Mucous Membrane Symptoms Research Articles

Public perceptions of air pollution and associated health risks in Nevada, USA: applications for health communication

ABSTRACT Background We examine the extent to which acute and chronic health conditions motivate individuals to seek air quality information. We apply the theoretical elements of the Health Belief Model (HBM) to improve risk communication about ambient air pollution. We discuss the practical applications of HBM, in tandem with the principles of health communication, within an environmental health context. Methods We test the predictive power of selected components related to the HBM (perceived susceptibility, perceived severity, and cues to action) for intentions to seek information about ambient air quality. We surveyed 325 individuals throughout Nevada where poor air quality poses a risk for vulnerable populations. Results Ordinal logistic regression analyses showed that experiencing mucous membrane symptoms (eye itching, nose irritation, and dry throat/cough), perceived severity to future health threats, and having an at-risk member in the household positively and significantly predicted intentions to seek air quality information. Experiencing neuropsychological symptoms (fatigue, feeling heavy-headed, and nausea/dizziness), and having a cardiovascular or a respiratory condition did not have significant effects on reported intentions. Conclusions We discuss how the results of this study can be integrated into health communication practices to increase public engagement with air quality information as a personal intervention measure.

Epidemiological survey of self-reported food allergy among university students in China.

The aim of this study was to investigate the prevalence of self-reported food allergy among university students in China.A cluster-random sampling population-based cross-sectional study using self - administrated questionnaire was conducted with 2538 college students recruited from 6 universities in China. The questionnaire included data on age, sex, weight, height, FA, comorbid allergic diseases, family history, and understanding food allergy. Data were analyzed by SPSS 25.0 statistical software. Multivariate logistic regression analysis was performed to analyze the risk factors related to self-reported food allergy and estimate the odds ratio.A total of 2538 questionnaires were distributed to the undergraduate students and 2313 completely effective questionnaires were collected, the effective response rate was 91.1%. 834 males and 1479 females were recruited, and their age ranged from 18 to 25 years old. The prevalence of self-reported food allergy was 15.7%, and the rate of doctor-diagnosed food allergy was 8.4%. The leading food allergens included shrimp, shellfish, milk, egg, peach, mango, beef, and peanut, and the prevalence of shrimp allergy was the highest (5.8%). The main clinical manifestation included skin mucous membrane and respiratory symptoms. The prevalence of food allergy were statistically significant difference (P < .05) between different age groups, family history, sun exposure times, smoking, and antibiotic use. Over 45% college students know little about food allergy.The prevalence of self-reported food allergy among Chinese college students was high (15.7%). Shrimp was the main allergenic food, followed by shellfish, milk, egg, peach, and mango. Family history, sun exposure, obesity, and using antibiotics may be the influencing factors of food allergy. The Chinese undergraduates lacked the knowledge about food allergy. Thus, it is necessary to strengthen the health education program on food allergy for college students in China and other middle high-income nations.

A pemphigus csoport betegségei és terápiás lehetőségei

The diseases of the pemphigus group are chronic conditions belonging to the autoimmune blistering disorders. They appear with characteristic skin and mucous membrane symptoms. Their major forms are pemphigus vulgaris, pemphigus foliaceus, and paraneoplastic pemphigus. The aim of this review is to present the diseases of the pemphigus group and to summarize the latest therapeutic options with the exception of paraneoplastic and IgA pemphigus that are discussed separately

