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Nasal reactions and the school environment: Nasal patency and lavage biomarkers in relation to ventilation, cleaning and some indoor air pollutants
Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences.
1999 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In Sweden, 2 million persons are exposed to the school environment, and there has been reports on insufficient cleaning, and inadequate ventilation. The nasal mucosa is more easy to study than the lower airways, and rhinitis is common and possibly related to asthma. The main aim was to study nasal symptoms, nasal patency, and biomarkers in nasal lavage (NAL), in relation to exposures in schools. Acoustic rhinometry and nasal lavage were performed in 234 school personnel in 12 randomly selected schools in Uppsala. An extended study was made, including 89 office workers, and 88 hospital workers. The technical investigations comprised a building survey and measurements of ventilation flow, settled dust, respirable dust, formaldehyde, nitrogen dioxide (NO2), molds, and bacteria in the classroom air. A ventilation flow below current Swedish standard was found in 92% of the schools, and 42% did not follow the recommendation of daily cleaning. Nasal patency was decreased in schoolswith lower air exchange rate. In schools with older mechanical ventilation, based on dilution, there were more nasal symptoms than in naturally ventilated schools, and decreased nasal patency and increase of eosinophil cationic protein (ECP) and lysozyme in NAL. One school with a new type of displacement ventilation had the highest air exchange rate, increased nasal patency and lower ECP and lysozyme. Nasal symptoms were more common in schools with more settled dust. Beneficial effects on nasal patency, ECP and lysozyme in NAL were observed for higher cleaning frequency, particularly desk cleaning. Dry cleaning methods seemed preferable. Decreased nasal patency and higher concentrations of ECP and lysozyme were observed at higher indoor concentration of formaldehyde, NO2 and molds, particularly Aspergillus sp. This indicate increased eosinophil and glandular activity, and mucosal swelling, related to these exposures. In conclusion, the school environment may affect the nasal mucosa, with mucosal swelling and increase of specific inflammatory and secretory biomarkers. Acoustic rhinometry in combination with the determination of specific nasal biomarkers seems to be useful tools for the study of nasal physiological reactions to the indoor environment. Finally, the results implicate that there is a potential to reduce possible airway inflammation in relation to the school environment, by improving cleaning and ventilation.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis , 1999. , 59 p.
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 0282-7476 ; 875
Keyword [en]
Medical sciences, acoustic rhinometry, enviromnental illness, eosinophil cationic protein (ECP), formaldehyde, lysozyme, mold, nasal lavage, nasal obstruction, N02, rhinitis, school
Keyword [sv]
National Category
Medical and Health Sciences
Research subject
Occupational and Environmental Medicine
URN: urn:nbn:se:uu:diva-381ISBN: 91-554-4570-5OAI: oai:DiVA.org:uu-381DiVA: diva2:163752
Public defence
1999-11-23, Grönwallsalen,University Hospital, Entrance 70, Uppsala, Uppsala, 09:15
Available from: 1999-11-02 Created: 1999-11-02Bibliographically approved

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