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  • 1. Bakke, J V
    et al.
    Norbäck, D
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Wieslander, G
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Hollund, B-E
    Florvaag, E
    Haugen, E N
    Moen, B E
    Symptoms, complaints, ocular and nasal physiological signs in university staff in relation to indoor environment: temperature and gender interactions2008Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 18, nr 2, s. 131-143Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Symptoms, signs, perceptions, and objective measures were studied in university buildings. Two problem buildings with a history of dampness and complaints were compared with two control buildings. Health investigations among university staff were performed at the workplace (n = 173) including tear film stability [non-invasive break-up time (NIBUT) and self-reported break-up time (SBUT)], nasal patency (acoustic rhinometry), nasal lavage fluid analysis [NAL: eosinophil cationic protein (ECP), myeloperoxidase (MPO), lysozyme and albumin] and atopy by total serum IgE and IgE antibodies (Phadiatop (R)). Exposure assessment included inspections, thermal and atmospheric climate at 56 points modelled for all work sites. Multiple regressions were applied, controlling for age and gender. Exposure differences between problem buildings and controls were small, and variations between rooms were greater. Workers in the problem buildings had more general and dermal symptoms, but not more objective signs than the others. Adjusted day NIBUT and SBUT increased at higher night air temperatures, with B (95% CI) 0.6 (0.04-1.2) and 1.3 (-0.02 to 2.5), respectively. Higher relative humidity at mean day air temperature < 22.1 degrees C was associated with adjusted NIBUT and SBUT, with B (95% CI) 0.16 (0.03-0.29) and 0.37 (-0.01 to 0.75), respectively. Air velocity below recommended winter values and reduced relative humidity in the range of 15-30% were associated with dry air and too low temperature.

  • 2. Bakke, JV
    et al.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Wieslander, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Hollund, B.E
    Moen, B.E
    Pet keeping and dampness in the dwelling: associations with airway infections, symptoms, and physiological signs from the ocular and nasal mucosa2007Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 17, nr 1, s. 60-69Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim was to utilize data from a study of occupational indoor environments to analyze symptoms and physiological signs in relation to the home environment. A medical investigation was performed at the workplace among university staff (n = 173) from four university buildings in Bergen, in March 2004. Tear film break up time (BUT) was measured by two methods. Nasal patency was measured by acoustic rhinometry. Nasal lavage fluid analysis (NAL) included eosinophilic cationic protein (ECP); myeloperoxidase (MPO), lysozyme and albumin. Atopy was assessed by total serum IgE and specific IgE (Phadiatop®). Totally 21%, 21%, 18%, 11%, and 27% had weekly ocular, nasal, facial dermal symptoms, headache and tiredness, respectively, 15% had a damp dwelling, and 20% had a cat or dog. Multiple linear or logistic regressions were applied, controlling for age gender, smoking, and environmental factors. Building dampness was associated with increased NAL-lysozyme (P = 0.02) and an increase of airway infections [odd ratio (OR) = 3.14, P = 0.04]. Pet keeping was associated with difficulties to concentrate (OR = 5.10, P = 0.001), heavy headedness (OR = 4.35, P = 0.004), four more days with tiredness per month (P = 0.04), and less airway infections (OR = 0.32; P = 0.02). In conclusion, pet keeping was associated with more central nervous system (CNS)-symptoms but less airway infections. Dampness in the dwelling may have inflammatory effects on the airway mucosa, possibly mediated via increased infection proneness.

  • 3. Bakolis, I
    et al.
    Heinrich, J
    Zock, J P
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Svanes, C
    Chen, C M
    Accordini, S
    Verlato, G
    Olivieri, M
    Jarvis, D
    House dust-mite allergen exposure is associated with serum specific IgE but not with respiratory outcomes2015Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 25, nr 3, s. 235-244Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Exposure to house dust has been associated with asthma in adults, and this is commonly interpreted as a direct immunologic response to dust-mite allergens in those who are IgE sensitized to house dust-mite. Mattress house dust-mite concentrations were measured in a population-based sample of 2890 adults aged between 27 and 56 years living in 22 centers in 10 countries. Generalized linear mixed models were employed to explore the association of respiratory symptoms with house dust-mite concentrations, adjusting for individual and household confounders. There was no overall association of respiratory outcomes with measured house dust-mite concentrations, even in those who reported they had symptoms on exposure to dust and those who had physician-diagnosed asthma. However, there was a positive association of high serum specific IgE levels to HDM (>3.5 kUA /l) with mattress house dust-mite concentrations and a negative association of sensitization to cat with increasing house dust-mite concentrations. In conclusion, there was no evidence that respiratory symptoms in adults were associated with exposure to house dust-mite allergen in the mattress, but an association of house mite with strong sensitization was observed.

  • 4.
    Bröms, Kristina
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi.
    Svärdsudd, Kurt F
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi.
    Sundelin, Claes
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    A nationwide study of indoor and outdoor environments in allergen avoidance and conventional daycare centers in Sweden2006Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 16, nr 3, s. 227-35Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Sweden has had specialized 'allergen avoidance daycare centers' (AADC) since 1979. The aim was to compare AADC with ordinary daycare centers (ODC). Through contacts with municipalities and hospitals, 72 AADC were identified. For each AADC, the two nearest ODCs served as controls. A questionnaire was sent to the local directors of the 216 daycare centers (531 sections), 83% responded. A total of 39% of the ODCs had ever had dampness/molds, 12% were near (<500 m) stables/farms, 23% were closer than 50 m to a heavy trafficked road, and 13% were exposed to wood smoke in winter. Only 11% of the AADCs had any child with furred pets at home, while 97% of the ODCs had children with furred pets. Bans on smoking at home and on perfumes were more common at the AADCs (P = 0.001). Fewer AADCs had PVC floors (OR = 0.53; P = 0.01), dampness/molds (OR = 0.55; P = 0.04), shelves (OR 3.03; P = 0.001), curtains (OR = 1.67; P = 0.047), and flowers (OR = 0.03; P < 0.001), while more had daily floor cleaning (OR = 19.9; P = 0.004), weekly wiping of furniture (OR = 11.0; P = 0.001), and washing of pillows/mattresses (OR = 2.74; P = 0.005) and curtains (OR = 9.07; P = 0.001). In conclusion, allergy avoidance daycare centers differ from other daycare centers, and may have better indoor environments. PRACTICAL IMPLICATIONS: There is a need to improve the indoor environments of daycare centers, including reduction of building dampness and molds. Allergen avoidance daycare centers (AADC) in Sweden differ from ordinary daycare centers in many respects, with fewer indoor and building factors related to dust, allergens and irritants. This shows that the indoor environments of daycare centers can be improved. Data suggest that AADC may have lower levels of pet allergens, and this is beneficial for children with pet allergy. The effects of these improvements on indoor exposures and health of the children need to be further evaluated.

  • 5.
    Cai, G-H
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Bröms, Kristina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi.
    Mälarstig, B
    Zhao, Z-H
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Kim, J L
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Svärdsudd, Kurt
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi.
    Janson, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Quantitative PCR analysis of fungal DNA in Swedish day care centers and comparison with building characteristics and allergen levels2009Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 19, nr 5, s. 392-400Artikel i tidskrift (Refereegranskat)
    Abstract [en]

     Sweden has had allergen-avoidance day care centers (AADCs) since 1979. The aim of this study was to measure fungal DNA by quantitative polymerase chain reaction (qPCR), a new method, in AADCs and ordinary day care centers (ODCs) and examine associations between allergen levels and building characteristics. Dust samples were collected by swabbing doorframes, vacuum-cleaning, and using Petri dishes. In total, 11 AADCs and 11 ODCs were studied (70 rooms). Total fungal DNA, measured by qPCR in the swab dust, was detected in 89%, Aspergillus or Penicillium (Asp/Pen) DNA in 34%, and Stachybotrys chartarum DNA in 6% of the rooms. Total fungal DNA was significantly higher in rooms with linoleum floor (P = 0.02), textile carpets (P = 0.03), reported dampness/molds (P = 0.02) and reported odor (P < 0.001) in the buildings, and significantly lower in wooden facade buildings (P = 0.003). Reported odor was related to the amount of sieved fine dust, reported dampness/molds and type of building construction. Total fungal DNA was related to cat, dog, horse and total allergen levels (P = 0.003) in the day care centers. In conclusion, total fungal DNA is related to reported dampness/molds, reported odor, and type of wall construction. The association between fungal and allergen contamination indicated a general 'hygiene factor' related to biological contaminants. Practical Implications The associations between fungal DNA, reported dampness/molds, and odor support the view that buildings with odor problems should be investigated for possible hidden fungal growth. There is a need to measure fungal biomass in different types of building constructions by monitoring fungal DNA. Analysis of fungal DNA with quantitative PCR can be a fast and practical way to study indoor fungal contamination. Swabbing dust from the doorframe of the main entrance to the room can be a convenient method of sampling dust for fungal DNA analysis. The high prevalence of reported dampness/molds and the common occurrence of fungal DNA indicate the need to improve the indoor environment of Swedish day care centers.