Health and Exposure to VOCs From Pinewood in Indoor Environments

As a natural, biological material, wood emits various organic chemical substances, mostly volatile organic compounds (VOCs), very volatile organic compounds (VVOCs) and formaldehyde. When such emissions occur in indoor spaces, concentrations of these substances are higher than concentrations outdoors. Consequently, the level of emissions from building materials are of relevance in relation to their possible health effects. The aim of the study was to test the hypothesis that exposure to VOCs from Scots pine (Pinus sylvestris) might increase mucous membrane symptoms and/or general symptoms, compared to exposure to VOCs from Norway spruce (Picea abies). The study was carried out as a double-blinded, crossover, randomized, controlled trial. The health indicators were measured using objective and subjective methods. The VOC exposure was measured with a proton-transfer-reaction time-of-flight mass spectrometer. Thirty healthy individuals participated. The mean concentration of CO2 inside the chamber in each session varied between 420 ppm and 533 ppm. The temperature and RH varied between 21.5°C and 23.7°C and 12.0% and 24.2%. Ozone was supplied via ventilated outdoor air. The median concentration in outdoor air was 23 μg/m3 (13 ppb). The study was conducted with a statistically significant difference in the exposure to VOCs between the experimental (pine) exposure and the control (spruce) exposure. The mean concentrations of VOCs during the experimental exposure were methanol (31 ppb), acetaldehyde (8 ppb), formic acid (11 ppb), acetone/propanal (14 ppb), acetic acid (14 ppb) and monoterpenes (172 ppb). No difference in health outcome was revealed between the experimental and the control exposure. No inflammatory reactions or sensory irritation were found with exposure to 172 ppb monoterpenes and a low ozone concentration. Low relative humidity may have increased eye blinking in the participants in both exposure situations.

Outdoor air pollution in relation to sick building syndrome (SBS) symptoms among residents in Shanghai, China

In order to investigate the relationship between outdoor air pollution and sick building syndrome (SBS) symptoms, the CCHH (China, Children, Home, Health) group in Shanghai conducted a cross-sectional survey on the current incidence of SBS symptoms among residents in five districts of Shanghai during April 2011–April 2012. It also collected the related outdoor air pollutants data from Shanghai environmental monitoring center (SEMC), including nitrogen dioxide (NO2), sulfur dioxide (SO2) and particles with aerodynamic diameter less than 10 µm (PM10). The logistic regression models were used in this paper to study the associations between air pollutants and SBS symptoms. Results were found that the daily mean concentrations of NO2 and SO2 met standard requirement, but that of PM10 exceeded the limit values of the standard in China during this survey. The significant differences were found between the pollutants concentration in urban and suburban area. In addition, the incidences of three categories of SBS symptoms among residents were 79.1% for general symptoms (GS), 65.2% for mucous membrane symptoms (MS) and 35.7% for skin symptoms (SS), respectively. Multiple logistic regression analysis by two case studies illustrated that three outdoor air pollutants, both their concentration quartiles and equal increment, were all associated to and taken as the risk factors for SBS symptoms, for GS ORNO2 = 1.62 (1.18–2.22), MS OR NO2 = 1.58 (1.21–2.06) and SS OR PM10 = 1.21 (1.09–1.35). Furthermore, the new pollutants expressed as the mixtures of their combination were also significantly associated with part of the SBS symptoms. The synthetic air quality indexes of all surveyed residents were calculated as III-level, which represented mild pollution. Therefore, it would be an effective way to decrease the incidence of SBS symptoms in residence to reduce the outdoor air pollution and control the penetration from outdoor to indoor environment.

Health effects and exposure to volatile organic compounds from woods – an experimental study

Introduction Woods are energy efficient and carbon-neutral building materials; however we need more scientific knowledge of their chemical emissions and the health impacts. The aim of this study was to investigate whether exposure to volatile organic compounds (VOCs) from pine may increase mucous membrane symptoms from eyes and respiratory airways compared to exposure to VOCs from spruce. Methods The study was carried out with a randomized, double-blind, cross-over experimental design. The study was approved by the Regional Medical Ethics Committee. The intervention treatment was an exposure by VOCs from pine for 2 hours, while the control exposure was VOCs from spruce. 30 persons participated in the study, 16 men and 14 women. They were all young adult non-smokers. Two persons had former moderate allergic symptoms. The exposures were measured with the mass spectrometer “PTR-TOF-MS”. The health indicators were measured before and after the treatment. The questionnaire used was the Örebro questionnaire, the lung functions were measured with “Micro medical spiro usb”. Measurements of the VOCs revealed that the exposure was primarily from monoterpenes. The mean concentration of monoterpenes from pine was 163.4 ppb while the corresponding concentration from spruce was 1.0 ppb. T-test was used to unveil a statistical significant difference between change in health effects between intervention and control condition. Results The change of subjective symptoms was almost similar in control and intervention conditions. No statistical significant differences were revealed. The spirometry analyses, PEF, MEF50 and FVC, showed no statistically significant changes. However, measurements of the FEV1 showed that upon the exposure of pine no change occurred, while during exposure to spruce a small negative change was detected. Conclusions The results showed no increased mucous membrane symptoms and respiratory airways symptoms during exposure of VOCs to pine compared to spruce.

