Jacobs José, Borràs-Santos Alicia, Krop Esmeralda, Täubel Martin, Leppänen Hanna, Haverinen-Shaughnessy Ulla, Pekkanen Juha, Hyvärinen Anne, Doekes Gert, Zock Jan-Paul, Heederik Dick
Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain Hospital del Mar Research Institute (IMIM), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
Occup Environ Med. 2014 Oct;71(10):704-12. doi: 10.1136/oemed-2014-102246. Epub 2014 Jul 17.
Respiratory health effects of damp housing are well recognised, but less is known about the effect of dampness and water damage in schools. The HITEA study previously reported a higher prevalence of respiratory symptoms in pupils from moisture damaged schools, but the role of specific microbial exposures remained unclear.
To study associations between school dampness, levels of fungal and bacterial markers, respiratory symptoms and lung function in children.
Primary schools in Spain, the Netherlands and Finland were selected on the basis of the observed presence (n=15) or absence (n=10) of moisture, dampness and/or mould. Settled dust was repeatedly sampled in 232 classrooms and levels of 14 different microbial markers and groups of microbes were determined. Parental reports of respiratory symptoms were available from 3843 children aged 6-12 years, of whom 2736 provided acceptable forced spirometry testing. Country-specific associations between exposure and respiratory health were evaluated by multilevel mixed-effects logistic and linear regression models and combined using random-effects meta-analysis.
The prevalence of respiratory symptoms was higher in moisture damaged schools, being more pronounced in Finnish pupils. Effects on lung function were not apparent. Levels of microbial markers were generally higher in moisture damaged schools, varied by season and were lower in Finnish schools. Wheeze tended to be inversely associated with microbial levels. All other respiratory symptoms were not consistently associated with microbial marker levels.
Health effects of moisture and microbial exposures may vary between countries, but this requires further study.
潮湿住房对呼吸健康的影响已得到充分认识,但对于学校潮湿和水损的影响了解较少。HITEA研究先前报告称,来自受水损学校的学生呼吸道症状患病率较高,但特定微生物暴露的作用仍不明确。
研究学校潮湿、真菌和细菌标志物水平、儿童呼吸道症状与肺功能之间的关联。
根据观察到的潮湿、水损和/或霉菌的存在情况(n = 15)或不存在情况(n = 10),在西班牙、荷兰和芬兰选择小学。在232间教室中反复采集沉降灰尘样本,并测定14种不同微生物标志物和微生物组的水平。获得了3843名6至12岁儿童家长关于呼吸道症状的报告,其中2736名儿童提供了可接受的用力肺活量测试结果。通过多级混合效应逻辑回归和线性回归模型评估暴露与呼吸健康之间的国家特异性关联,并使用随机效应荟萃分析进行合并。
受水损学校的呼吸道症状患病率较高,在芬兰学生中更为明显。对肺功能的影响不明显。受水损学校的微生物标志物水平通常较高,随季节变化,在芬兰学校较低。喘息往往与微生物水平呈负相关。所有其他呼吸道症状与微生物标志物水平之间没有一致的关联。
潮湿和微生物暴露对健康的影响可能因国家而异,但这需要进一步研究。