  • 6. Chen, C-M
    et al.
    Thiering, E
    Doekes, G
    Zock, J-P
    Bakolis, I
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Sunyer, J
    Villani, S
    Verlato, G
    Täubel, M
    Jarvis, D
    Heinrich, J
    Geographical variation and the determinants of domestic endotoxin levels in mattress dust in Europe2012Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 22, nr 1, s. 24-32Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Endotoxin exposures have manifold effects on human health. The geographical variation and determinants of domestic endotoxin levels in Europe have not yet been extensively described. To investigate the geographical variation and determinants of domestic endotoxin concentrations in mattress dust in Europe using data collected in the European Community Respiratory Health Survey follow-up (ECRHS II). Endotoxin levels were measured in mattress dust from 974 ECRHS II participants from 22 study centers using an immunoassay. Information on demographic, lifestyle, and housing characteristics of the participants was obtained in face-to-face interviews. The median endotoxin concentration in mattress dust ranged from 772 endotoxin units per gram (EU/g) dust in Reykjavik, Iceland, to 4806 EU/g in Turin, Italy. High average outdoor summer temperature of study center, cat or dog keeping, a high household crowding index, and visible damp patches in the bedroom were significantly associated with a higher endotoxin concentrations in mattress dust. There is a large variability in domestic endotoxin levels across Europe. Average outdoor summer temperature of study center, which explains only 10% of the variation in domestic endotoxin level by center, is the strongest meteorological determinant. The observed variation needs to be taken into account when evaluating the health effects of endotoxin exposures in international contexts.

    PRACTICAL IMPLICATIONS:

    The incoherent observations of the health effects of endotoxin may be partly owing to the geographical heterogeneity of endotoxin exposure. Therefore, the observed variation should be considered in further studies. Measurements of indoor endotoxin are recommended as an indicator for the level of exposures of individual domestic environments.

  • 7.
    Engvall, Karin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Norrby, Christina
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Ocular, nasal, dermal and respiratory symptoms in relation to heating, ventilation, energy conservation and reconstruction of older multi-family houses2003Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 13, nr 3, s. 206-211Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim was to study relationships between symptoms compatible with the sick building syndrome, type of heating and ventilation system, energy saving, and reconstruction in older dwellings. In Stockholm, 4815 inhabitants in 231 multi-family buildings built before 1961 were randomly selected, of whom 3241 participated (77%). Symptoms and personal factors were assessed by a postal questionnaire. Independent information on building characteristics, and energy saving measures was gathered from the building owners. Multiple logistic regression analysis was applied to calculate odds ratios (OR) adjusting for age, gender, hay fever, current smoking, population density, type of ventilation, type of heating system, and ownership of the building. Subjects in buildings with a mechanical ventilation system had less ocular and nasal symptoms (OR = 0.29-0.85). Heating by electric radiators, and wood heating was associated with an increase of most symptoms (OR = 1.18-1.74). In total, 48% lived in buildings that had gone through at least one type of reconstruction or energy saving remedies during the latest 10 years, including exchange of heating or ventilation system, and sealing measures (exchange of windows, sealing of window frames, roof/attic insulation, and phasade insulation). Energy saving was associated with both a decrease and increase of different symptoms. Major reconstruction of the interior of the building was associated with an increase of most symptoms (OR = 1.09-1.90), and buildings with more than one sealing measure had an increase of ocular, nasal symptoms, headache and tiredness (OR = 1.22-2.49). In conclusion, major reconstruction of the interior, direct heated electric radiators, wood heating, and multiple sealing of buildings were associated with an increase of some symptoms. The study supports the view that mechanical ventilation in dwellings is beneficial from a health point of view.

  • 8.
    Engvall, Karin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Norrby, Christina
    Sandstedt, Eva
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutet för bostads- och urbanforskning (IBF). Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    The Stockholm Indoor Environment Questionnaire (SIEQ): A sociological based tool for assessment of indoor environment and health in dwellings2004Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 14, nr 1, s. 24-33Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim was to develop and validate a standardized questionnaire - the Stockholm Indoor Environment Questionnaire (SIEQ). The validation procedure was based on sociological principles and test procedures for validation. The indicators of indoor environment are air quality, thermal climate, noise, and illumination. The indicators of health are symptoms comprised in the sick building syndrome (SBS). The questionnaire also contains questions about the apartment, individual behavior, and personal factors. The everyday language describing the building and its function was first obtained by qualitative personal interviews, then by standardized questions. The interview questionnaire was transformed into a postal self-administered questionnaire. The reduction of the questionnaire was based on correlation analysis. It was found that to obtain a good validity, general questions are not sufficient, but specific question on perceptions and observations are needed. Good test-retest agreement was found both on an area level, building level, and individually. For each indicator, a set of questions are constructed and validated. SIEQ has been used in several studies, and the results are presented in graphic problem profiles. Reference data has been calculated for the Stockholm area.

  • 9. Ernstgård, L
    et al.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Nordquist, Tobias
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Wieslander, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Wålinder, Robert
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Johanson, G
    Acute effects of exposure to vapors of 3-methyl-1-butanol in humans2013Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 23, nr 3, s. 227-235Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The secondary alcohol 3-methyl-1-butanol (3MB, isoamyl alcohol) is used, for example, as a solvent in a variety of applications and as a fragrance ingredient. It is also one of the microbial volatile organic compounds (MVOCs) found in indoor air. There are little data on acute effects. The aim of the study was to assess the acute effects of 3MB in humans. Thirty healthy volunteers (16 men and 14 women) were exposed in random order to 1 mg/m3 3MB or clean air for 2 h at controlled conditions. Ratings with visual analogue scales revealed slightly increased perceptions of eye irritation (P = 0.048, Wilcoxon) and smell (P < 0.0001) compared with control exposure. The other ratings were not significantly affected (irritation in nose and throat, dyspnea, headache, fatigue, dizziness, nausea, and intoxication). No significant exposure-related effects were found in blinking frequency, tear film break-up time, vital staining of the eye, nasal lavage biomarkers, lung function, and nasal swelling. In conclusion, this study suggests that 3MB is not a causative factor for health effects in damp and moldy buildings.

  • 10. Ernstgård, Lena
    et al.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Nordquist, Tobias
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Wieslander, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Wålinder, Robert
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Johanson, G.
    Acute effects of exposure to 1 mg/m(3) of vaporized 2-ethyl-1-hexanol in humans2010Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 20, nr 2, s. 168-175Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The objective was to assess acute effects from controlled exposure of volunteers to 2-ethyl-1-hexanol, a volatile organic compound that is often found in indoor air. Sixteen males and fourteen females were in random order exposed to 1 mg/m3 of vapors of 2-ethyl-1-hexanol or to clean air (control exposure) in an exposure chamber during 2 h at rest. The subjects performed symptom ratings on Visual Analog Scales. During exposure to 2-ethyl-1-hexanol subjective ratings of smell and eye discomfort were minimally but significantly increased. Ratings of nasal irritation, throat irritation, headache, dyspnoea, fatigue, dizziness, nausea, and intoxication were not significantly affected. No exposure-related effects on measurement of blinking frequency by electromyography, measurement of the eye break-up time, vital staining of the eye, nasal lavage biomarkers, transfer tests, spirometric and rhinometric measures were seen. No differences in response were seen between sexes or between atopics and non-atopics

