Association of toxic indoor air with multi-organ symptoms in pupils attending a moisture-damaged school in Finland.

IF 1.4 Q4 IMMUNOLOGY American journal of clinical and experimental immunology Pub Date : 2020-12-15 eCollection Date: 2020-01-01
Saija M Hyvonen, Jouni J Lohi, Leena A Rasanen, Tuula Heinonen, Marika Mannerstrom, Kirsi Vaali, Tamara Tuuminen
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Abstract

Background: There is an on-going debate on how best to test toxic indoor air. Toxicological methods based on condensed water samples and cell culture technique are newly introduced research tools which were tested in this study.

Methods: Pupils (n=47) from a water-damaged and (n=56) healthy schools were interviewed using a questionnaire. Indoor air was collected with a novel condensed water sampling technique and human THP-1 macrophages were exposed to the condensate. The cytotoxicity of cotton wool swab samples was tested using human BJ fibroblasts. Conventional microbiological culture methods were also performed.

Results: Gastrointestinal problems (GI) were reported by 51% from the study cohort but only 4% of the control cohort, relative risk RR=14.30. For any neurological or neuropsychological symptoms, the RR was 63.04, muscular-skeletal pain RR=58.28, headache RR=31.00, respiratory symptoms RR=22.64, fatigue RR=21.45, sub febrility RR=15.49, ear infections RR=7.74, skin rash RR=5.96, all being statistically significant (P<0.001). All indoor air (n=7) and cotton wool samples (n=2) taken from the water-damaged classroom or in proximity of the problematic classrooms were toxic in cell culture assays. Low numbers of moisture-damage indicators were recovered from wall, passive air, and swab samples, namely Aspergillus ochraceus species group, Aspergillus, Eurotium species group, Fusarium, Tritirachium, Scopulariopsis genus group and Aspergillus versicolores species group.

Conclusions: Indoor air toxicity and dampness-related microbiota recovered from the classrooms were associated with multi-organ morbidity of the school occupants. These results corroborated our previous reports from two adult cohorts i.e. evidence of causality. These new toxicological methods based on condensed water and cell culturing techniques seem to be superior to conventional microbiological methods in correlating with clinical symptoms.

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芬兰一所湿气受损学校的学生中有毒室内空气与多器官症状的关系。
背景:关于如何最好地检测室内有毒空气一直存在争论。以凝结水样品为基础的毒理学方法和细胞培养技术是本研究中新引入的研究工具。方法:采用问卷调查的方法对一所水患学校和一所健康学校的学生(n=47)进行调查。采用一种新型冷凝水取样技术收集室内空气,将人THP-1巨噬细胞暴露于冷凝水中。用人BJ成纤维细胞检测棉絮拭子样本的细胞毒性。采用常规微生物培养方法。结果:研究队列中有51%的人报告了胃肠道问题,而对照组中只有4%的人报告了胃肠道问题,相对风险RR=14.30。神经或神经心理症状的RR为63.04,肌肉-骨骼疼痛RR=58.28,头痛RR=31.00,呼吸道症状RR=22.64,疲劳RR=21.45,亚发热RR=15.49,耳部感染RR=7.74,皮疹RR=5.96,差异均有统计学意义(红曲霉属组、曲霉属组、欧氏菌属组、镰刀菌属组、小曲霉属组、scopariopsis属组、versicolores曲霉属组)。结论:室内空气毒性和教室湿相关微生物群与学校居住者多器官发病有关。这些结果证实了我们之前的两个成人队列的报告,即因果关系的证据。这些新的基于凝结水和细胞培养技术的毒理学方法在与临床症状相关方面似乎优于传统的微生物学方法。
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