Indicators of Moisture and Ventilation System Contamination in U.S. Office Buildings as Risk Factors for Respiratory and Mucous Membrane Symptoms: Analyses of the EPA BASE Data

Mendell, Mark J.; Cozen, Myrna; Lei-Gomez, Q.; Brightman, Howard S.; Erdmann, Christine A.; Girman, J.R.; Womble, Susan E.

doi:10.1080/15459620600628589

Cited by 32 publications

(27 citation statements)

References 17 publications

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“…While several HVAC factors related to moisture and related contamination have been associated with increased symptoms in prior analyses of these or other data (e.g., poorly draining condensate drain pans, residue in drain pans, dirt and contamination at outdoor air intakes, infrequently cleaned coils and pans) (Sieber, Stayner et al 1996;Mendell, Naco et al 2003;Mendell, Cozen et al 2006), predicted associations of symptoms with most other aspects of HVAC systems investigated here were conjectural, based on engineering judgement. Thus, the analyses reported here were primarily to explore previously untested hypotheses.…”

Section: Introductionmentioning

confidence: 80%

“…Prior analyses of the BASE study data, using slightly different definitions for symptom outcomes and risk factor categories, found similarly elevated risks for less frequently cleaned condensate drain pans and coils (Mendell, Cozen et al 2006). Prior analyses of other data, from office buildings investigated for health complaints by occupants, found elevated lower respiratory symptoms associated with several aspects of poor HVAC maintenance, including poorly draining condensate drain pans and debris in air intakes (Mendell, Naco et al 2003).…”

Section: Comparison With Prior Findings and Predictionsmentioning

confidence: 98%

“…Researchers have, however, identified a number of environmental "risk factors" that are correlated with higher prevalence of symptoms in buildings selected without regard to occupant complaints, and thus may indicate as yet unidentified causal exposures. These risk factors include the presence of air-conditioning systems (Seppanen and Fisk 2002), contaminated components of heating, ventilating, and air-conditioning (HVAC) systems (Sieber, Stayner et al 1996;Mendell, Naco et al 2003), low ventilation rates (Seppanen, Fisk et al 1999), higher temperatures , and dampness/visible mold in buildings (Park, Schleiff et al 2004;Mendell, Cozen et al 2006). …”

Section: Introductionmentioning

confidence: 99%

“…Current causal hypotheses focus on aspects of HVAC that may influence production, dissemination, or concentration of indoor biological and chemical contaminants. Regarding these hypotheses, much epidemiologic evidence is available related to low ventilation rates as risk factors (Seppanen, Fisk et al 1999) and limited evidence is available related to moisture in HVAC systems (Mendell, Cozen et al 2006) and poor condition and maintenance of HVAC systems (Mendell, Naco et al 2003). …”

Section: Introductionmentioning

confidence: 99%

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Risk Factors in Heating, Ventilating, and Air-Conditioning Systemsfor Occupant Symptoms in U.S. Office Buildings: the EPA BASE Study