  • 11.
    Kim, Jeong-Lim
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Elfman, Lena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Mi, Yahong
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Wieslander, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Smedje, Greta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Indoor molds, bacteria, microbial volatile organic compounds and plasticizers in schools: associations with asthma and respiratory symptoms in pupils2007Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 17, nr 2, s. 153-163Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We investigated asthma and atopy in relation to microbial and plasticizer exposure. Pupils in eight primary schools in Uppsala (Sweden) answered a questionnaire, 1014 (68%) participated. Totally, 7.7% reported doctor-diagnosed asthma, 5.9% current asthma, and 12.2% allergy to pollen/pets. Wheeze was reported by 7.8%, 4.5% reported daytime breathlessness, and 2.0% nocturnal breathlessness. Measurements were performed in 23 classrooms (May–June), 74% had <1000 ppm CO2 indoors. None had visible mold growth or dampness. Mean total microbial volatile organic compound (MVOC) concentration was 423 ng/m3 indoors and 123 ng/m3 outdoors. Indoor concentration of TMPD-MIB (2,2,4-trimethyl-1,3-pentanediol monoisobutyrate, Texanol) and TMPD-DIB (2,2,4-trimethyl-1,3-pentanediol diisobutyrate, TXIB), two common plasticizers, were 0.89 and 1.64 μg/m3, respectively. MVOC and plasticizer concentration were correlated (r = 0.5; P < 0.01). Mold concentration was 360 cfu/m3 indoors and 980 cfu/m3 outdoors. At higher indoor concentrations of total MVOC, nocturnal breathlessness (P < 0.01) and doctor-diagnosed asthma (P < 0.05) were more common. Moreover, there were positive associations between nocturnal breathlessness and 3-methylfuran (P < 0.01), 3-methyl-1-butanol (P < 0.05), dimethyldisulfide (P < 0.01), 2-heptanone (P < 0.01), 1-octen-3-ol (P < 0.05), 3-octanone (P < 0.05), TMPD-MIB (P < 0.05), and TMPD-DIB (P < 0.01). TMPD-DIB was positively associated with wheeze (P < 0.05), daytime breathlessness (P < 0.05), doctor-diagnosed asthma (P < 0.05), and current asthma (P < 0.05). In conclusion, exposure to MVOC and plasticizers at school may be a risk factor for asthmatic symptoms in children.

  • 12.
    Kim, Jeong-Lim
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Elfman, Lena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Respiratory symptoms, asthma and allergen levels in schools: comparison between Korea and Sweden2007Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 17, nr 2, s. 122-129Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We studied reports on respiratory symptoms, asthma and atopic sensitisation in relation to allergen contamination in Korean schools and compared with data from a previous Swedish study performed in eight primary schools. Korean pupils (n = 2365) in 12 primary schools first completed a questionnaire. Then airborne and settled dust were collected from 34 classrooms and analyzed for allergens by ELISA. In both countries, boys reported more symptoms. The prevalence of wheeze was similar, while daytime [odds ratio (OR) = 14.0, 95% confidence interval (CI) = 9.0–21.9] and nocturnal breathlessness (OR = 3.1, 95% CI = 1.5–6.4) were much higher among Korean students. In Korean schools, dog allergen (Can f 1) was the most common followed by mite allergen (Der f 1), while cat (Fel d 1), dog, and horse allergen (Equ cx) were abundant in Sweden. Moreover, CO2 levels were high in most Korean schools (range 907–4113 ppm). There was an association between allergen levels in dust and air samples, and number of pet-keepers in the classrooms. In conclusion, allergen contamination in Korean schools may be an important public issue.

  • 13.
    Lindgren, Torsten
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Wieslander, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Perception of cabin air quality in airline crew related to air humidification, on intercontinental flights2007Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 17, nr 3, s. 204-210Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The influence of air humidification in aircraft, on perception of cabin air quality among airline crew (N = 71) was investigated. In-flight investigations were performed in the forward part and in the aft part on eight intercontinental flights with one Boeing 767 individually, equipped with an evaporation humidifier combined with a dehumidifying unit, to reduce accumulation of condensed water in the wall construction. Four flights had the air humidification active when going out, and turned off on the return flight. The four others had the inverse humidification sequence. The sequences were randomized, and double blind. Air humidification increased relative air humidity (RH) by 10% in forward part, and by 3% in aft part of the cabin and in the cockpit. When the humidification device was active, the cabin air was perceived as being less dry (P = 0.008), and fresher (P = 0.002). The mean concentration of viable bacteria (77–108 cfu/m3), viable molds (74–84 cfu/m3), and respirable particles (1–8 μg/m3) was low, both during humidified and non-humidified flights. On flights with air humidification, there were less particles in the forward part of the aircraft (P = 0.01). In conclusion, RH can be slightly increased by using ceramic evaporation humidifier, without any measurable increase of microorganisms in cabin air. The cabin air quality was perceived as being better with air humidification.

  • 14.
    Liu, Wei
    et al.
    Tsinghua Univ, Dept Bldg Sci, Beijing, Peoples R China;Tsinghua Univ, Beijing Key Lab Indoor Air Qual Evaluat & Control, Beijing, Peoples R China.
    Huang, Chen
    Univ Shanghai Sci & Technol, Sch Environm & Architecture, Shanghai, Peoples R China.
    Li, Baizhan
    Chongqing Univ, Joint Int Res Lab Green Bldg & Built Environm, Minist Educ, Chongqing, Peoples R China.
    Zhao, Zhuohui
    Fudan Univ, Sch Publ Hlth, Dept Environm Hlth, Shanghai, Peoples R China.
    Yang, Xu
    Cent China Normal Univ, Coll Life Sci, Wuhan, Hubei, Peoples R China.
    Deng, Qihong
    Cent S Univ, Sch Energy Sci & Engn, Changsha, Hunan, Peoples R China.
    Zhang, Xin
    Shanxi Univ, Res Ctr Environm Sci & Engn, Taiyuan, Shanxi, Peoples R China.
    Qian, Hua
    Southeast Univ, Sch Energy & Environm, Nanjing, Jiangsu, Peoples R China.
    Sun, Yuexia
    Tianjin Univ, Sch Environm Sci & Technol, Tianjin, Peoples R China.
    Qu, Fang
    China Meteorol Adm, China Meteorol Adm Training Ctr, Beijing, Peoples R China.
    Wang, Lifang
    Inner Mongolia Univ Sci & Technol, Sch Energy & Environm, Baotou, Peoples R China.
    Lin, Zhijing
    Fudan Univ, Sch Publ Hlth, Dept Environm Hlth, Shanghai, Peoples R China.
    Lu, Chan
    Cent S Univ, Sch Energy Sci & Engn, Changsha, Hunan, Peoples R China.
    Wang, Han
    Chongqing Univ, Joint Int Res Lab Green Bldg & Built Environm, Minist Educ, Chongqing, Peoples R China.
    Wang, Juan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Cai, Jiao
    Chongqing Univ, Joint Int Res Lab Green Bldg & Built Environm, Minist Educ, Chongqing, Peoples R China.
    Zhang, Jialing
    Univ Shanghai Sci & Technol, Sch Environm & Architecture, Shanghai, Peoples R China.
    Sun, Chanjuan
    Univ Shanghai Sci & Technol, Sch Environm & Architecture, Shanghai, Peoples R China.
    Mo, Jinhan
    Tsinghua Univ, Dept Bldg Sci, Beijing, Peoples R China;Tsinghua Univ, Beijing Key Lab Indoor Air Qual Evaluat & Control, Beijing, Peoples R China.
    Weschler, Louise B.
    Tsinghua Univ, Dept Bldg Sci, Beijing, Peoples R China.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Sundell, Jan
    Tsinghua Univ, Dept Bldg Sci, Beijing, Peoples R China;Tsinghua Univ, Beijing Key Lab Indoor Air Qual Evaluat & Control, Beijing, Peoples R China;Tianjin Univ, Sch Environm Sci & Technol, Tianjin, Peoples R China.
    Zhang, Yinping
    Tsinghua Univ, Dept Bldg Sci, Beijing, Peoples R China;Tsinghua Univ, Beijing Key Lab Indoor Air Qual Evaluat & Control, Beijing, Peoples R China.
    Household renovation before and during pregnancy in relation to preterm birth and low birthweight in China2019Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 29, nr 2, s. 202-214Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    From October 2010 to April 2012, we conducted a cross-sectional study of associations between household environments and childhood health among preschool children in eight Chinese cities. Here, we analyze associations of early household renovation with preterm birth (PTB), low birthweight (LBW), term low birthweight (Term-LBW), and small for gestational age (SGA). Parents responded to questions about household renovation and their children's gestational age and birthweight. In the multivariate logistic regression analyses, household renovation in the year before pregnancy was significantly associated with LBW (sample size: N = 25 813; adjusted odds ratio (OR) with 95% confidence intervals (CIs): 1.23, 1.01-1.50) and Term-LBW (N = 24 823; 1.29, 1.01-1.67). Household renovation during pregnancy was significantly associated with PTB (N = 25 202; 1.28, 1.01-1.69). These significant associations were also found in the two-level (city-child) logistic regression analyses and in the sensitivity analyses among 21 009 children with complete data in all studied variates. Stronger associations were found in certain subgroups. Our findings indicate that household renovation within one year before pregnancy might be a risk factor for LBW and Term-LBW, while household renovation during pregnancy could be a risk factor for PTB.

