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Biomedical subjects

G Wieslander

Publications and source records attributed to G Wieslander.

At least 19 recordsLinked to original sources
PubMed2006

Asthma, eczema, and reports on pollen and cat allergy among pupils in Shanxi province, China.

OBJECTIVES: To study self-reported asthma, eczema, and pollen and furry pet allergy among pupils (9-20 years) in Shanxi province, China, in relation to dietary and environmental factors. METHODS: A standardised questionnaire was distributed to pupils in two primary and two secondary schools, one in Taiyuan city (3.0 milj. inhabitants), the others in Qingxu county, a rural area 30 km outside Taiyuan. Totally, 2,116 pupils (90%) participated. RESULTS: Fifty percent were girls, 61% had been growing up on the countryside, 18% lived in Taiyuan now, 1.7% had ever had asthma, 0.8% had doctor's diagnosed asthma, 1.4% pollen allergy, 1.7% cat allergy, and 0% had dog allergy. Multiple logistic regression was applied, controlling for age, gender, diet, indoor exposures, rural childhood, and current urban residency. Girls had less eczema (OR = 0.51; 95%CI 0.28-0.92). Pupils in the city had more eczema (OR = 5.05; 95% CI 1.11-23.3). Those with a rural childhood had less asthma (OR = 0.17; 95% CI 0.05-0.60), eczema (OR = 0.15; 95% CI 0.13-0.66) and pollen/cat allergy (OR = 0.50; 95%CI 0.25-0.99). None of the indoor variables was related to asthma or allergy. Children with frequent fruit consumption had less asthma (OR = 0.40; 95% CI 0.19-0.82) and pollen/cat allergy (OR = 0.49; 95% CI 0.29-0.84). Those with frequent fish consumption had less asthma (OR = 0.32; 95% CI 0.11-0.97). Those with frequent hamburgers consumption had more asthma (OR = 2.05; 95% CI 1.09-3.87) and eczema (OR = 1.85; 95% CI 1.12-3.04). CONCLUSION: Asthma, eczema, and pollen or pet allergy was uncommon, compared with western countries and other areas in China. Pupils with a rural childhood had less asthma and allergy, which is consistent with the "hygiene hypothesis". Fruit and fish consumption may reduce, and fast food consumption may increase the risk for asthma. Finally, the higher prevalence of asthma and eczema among younger children, born in the 1990s, indicates a cohort effect similar to that observed in western countries.

Adolescent↗
PubMed2006

Personal and psychosocial factors and symptoms compatible with sick building syndrome in the Swedish workforce.

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. Practical Implications A multi-disciplinary approach, including psychosocial stress factors as well as personal factors such as gender, age, atopy and asthma, and indoor exposures, should be applied in studies on symptoms compatible with sick building syndrome (SBS). Males and females perceive psychosocial work conditions differently, and may react differently to job stressors. The psychosocial work environment can be as important as gender and atopy as a predictor of SBS symptoms.

Adult↗
PubMed2004

Obesity and nocturnal gastro-oesophageal reflux are related to onset of asthma and respiratory symptoms.

Several studies have identified obesity as a risk factor for asthma in both children and adults. An increased prevalence of asthma in subjects with gastro-oesophageal reflux (GOR) and obstructive sleep apnoea syndrome has also been reported. The aim of this investigation was to study obesity, nocturnal GOR and snoring as independent risk factors for onset of asthma and respiratory symptoms in a Nordic population. In a 5-10 yr follow-up study of the European Community Respiratory Health Survey in Iceland, Norway, Denmark, Sweden and Estonia, a postal questionnaire was sent to previous respondents. A total of 16,191 participants responded to the questionnaire. Reported onset of asthma, wheeze and night-time symptoms as well as nocturnal GOR and habitual snoring increased in prevalence along with the increase in body mass index (BMI). After adjusting for nocturnal GOR, habitual snoring and other confounders, obesity (BMI >30) remained significantly related to the onset of asthma, wheeze and night-time symptoms. Nocturnal GOR was independently related to the onset of asthma and in addition, both nocturnal GOR and habitual snoring were independently related to onset of wheeze and night-time symptoms. This study adds evidence to an independent relationship between obesity, nocturnal gastro-oesophageal reflux and habitual snoring and the onset of asthma and respiratory symptoms in adults.

Adult↗
PubMed2002

Biomarkers and chemosensory irritations.

