Source: International Congress 2014 – Occupational asthma: from childhood to adulthood
Disease area: Airway diseases

Abstract

Indoor dampness and mould adversely affects respiratory health. Microbial secondary metabolites (mycotoxins and bacterial toxins) may be involved in the underlying effect mechanism. We studied respiratory symptoms in teachers in relation to dampness and levels of microbial toxins in schools. Primary schools in Finland, The Netherlands and Spain were selected according to the presence (n=29) or absence (n=26) of dampness and/or mould. Ten settled dust swab samples per school were taken and analysed for 188 toxins using liquid chromatography/mass spectrometry. Teachers (n=645, 79% women) completed a questionnaire on respiratory symptoms in the last year, and the ECRHS symptom score (0-5 asthma symptoms) was calculated. Associations between moisture damage, categorised toxin load and symptoms were evaluated using mixed regression models adjusted for sex, age, smoking status and country. Teachers from damp schools had more nasal symptoms (Odds Ratio (OR) 1.6; 95% CI 1.1-2.3) and a higher symptom score (Ratio 1.4; CI 0.9-1.9). Finnish teachers from schools with higher toxin levels had a higher symptom score (Ratio 1.6; 1.0-2.5) and more nasal symptoms (OR 2.0; 0.9-4.4). This was apparent for toxins with both strong outdoor and indoor context, and not confounded by dampness after mutual adjustment. Specifically, higher levels of anthraquinones (2.3; 0.9-5.8) and Penicillium metabolites (1.7; 1.0-2.8) increased the symptom score. Associations were less apparent in the other two countries. In conclusion, teachers working in schools affected by dampness or mould have a higher risk of upper and lower respiratory tract symptoms. At least in Finland, microbial toxins may be involved in these effects.

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J. P. Zock, A. Borràs-Santos, J. Jacobs, M. Täubel, A. Espinosa, U. Haverinen-Shaughnessy, M. Peitsch, M. Sulyok, A. Hyvärinen (Barcelona, Spain; Utrecht, Netherlands; Kuopio, Finland; Dresden, Germany; Tulln, Austria). Dampness and microbial secondary metabolites in schools and respiratory symptoms in teachers. Eur Respir J 2014; 44: Suppl. 58, 412

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