  • 15.
    Mi, Y-H
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Tao, J.
    Mi, Y-L
    Ferm, M.
    Current asthma and respiratory symptoms among pupils in Shanghai, China: influence of building ventilation, nitrogen dioxide, ozone, and formaldehyde in classrooms2006Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 16, nr 6, s. 454-464Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We investigated 10 naturally ventilated schools in Shanghai, in winter. Pupils (13-14 years) in 30 classes received a questionnaire, 1414 participated (99%). Classroom temperatures were 13-21 degrees C (mean 17 degrees C), relative air humidity was 36-82% (mean 56%). The air exchange rate was 2.9-29.4 ac/h (mean 9.1), because of window opening. Mean CO2 exceeded 1000 ppm in 45% of the classrooms. NO2 levels were 33-85 mu g/m(3) indoors, and 45-80 mu g/m(3) outdoors. Ozone were 1-9 mu g/m(3) indoors and 17-28 mu g/m(3) outdoors. In total, 8.9% had doctors' diagnosed asthma, 3.1% wheeze, 23.0% daytime breathlessness, 2.4% current asthma, and 2.3% asthma medication. Multiple logistic regression was applied. Observed indoor molds was associated with asthma attacks [odds ratio (OR) = 2.40: P < 0.05]. Indoor temperature was associated with daytime breathlessness (OR = 1.26 for 1 C; P < 0.001), and indoor CO2 with current asthma (OR = 1.18 for 100 ppm; P < 0.01) and asthma medication (OR = 1.15 for 100 ppm; P < 0.05). Indoor NO2 was associated with current asthma (OR = 1.51 for 10 mu g/m(3); P < 0.01) and asthma medication (OR = 1.45 for 10 mu g/m(3); P < 0.01). Outdoor NO2 was associated with current asthma (OR = 1.44 for 10 mu g/m(3); P < 0.05). Indoor and outdoor ozone was negatively associated with daytime breathlessness. In conclusion, asthma symptoms among pupils in Shanghai can be influenced by lack of ventilation and outdoor air pollution from traffic.

  • 16.
    Norbäck, D
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Nordström, K
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    An experimental study on effects of increased ventilation flow on students' perception of indoor environment in computer classrooms.2008Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 18, nr 4, s. 293-300Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The effects of ventilation in computer classrooms were studied with university students (n = 355) in a blinded study, 31% were women and 3.8% had asthma. Two classrooms had a higher air exchange (4.1-5.2 ac/h), two others had a lower air exchange (2.3-2.6 ac/h). After 1 week, ventilation conditions were shifted. The students reported environmental perceptions during the last hour. Room temperature, RH, CO2, PM10 and ultra-fine particles were measured simultaneously. Mean CO2 was 1185 ppm at lower and 922 ppm at higher air exchange. Mean temperature was 23.2 degrees C at lower and 22.1 degrees C at higher air exchange. After mutual adjustment (temperature, RH, CO2, air exchange), measured temperature was associated with a perception of higher temperature (P < , 0.001), lower air movement (P < , 0.001), and poorer air quality (P < , 0.001). Higher air exchange was associated with a perception of lower temperature (P < , 0.001), higher air movement (P = 0.001), and better air quality (P < , 0.001). In the longitudinal analysis (n = 83), increased air exchange caused a perception of lower temperature (P = 0.002), higher air movement (P < , 0.001), better air quality (P = 0.001), and less odor (P = 0.02). In conclusion, computer classrooms have CO2 levels above 1000 ppm and temperatures above 22 degrees C. Increased ventilation from 7 l/s per person to 10-13 l/s per person can improve thermal comfort and air quality.

  • 17.
    Norbäck, Dan
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin. Shanxi Univ, Inst Environm Sci, Taiyuan 030006, Shanxi, Peoples R China.
    Li, Tian
    Shanxi Univ, Inst Environm Sci, Taiyuan 030006, Shanxi, Peoples R China.
    Bai, Xu
    Shanxi Univ, Inst Environm Sci, Taiyuan 030006, Shanxi, Peoples R China.
    Li, Chenghuan
    Shanxi Univ, Inst Environm Sci, Taiyuan 030006, Shanxi, Peoples R China.
    Zhao, Zhuohui
    Fudan Univ, Sch Publ Hlth, Shanghai, Peoples R China.
    Zhang, Xin
    Shanxi Univ, Inst Environm Sci, Taiyuan 030006, Shanxi, Peoples R China.
    Onset and remission of rhinitis among students in relation to the home and school environment: A cohort study from Northern China2019Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 29, nr 4, s. 527-538Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Few prospective studies exist on indoor and outdoor air pollution in relation to adolescent rhinitis. We studied associations between onset and remission of rhinitis among junior high school students in relation to the home and school environment. A 2-year questionnaire cohort study was performed among 1325 students (11-15 years) in eight schools in Taiyuan, Northern China. Climate and air pollution were measured by direct reading instruments and passive samplers inside and outside the schools at baseline. Associations were calculated by multilevel logistic regression. Two-year onset of rhinitis and weekly rhinitis were 26.7% and 13.1%, respectively. RH (P < 0.001), CO2 (P < 0.01) and PM10 (P < 0.01) in the classrooms, PM10 (P < 0.01) and NO2 (P < 0.05) outside the schools, and redecoration (OR = 2.25) and dampness/indoor mold at home (OR = 2.04) were associated with onset of weekly rhinitis. RH (P < 0.05) and CO2 (P < 0.05) in the classroom and dampness/indoor mold (OR = 0.67) and environmental tobacco smoke (ETS) at home (OR = 0.63) reduced remission of rhinitis. In conclusion, dampness/mold and chemical emissions from new materials at home can increase onset of rhinitis and ETS and dampness/mold can reduce the remission. PM10, RH, CO2, and NO2 at school can increase the onset, and RH and CO2 can reduce the remission of rhinitis.

  • 18.
    Norbäck, Dan
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Wieslander, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Zhang, X.
    Zhao, Zhuohui
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Respiratory symptoms, perceived air quality and physiological signs in elementary school pupils in relation to displacement and mixing ventilation system: an intervention study2011Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 21, nr 5, s. 427-437Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Schools may be poorly ventilated and may contain furry pet allergens, particles and microorganisms. We studied health effects when changing from mixing ceiling ventilation to two types of displacement ventilation, front ventilation system (FVS) and floor master system (FMS). The study included pupils in three elementary school classes (N = 61), all with floor heating. One class received blinded interventions; the two others were unchanged (controls). Ventilation flow and supply air temperature was kept constant. The medical investigation included tear film stability (BUT), nasal patency and a questionnaire containing rating scales. When changing from mixing ventilation to FVS, the pupils (N = 26) perceived better air quality (P = 0.006) and less dyspnoea (P = 0.007) as compared to controls (N = 35), and BUT was improved (P = 0.03). At desk level, mean CO(2) was reduced from 867 to 655 ppm. Formaldehyde and viable bacteria were numerically lower, while total bacteria and molds were higher with displacement ventilation. There was no difference in symptoms or signs when changing from FVS to FMS. Cat (Der p1), dog (Can f1) and horse allergen (Equ cx) were common in air at all conditions. In conclusion, displacement ventilation may have certain positive health effects among pupils, as compared to conventional mixing ceiling systems.

