Skin test reactivity to molds in pre-school children with newly diagnosed asthma.

BACKGROUND: The aim of the present study was to evaluate the prevalence of sensitization to molds and to house dust mites (HDM) in pre-school children with newly-diagnosed asthma. METHODS: From 1996 to 2000, 122 children 1 to 6 years of age with fresh asthma treated in the Kuopio University Hospital, Kuopio, Finland, were recruited in the study; 94% attended. Skin prick tests were performed to common inhalant allergens and to 10 molds. The homes were surveyed for moisture damage. RESULTS: A majority of the houses had signs of dampness and moisture. One-third of the children reacted to inhalant allergens. There were 11 positive reactions to molds in five children who all reacted to at least one animal dander or seasonal pollen. Aspergillus fumigatus, Botrytis cinerea, and Cladosporium herbarum were the most common mold allergens. There were only two children with positive reactions to HDM, and none of them reacted to molds. No associations were found between the presence or degree of moisture problems at home and mold or HDM allergy. CONCLUSION: Sensitization to molds seems to play only a minor role in pre-school children with newly-diagnosed asthma in a northern climate where the incidences of mold and HDM allergies are rather low.

Exposure of workers to mites in Finnish groceries.

We assessed the mite exposure of workers in Finnish groceries by collecting samples of settled dust in 5 different grocerys. Mites were counted and identified microscopically. Mite allergen (Der p 1 and Der f 1) content of dust was analyzed with 2-site ELISA. Mites were found in 20-100 % of the samples, both from storage and salesrooms. Seven samples (8 %) contained more than 100 mites per gram dust and 3 additional samples (6 %) more than 500 mites per gram dust, the suggested limits for mite sensitization and acute allergic symptoms, respectively. Most of the mites were storage mites belonging to Astigmata (Acaridae, Glycyphagidae) or Prostigmata (tarsonemids). House dust mites were found only occasionally. One dust sample out of 15 contained Der p 1, and none contained Der f 1.

Effects of mould remediation on school teachers' health.

The follow-up study of the health of teachers (n = 56) of three mould damage schools were done with self-administered symptom questionnaire before and 1 year after the remediation of school buildings. Technical and microbiological investigations were done parallel at the same time. In the beginning of the study symptoms of allergic rhinitis, sinusitis, conjunctivitis and fatigue were high compared to normal population and 1 year after the intervention a decrease in fatigue (OR = 0.4) and headache (OR = 0.2) was observed. An association between female gender and sinusitis was found before the remediation (OR = 8.1). Age over 40 years was a risk factor for voice problems and more than 10 working years at the same school were associated with increased risk for conjunctivitis (OR = 8.5) and headache (OR = 5.4). Other exposure situations such as mould problems at home and mould exposure during leisure time also have an effect on teachers' health. Significant reduction was found in symptoms of fatigue and headache after the cessation of exposure, while respiratory symptoms need much longer time to relieve after the remediation. