Moisture damage and fungal contamination in buildings are a massive health threat - a surgeon's perspective.

OBJECTIVES: Indoor air toxicity is of major public health concern due to the increase in humidity-induced indoor mould exposure and associated health changes. The objective is to present evidence for the causality of health threats and indoor mould exposure. METHODS: PubMed search on the following keywords: dampness, mould, indoor air quality, public health, dampness, and mould hypersensitivity syndrome, sick building syndrome, and building-related illness as well as information from the health authorities of Bavaria and North Rhine-Westphalia, the Center of Disease Control (CDC), World Health Organisation (WHO), and guidelines of professional societies. RESULTS: The guidelines of professional societies published in 2017 are decisive for the assessment of the impact of mould pollution caused by moisture damage on human health and for official regulations in Germany. Until 2017, a causal connection between moisture damage and mould exposure could usually only be established for pulmonary diseases. The health risk of fungal components is apparent as documented in the fungal priority pathogens list (FPPL) of the WHO. Since 2017, studies, especially in Scandinavia, have proved causality between moisture and mould exposure not only for pulmonary diseases but also for extrapulmonary diseases and symptoms. This was made possible by new test methods for determining the toxicity of fungal components in indoor air. Environmental medical syndromes, e.g., dampness and mould hypersensitivity syndrome (DMHS), sick building syndrome (SBS), building-related symptoms (BRS), and building-related illness (BRI), and fungal pathogens, e.g., Aspergillus fumigatus, pose a major threat to public health. CONCLUSION: There is evidence for the causality of moisture-induced indoor moulds and severe health threats in these buildings. According to these findings, it is no longer justifiable to ignore or trivialize the mould contamination induced by moisture damage and its effects on pulmonary and extrapulmonary diseases. The health and economic implications of these attitudes are clear.

Investigating the Ventilation System of an Intensive Care Unit in the COVID-19 Crisis: A Study in a Hospital of Tehran, Iran.

Background: Ventilation system besides other prevention strategies such as surface disinfecting and personal protective equipment (PPE) decrease the risk of coronavirus disease 2019 (COVID-19) infection. This study aimed to examine the ventilation system of an intensive care unit (ICU) in a hospital in Tehran, Iran to evaluate the potency of heating, ventilation, and air conditioning system (HVAC) for COVID-19 spread. Materials and Methods: Contamination of air turnover caves was evaluated in supplier diffuser and extractor grills of negative pressure HVAC by ten samples. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the samples was evaluated by the real time reverse transcription-polymerase chain reaction (PCR). Moreover, air conditioning and sick building syndrome (SBS) was assessed according to MM040EA questioning from health care workers. Results: In the health care workers, respiratory effects were more prevalent compared to other signs. Despite suitable air conditioning, this study highlighted carrier potency of ICU workers for SARS-COV-2. Conclusion: According to our results, although the HVAC of ICU ward had an appropriate air movement, it was not safe enough for health care workers.

Building and Health: Mapping the Knowledge Development of Sick Building Syndrome

At present, with more and more attention paid to the impact of buildings on the health and well-being of occupants, sick building syndrome (SBS) has become a global concern. Since the introduction of SBS by the World Health Organization (WHO) in 1983, thousands of research literatures have been published in this field. This paper systematically arranges knowledge development of SBS through bibliometric analysis, exploring the most influential countries, institutions, journals and scholars, as well as the main subject categories and keywords. Main path analysis (MPA) was used to list development trajectory under inheritance relationship of SBS knowledge, including symptom analysis, risk factors of SBS and the improved impact of ventilation on SBS and productivity. Furthermore, it is an emerging research trend to propose SBS solution in the building design stage.