  • 19.
    Norbäck, Dan
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Zock, J-P
    Ctr Res Environm Epidemiol CREAL, Barcelona, Spain.; IMIM Hosp del Mar, Municipal Inst Med Res, Barcelona, Spain.; CIBERESP, Madrid, Spain.
    Plana, E
    Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.; Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain.; CIBER Epidemiologia y Salud Publica, (CIBERESP), Madrid, Spain.
    Heinrich, J
    German Research Centre for Environmental Health, Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany.
    Tischer, C
    Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.; Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain.; CIBER Epidemiologia y Salud Publica, (CIBERESP), Madrid, Spain.
    Jacobsen Bertelsen, R
    Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.
    Sunyer, J
    Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.; Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain.; CIBER Epidemiologia y Salud Publica, (CIBERESP), Madrid, Spain.; Pompeu Fabra Univ UFP, Barcelona, Spain.
    Künzli, N
    Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.; Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland.; University of Basel, Basel, Switzerland.
    Villani, S
    Department of Public Health, Experimental and Forensic Medicine, Unit of Biostatistics and Clinical Epidemiology, University of Pavia, Pavia, Italy.
    Olivieri, M
    Occupational Medicine, University of Verona, Verona, Italy.
    Verlato, G
    Epidemiology and Medical Statistics, University of Verona, Verona, Italy.
    Soon, A
    Department of Public Health, University of Tartu, Tartu, Estonia.; Estonian Research Council, Tartu, Estonia.
    Schlünssen, V
    Department of Public health, Aarhus University, Aarhus, Denmark.; The National Research Center for the Working Environment, Copenhagen, Denmark.
    Gunnbjörnsdottir, M I
    Allergy Department, Landspitali University Hospital, Reykjavik, Iceland.
    Jarvis, D
    Respiratory Epidemiology and Public Health Group, National Heart and Lung Institute, Imperial College, London, UK.
    Building dampness and mold in European homes in relation to climate, building characteristics and socio-economic status: The European Community Respiratory Health Survey ECRHS II2017Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 27, nr 5, s. 921-932Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We studied dampness and mold in homes in relation to climate, building characteristics and socio-economic status (SES) across Europe, for 7127 homes in 22 centers. A subsample of 3118 homes was inspected. Multilevel analysis was applied, including age, gender, center, SES, climate, and building factors. Self-reported water damage (10%), damp spots (21%), and mold (16%) in past year were similar as observed data (19% dampness and 14% mold). Ambient temperature was associated with self-reported water damage (OR=1.63 per 10°C; 95% CI 1.02-2.63), damp spots (OR=2.95; 95% CI 1.98-4.39), and mold (OR=2.28; 95% CI 1.04-4.67). Precipitation was associated with water damage (OR=1.12 per 100 mm; 95% CI 1.02-1.23) and damp spots (OR=1.11; 95% CI 1.02-1.20). Ambient relative air humidity was not associated with indoor dampness and mold. Older buildings had more dampness and mold (P<.001). Manual workers reported less water damage (OR=0.69; 95% CI 0.53-0.89) but more mold (OR=1.27; 95% CI 1.03-1.55) as compared to managerial/professional workers. There were correlations between reported and observed data at center level (Spearman rho 0.61 for dampness and 0.73 for mold). In conclusion, high ambient temperature and precipitation and high building age can be risk factors for dampness and mold in homes in Europe.

  • 20.
    Olivieri, Mario
    et al.
    Univ Verona, Dept Diagnost & Publ Hlth, Unit Occupat Med, Verona, Italy.
    Murgia, Nicola
    Univ Perugia, Sect Occupat Med Resp Dis & Toxicol, Perugia, Italy.
    Carsin, Anne-Elie
    ISGlobal Inst Salud Global Barcelona, Campus MAR,Barcelona Biomed Res Pk PRBB, Barcelona, Spain.
    Heinrich, Joachim
    Ludwig Maximilians Univ Munchen, Univ Hosp Munich, Inst & Outpatient Clin Occupat Social & Environm, Munich, Germany.
    Benke, Geza
    Monash Univ, Sch Publ Hlth & Prevent Med, Dept Epidemiol & Prevent Med, Melbourne, Vic, Australia.
    Bono, Roberto
    Univ Turin, Dept Publ Hlth & Pediat, Turin, Italy.
    Corsico, Angelo Guido
    IRCCS Policlin San Matteo Fdn, Div Resp Dis, Pavia, Italy.
    Demoly, Pascal
    Univ Hosp Montpellier, Dept Pneumol & Addictol, Montpellier, France.
    Forsberg, Bertil
    Umea Univ, Dept Publ Hlth & Clin Med, Occupat & Environm Med, Umea, Sweden.
    Gislason, Thorarinn
    Univ Iceland, Landspitali Univ Hosp, Fac Med, Reykjavik, Iceland;Univ Iceland, Landspitali Univ Hosp, Dept Sleep, Reykjavik, Iceland.
    Janson, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lung- allergi- och sömnforskning.
    Jogi, Rain
    Tartu Univ Hosp, Lung Clin, Tartu, Estonia.
    Leynaert, Benedicte
    Univ Paris Diderot, Inserm UMR Equipe Epidemiol 1152, Paris, France.
    Martinez-Moratalla Rovira, Jesus
    CHUA, Unit Pneumol, Albacete, Spain.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Nowak, Dennis
    Klinikum Univ Munchen, WHO Collaborating Ctr Occupat Hlth, Inst & Poliklin Arbeits Sozial & Umweltmed, Munich, Germany.
    Pascual, Silvia
    Galdakao Hosp, Pulmonol Dept, Biscay, Spain.
    Pin, Isabelle
    CHU Grenoble Alpes, Dept Pediat, Grenoble, France.
    Probst-Hensch, Nicole
    Swiss Trop & Publ Hlth Inst, Dept Epidemiol & Publ Hlth, Basel, Switzerland.
    Raherison, Chantal
    Bordeaux Univ, Inst Publ Hlth & Epidemiol, INSERM U897, Bordeaux, France.
    Sigsgaard, Torben
    Aarhus Univ, Danish Ramazzini Ctr, Sect Environm Occupat & Hlth, Dept Publ Hlth, Aarhus, Denmark.
    Svanes, Cecilie
    Univ Bergen, Ctr Int Hlth, Bergen, Norway.
    Toren, Kjell
    Univ Gothenburg, Sect Occupat & Environm Med, Gothenburg, Sweden.
    Urrutia, Isabel
    Galdakao Hosp, Pulmonol Dept, Biscay, Spain.
    Weyler, Joost
    Univ Antwerp, Epidemiol & Social Med, Antwerp, Belgium;Univ Antwerp, StatUA Stat Ctr, Antwerp, Belgium.
    Jarvis, Deborah
    Imperial Coll, Natl Heart & Lung Inst, Resp Epidemiol Occupat Med & Publ Hlth, London, England.
    Zock, Jan-Paul
    ISGlobal Inst Salud Global Barcelona, Campus MAR,Barcelona Biomed Res Pk PRBB, Barcelona, Spain.
    Verlato, Giuseppe
    Univ Verona, Dept Diagnost & Publ Hlth, Unit Epidemiol & Med Stat, Verona, Italy.
    Effects of smoking bans on passive smoking exposure at work and at home: The European Community respiratory health survey2019Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 29, nr 4, s. 670-679Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This longitudinal study investigated whether smoking bans influence passive smoking at work and/or at home in the same subjects. Passive smoking at work and/or at home was investigated in random population samples (European Community Respiratory Health Survey) in 1990-1995, with follow-up interviews in 1998-2003 and 2010-2014. National smoking bans were classified as partial (restricted to public workplaces) or global (extended to private workplaces). Multivariable analysis was accomplished by three-level logistic regression models, where level-1, level-2, and level-3 units were, respectively, questionnaire responses, subjects, and centers. Passive smoking at work was reported by 31.9% in 1990-1995, 17.5% in 1998-2003, and 2.5% in 2010-2014. Concurrently, passive smoking at home decreased from 28.9% to 18.2% and 8.8%. When controlling for sex, age, education, smoking status, and ECHRS wave, the odds of passive smoking at work was markedly reduced after global smoking bans (OR = 0.45, 95% CI 0.25-0.81), particularly among non-smokers, while the protective effect of global smoking bans on passive smoking at home was only detected in non-smokers. Smoking bans both in public and private workplaces were effective in reducing passive smoking at work in Europe. However, given the inefficacy of smoking bans in current smokers' dwellings, better strategies are needed to avoid smoking indoors.