OBJECTIVES: A literature review on studies in humans, applying physiological methods to monitor environmentally induced reactions in eyes and upper respiratory tract. The focus was on chemical exposures, but other occupational factors and indoor exposures were included. METHODS: Original articles were gathered from Medline until November 2000, combined with peer-reviewed publications from other sources. RESULTS: Ocular methods included measurement of tear film break-up time (BUT), blink frequency, detection of corneal damage, by vital staining, and cells or inflammatory markers in tear fluid. Nasal methods included acoustic rhinometry, rhinostereometry, and nasal peak expiratory flow. In addition, nasal lavage with isotonic sodium chloride solution was applied to measure concentrations of leucocytes, or biomarkers of secretion or inflammation in nasal lavage fluid (NAL). Most occupational studies were on nasal effects of organic or inorganic dust. There were few studies on occupational exposure to organic solvents or chemical irritants. Some studies demonstrated associations between ocular and nasal physiological response and the indoor environment. Finally, there were some exposure-chamber studies on effects of specific volatile organic compounds (VOCs). Little is known about adaptation at repeated ocular or nasal exposure to irritants. CONCLUSION: Physiological measurements can be valuable complements to symptom registration, but there is a need for standardised investigations. There is a lack of studies on ocular and nasal physiological responses in relation to specific chemical compounds. Experimental studies, with repeated exposure and longer follow-up time on biomarkers, are needed. Finally, there is a need for longitudinal epidemiological studies to elucidate if observed effects should be interpreted as variation within normal physiology, or as early signs of impaired ocular and respiratory health.

Air Pollutants, Occupational↗
PubMed2001

Acoustic rhinometry and lavage biomarkers in relation to some building characteristics in Swedish schools.

It has been suggested that certain building factors can be associated with specific exposures, such as dampness, chemical emissions and dust. The aim of the study was to examine the relationships between some selected building factors, on the one hand, and signs of inflammation or obstruction in the upper airways on the other. Acoustic rhinometry and nasal lavage were used in a field study among 234 school personnel in 12 randomly selected schools (participation rate 84%). Eosinophil cationic protein (ECP), lysozyme, albumin and myeloperoxidase (MPO) were analyzed in the lavage fluid. Building related factors selected for the study were: roof inclination, fundament, building construction, signs of water damage, floor material, building age, ceiling height, bookcases and plants in the classroom. Control was made for potential confounders. The results indicate a pattern of nasal responses: less patent noses and an inflammatory biomarker response could be related to flat roof and a concrete slab fundament, factors that are known risk factors for water leakage, building dampness and possibly microbial growth. A reduced nasal patency without an inflammatory biomarker response was related to factors associated with plasticizers and dust. Positive effects were observed for plants in the classroom and in older buildings.

Adult↗
PubMed2001

Experimental exposure to propylene glycol mist in aviation emergency training: acute ocular and respiratory effects.

OBJECTIVES: Propylene glycol (PG) (1-2 propanediol; CAS No 57-55-6) is a low toxicity compound widely used as a food additive, in pharmaceutical preparations, in cosmetics, and in the workplace-for example, water based paints, de-icing fluids, and cooling liquids. Exposure to PG mist may occur from smoke generators in discotheques, theatres, and aviation emergency training. Propylene glycol may cause contact allergy, but there is sparse information on health effects from occupational exposure to PG. METHODS: Non-asthmatic volunteers (n=27) were exposed in an aircraft simulator to PG mist over 1 minute, during realistic training conditions. Geometric mean concentration of PG was 309 mg/m3 (range 176-851 mg/m3), with the highest concentrations in the afternoon. The medical investigation was performed both before and after the exposure (within 15 minutes). It included an estimate of tear film stability break up time, nasal patency by acoustic rhinometry, dynamic spirometry, and a doctor's administered questionnaire on symptoms. RESULTS: After exposure to PG mist for 1 minute tear film stability decreased, ocular and throat symptoms increased, forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) was slightly reduced, and self rated severity of dyspnoea was slightly increased. No effect was found for nasal patency, vital capacity (VC), FVC, nasal symptoms, dermal symptoms, smell of solvent, or any systemic symptoms. Those exposed to the higher concentrations in the afternoon had a more pronounced increase of throat symptoms, and a more pronounced decrease of tear film stability. In four subjects who reported development of irritative cough during exposure to PG, FEV1 was decreased by 5%, but FEV1 was unchanged among those who did not develop a cough. Those who developed a cough also had an increased perception of mild dyspnoea. CONCLUSION: Short exposure to PG mist from artificial smoke generators may cause acute ocular and upper airway irritation in non-asthmatic subjects. A few may also react with cough and slight airway obstruction.

