Mendell Mark J, Naco Gina M, Wilcox Thomas G, Sieber W Karl
Indoor Environment Department, Environmental Energy Technologies Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA.
Am J Ind Med. 2003 Jun;43(6):630-41. doi: 10.1002/ajim.10211.
We evaluated relationships between lower respiratory symptoms and risk factors for microbiological contamination in office buildings.
The National Institute for Occupational Safety and Health collected data from 80 office buildings during standardized indoor environmental health hazard evaluations. Present analyses included lower respiratory symptom-based outcome definitions and risk factors for potential microbiologic contamination. Multivariate logistic regression models for selected outcomes identified key risk factors.
Adjusted odds ratios (95% confidence intervals) for "at least three of four work-related lower respiratory symptoms" were, for debris in ventilation air intake, 2.0 (1.0-3.9), and for poor drainage in air-conditioning drip pans, 2.6 (1.3-5.2). Adjusted associations with risk factors were consistently stronger for outcomes requiring both multiple symptoms and improvement away from work, and somewhat stronger among diagnosed asthmatics.
Moisture and debris in ventilation systems, possibly by supporting microbiologic growth, may increase adverse respiratory effects, particularly among asthmatics. Data from more representative buildings are needed to confirm these findings.
我们评估了办公建筑中下呼吸道症状与微生物污染风险因素之间的关系。
美国国家职业安全与健康研究所（National Institute for Occupational Safety and Health）在标准化室内环境卫生危害评估期间，从80座办公建筑收集了数据。目前的分析包括基于下呼吸道症状的结局定义和潜在微生物污染的风险因素。针对选定结局的多变量逻辑回归模型确定了关键风险因素。
对于“四种与工作相关的下呼吸道症状中至少三种”，通风进气口中有碎屑时的调整优势比（95%置信区间）为2.0（1.0 - 3.9），空调滴水盘中排水不畅时为2.6（1.3 - 5.2）。对于需要多种症状且离开工作场所后症状有所改善的结局，与风险因素的调整关联始终更强，在已诊断哮喘患者中关联稍强。
通风系统中的水分和碎屑可能通过促进微生物生长而增加不良呼吸影响，尤其是在哮喘患者中。需要来自更具代表性建筑的数据来证实这些发现。