  • 21.
    Runeson, Roma
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    af Klinteberg, Britt
    Edling, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    The infuence of personality, measured by the Karolinska Scales of Personality (KSP), on symptoms among subjects in suspected sick buildings2004Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, nr 14, s. 394-404Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim was to study possible relationships between personality traitsas measured by the Karolinska Scales of Personality (KSP), a self-report personalityinventory based on psychobiological theory, and medical symptoms, insubjects with previous work history in suspected sick buildings. The studycomprised 195 participants from 19 consecutive cases of suspected sick buildings,initially collected in 1988–92. In 1998–89, the KSP inventory and a symptomsquestionnaire were administered in a postal follow-up study. There were 16questions on symptoms, including symptoms from the eyes, nose, throat, skin,and headache, tiredness, and a symptom score (SC), ranging from 0 to 16, wascalculated. The questionnaire also requested information on personal factors,including age, gender, smoking habits, allergy and diagnosed asthma. The KSPratings in the study group did not differ from the mean personality scale normscores, calculated from an external reference group. Females had higher scoresfor somatic anxiety (P < 0.01), muscular tension (P < 0.001), psychic anxiety(P < 0.01), psychasthenia (P < 0.05), indirect aggression (P < 0.05), and guilt(P < 0.05), while males scored higher on detachment (P < 0.001). Subjects withhigher SC were found to display higher degree of somatic anxiety (P < 0.001),muscular tension (P < 0.001), psychic anxiety (P < 0.001), psychasthenia(P < 0.001), inhibition of aggression (P < 0.05), detachment (P < 0.05), suspicion(P < 0.01), indirect aggression (P < 0.01), and verbal aggression(P < 0.05). In addition, ocular, respiratory, dermal, and systemic symptoms(headache and tiredness) were significantly related to anxiety- and aggressivityrelatedscales. There were associations between personality scales and change ofsymptom score (SC) during the 9-year period. The associations between KSPpersonality traits and symptoms were more pronounced in females. In conclusion,there are gender differences in personality and SBS symptoms. Personalitymay play a role in the occurrence of symptoms studied in indoor environmentalepidemiology. Our results support a view that measurement of personality couldbe of value in future studies and vulnerability to environmental stress.

  • 22.
    Runeson, Roma
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Wahlstedt, Kurt
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Wieslander, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Personal and psychosocial factors and symptoms compatible with sick building syndrome in the Swedish workforce2006Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 16, nr 6, s. 445-453Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A random sample of 1000 subjects (20-65 years of age) received a postal questionnaire regarding sick building syndrome (SBS), including the three-dimensional model of demand-control-support (DCS). The response rate was 70% (n = 695), and 532 were occupationally active. Female gender and atopy were the main predictors of symptoms. Eye symptoms were more common at low social support combined with strained work situation [odds ratio (OR) 2.37], and at high social support combined with active work situation (OR 3.00). Throat symptoms were more common at low social support combined with either passive (OR 1.86) or strained situation (OR 2.42). Tiredness was more common at low social support combined with either passive (OR 2.41), strained (OR 2.25), or active situation (OR 1.87), and at high social support combined with active work situation (OR 1.83). Low social support combined with either passive (P = 0.01) or strained job situation (P = 0.01) was associated with a higher symptom score (SC). The lowest SC was found at a relaxed work situation, irrespective of social support. In conclusion, female gender, low age, asthma, atopy and psychosocial work environment are associated with symptoms. The three-dimensional model can predict symptoms compatible with SBS, but in a more complex way than earlier research indicated.

  • 23.
    Sahlberg, Bo
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Wieslander, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Gislason, Thorarinn
    Janson, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Onset of mucosal, dermal, and general symptoms in relation to biomarkers and exposures in the dwelling: a cohort study from 1992 to 20022012Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 22, nr 4, s. 331-338Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We examined the associations between biomarkers of allergy and inflammation, indoor environment in dwellings, and incidence and remission of symptoms included in the sick building syndrome (SBS) and changes in the home environment of 452 adults who were followed from 1992 to 2002 within the Uppsala part of the European Community Respiratory Health Survey (ECRHS). The 10-year incidence (onset) of general, mucosal, and dermal symptoms was 8.5%, 12.7%, and 6.8%, respectively. Dampness or indoor molds at baseline was a predictor of incidence of general (relative risk [RR] = 1.98), mucosal (RR = 2.28), and dermal symptoms (RR = 1.91). Women had higher incidence of general (RR = 1.74) and mucosal symptoms (RR = 1.71). Indoor painting increased the incidence of general symptoms (RR = 1.62). Bronchial responsiveness (BR), eosinophil counts in blood, total IgE and eosinophilic cationic protein (ECP) in serum at baseline were predictors of incidence of SBS. At follow-up, BR, total IgE, and C-reactive protein (CRP ) were associated with increased incidence of SBS. Moreover, subjects with doctor-diagnosed asthma at baseline had a higher incidence of general (RR = 1.65) and mucosal symptoms (RR = 1.97). In conclusion, female gender, dampness or indoor molds, indoor painting, and biomarkers of allergy and inflammation were associated with a higher incidence of SBS symptoms, in particular mucosal symptoms.

  • 24.
    Sandstedt, Eva
    et al.
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutet för bostads- och urbanforskning (IBF).
    Engvall, Karin
    Norrby, Christina
    The Stockholm Indoor Environment Questionnaire: a sociologically based tool for the assessment of indoor environment and health in dwellings2004Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 14, nr 1, s. 24-33Artikel i tidskrift (Refereegranskat)
  • 25.
    Smedje, Greta
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Mattsson, M
    Wålinder, Robert
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Comparing mixing and displacement ventilation in classrooms: pupils' perception and health2011Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 21, nr 6, s. 454-461Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Several studies have found that indoor air quality (IAQ) in schools is often poor and may affect the health of the pupils. Building ventilation is a means to reduce pollutants indoors, but different designs should be evaluated for their effectiveness in different environments. In a field experiment performed at four classrooms in one school building, air was supplied either in the mixing or in the displacement mode, and we collected information on exposures, pupils' perception of IAQ and climate, and health symptoms and performed clinical examinations. The room temperature, relative humidity, concentration of CO(2) , and cat allergen were measured at the breathing height and were similar during each ventilation mode. The children perceived IAQ were similar in the two ventilation regimes, and there were few differences in symptom reports or clinical parameters. However, the pupils reported more eye symptoms during displacement ventilation. PRACTICAL IMPLICATIONS: Both mixing and displacement ventilation may be appropriate in school classrooms as long as the overall design, ventilation rates, and maintenance of systems are satisfactory.

  • 26. Svanes, C
    et al.
    Dharmage, S
    Sunyer, J
    Zock, J P
    Norbäck, D
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Wjst, M
    Heinrich, J
    Jarvis, D
    de Marco, R
    Plana, E
    Villani, S
    Antó, J M
    Long-term reliability in reporting of childhood pets by adults interviewed twice, 9 years apart. Results from the European Community Respiratory Health Survey I and II2008Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 18, nr 2, s. 84-92Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Investigation of long-term effects of childhood pet exposure is usually based on retrospective information provided by adults, while there is little knowledge about the reliability in adult reporting of childhood events. We analyzed 8287 adults interviewed about childhood pets twice, on average nine years apart, in the European Community Respiratory Health Survey. Agreement between the surveys in reporting of childhood cats, dogs and birds were investigated with kappa statistics, and potential effects of disease status on agreement were analyzed with kappa statistics and multiple logistic regressions. Cats, dogs and birds in childhood were reported by 44, 41 and 38%, respectively. Cohen's kappa for agreement in adult reporting of childhood pets was 0.714 (95% CI=0.698-0.729) for cat, 0.709 (0.691-0.722) for dog, and 0.606 (0.591-0.626) for bird. Thus, agreement was significantly higher for reporting of cat and dog than for bird. Adult wheeze, asthma or atopy did not influence agreement. Neither did adult cat sensitization influence agreement in adult reporting of childhood cat. Childhood factors such as moving house <5 years, or growing up as a single child, in a large family or in a rural area, were associated with poorer agreement, while adult factors were unrelated to agreement. PRACTICAL IMPLICATIONS: Long-term reliability in adult reporting of childhood pets was substantial, and not influenced by disease status. Thus, collection of information about childhood pets from adults appears to be reliable for the purpose of studying adult allergic disease. Future studies should consider that the reliability was higher for a more important childhood event and influenced by childhood rather than adult characteristics. Imperfect reliability contributed to underestimation of the effects of pets on adult allergy; i.e. with a kappa of 0.71, a true odds ratio (OR) of 0.80 would be attenuated to 0.86. Future studies should account for non-differential misclassification error.

