RATIONALE: Damp buildings are commonly remediated without removing employees. Objective measures of health status may be useful in complementing self-reported measures in following changes in occupant health status. Our objectives were to examine if the respiratory health of occupants improved from 1) building remediation to address water damage and 2) relocation within the building during the remediation period. METHODS: We examined paired pulmonary function and questionnaire data from 2002 and 2005 for a cohort of 97 employees in a water-damaged building during remediation. We defined respiratory cases as those reporting at least three of five lower respiratory symptoms occurring weekly over the past month; or at least two of three symptoms consistent with hypersensitivity pneumonitis (HP); or physician-diagnosed post-occupancy asthma, HP or sarcoidosis. We compared 2002 and 2005 results using paired t-tests for continuous variables and McNemar's tests for categorical variables. We used generalized linear models to study the effect of relocation among respiratory cases. RESULTS: We observed no overall improvement in respiratory health indices over the three-year interval, as reflected in symptom scores, overall medication use, spirometry abnormalities, or sick leave. Four employees went from borderline bronchial hyperresponsiveness to bronchial hyperresponsiveness; six developed abnormal spirometry; three more reported post-occupancy current asthma, and four hypersensitivity pneumonitis; some of these incident findings occurred among workers who did not meet a respiratory case definition in 2002. Relocated respiratory cases had a significant decrease in their medication use scale, with a decrease in use of any breathing medication from 60% to 20%, accounted for by decreasing bronchodilator use and elimination of use of oral steroids in the previous year and inhaled steroids in the last four weeks, although they also had a small decrease in lung function. In contrast, respiratory cases that were not relocated showed no significant change in medication usage. CONCLUSIONS: This cohort study suggests that prolonged remediation of this water-damaged building did not improve respiratory health of the occupants. In buildings with partial and ongoing remediation, relocation of occupants may be health protective. If employees are not removed from the building during remediation, medical surveillance is advisable for identifying persons who might improve with relocation.
Airborne-particles; Allergens; Bacterial-dusts; Bacteriology; Biological-effects; Biological-monitoring; Dust-exposure; Exposure-assessment; Exposure-levels; Exposure-methods; Immune-system; Immunodiagnosis; Inhalation-studies; Lung; Lung-disorders; Lung-irritants; Microscopic-analysis; Occupational-diseases; Occupational-exposure; Occupational-hazards; Occupational-health; Occupational-respiratory-disease; Particle-aerodynamics; Particle-counters; Particulates; Pulmonary-disorders; Pulmonary-congestion; Pulmonary-disorders; Pulmonary-system; Pulmonary-system-disorders; Quantitative-analysis; Questionnaires; Respiratory-hypersensitivity; Respiratory-infections; Respiratory-irritants; Respiratory-system-disorders; Risk-analysis; Statistical-analysis; Toxic-effects; Work-areas; Work-environment; Worker-health; Work-operations; Work-performance; Workplace-monitoring; Workplace-studies