A nationwide survey on the epidemiology and clinical features of eosinophilic granulomatosis with polyangiitis (Churg-Strauss) in Japan

Objective. We conducted a cross-sectional nationwide survey to determine eosinophilic granulomatosis with polyangiitis (Churg-Strauss) (EGPA) prevalence and clinical features in Japan.Methods. Data for EGPA patients in 2008 were collected from 1,564 hospitals. In total, 965 patients were reported from 365 departments. In a second survey, clinical data for 473 patients were obtained.Results. We estimated that 1,866 (95% CI: 1,640–2,092) patients have EGPA in Japan (prevalence, 17.8/1,000,000). Of the 473 patients in the second survey, 315 fulfilled American College of Rheumatology (ACR) criteria or Lanham's criteria for EGPA. The mean age (± SD) of the 315 at onset was 55 ± 14 years, male to female ratio 1:2. 93% of patients had neurological manifestations, which were the organ system most frequently involved. Among 277 patients tested for myeloperoxidase (MPO)-/p anti-neutrophil cytoplasmic antibody (ANCA), 139 (50%) were positive, while only 6 of 238 were positive for proteinase3 (PR3)-/cANCA. MPO-ANCA-positive patients had renal involvement, mucous membrane or ophthalmological symptoms, and ENT symptoms more frequently, whereas cutaneous lesions and cardiovascular involvement were less common.Conclusion. The prevalence of EGPA and the frequency of MPO-/p-ANCA-positivity in Japanese EGPA patients were mostly similar to those of Western countries. However, female predominance and a high frequency of neurological manifestations characterized Japanese patients.

Lung function in volunteers before and after exposure to trichloramine in indoor pool environments and asthma in a cohort of pool workers

ObjectivesExposure to trichloramine (NCl3) in indoor swimming-pool environments is known to cause mucous membrane irritation, but if it gives rise to changes in lung function or asthma in adults is...

Relationship between selected indoor volatile organic compounds, so-called microbial VOC, and the prevalence of mucous membrane symptoms in single family homes

Microorganisms are known to produce a range of volatile organic compounds, so-called microbial VOC (MVOC). Chamber studies where humans were exposed to MVOC addressed the acute effects of objective and/or subjective signs of mucosal irritation. However, the effect of MVOC on inhabitants due to household exposure is still unclear. The purpose of this epidemiological study was to measure indoor MVOC levels in single family homes and to evaluate the relationship between exposure to them and sick building syndrome (SBS). All inhabitants of the dwellings were given a self-administered questionnaire with standardized questions to assess their symptoms. Air samples were collected and the concentrations of eight selected compounds in indoor air were analyzed by gas chromatography/mass spectrometry — selective ion monitoring mode (GC/MS-SIM). The most frequently detected MVOC was 1-pentanol at a detection rate of 78.6% and geometric mean of 0.60 μg/m 3. Among 620 participants, 120 (19.4%) reported one or more mucous symptoms; irritation of the eyes, nose, airway, or coughing every week (weekly symptoms), and 30 (4.8%) reported that the symptoms were home-related (home-related symptoms). Weekly symptoms were not associated with any of MVOC, whereas significant associations between home-related mucous symptoms and 1-octen-3-ol (per log 10-unit: odds ratio (OR) 5.6, 95% confidence interval (CI): 2.1 to 14.8) and 2-pentanol (per log 10-unit: OR 2.3, 95% CI: 1.0 to 4.9) were obtained after adjustment for gender, age, and smoking. Associations between home-related symptoms and 1-octen-3-ol remained after mutual adjustment. However, concentrations of the selected compounds in indoors were lower than the estimated safety level in animal studies. Thus, the statistically significant association between 1-octen-3-ol may be due to a direct effect of the compounds or the associations may be being associated with other offending compounds. Additional studies are needed to evaluate these possibilities.