  • 27.
    Valkonen, M.
    et al.
    Natl Inst Hlth & Welf, Living Environm & Hlth Unit, Kuopio, Finland.;Univ Eastern Finland, Dept Environm & Biol Sci, Kuopio, Finland..
    Täubel, M.
    Natl Inst Hlth & Welf, Living Environm & Hlth Unit, Kuopio, Finland..
    Pekkanen, J.
    Natl Inst Hlth & Welf, Living Environm & Hlth Unit, Kuopio, Finland.;Univ Helsinki, Dept Publ Hlth, Helsinki, Finland..
    Tischer, C.
    Ctr Res Environm Epidemiol CREAL, ISGlobal, Barcelona, Spain.;UPF, Barcelona, Spain.;CIBERESP, Barcelona, Spain..
    Rintala, H.
    Natl Inst Hlth & Welf, Living Environm & Hlth Unit, Kuopio, Finland..
    Zock, J. -P
    Casas, L.
    Katholieke Univ Leuven, Dept Publ Hlth & Primary Care, Ctr Environm & Hlth, Leuven, Belgium.;Res Fdn Flanders FWO, Brussels, Belgium..
    Probst-Hensch, N.
    Swiss Trop & Publ Hlth Inst, Head Dept Epidemiol & Publ Hlth, Basel, Switzerland.;Univ Basel, Dept Publ Hlth, Basel, Switzerland..
    Forsberg, B.
    Umea Univ, Dept Publ Hlth & Clin Med, Occupat & Environm Med, Umea, Sweden..
    Holm, M.
    Sahlgrens Univ Hosp, Dept Occupat & Environm Med, Gothenburg, Sweden..
    Janson, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lung- allergi- och sömnforskning.
    Pin, I.
    Univ Grenoble Alpes, INSERM, CHU Grenoble Alpes, U 1209, Grenoble, France..
    Gislason, T.
    Landspitali Univ Hosp E7, Dept Resp Med & Sleep, Reykjavik, Iceland.;Univ Iceland, Fac Med, Reykjavik, Iceland..
    Jarvis, D.
    Imperial Coll, Natl Heart & Lung Inst, Populat Hlth & Occupat Dis, London, England.;Imperial Coll, MRC PHE Ctr Environm & Hlth, London, England..
    Heinrich, J.
    Ludwig Maximillians Univ Munich, Univ Hosp Munich, Inst & Outpatient Clin Occupat Social & Environm, German Ctr Lung Res DZL, Munich, Germany.;German Res Ctr Environm Hlth, Inst Epidemiol 1, Helmholtz Zentrum Munchen, Neuherberg, Germany..
    Hyvärinen, A.
    Natl Inst Hlth & Welf, Living Environm & Hlth Unit, Kuopio, Finland..
    Microbial characteristics in homes of asthmatic and non-asthmatic adults in the ECRHS cohort2018Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 28, nr 1, s. 16-27Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Microbial exposures in homes of asthmatic adults have been rarely investigated; specificities and implications for respiratory health are not well understood. The objectives of this study were to investigate associations of microbial levels with asthma status, asthma symptoms, bronchial hyperresponsiveness (BHR), and atopy. Mattress dust samples of 199 asthmatics and 198 control subjects from 7 European countries participating in the European Community Respiratory Health Survey II study were analyzed for fungal and bacterial cell wall components and individual taxa. We observed trends for protective associations of higher levels of mostly bacterial markers. Increased levels of muramic acid, a cell wall component predominant in Gram-positive bacteria, tended to be inversely associated with asthma (OR's for different quartiles: II 0.71 [0.39-1.30], III 0.44 [0.23-0.82], and IV 0.60 [0.31-1.18] P for trend .07) and with asthma score (P for trend .06) and with atopy (P for trend .02). These associations were more pronounced in northern Europe. This study among adults across Europe supports a potential protective effect of Gram-positive bacteria in mattress dust and points out that this may be more pronounced in areas where microbial exposure levels are generally lower.

  • 28.
    Wang, Juan
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin. Univ Hosp, Uppsala, Sweden..
    Engvall, Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin. Univ Hosp, Uppsala, Sweden..
    Smedje, Greta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin. Univ Hosp, Uppsala, Sweden..
    Nilsson, H.
    KTH Royal Inst Technol, Div Bldg Serv & Energy Syst, Sch Architecture & Built Environm, Stockholm, Sweden..
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin. Univ Hosp, Uppsala, Sweden..
    Current wheeze, asthma, respiratory infections, and rhinitis among adults in relation to inspection data and indoor measurements in single-family houses in Sweden - The BETSI study2017Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 27, nr 4, s. 725-736Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In the Swedish Building Energy, Technical Status and Indoor environment study, a total of 1160 adults from 605 single-family houses answered a questionnaire on respiratory health. Building inspectors investigated the homes and measured temperature, air humidity, air exchange rate, and wood moisture content (in attic and crawl space). Moisture load was calculated as the difference between indoor and outdoor absolute humidity. Totally, 7.3% were smokers, 8.7% had doctor' diagnosed asthma, 11.2% current wheeze, and 9.5% current asthma symptoms. Totally, 50.3% had respiratory infections and 26.0% rhinitis. The mean air exchange rate was 0.36/h, and the mean moisture load 1.70g/m(3). Damp foundation (OR=1.79, 95% CI 1.16-2.78) was positively associated while floor constructions with crawl space (OR=0.49, 95% CI 0.29-0.84) was negatively associated with wheeze. Concrete slabs with overlying insulation (OR=2.21, 95% CI 1.24-3.92) and brick facade (OR=1.71, 95% CI 1.07-2.73) were associated with rhinitis. Moisture load was associated with respiratory infections (OR=1.21 per 1g/m(3), 95% CI 1.04-1.40) and rhinitis (OR=1.36 per 1g/m(3), 95% CI 1.02-1.83). Air exchange rate was associated with current asthma symptoms (OR=0.85 per 0.1/h, 95% CI 0.73-0.99). Living in homes with damp foundation, concrete slabs with overlying insulation, brick facade, low ventilation flow, and high moisture load are risk factors for asthma, rhinitis, and respiratory infections.

  • 29.
    Wieslander, Gunilla
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Venge, Per
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk kemi.
    Changes of symptoms, tear film stability and eosinophilic cationic protein in nasal lavage fluid after re-exposure to a damp office building with a history of flooding2007Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 17, nr 1, s. 19-27Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim was to study health effects in office workers (N = 18) in a medical case book archive with dampness caused by flooding. They were first investigated in a building without dampness (exposure free for 10 days). Then all returned to the damp building, and were re-investigated after 2 days. We measured tear film break up time (BUT), nasal patency, biomarkers in nasal lavage (NAL), and dynamic spirometry. Both buildings had low CO2 (380-600 ppm), low levels of respirable particles (8-10 μg/m3), and formaldehyde (5-7 μg/m3). The flooded building had slightly higher (149 ng/m3 vs. 94 ng/m3) levels of microbial volatile organic compounds (MVOC). After 2 days of re-exposure, there was an increase of ocular (P < 0.001), nasal (P = 0.002), and throat symptoms (P < 0.001), dyspnea (P = 0.006), headache (P = 0.002), nausea (P = 0.04), and tiredness (P = 0.01). The median BUT decreased from 16 to 8 s (P = 0.003), and eosinophilic cationic protein (ECP) in NAL increased slightly (P = 0.04). A separate test of the weekday effect showed slight improvements, or no change of symptoms and signs from Monday to Wednesday. In conclusion, subjects previously exposed to building dampness had an increase of symptoms, reduced tear film stability, and signs of eosinophilic inflammation in the nasal mucosa after 2 days of re-exposure.

