Building-Associated Risk of Febrile Acute Respiratory Diseases in Army Trainees

Abstract

Airborne transmission of infectious agents and associations of indoor air pollutants with respiratory illnesses are well documented. We hypothesized that energy conservation measures that tighten buildings also increase risks of respiratory infection among building occupants. At four Army training centers during a 47-month period, incidence rates of febrile acute respiratory disease were compared between basic trainees in modern (energy-efficient design and construction) and old barracks. Rates of febrile acute respiratory disease were significantly higher among trainees in modern barracks (adjusted relative risk estimate, 1.51; 95% confidence interval, 1.46 to 1.56), and relative risks were consistent at the four centers. These results support the hypothesis that tight buildings with closed ventilation systems significantly increase risks of respiratory-transmitted infection among congregated, immunologically susceptible occupants.

A longitudinal study of ventilation rates in California office buildings and self-reported occupant outcomes including respiratory illness absence

“…The finding by Pejtersen et al [26] of a nearly monotonic relationship between numbers of others sharing an office and annual days of selfreported sickness absence, although not replicated here, could have been due to long-range or other means of disease transmission. Specific studies have reported associations of lower VRs (or higher CO 2 concentrations) with increased respiratory infections in densely occupied group domiciles, including respiratory infections in dormitories [12], febrile respiratory illness in barracks [13], and pneumococcal disease in a jail [14].…”

Respiratory illness in Saskatoon infants: The impact of housing and neighbourhood characteristics

“…Research has also linked adverse indoor environments to respiratory morbidity in children, especially factors such as the presence of dampness and mould (Hynes et al 2003;Mommers et al 2005;), overcrowded living situations (Fuchs et al 1996) and ventilation (Brundage et al 1998;Wickman et al 1991;Hynes et al 2003;Chaudhuri 2004). Exposure to fungi and their component toxins may increase lower respiratory illness by acting as irritants or through increased susceptibility to infection (Stark et al 2003).…”

Airborne Pathogens Transport in an Aircraft Cabin

“…Models for examining infection in confined spaces are generally based on the work of Wells [6] and Riley et al [7]. In 1988, Brundage et al [8] showed that febrile illness rates were about 50% higher in sealedwindow than in operable window army barracks. Wagner et al [9] estimated that one passenger infected with H1N1 and travelling in economy class of a commercial aircraft may cause two to five infections during a 5 hour flight and a 5-10 during an 11 hour flight.…”