Involvement of mucous membranes in papulosquamous diseases

Many skin diseases may affect the oral and genital mucous membranes but involvement is generally uncommon. Mucous membranes are most often affected by lichen planus and less frequently by psoriasis or lupus erythematosus. Macroscopic changes may vary from increased vulnerability, erythema and erosions to leukoplakia. Subjective symptoms of burning sensations or localized pain must be distinguished from underlying psychiatric disorders. Furthermore, neoplasia may complicate chronic lichen planus. Therefore, depending on the location and extent of mucous membrane symptoms, both local and systemic therapy may be necessary. Short- and long-term dermatologic care are required.

A case of indoor air pollution of ammonia emitted from concrete in a newly built office in Beijing

A case of suspected indoor ammonia contamination from concrete was investigated in an airline company office in Beijing. A standardized questionnaire on indoor environment perceptions, medical symptoms and psychosocial work environment was distributed to all staff, and compared with a reference group of office workers from the same company in Stockholm. Temperature, relative humidity, formaldehyde, volatile organic compounds (VOC), ammonia, and carbon dioxide were measured both in Beijing and Stockholm. In Beijing mould and bacteria were also measured. Totally 95% ( N = 14) participated. The Beijing staff reported a higher rate of complaints regarding poor work satisfaction, and work stress as compared to the Stockholm reference group. In the total material ( N = 203) the psychosocial environment was related to general symptoms (headache and tiredness) but not odour perception or mucous membrane symptoms. Controlling for age, smoking habits, and psychosocial work environment the Beijing staff had more complaints on unpleasant odour and mucous membrane symptoms. An increased indoor concentration of ammonia (3–6 ppm) and benzene (26.8 μg/m 3) was measured in the indoor air in the Beijing office, as compared to the office in Stockholm (<0.1 ppm ammonia and 0.4 μg/m 3 benzene). The ammonia contamination in the Beijing office was confirmed, the probable source being additives in the concrete. The ammonia level was well below the Swedish threshold limit values (TLV) (25 ppm). In addition the exposure to benzene, an indicator of traffic exhaust pollution was high both indoors and outdoors in Beijing, possible related to increased levels of odour complaints and mucous membrane irritation.

Von Willebrand disease (VWD): evidence‐based diagnosis and management guidelines, the National Heart, Lung, and Blood Institute (NHLBI) Expert Panel report (USA)1

von Willebrand disease (VWD) is a commonly encountered inherited bleeding disorder affecting both males and females, causing mucous membrane and skin bleeding symptoms, and bleeding with surgical or other haemostatic challenges. VWD may be disproportionately symptomatic in women of child-bearing age. It may also occur less frequently as an acquired disorder (acquired von Willebrand syndrome). VWD is caused by deficiency or dysfunction of von Willebrand factor (VWF), a plasma protein that mediates platelet haemostatic function and stabilizes blood coagulation factor VIII. The pathophysiology, classification, diagnosis and management of VWD are relatively complex, but understanding them is important for proper diagnosis and management of patients with VWD. These evidence-based guidelines for diagnosis and management of VWD from the National Heart, Lung, and Blood Institute (NHLBI) Expert Panel (USA) review relevant publications, summarize current understanding of VWD pathophysiology and classification, and present consensus diagnostic and management recommendations based on analysis of the literature and expert opinion. They also suggest an approach for clinical and laboratory evaluation of individuals with bleeding symptoms, history of bleeding or conditions associated with increased bleeding risk. This document summarizes needs for further research in VWF, VWD and bleeding disorders, including clinical research to obtain more objective information about bleeding symptoms, advancements in diagnostic and therapeutic tools, and enhancement in the education and training of clinicians and scientists in bleeding and thrombotic disorders. The NHLBI Web site (http://www.nhlbi.nih.gov/guidelines/vwd) has a more detailed document, a synopsis of these recommendations, and patient education information.