Adult↗
PubMed2000

Indoor air pollutants in schools: nasal patency and biomarkers in nasal lavage.

BACKGROUND: There is growing concern about the respiratory health aspects of the indoor air quality in schools. METHODS: A standardized investigation, including nasal lavage (NAL), measurement of the nasal cavity by acoustic rhinometry, and hygienic measurements of airborne pollutants, was performed in classrooms, outside the pollen season. All 279 school personnel working in the main buildings of 12 randomly selected primary schools in an urban community in central Sweden (Uppsala) were invited to enroll in the study; 234 (84%) participated. Eosinophil cationic protein (ECP), myeloperoxidase (MPO), lysozyme, and albumin were analyzed in NAL fluid. Crude statistical analysis, as well as multiple regression analysis, was performed, controlling for room temperature, age, sex, current smoking, and a history of atopy. RESULTS: Most classrooms (83%) did not meet the Swedish ventilation standards. A lower degree of nasal patency was found at higher concentrations of respirable dust, nitrogen dioxide (NO2), formaldehyde, and total molds, and in the presence of Aspergillus spp. in the classroom air. The most consistent findings were observed for formaldehyde, NO2, and Aspergillus spp., related to both decreased nasal patency and increase of ECP and lysozyme in NAL. The presence of yeast was associated with an increase of ECP and lysozyme in NAL, but was not related to nasal patency. CONCLUSIONS: Ventilation flow was below current hygienic standards in the classrooms. Air pollutants in the classroom air may influence nasal patency and inflammatory response in the nasal mucosa.

Air Pollutants↗
PubMed2000

Changes in the ocular and nasal signs and symptoms of aircrews in relation to the ban on smoking on intercontinental flights.

OBJECTIVES: This study determined the influence of exposure to environmental tobacco smoke (ETS) in aircraft on measured and perceived cabin air quality (CAQ), symptoms, tear-film stability, nasal patency, and biomarkers in nasal lavage fluid. METHODS: Commercial aircrews underwent a standardized examination, including acoustic rhinometry, nasal lavage, and measurement of tear-film break-up time. Eosinophilic cationic protein, myeloperoxidase, lysozyme, and albumin were analyzed in the nasal lavage fluid. Inflight investigations [participation rate 98% (N=39)] were performed on board 4 flights, 2 in each direction between Scandinavia and Japan. Scandinavian crew on 6 flights from Scandinavia to Japan participated in postflight measurements after landing [participation rate 85% (N=41)]. Half the flights permitted smoking on board, and the other half, 0.5 months later, did not. Hygienic measurements showed low relative air humidity on board (2-10%) and a carbon dioxide concentration of <1000 ppm during 99.6% of the cruising time. RESULTS: The smoking ban caused a drastic reduction of respirable particles, from a mean of 66 (SD 56) microg/m3 to 3 (SD 0.8) microg/m3. The perceived CAQ was improved, and there were fewer symptoms, particularly ocular symptoms, headache and tiredness. Tear-film stability increased, and nasal patency was altered. CONCLUSIONS: Despite a high air exchange rate and spatial separation between smokers and nonsmokers, smoking in commercial aircraft may cause significant air pollution, as indicated by a large increase in respirable particles. This ETS exposure is associated with an increase in ocular and general symptoms, decreased tear-film stability, and alterations of nasal patency.

Air Pollution, Indoor↗
PubMed2000

Influence of personal factors on nasal patency and lavage biomarkers in white-collar workers.

