Background. Recurrent complaints of new onset asthma and building-related symptoms persisted after 14 environmental investigations over 20 years. We undertook an epidemiologic survey of college employees in 12 campus buildings to assess symptom and diagnosis excesses in relation to environmental indices of water damage in their offices, classrooms, and laboratories. Methods. Participants completed questionnaires regarding symptoms, diagnoses, smoking, and job location. Trained industrial hygiene team pairs scored occupied rooms for mold odor, visible mold, stains, and moisture, the results of which were time-weighted by job location in exposure indices for individual participants. Health outcome prevalences were examined by building characteristics and exposure indices. We used logistic models to obtain odds ratios for symptoms in relation to exposure indices, taking into consideration faculty/staff status, gender, age, cigarette smoking, reported allergies, reported use of latex gloves, and year of hire. Results. About half of the 393 participants (71% response rate) reported wheeze, chest tightness, or shortness of breath. Sixty percent of those reporting these symptoms noted them to be either less severe away from work or required less medication away from work. Overall, 17% reported physician-diagnosed asthma, about half of whom noted post-hire onset or work-exacerbation. Occupants of water-damaged buildings had statistically higher prevalence of any post-hire chest symptom (44%) compared to occupants of other buildings (17%). Work-related chest symptoms followed the same pattern (34% and 10%, respectively). Visible mold significantly increased the odds of work-related lower and upper respiratory symptoms (wheeze (2.0), chest tightness (2.6), shortness of breath (2.6), nasal symptoms (1.7), and sinus symptoms (2.0)). Water stain indices were significantly associated with odds of work-related wheeze (2.6), work-related nasal symptoms (4.4), work-related sinus symptoms (3.8), and work-related throat irritation (2.0). Mold odor was associated with work-related throat irritation (2.3) and any work-related upper respiratory symptom or eye irritation (2.3). A subset of participants in the nursing department had relocated from a water-damaged building in the same year of the survey; 54% reported chest symptoms prior to the move, of whom 36% reported improvement in symptoms or breathing problems after relocation to older buildings. Conclusions. Building-related excesses of chest symptoms occurred in water-damaged buildings and were associated with indices of potential mold exposure. Exposure indices from visual and olfactory scoring may be useful in predicting risk and need for remediation, overcoming limitations of available bioaerosol measurement methods in predicting hazard.
Respiratory-infections; Respiratory-irritants; Respiratory-system-disorders; Pulmonary-system-disorders; Work-environment; Workers; Environmental-factors; Questionnaires; Age-factors; Allergies; Smoking; Demographic-characteristics; Nasal-disorders; Eye-irritants; Throat-disorders; Indoor-air-pollution; Microorganisms; Fungi; Indoor-environmental-quality