Park Ju-Hyeong, Cho Sook Ja, White Sandra K, Cox-Ganser Jean M
Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, United States of America.
PLoS One. 2018 Jan 11;13(1):e0191165. doi: 10.1371/journal.pone.0191165. eCollection 2018.
There is limited information on the natural history of building occupants' health in relation to attempts to remediate moisture damage. We examined changes in respiratory and non-respiratory symptoms in 1,175 office building occupants over seven years with multiple remediation attempts. During each of four surveys, we categorized participants using a severity score: 0 = asymptomatic; 1 = mild, symptomatic in the last 12 months, but not frequently in the last 4 weeks; 2 = severe, symptomatic at least once weekly in the last 4 weeks. Building-related symptoms were defined as improving away from the building. We used random intercept models adjusted for demographics, smoking, building tenure, and microbial exposures to estimate temporal changes in the odds of building-related symptoms or severity scores independent of the effect of microbial exposures. Trend analyses of combined mild/severe symptoms showed no changes in the odds of respiratory symptoms but significant improvement in non-respiratory symptoms over time. Separate analyses showed increases in the odds of severe respiratory symptoms (odds ratio/year = 1.15‒1.16, p-values<0.05) and severity scores (0.02/year, p-values<0.05) for wheezing and shortness of breath on exertion, due to worsening of participants in the mild symptom group. For non-respiratory symptoms, we found no changes in the odds of severe symptoms but improvement in severity scores (-0.04‒-0.01/year, p-values<0.05) and the odds for mild fever and chills, excessive fatigue, headache, and throat symptoms (0.65-0.79/year, p-values<0.05). Our study suggests that after the onset of respiratory and severe non-respiratory symptoms associated with dampness/mold, remediation efforts might not be effective in improving occupants' health.
关于建筑物居住者健康的自然史与补救湿气损害尝试之间的关系,相关信息有限。我们对1175名办公楼居住者进行了为期七年的跟踪调查,期间进行了多次补救尝试,观察他们呼吸和非呼吸症状的变化。在四次调查中的每一次,我们都使用严重程度评分对参与者进行分类:0 = 无症状;1 = 轻度,在过去12个月有症状,但在过去4周不频繁;2 = 重度,在过去4周至少每周有一次症状。与建筑物相关的症状定义为离开建筑物后有所改善。我们使用了针对人口统计学、吸烟、建筑物居住时间和微生物暴露进行调整的随机截距模型,以估计与建筑物相关的症状或严重程度评分的几率随时间的变化,独立于微生物暴露的影响。对轻度/重度症状合并进行的趋势分析显示,呼吸症状的几率没有变化,但随着时间推移,非呼吸症状有显著改善。单独分析显示,由于轻度症状组参与者病情恶化,重度呼吸症状的几率(优势比/年 = 1.15 - 1.16,p值<0.05)以及运动时喘息和呼吸急促的严重程度评分(0.02/年,p值<0.05)有所增加。对于非呼吸症状,我们发现重度症状的几率没有变化,但严重程度评分有所改善(-0.04 - -0.01/年,p值<0.05),轻度发烧和寒战、过度疲劳、头痛和喉咙症状的几率也有所改善(0.65 - 0.79/年,p值<0.05)。我们的研究表明,在出现与潮湿/霉菌相关的呼吸和严重非呼吸症状后,补救措施可能无法有效改善居住者的健康状况。