COVÍD-19, HASTA BÍNA SENDROMU ve STRES

Bir binada yaşayanların ya da çalışanların beklenenden daha sık karşılaştığı, bina ile ilişkili olarak görülen solunum sistemi şikayetleri, halsizlik, baş ağrısı ve konsantrasyon bozukluğu, cilt hastalığı gibi kişide rahatsızlık veren bir dizi ortak belirti olarak ifade edilen hasta bina sendromu, günümüzde hemen her kapalı alanda kendini göstermektedir. Hasta bina sendromu semptomlarının ortaya çıkması, ergonomik risk faktörlerinin yanısıra, anksiyete ve stres gibi psiko-sosyal risk faktörlerine de neden olmaktadır. Bu çalışmanın amacı, hasta bina sendromu semptomları ile stres ilişkisini ortaya koymak ve COVÍD-19 pandemisi nedeniyle uzun süre kapalı alanlarda kalanlarda görülebilecek semptomlara dikkat çekmektir. Bu çalışmada, COVÍD-19 pandemisi nedeniyle Dünya Sağlık Örgütünün "evde kal" sloganıyla başlattığı genel karantina ilanı ile kapalı alanlarda uzun süre yaşayanlarda ortaya çıkabilecek bu semptomların, tüm bireyleri etkileyen küresel korku ve endişenin yanısıra stresi daha da arttıracağının önemi de vurgulanmaya çalışılmıştır. 259 AVM mağaza çalışanı ile gerçekleştirilen araştırma sonuçları;çalışanlarda boğaz kuruluğu, burun akıntısı, nefes darlığı ve genel kas-eklem ağrısı semptomlarının görüldüğü, bunun da Covid-19 belirtilerine benzer göstergeler olduğu anlaşılmaktadır. Ayrıca alışveriş merkezlerinde görülen hasta bina sendromu belirtilerinin çalışanların stres seviyelerini yükselttiği tespit edilmiştir (F: 55.769, p: 0.00).Alternate :Sick building syndrome, which expressed as a series of common symptoms that are seen more frequently than expected by the residents or employees of a building, which are associated with the building, such as skin, respiratory system complaints, headache, fatigue, and concentration impairment, which cause discomfort in the person. The emergence of sick building syndrome symptoms causes psycho-social risk factors such as anxiety and stress as well as ergonomic risk factors. The aim of this study is to reveal the relationship between sick building syndrome symptoms and stress and to draw attention to the symptoms that may be seen in those who stay in closed area for a long time due to the COVID-19 pandemic. In this study, with the general quarantine declaration initiated by the World Health Organization with the slogan of "stay at home" due to the COVID-19 pandemic, the importance of these symptoms, which may occur in those living in closed area for a long time, will increase the stress as well as the global fear and anxiety affecting all individuals. The results of the research conducted with 259 shopping mall employees;it is understood that employees have symptoms of dry throat, runny nose, shortness of breath, and general muscle-joint pain, which are indicators similar to Covid-19 symptoms. In addition, it has been found that the symptoms of sick building syndrome seen in shopping malls increase the stress levels of employees (F: 55.769, p: 0.00).

The "Quarantine Dry Eye": The Lockdown for Coronavirus Disease 2019 and Its Implications for Ocular Surface Health.

The pandemic of coronavirus disease 2019 (COVID-19) has led many countries of the world to impose a series of containment measures such as lockdowns (mass quarantines), curfews or similar restrictions (eg, stay-at-home orders, or shelter-in-place orders). All these restrictions were established in order to limit spread of COVID-19. Thus, approximately 3.9 billion people worldwide were under lockdown by early April 2020. During this time (home confinement), some solutions have been proposed by experts to improve work and school productivity, including smart working and online school lessons. However, many of the restrictive measures are likely to act as predisposing factors for dry eye disease (DED), directly or related to sick building syndrome (SBS). Herein, we discuss the implications of quarantine measures on eye health, in particular on DED associated with SBS, and introduce some potential preventive strategies for lockdown-related ocular surface disorders. Several risk factors are implicated in their pathogenesis, including environmental changes (eg, air quality) and modifications in personal behaviors (eg, the abuse of digital devices, malnutrition, and sleep/psychiatric disorders). Considering a number of predisposing factors for DED, it is possible to state that patients under lockdown are at risk of ocular surface alterations. Accordingly, the COVID-19 pandemic era is expected to determine an increase in dry eye patients all around the world (a new phenomenon that we propose to name the "quarantine dry eye") in the event that the restrictive measures will be recursively extended over time.