Health hazard evaluation report: HETA-2005-0135-3116, comparison of mold exposures, work-related symptoms, and visual contrast sensitivity between employees at a severely water-damaged school and employees at a school without significant water damage, Alcee Fortier Senior High School, New Orleans.
Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, HETA 2005-0135-3116, 2010 Sep; :1-43
On January 18, 2005, NIOSH received a request for an HHE at AFSHS in New Orleans, Louisiana. Employees submitted the request because of concerns about exposure to mold and lead paint in their school building. Employees reported a variety of health effects, including difficulty breathing, chronic sinusitis, immune system problems, nosebleeds, skin rashes, irregular menses, headaches, irritable bowel syndrome, and nausea. We visited AFSHS on April 18-19, 2005. During informal interviews, employees reported possible work-related symptoms, some of which were consistent with symptoms reported by people working in water-damaged buildings. The building had obvious microbial contamination, so we decided that further evaluation was needed. On May 23-24, 2005, we returned to New Orleans for a follow-up evaluation. During this visit we administered a work history and health symptom questionnaire. We also conducted VCS testing using the F.A.C.T. handheld chart. VCS testing measures the subjects' ability to determine changes in alternating light and dark bands of varying intensity. Performance on this test has been adversely associated with exposure to neurotoxins such as solvents and lead among many other conditions and exposures such as aging, certain eye conditions, alcohol and medication use, and depression. We used VCS testing for this evaluation to determine if it could serve as a biomarker of effect for occupants who experience adverse effects from a water-damaged building. We also collected environmental samples for culturable and aerosolized fungal spores and measured IEQ parameters (CO2, temperature, and RH). We performed a similar evaluation at WHHS in Cincinnati, Ohio, on February 27-29, 2006. WHHS had no history of ongoing water intrusion or mold growth. Of 119 employees at AFSHS, 95 (80%) participated in the evaluation. Of 165 employees at WHHS, 110 (67%) participated. Participants at both schools were similar in sex, age, history of psychiatric disease, atopy (the predisposition to allergic disease), smoking history, and having mold or moisture problems in their homes. Employees at AFSHS had higher prevalences of work-related cough, wheezing, or whistling in the chest; chest tightness; unusual shortness of breath; sinus problems; sore or dry throat; frequent sneezing; stuffy nose; runny nose; fever or sweats; aching all over; unusual tiredness or fatigue; headache; difficulty concentrating; confusion or disorientation; trouble remembering things; change in sleep patterns; and rash, dermatitis, or eczema on the face, neck, or arms than employees at WHHS. At each school, 13 employees reported currently having asthma. A significantly higher percent of the asthmatics at AFSHS reported their asthma was worse at work. Monocular and binocular VCS values were significantly lower at all spatial frequencies among AFSHS employees. A significantly higher percentage of employees at AFSHS had scores that fell below the average performance for 90% of the population compared to the results found among employees at WHHS. Actively growing Cladosporium was found on the walls of AFSHS. Mold was found in all three MSQPCR air samples with C. sphaerospermum being the most prevalent. The vacuum dust samples detected 32 of the 35 fungal species tested. The culturable air samples showed that Cladosporium and Pencillium were the most prevalent genera both inside and outside the school. Aspergillus species were detected in inside samples but not in outside air samples. The spore trap samples showed that Cladosporium was the prevalent genera both inside and outside the school with the exception of Room 316. No fungal growth was detected on six of eight sticky tape samples collected at WHHS. One had a trace of hyphae, and the other showed a few Aspergillus/Pencillium-like spores and a trace of hyphae. Both were from the band room. Air samples analyzed with MSQPCR showed low counts for inside samples compared to outside samples. The culturable and spore trap air samples collected inside and outside WHHS were comparable in terms of both counts and genera ranking. CO2 concentrations were elevated in some classrooms. We determined that a health hazard existed at AFSHS. Employees had significantly higher prevalences of rashes and nasal, lower respiratory, and constitutional symptoms than employees at WHHS. The prevalences of several neurobehavioral symptoms were also significantly higher. VCS values across all spatial frequencies were lower in the employees at AFSHS. Further studies are needed to determine what factors could be responsible for the VCS findings and whether they have any clinical significance for affected individuals. The building problems at AFSHS need to be addressed; recommendations to prevent water damage and microbial growth and for remediation in NOPS and WHHS are provided in this report.