Microbial exposures in moisture-damaged schools and associations with respiratory symptoms in students: A multi-country environmental exposure study
Adams, Rachel I; Leppänen, Hanna; Karvonen, Anne M; Jacobs, José; Borràs-Santos, Alicia; Valkonen, Maria; Krop, Esmeralda; Haverinen-Shaughnessy, Ulla; Huttunen, Kati; Zock, Jan-Paul; Hyvärinen, Anne; Heederik, Dick; Pekkanen, Juha; Täubel, Martin
(2021) Indoor Air, volume 31, issue 6, pp. 1952 - 1966
(Article)
Abstract
Moisture-damaged buildings are associated with respiratory symptoms and underlying diseases among building occupants, but the causative agent(s) remain a mystery. We first identified specific fungal and bacterial taxa in classrooms with moisture damage in Finnish and Dutch primary schools. We then investigated associations of the identified moisture damage indicators with
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respiratory symptoms in more than 2700 students. Finally, we explored whether exposure to specific taxa within the indoor microbiota may explain the association between moisture damage and respiratory health. Schools were assessed for moisture damage through detailed inspections, and the microbial composition of settled dust in electrostatic dustfall collectors was determined using marker-gene analysis. In Finland, there were several positive associations between particular microbial indicators (diversity, richness, individual taxa) and a respiratory symptom score, while in the Netherlands, the associations tended to be mostly inverse and statistically non-significant. In Finland, abundance of the Sphingomonas bacterial genus and endotoxin levels partially explained the associations between moisture damage and symptom score. A few microbial taxa explained part of the associations with health, but overall, the observed associations between damage-associated individual taxa and respiratory health were limited.
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Keywords: bacteria, built environment, classrooms, fungi, indoors, microbiome, mold, mycobiome, Environmental Engineering, Building and Construction, Public Health, Environmental and Occupational Health
ISSN: 0905-6947
Publisher: Blackwell Munksgaard
Note: Funding Information: The authors wish to extend special thanks to the teachers, pupils, principals, and cleaning personnel of the participating study schools for their support and cooperation. We acknowledge the HITEA team of field workers in Finland, the Netherlands, and Spain for sample and data collection, and the laboratory personnel at THL for sample processing and analysis. We are grateful to Asko Vepsäläinen for statistical support and data management, and we thank Pekka Tiittanen for developing data management practices for the HITEA study. We thank Zachary Foster for help in generating the heat tree figure. This work was supported by the European Commission as part of HITEA (Health Effects of Indoor Pollutants: Integrating microbial, toxicological, and epidemiological approaches), Grant agreement no. 211488 under the Seventh Framework Programme, Topic ENV.2007.1.2.1.1. “Indoor air pollution in Europe: An emerging environmental health issue.” Additional funding was granted to the project by the Finnish Work Environment Fund (grant numbers 115424, 114139), Juho Vainion Säätiö, Yrjö Jahnssonin Säätiö, the Academy of Finland (grant numbers 252718, 339666, 296587), and the California Department of Public Health Publisher Copyright: © 2021 The Authors. Indoor Air published by John Wiley & Sons Ltd.
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