Large biological variability between subjects has been shown for both acoustic rhinometry and nasal lavage biomarker concentrations, but relatively little is known about the influence of personal factors on these techniques. The aim was to evaluate if nasal symptoms, acoustic rhinometric measurements and nasal lavage fluid biomarkers are related to age, gender, smoking, atopy or asthma. A standardized nasal investigation was applied in 411 white-collar workers, belonging to three occupational groups: school personnel (n = 234), office workers (n = 89) and hospital workers (n = 88). Lavage fluid analysis included determination of eosinophil cationic protein (ECP), myeloperoxidase (MPO), lysozyme and albumin. Females had smaller nasal dimensions in the anterior part of the nose (p < 0.001), and lower lavage fluid concentrations of ECP (p = 0.004), MPO (p = 0.002), and albumin (p = 0.01). Rhinometric dimensions or lavage fluid biomarker concentrations were not related to age, smoking, atopy or asthma. Some differences in rhinometric and biomarker measurements were observed between the occupational groups, and adjustment was made for occupation. Rhinometric measures and lavage biomarkers were consistently interrelated, which suggests a combined mucosal swelling and inflammatory reaction. This indicates a potential usefulness of a combined use of acoustic rhinometry and lavage biomarkers to study nasal mucosal reactions.

Albumins↗
PubMed2000

Asthma symptoms in relation to measured building dampness in upper concrete floor construction, and 2-ethyl-1-hexanol in indoor air.

SETTING: Asthma symptoms in adults in relation to the indoor environment. OBJECTIVES: To study the relationships between current asthma symptoms (wheeze or attacks of breathlessness) and the indoor environment and dampness in hospitals. DESIGN: A study among personnel (n = 87) in four geriatric hospitals in winter. Indoor air pollutants, dampness in the concrete floor, and allergens in settled dust were measured. Multiple logistic regression analysis was applied, adjusting for age, sex, atopy, and dampness in the participants' own dwellings. RESULTS: Current asthma symptoms were reported by 17%, and 8% had doctor's diagnosed asthma. Asthma symptoms were more common (adjusted odds ratio = 8.6; 95% confidence interval 1.3-56.7) in two buildings with signs of dampness-related degradation of di(ethylhexyl)-phthalate (DEHP) in polyvinyl chloride (PVC) floor material, detected as presence of 2-ethyl-1-hexanol (2-32 microg/m3) in indoor air (CAS nr 104-76-7). Asthma symptoms were related to higher relative humidity in the upper concrete floor construction, and ammonia in the floor. The newest hospital, built by an anthroposophic society, had low levels of dampness and few asthma symptoms (4%). Cat (Fel d1) and dog allergens (Can f1) were found in dust from all buildings (geometric mean 340 ng/g and 2490 ng/g, respectively). House dust mite allergens (Derp1, Derf1, or Derm1) were found in 75% of all samples (geometric mean 130 ng/g). There was no relationship between allergen levels and asthma symptoms. CONCLUSIONS: Asthma symptoms may be related to increased humidity in concrete floor constructions and emission of 2-ethyl-1-hexanol, an indicator of dampness-related alkaline degradation of plasticiser DEHP. Moreover, geriatric hospitals can be contaminated by significant amounts of cat, dog and mite allergens.

Air Pollution, Indoor↗
PubMed2000

Acoustic rhinometry in epidemiological studies--nasal reactions in Swedish schools.

A cross-sectional study was performed on the relationships between hygienic measurements and nasal investigations in 234 personnel in 12 primary schools in mid-Sweden. Hygienic data included building characteristics, measurements of indoor air pollutants, air change rate, temperature and humidity. Clinical examinations included symptom reports, acoustic rhinometry and nasal lavage, with the determination of biomarker levels for eosinophil cationic protein (ECP), lysozyme, myeloperoxidase (MPO) and albumin. Subjective nasal obstruction was increased in schools with mechanical ventilation (adjusted prevalence OR = 2.0; 95 CI 1.1-3.7) and subjects reporting nasal obstruction had higher levels of dust in the classroom, compared to those not reporting this symptom (p = 0.008 by Mann-Whitney U-test). Congruently, a decreased nasal patency measured by acoustic rhinometric minimum cross-sectional areas (MCA1 and MCA2) was related to the use of mechanical ventilation (p = 0.008 and p = 0.02 respectively, by Mann-Whitney U-test), dust levels (p = 0.03 and p < 0.001 respectively, by Kendall's tau correlation analysis), a lower cleaning frequency of desks (p < 0.001 and p = 0.02 respectively, by Kendall's tau correlation analysis), the use of wet mopping (p < 0.001 and p = 0.04 respectively, by Mann-Whitney U-test) and PVC floor material (p < 0.001 and p = 0.034 respectively, by Mann-Whitney U-test). The cleaning frequency of floors was positively correlated with MCA1 (p = 0.049 by Kendall's tau correlation analysis). In buildings with signs of water damage, flat roof or a concrete slab fundament the personnel had increased ECP, lysozyme or albumin levels in nasal lavage. A reduced nasal patency and an increased inflammatory biomarker response were seen for higher levels of formaldehyde (MCA1, MCA2, VOL1, VOL2, ECP and lysozyme) and nitrogen dioxide (MCA1, VOL2, ECP and lysozyme) in the classrooms. In conclusion, the results indicate that acoustic rhinometry in combination with the determination of nasal lavage biomarkers can be used to study effects on the upper airways of the indoor environment. Actual exposures to indoor air pollutants in Swedish schools can affect the occurrence of subjective nasal obstruction and give clinical signs of reduced nasal patency together with an inflammatory biomarker response in the nasal mucosa.