Acute Generalized Exanthematous Pustulosis (AGEP) Due To Exposure to Sulfuric Acid and Bromic Acid Vapor: A Case Report

Acute generalized exanthematous pustulosis (AGEP, toxic pustuloderma, pustular drug eruption) is a not uncommon cutaneous reaction pattern that is usually related to drug administration. The eruption is of sudden onset and appears 7–10 days after the medication is started. A 22-year-old male patient who was a student at a chemical faculty attended our outpatient clinic with a complaint of pustular eruption on his face. According to his history, the eruption started with pruritus and erythema on his chin 3 days ago and spread to his face and chest. He explained that he had performed an experiment with sulfuric acid and bromic acid and was exposed to their vapor. His dermatological examination revealed erythema and pustules on his cheeks, on his chin, above his upper lip, and on his eyebrows. He also had a few pustules on his chest. There were no ocular, mucous membrane, or pulmonary symptoms. Histopathological examination of the skin biopsy specimen revealed superficial orthokeratosis, focal subcorneal pustule formation, and perivascular chronic inflammatory cell infiltration in superficial dermis. After administration of systemic antihistamines and wet dressing topically, we observed rapid healing of the lesions. Because there was no systemic drug intake in his history, we were concerned that exposure to sulfuric acid and bromic acid vapor caused AGEP in this patient. We present this rare case to show that the vapor of chemical materials may cause AGEP or other drug eruptions.

Indoor climate, psychosocial work environment and symptoms in open-plan offices

To study the indoor climate, the psychosocial work environment and occupants' symptoms in offices a cross-sectional questionnaire survey was made in 11 naturally and 11 mechanically ventilated office buildings. Nine of the buildings had mainly cellular offices; five of the buildings had mainly open-plan offices, whereas eight buildings had a mixture of cellular, multi-person and open-plan offices. A total of 2301 occupants, corresponding to a response rate of 72%, completed a retrospective questionnaire. The questionnaire comprised questions concerning environmental perceptions, mucous membrane irritation, skin irritation, central nervous system (CNS) symptoms and psychosocial factors. Occupants in open-plan offices are more likely to perceive thermal discomfort, poor air quality and noise and they more frequently complain about CNS and mucous membrane symptoms than occupants in multi-person and cellular offices. The association between psychosocial factors and office size was weak. Open-plan offices may not be suited for all job types. PRACTICAL IMPLICATION: Open-plan offices may be a risk factor for adverse environmental perceptions and symptoms.

Indicators of Moisture and Ventilation System Contamination in U.S. Office Buildings as Risk Factors for Respiratory and Mucous Membrane Symptoms: Analyses of the EPA BASE Data

We assessed associations between indicators for moisture in office buildings and weekly, building-related lower respiratory and mucous membrane symptoms in office workers, using the U.S. EPA BASE data, collected in a representative sample of 100 U.S. office buildings. We estimated the strength of associations between the symptom outcomes and moisture indicators in multivariate logistic regression models as odds ratios (ORs) and 95% confidence intervals (CI), controlling for potential confounding factors and adjusting for correlation among workers in buildings. This analysis identified associations between building-related symptoms and several indicators of moisture or contamination in office buildings. One set of models showed almost a tripling of weekly building-related lower respiratory symptoms in association with lack of cleaning of the drip pans under air-conditioning cooling coils (OR [CI] = 2.8 (1.2–6.5)). Other models found that lack of cleaning of either drip pans or cooling coils was associated with increased mucous membrane symptoms (OR [CI] = 1.4 (1.1–1.9)). Slightly increased symptoms were also associated with other moisture indicators, especially mucous membrane symptoms and past water damage to building mechanical rooms (OR [CI] = 1.3 (1.0–1.7)). Overall, these findings suggest that the presence of moisture or contamination in ventilation systems or occupied spaces in office buildings may have adverse respiratory or irritant effects on workers. The analysis, however, failed to confirm several risks identified in a previous study, such as condition of drain pans or outdoor air intakes, and other hypothesized moisture risks. Studies with more rigorous measurement of environmental risks and health outcomes will be necessary to define moisture-related risks in buildings.

No consistent risk factor pattern for symptoms related to the sick building syndrome: a prospective population based study

To examine associations between perceived indoor environment at work and the non-specific symptoms that are often referred to as the sick building syndrome (SBS), using cross-sectional and prospective analyses for a large cohort from the general population. The sample comprised 2,164 adults in employment, who completed a postal questionnaire in April 2001. Of these 1,402, who were still working and living in the same place, completed a second questionnaire a year later. The outcome measures were the prevalence of mucous membrane symptoms and general symptoms at baseline and the incidence and persistence of these symptoms at follow-up. Self-reports of the indoor environment from the baseline questionnaire were used as predictors in the analyses. Inconsistent results were found between the cross-sectional and the longitudinal analyses for the associations between perceived indoor environment factors at work and symptoms. Whereas mucous membrane symptoms in the cross-sectional analysis were significantly associated with self-reported high temperature and dry air, the prospective analyses showed that onset of mucous membrane symptoms was associated with the sensation of draught, dry air, and noise. Persistent mucous membrane symptoms were associated only with stuffy air. General symptoms were associated with self-reported stuffy air and dry air in the cross-sectional analysis, while draught was the only predictor of onset of general symptoms. We found no predictors in the indoor environment for the persistence of general symptoms. The symptoms that are often connected with SBS are very common symptoms in the general population among manual workers as well as non-manual workers. Our study gives only limited support to the hypothesis of causal relationships between the indoor environment and these symptoms. We found no evidence of persistent mucous membrane symptoms and general symptoms related to specific factors in the indoor environment.

Double blind placebo controlled exposure to molds: exposure system and clinical results*

The objective was to develop an experimental setup for human exposure to mold spores, and to study the clinical effect of this exposure in sensitive subjects who had previously experienced potentially building-related symptoms (BRS) at work. From three water-damaged schools eight employees with a positive histamine release test to Penicillium chrysogenum were exposed double- blinded to either placebo, approximately 600,000 spores/m3 air of P. chrysogenum or approximately 350,000 spores/m3 of Trichoderma harzianum for 6 min on three separate days. A statistically significant rise in symptoms from mucous membranes appeared from the 9-graded symptom scale after exposure to T. harzianum or placebo. Dichotomizing the data, whether the participants experienced at least a two-step rise on the symptom scale or not, gave borderline increase in mucous membrane symptoms after exposure to P. chrysogenum. In conclusion this is, to our knowledge, the first study to successfully conduct a human exposure to a highly controlled dose of fungal material aerosolized directly from wet building materials. This short-term exposure to high concentrations of two different molds induced no more reactions than exposure to placebo in eight sensitive school employees. However, a statistical type II error cannot be excluded because of the small sample size. In this double blind, placebo controlled study of mold exposure changes in symptoms, objective measurements and blood samples were small and mostly non-significant, and at the same level as after placebo exposure. The developed exposure system based on the Particle-Field and Laboratory Emission Cell (P-FLEC) makes it possible to deliver a precise and highly controlled dose of mold spores from water-damaged building materials, imitating realistic field exposure conditions. The present experiment is too small to rule out an effect of mold exposure; long-term experimental exposure studies on larger number of subjects are needed.

