Aerobiologia 1995; 11: 27-34. http://dx.doi.org/10.1007/BF02136141
Strachan DP and Sanders CH. Damp housing and childhood asthma: respiratory effects of indoor air temperature and relative humidity. J Epidemiol Community Health 1989; 43: 7-14. http://dx.doi.org/10.1136/jech.43.1.7
Koskinen OM, Husman TM, Hyvärinen AM, Reponen TA and Nevalainen AL. Two moldy day-care centers: a follow-up study of respiratory symptoms and infections. Indoor Air 1997; 7: 262-268. http://dx.doi.org/10.1111/j.1600-0668.1997.00005.x
Karvonen AM, Hyvärinen A, Korppi M, Haverinen- Shaughnessy U, Renz H, Pfefferle PI, et al. Moisture damage and asthma: a birth cohort study. Pediatrics 2015; 135(3): 598-606. http://dx.doi.org/10.1542/peds.2014-1239
Norbäck D, Cai GH, Kreft I, Lampa E and Wieslander G. Fungal DNA in dust in Swedish day care centres: associations with respiratory symptoms, fractional exhaled nitrogen oxide (FENO) and C-reactive protein (CRP) in serum among day care centre staff. Int Arch Occup Environ Health 2016; 89(2): 331-340. http://dx.doi.org/10.1007/s00420-015-1076-4
Mendell MJ, Mirer AG, Cheung K, Tong M and Douwes J. Respiratory and allergic health effects of dampness, mold and dampness related agents: a review of the epidemiologic evidence. Environ Health Perspect 2011; 119(6): 748-756. http://dx.doi.org/10.1289/ehp.1002410
Nikulin M, Pasanen AL, Berg S and Hintikka EL. Stachybotrys atra and toxin production in some materials and fodder under different relative humidities. Appl Environ Microbiol 1994; 60(9): 3421-3424.
Fung F, Clark R and Williams S. Stachybotrys a mycotoxinproducing fungus of increasing toxicologic importance. J Toxicol Clin Toxicol 1998; 36(1-2): 79-86. http://dx.doi.org/10.3109/15563659809162592
Hodgson MJ, Morey P, Leung WY, Morrow D, Jarvis B, Robbins H, et al. Building-associated pulmonary disease from exposure to Stachybotrys chartarum and Aspergillus versicolor. J Occup Environ Med 1998; 40(3): 241-249. http://dx.doi.org/10.1097/00043764-199803000-00006
Johanning E, Bigiani R, Hull D, Morey P, Jarvis B and Landsbergis P. Health and immunology study following exposure to toxigenic fungi (Stachybotrys chartarum) in a water-damaged office environment. Int Arch Occup Environ Health 1996; 68(4): 207-218. http://dx.doi.org/10.1007/s004200050052
Peltola J, Andersson M, Mikkola R, Mussalo-Rauhamaa H and Salkinoja-Salonen MS. Membrane toxic substances in water-damaged construction materials and fungal pure cultures. In: Johanning E, editor. Bioaerosols, Fungi and Mycotoxins: Health Effects, Assessment, Prevention and Control, Eastern New York Occupational and Environmental Health Center, Albany, Boyd Printing Company, New York, USA, 1999: 432-443.
Jaakkola JJ, Verkasalo PK and ja Jaakkola N. Plastic wall materials in the home and respiratory health in young children. Am J Public Health 2000; 90(5): 797-799. http://dx.doi.org/10.2105/AJPH.90.5.797
Villberg K, Mussalo-Rauhamaa H, Haahtela T and Saarela K. Prevalence of plastic additives in indoor air related to newly diagnosed asthma. Indoor and Built Environment 2008; 17(5); 455-459. http://dx.doi.org/10.1177/1420326X08096413
Haverinen-Shaughnessy U, Hyvärinen A, Putus T and Nevalainen A. Monitoring success of remediation: seven case studies of moisture and mold damaged buildings. Sci Total Environ 2008; 399(1-3): 19-27. http://dx.doi.org/10.1016/j.scitotenv.2008.03.033
Patovirta RL, Husman T, Haverinen U, Vahteristo M, Uitti JA, Tukiainen H, et al. The remediation of mold damaged school – a three-year follow-up study on teachers’ health. Cent Eur J Public Health 2004; 12(1): 36-42.
Sauni R, Uitti J, Jauhiainen M, Kreiss K, Sigsgaard T and Verbeek JH. Remediating buildings damaged by dampness and mould for preventing or reducing respiratory tract symptoms, infections and asthma (review). Evid Based Child Health 2013; 8(3): 944-1000. http://dx.doi.org/10.1002/ebch.1914