Acoustics↗
PubMed2000

Buckwheat allergy and reports on asthma and atopic disorders in Taiyuan City, Northern China.

Allergy to common buckwheat (Fagopyrum esculentum) has been reported from Europe and Japan, and a 24 kDa globulin protein has been identified as one of the major allergens. In China also another type, tartary buckwheat (Fagopyrum tartaricum) is grown and consumed. Three groups of individuals in Shanxi province, China, were investigated for buckwheat allergy using skin prick test. The groups were: agricultural researchers with occupational exposure to buckwheat (N = 16); workers in a food industry producing buckwheat noodles (N = 25), and patients with diabetes or cardiovascular disease consuming buckwheat as functional food (N = 20). Information on atopic disorders and adverse food reactions were collected by a doctors-administered questionnaire. One male industrial worker had a positive skin prick test to buckwheat, but no symptoms while eating or handling buckwheat products. In total, 34% consumed buckwheat food at least every week, and 23% had a weekly consumption of tartary buckwheat. The prevalence of doctor's diagnosed asthma was low (1.6%). Four subjects (6.6%) reported a history of allergic rhinitis, with allergy to cedar pollen, carnation and peach.

Adult↗
PubMed1999

Nasal and ocular symptoms, tear film stability and biomarkers in nasal lavage, in relation to building-dampness and building design in hospitals.

OBJECTIVES: To study the relationships between dampness in concrete floors and building design on the one hand, and symptoms and medical signs of the eyes and nose in hospital workers, on the other. METHODS: Four hospitals for geriatrics were selected to represent buildings with different ages and design, irrespective of symptom prevalence. The first building was built in 1925. The second, built in 1985, was known to have dampness in the floor. Conventional building techniques were used in the third building, built in 1993, and the last building was built in 1994, and was specially designed to include high ceilings, and minimal use of fluorescent lighting and interior plastic materials. The interior surfaces were painted with water-based beeswax glazing. All staff (n=95) working day shifts were invited to take part in a medical examination of the eyes and nose including acoustic rhinometry and nasal lavage, and a medical questionnaire, and 93% participated. Measurements of temperature, relative air humidity, air flow, illumination, volatile organic compounds (VOCs), molds, and bacteria were carried out in all buildings, together with measurements of formaldehyde, respirable dust, carbon monoxide (CO), carbon dioxide (CO(2)), nitrogen dioxide (NO(2)) and ozone. Statistical analyses were performed by bivariate analysis, and linear, ordinal, and logistic multiple regressions, adjusting for age, gender, tobacco smoking, atopy, and the perceived psychosocial work environment. RESULTS: Dampness in the upper concrete floor surface (75-84%), ammonia under the floor [3 parts per million (ppm)], and 2-ethyl-1-hexanol in the air were detected in the two buildings built in 1985 and 1993. Increased occurrences of ocular and nasal symptoms, an increased concentration of lysozyme in nasal lavage, and decreased tear film stability were found in the subjects working in the damp buildings. Those in the specially designed building had fewer ocular and nasal symptoms, and increased tear film stability. All buildings had low levels of formaldehyde, molds, bacteria, ozone, and NO(2). The lowest total concentration of VOCs, and the highest concentration of specific VOCs of microbial origin, were found in the building with special design. CONCLUSION: The study provides new evidence of the role of dampness-related alkaline degradation of di-(2-ethylhexyl) phthalate (DEHP) in polyvinyl chloride (PVC) building material. Emissions related to degradation of DEHP due to dampness in the floor, indicated by increased 2-ethyl-1-hexanol in the air, seem to increase both the secretion of lysozyme from the nasal mucosa and the occurrence of ocular and nasal symptoms. The indoor environment of the specially designed building with high ceilings and no fluorescent lighting or interior plastics seemed to have a positive influence on the nasal and ocular mucous membranes.

Adult↗
PubMed1999

Inflammation markers in nasal lavage, and nasal symptoms in relation to relocation to a newly painted building: a longitudinal study.

INTRODUCTION: There is a need to evaluate possible health effects of ventilation improvements and emissions from new buildings, in longitudinal studies. New methods to study biological effects on the eyes and upper airways are now available. MATERIAL AND METHODS: A longitudinal study was performed on 83 trained social workers in two offices in Uppsala, Sweden. The exposed group (n = 57) moved to a newly redecorated building nearby. Low emitting building material had been used, including a new type of solvent-free water-based paint. The control group (n = 26) worked in the same office during the study period (November 1995 to February 1996). Hygiene management was carried out in both offices, at the beginning and the end of the investigation. Tear film stability (BUT) was measured. Nasal patency was measured by acoustic rhinometry, and eosinophilic cationic protein (ECP), myeloperoxidase (MPO), lysozyme and albumin were analyzed in nasal lavage fluid (NAL). RESULTS: The relocation resulted in an increase in the personal outdoor airflow rate from 11 to 22 l/s. Indoor concentrations of terpenes were higher in the new building, and powdering of the new linoleum floor was observed. Measurements showed low levels of volatile organic compounds (VOC), formaldehyde, carbon dioxide (CO(2)), nitrogen dioxide, respirable dust, and microorganisms in the air of all buildings. The move resulted in an increased nasal patency and an increase of ECP and lysozyme in NAL, after adjusting for changes in the control group. No changes were observed for nasal or ocular symptoms. A seasonal effect, with a decrease of ECP, was observed in the control group. CONCLUSSION A well-ventilated office building can be redecorated without any major ocular or nasal effects, or measurable increase of indoor air pollution if low-emitting building materials are selected. In agreement with previous evidence, the improved ventilation flow may explain the increase of nasal patency. The increase of ECP and lysozyme in NAL suggested an inflammatory effect in the new building. Since this building had increased ventilation flow, increased concentrations of terpenes, and powdering from the polish on the new linoleum floor, identification of causative agents was difficult. The hygiene measures did not give any evidence that emissions from the new type of solvent-free water-based paints or building dampness were responsible for the observed nasal effects. Considering the higher emissions of VOC reported from older types of water-based latex paints and solvent-based wall paints, the new type of solvent-free water-based paint seems to be a good choice from the hygiene point of view.

Adult↗
PubMed1999

Nasal patency and lavage biomarkers in relation to settled dust and cleaning routines in schools.

OBJECTIVES: This study determined the relations between settled dust and cleaning routines in classrooms on one hand, and nasal symptoms, nasal cavity dimensions, and the concentration of selected biomarkers of inflammation in nasal lavage on the other. METHODS: Measurements of settled dust via standardized vacuum cleaning and an investigation of the cleaning routines were performed in 12 randomly selected primary schools in the municipality of Uppsala. Clinical examinations including acoustic rhinometry and nasal lavage were performed in the school environment among 279 school personnel working in the main buildings of the schools. Eosinophil cationic protein (ECP), myeloperoxidase (MPO), lysozyme, and albumin were analyzed in the lavage fluid. The relationships between the medical and hygienic data were analyzed both bivariately and with a multiple regression model controlling for age, gender, smoking, atopy, room temperature, and urban vicinity of the school. RESULTS: The amount of settled dust was positively related to subjective nasal obstruction and smaller nasal cavity dimensions measured with acoustic rhinometry. The noses were less patent, and the levels of ECP or lysozyme in the lavage were increased for the subjects in schools with a lower frequency of floor mopping, a lower frequency of desk cleaning, and where wet mopping was used. CONCLUSIONS: Our results indicate that the actual dust levels in Swedish classrooms can affect the occurrence of nasal obstruction among school personnel. A beneficial effect on the clinical signs of the nasal mucosa was observed for a higher frequency of both floor mopping and desk cleaning, whereas the use of wet mopping seemed disadvantageous in comparison with dry mopping. These findings illustrate the need for adequate cleaning procedures to minimize the environmental effects on the airway mucosa.

Air Pollution, Indoor↗
PubMed1998

Nasal patency and biomarkers in nasal lavage--the significance of air exchange rate and type of ventilation in schools.

OBJECTIVES: The aim of the present study was to examine the relationships between the ventilation rate and the type of ventilation system, on the one hand, and objective nasal measures, on the other. METHODS: A standardized investigation, including acoustic rhinometry and nasal lavage, was performed in the school environment. All 279 school personnel working in the main buildings of 12 randomly selected primary schools in the municipality of Uppsala were invited, and 234 (84%) participated. The dimensions of the nasal cavity were measured with acoustic rhinometry. Eosinophil cationic protein (ECP), myeloperoxidase (MPO), lysozyme, and albumin were analyzed in the lavage fluid. The air exchange rate and the room temperature were measured in the classrooms. Relationships between nasal symptoms, nasal patency, and the concentration of biomarkers, on the one hand, and the type of ventilation system, the air exchange rate, and the temperature, on the other, were analyzed by both crude bivariate analysis and multiple regression models, controlling for the type of ventilation, the air exchange rate, room temperature, age, gender, smoking, atopy, and the urban vicinity of the school. RESULTS: A lower degree of nasal patency as measured by acoustic rhinometry and increased levels of ECP and lysozyme in nasal lavage were associated with a lower air exchange rate in the schools. Although mechanically ventilated schools had higher air exchange rates, they were associated with more nasal symptoms, and nasal mucosal swelling and with increased lavage levels of ECP and lysozyme as compared with schools with natural ventilation only. In contrast, 12 subjects working in a school with mechanical displacement ventilation had more patent noses and lower levels of inflammatory markers as compared with the personnel in schools with natural ventilation only. CONCLUSION: Our results indicate that both a low air exchange rate and mechanical ventilation systems based on dilution can be associated with reduced nasal patency and an inflammatory biomarker response of the nasal mucosa among school personnel. The only school with sufficient ventilation according to the current Swedish recommendations had a displacement system and the fewest signs of nasal reactions among the personnel.

Albumins↗
PubMed1997

Asthma and the indoor environment: the significance of emission of formaldehyde and volatile organic compounds from newly painted indoor surfaces.

As a part of the worldwide European Community Respiratory Health Survey, possible relations between asthma and emissions from newly painted indoor surfaces were studied. The participants (n = 562) answered a self-administered questionnaire, with questions on symptoms and indoor exposures, including indoor painting, during the last 12 months. The participants also underwent a structured interview, spirometry, peak flow measurements at home (PEF), methacholine provocation test for bronchial hyper-responsiveness (BHR), and skin prick tests. In addition, serum concentration of eosinophilic cationic protein (S-ECP), blood eosinophil count (B-EOS), and total immunoglobulin E (S-IgE) were measured. Current asthma was defined as a combination of BHR and at least one asthma-related symptom (wheezing and attacks of breathlessness). The information gathered on indoor painting was compared with exposure measurements of formaldehyde and volatile organic compounds (VOC) performed in a selected sample of the dwellings (n = 62). Relations between exposures, asthma and clinical signs were calculated by multiple linear or logistic regression, adjusting for possible influence of age, gender and tobacco smoking. The prevalence of asthma was increased among subjects with domestic exposure to newly painted surfaces (OR = 1.5; 95% CI 1.0-2.4), particularly newly painted wood details (OR = 2.3; 95% CI 1.2-4.5) and kitchen painting (OR = 2.2; 95% CI 1.1-4.5). Moreover, blood eosinophil concentrations were significantly elevated among subjects living in newly painted dwellings. A significantly increased prevalence of symptoms related to asthma, but not BHR, was observed in relation to workplace exposure to newly painted surfaces. The indoor concentration of aliphatic compounds (C8-C11), butanols, and 2,2,4-trimethyl 1,3-pentanediol diisobutyrate (TXIB) was significantly elevated in newly painted dwellings. The total indoor VOC was about 100 micrograms/m3 higher in dwellings painted in the last year. A significant increase in formaldehyde concentration was observed in dwellings with newly painted wood details. Our results indicate that exposure to chemical emissions from indoor paint is related to asthma, and that some VOCs may cause inflammatory reactions in the airways. To improve asthma management, and to counteract the increasing frequency of asthma, the significance of the indoor environment should not be neglected. Our study suggests that the contribution of emissions from paint to indoor concentrations of formaldehyde and VOCs should be as low as possible.

Adult↗