  • 30. Zhang, X
    et al.
    Zhao, Z
    Nordquist, Tobias
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    The prevalence and incidence of sick building syndrome in Chinese pupils in relation to the school environment: a two-year follow-up study2011Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 21, nr 6, s. 462-471Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    There are few incidence studies on sick building syndrome (SBS). We studied two-year change of SBS in Chinese pupils in relation to parental asthma/allergy (heredity), own atopy, classroom temperature, relative humidity (RH), absolute humidity (AH), crowdedness, CO₂, NO₂, and SO₂. A total of 1993 participated at baseline, and 1143 stayed in the same classrooms after two years. The prevalence of mucosal and general symptoms was 33% and 28% at baseline and increased during follow-up (P < 0.001). Twenty-seven percent reported at least one symptom improved when away from school. Heredity and own atopy were predictors of SBS at baseline and incidence of SBS. At baseline, SO₂ was associated with general symptoms (OR=1.10 per 100 μg/m³), mucosal symptoms (OR=1.12 per 100 μg/m³), and skin symptoms (OR=1.16 per 100 μg/m³). NO₂ was associated with mucosal symptoms (OR=1.13 per 10 μg/m³), and symptoms improved when away from school (OR=1.13 per 10 μg/m³). Temperature, RH, AH, and CO₂ were negatively associated with prevalence of SBS. Incidence or remission of SBS was not related to any exposure, except a negative association between SO₂ and new skin symptoms. In conclusion, heredity and atopy are related to incidence and prevalence of SBS, but the role of the measured exposures for SBS is more unclear. PRACTICAL IMPLICATIONS: We found high levels of CO₂ indicating inadequate ventilation and high levels of SO₂ and NO₂, both indoors and outdoors. All schools had natural ventilation, only. Relying on window opening as a tool for ventilation in China is difficult because increased ventilation will decrease the level of CO₂ but increase the level of NO₂ and SO₂ indoors. Prevalence studies of sick building syndrome (SBS) might not be conclusive for causal relationships, and more longitudinal studies on SBS are needed both in China and other parts of the world. The concept of mechanical ventilation and air filtration should be introduced in the schools, and when planning new schools, locations close to heavily trafficked roads should be avoided.

  • 31.
    Zhang, Xin
    et al.
    Shanxi Univ, Inst Environm Sci, Taiyuan, Shanxi, Peoples R China.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin. Shanxi Univ, Inst Environm Sci, Taiyuan, Shanxi, Peoples R China.
    Fan, Qiannan
    Shanxi Univ, Inst Environm Sci, Taiyuan, Shanxi, Peoples R China.
    Bai, Xu
    Shanxi Univ, Inst Environm Sci, Taiyuan, Shanxi, Peoples R China.
    Li, Tian
    Shanxi Univ, Inst Environm Sci, Taiyuan, Shanxi, Peoples R China.
    Zhang, Yinping
    Tsinghua Univ, Sch Architecture, Beijing, Peoples R China.
    Li, Baizhan
    Chongqing Univ, Key Lab Three Gorges Reservoir Reg Ecoenvironm, Chongqing, Peoples R China.
    Zhao, Zhuohui
    Fudan Univ, Dept Environm Hlth, Shanghai, Peoples R China.
    Huang, Chen
    Univ Shanghai Sci & Technol, Dept Bldg Environm & Energy Engn, Sch Environm & Architecture, Shanghai, Peoples R China.
    Deng, Qihong
    Cent S Univ, XiangYa Sch Publ Hlth, Changsha, Hunan, Peoples R China;Cent S Univ, Sch Energy Sci & Engn, Changsha, Hunan, Peoples R China.
    Lu, Chan
    Cent S Univ, XiangYa Sch Publ Hlth, Changsha, Hunan, Peoples R China;Cent S Univ, Sch Energy Sci & Engn, Changsha, Hunan, Peoples R China.
    Qian, Hua
    Southeast Univ, Sch Energy & Environm, Nanjing, Jiangsu, Peoples R China.
    Xu, Yang
    Cent China Normal Univ, Coll Life Sci, Wuhan, Hubei, Peoples R China.
    Sun, Yuexia
    Tianjin Univ, Sch Environm Sci & Engn, Tianjin, Peoples R China.
    Sundell, Jan
    Tianjin Univ, Sch Environm Sci & Engn, Tianjin, Peoples R China.
    Wang, Juan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Dampness and mold in homes across China: Associations with rhinitis, ocular, throat and dermal symptoms, headache and fatigue among adults2019Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 29, nr 1, s. 30-42Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We studied dampness and mold in China in relation to rhinitis, ocular, throat and dermal symptoms, headache and fatigue. A questionnaire study was performed in six cities including 36 541 randomized parents of young children. Seven self-reported signs of dampness were evaluated. Multilevel logistic regression models were used to calculate odds ratios (ORs). Totally, 3.1% had weekly rhinitis, 2.8% eye, 4.1% throat and 4.8% skin symptoms, 3.0% headache and 13.9% fatigue. Overall, 6.3% of the homes had mold, 11.1% damp stains, 35.3% damp bed clothing, 12.8% water damage, 45.4% window pane condensation, 11.1% mold odor, and 37.5% humid air. All dampness signs were associated with symptoms (ORs from 1.2 to 4.6; P < 0.001), including rhinitis (ORs from 1.4 to 3.2; P < 0.001), and ORs increased by number of dampness signs. The strongest associations were for mold odor (ORs from 2.3 to 4.6) and humid air (ORs from 2.8 to 4.8). Associations were stronger among men and stronger in Beijing as compared to south China. In conclusion, dampness and mold are common in Chinese homes and associated with rhinitis and ocular, throat and dermal symptoms, headache and fatigue. Men can be more sensitive to dampness and health effects of dampness can be stronger in northern China.

  • 32.
    Zhao, Zhu
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Elfman, Lena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Wang, Z. H.
    Zhang, Z
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    A comparative study of asthma, pollen, cat and dog allergy among pupils and allergen levels in schools in Taiyuan city, China, and Uppsala, Sweden2006Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 16, nr 6, s. 404-413Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We compared the school environment, asthma and allergy in 10 schools in Taiyuan, China, with eight schools in Uppsala, Sweden. In total 2193 pupils (mean age 13 years) participated. Chinese pupils had more respiratory symptoms, particularly daytime breathlessness after exercise (29.8% vs. 7.1%; P < 0.001), while cat allergy (1.2% vs. 6.6%; P < 0.001) and dog allergy (1.3% vs. 4.0%; P < 0.01) was less common. Cumulative incidence of asthma (1.8% vs. 9.5%; P < 0.001) and doctor's diagnosed asthma (1.2% vs. 9.0%; P < 0.001) were less common in China, indicating an under-diagnosis of asthma. Chinese classrooms were colder (mean 14.7 vs. 21.4 degrees C), more humid (mean 42% vs. 31% RH) and had higher CO2-levels (mean 2211 vs. 761 ppm). Levels of cat (Fel d1), dog (Can f1) allergens were low in settled dust from China (< 200 ng/g dust), but high in airborne dust on Petri-dishes (GM 16.8 ng/m2/day for Fel d1 and 17.7 for Can f1). The Swedish settled dust contained cat, dog and horse allergens in high levels (median 1300 ng/g, 1650 ng/g, 1250 U/g dust, respectively). In conclusion, there were large differences in the school environment, and in respiratory symptom and allergy. Allergen measurements in settled dust only may largely underestimate the classroom exposure. Practical Implications There is a need to improve the school environment, both in China and Sweden. The Swedish schools contained high levels of cat, dog and horse allergens and more amounts of open shelves and textiles that can accumulate dust and allergens. The air measurements indicated that Chinese schools may contain significant amounts of cat and dog allergen, and analysis of settled dust only may not reflect the true allergen exposure. Since the Chinese schools had no mechanical ventilation, they could not fulfill the ventilation standard in winter, and hence there is a need for improving the ventilation. The great discrepancy between respiratory symptoms and reports on asthma, and the high prevalence of attacks of breathlessness without wheeze, may have implication for future questionnaire studies on asthma in China.

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