Physical and mental health symptoms among NYC transit workers seven and one-half months after the WTC attacks

On September 11, 2001, 600-800 New York City transit (NYCT) workers were working near the World Trade Center (WTC) Towers. After the disaster, employees reported physical and mental health symptoms related to the event. Two hundred sixty-nine NYC transit employees were surveyed for mental and physical health symptoms 7(1/2) months after the WTC disaster. Workers in the dust cloud at the time of the WTC collapse had significantly higher risk of persistent lower respiratory (OR = 9.85; 95% CI: 2.24, 58.93) and mucous membrane (OR = 4.91; 95% CI: 1.53, 16.22) symptoms, depressive symptoms (OR = 2.48; 95% CI: 1.12, 5.51), and PTSD symptoms (OR = 2.91; 95% CI: 1.003, 8.16) compared to those not exposed to the dust cloud. Additional WTC exposures and potential confounders were also analyzed. Clinical follow up for physical and psychological health conditions should be provided for public transportation workers in the event of a catastrophic event.

Mucous membrane and lower respiratory building related symptoms in relation to indoor carbon dioxide concentrations in the 100-building BASE dataset

Indoor air pollutants are a potential cause of building related symptoms and can be reduced by increasing ventilation rates. Indoor carbon dioxide (CO(2)) concentration is an approximate surrogate for concentrations of occupant-generated pollutants and for ventilation rate per occupant. Using the US EPA 100 office-building BASE Study dataset, we conducted multivariate logistic regression analyses to quantify the relationship between indoor CO(2) concentrations (dCO(2)) and mucous membrane (MM) and lower respiratory system (LResp) building related symptoms, adjusting for age, sex, smoking status, presence of carpet in workspace, thermal exposure, relative humidity, and a marker for entrained automobile exhaust. In addition, we tested the hypothesis that certain environmentally mediated health conditions (e.g., allergies and asthma) confer increased susceptibility to building related symptoms. Adjusted odds ratios (ORs) for statistically significant, dose-dependent associations (P < 0.05) for combined mucous membrane, dry eyes, sore throat, nose/sinus congestion, sneeze, and wheeze symptoms with 100 p.p.m. increases in dCO(2) ranged from 1.1 to 1.2. Building occupants with certain environmentally mediated health conditions were more likely to report that they experience building related symptoms than those without these conditions (statistically significant ORs ranged from 1.5 to 11.1, P < 0.05). These results suggest that provision of sufficient per-person outdoor ventilation air, could significantly decrease prevalence of selected building related symptoms. The observed relationship between indoor minus outdoor CO(2) concentrations and mucous membrane and lower respiratory symptoms suggests that air contaminants are implicated in the etiology of building related symptoms. Levels of indoor air pollutants that are suspected to cause building related symptoms could be reduced by increasing ventilation rates, improving ventilation effectiveness, or reducing sources of indoor air pollutants, if known.

Effect of indoor environmental factors on development of atopic symptoms in children followed up to 4 years of age.

The increased prevalence of atopic diseases reported in many Western countries is thought to be caused by changes in living conditions. For a long time attention was focused on indoor environmental factors and early feeding patterns, but during recent years other factors have received more attention. An unselected, Swedish, population-based cohort of 904 children were followed from the age of 3 months to 4 years. Questionnaires were sent to the mothers of the children when they were 3 months, 18 months and 4 years of age. A blood sample was taken from a subgroup of the children when they were 4 years old which was analysed for IgE specific antibodies to food and inhalant allergens. The prevalences of asthma, allergic eye-nose reactions, eczema, and food reactions at 4 years of age and a positive blood test were analysed as outcome factors. Features of housing and early feeding patterns were found to have limited effect on the development of allergies in the children. Presence of older siblings resulted in a decreased tendency to produce IgE antibodies. Early exposure to furry animals seemed to prevent the development of asthma. Children who were frequently infected up to 18 months of age showed an increased prevalence of allergic symptoms at 4 years of age. Children of mothers with a higher prevalence of complaints about indoor factors, or who had increased general symptoms or skin or mucous membrane symptoms ran a greater risk of developing various allergic symptoms. However, these children did not have higher levels of IgE antibodies. The reported allergic symptoms in the children may be due to non-immunological reactions, although it is also possible that the mothers may have over-reported such symptoms.