Mendell¹,

Lei-Gomez²,

Mirer³

et al. 2006

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Background: Nonspecific building-related symptoms among occupants of modern office buildings worldwide are common and may be associated with important reductions in work performance, but their etiology remains uncertain. Characteristics of heating, ventilating, and air-conditioning (HVAC) systems in office buildings that increase risk of indoor contaminants or reduce effectiveness of ventilation may cause adverse exposures and subsequent increase in these symptoms among occupants.Methods: We analyzed data collected by the U.S. Environmental Protection Agency (EPA) from a representative sample of 100 large U.S. office buildings -the Building Assessment and Survey Evaluation (BASE) study -using multivariate-adjusted logistic regression models with generalized estimating equations. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) for associations between seven building-related symptom outcomes and selected HVAC system characteristics (excluding ventilation rate, analyzed elsewhere) in the 97 airconditioned study buildings.Results: Among factors of HVAC design or configuration: Outdoor air intakes less than 60 m above the ground were associated with substantially increased odds of most symptoms assessed (ORs up to 2.7). Among factors of HVAC condition, maintenance, or operation: the presence of humidification systems in good condition was associated with reduction in skin symptoms (OR=0.5), whereas the presence of humidification systems in poor condition was associated with increases in upper respiratory symptoms, eye symptoms, fatigue/difficulty concentrating, and skin symptoms (ORs=1.5 to 1.7). Lack of regularly scheduled inspections for HVAC components was associated with increased eye and upper respiratory symptoms (ORs=2.2, 1.6). Less frequent cleaning of cooling coils or condensate drain pans was associated with increased headache and eye symptoms (ORs=1.5, 1.5). Ventilation for 10-12 hours per day (relative to more) was associated with a general slight increase in symptoms, especially fatigue/difficulty concentrating (OR=1.3). Several specific associations opposite of predicted were found, such as with cleanliness of air handler components and operational condition of air handling components. Discussion: Most of the many potential risk factors assessed here had not been investigated previously, and associations found with single symptom groups may have been by chance, including some that were the reverse of expected. Risk factors newly identified in these analyses that deserve attention include outdoor air intakes less than 60 m above the ground (which were correlated with higher levels of some outdoor vehicle-emitted pollutants), poorly maintained humidification systems, and lack of scheduled inspection for HVAC systems. Infrequent cleaning of cooling coils and drain pans were associated with increases in several symptoms in these as well as prior analyses of BASE data. Replication of these findings is needed, using more objective measurements of both exposure and health response. Co...

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Section: Introductionmentioning

confidence: 80%

Section: Comparison With Prior Findings and Predictionsmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Risk Factors in Heating, Ventilating, and Air-Conditioning Systemsfor Occupant Symptoms in U.S. Office Buildings: the EPA BASE Study

Mendell¹,

Lei-Gomez²,

Mirer³

et al. 2006

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show abstract

“…50 Installed humidification systems can provide a refuge for microbes, although their role in the etiology of nonspecific building-related illnesses is unclear and unproven. 51 To complicate matters further, there has not been demonstrated association between the sensation of air dryness and actual environmental humidity. 45 Building temperature has also been considered in buildingrelated illness.…”

Section: Building Environmentsmentioning

confidence: 99%

Building-Related Illness

Gerardi¹

2010

Clinical Pulmonary Medicine

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Building-related illnesses represent a spectrum of disease. Important to their genesis are the unique features of the indoor air environment involving exposures to air pollution, mold spores, and various allergens. Specific building-related illnesses are primarily infectious, but also include the phenomenon of hypersensitivity pneumonitis and exacerbations of bronchial asthma, chronic obstructive pulmonary disease, and other chronic respiratory diseases. Nonspecific building-related illness includes an array of common symptoms but has no objective findings. It is found among a varied and susceptible working population.

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Indoor Air Quality in Nonindustrial Occupational Environments

Morey

Crawford

Rottersman³

2011

Patty's Industrial Hygiene

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The study summarizes about the indoor air quality of the buildings. Historically, the concept of indoor air quality (IAQ) has included view points that outdoor ventilation air is required both to prevent adverse health effects and to provide for comfort of occupants. It has been observed that airborne contagious diseases and malodor are more prominent in the crowded places with deﬁcient ventilation. The different approaches that can be used during IAQ evaluations reﬂect the varied kinds of problems that can occur in buildings. Higher morbidity and mortality in developing countries have multifactorial causes, with contaminated food, water, and air as major risk factors. An ASHRAE ventilation standard recommends the provision of outdoor air rate per person to lower the risk of diseases. The article focuses IAQ evaluation protocols and guidelines, Canadian and EPA guides, etc.

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Indicators of Moisture and Ventilation System Contamination in U.S. Office Buildings as Risk Factors for Respiratory and Mucous Membrane Symptoms: Analyses of the EPA BASE Data

Cited by 32 publications

References 17 publications

Risk Factors in Heating, Ventilating, and Air-Conditioning Systemsfor Occupant Symptoms in U.S. Office Buildings: the EPA BASE Study

Risk Factors in Heating, Ventilating, and Air-Conditioning Systemsfor Occupant Symptoms in U.S. Office Buildings: the EPA BASE Study

Building-Related Illness

Indoor Air Quality in Nonindustrial Occupational Environments

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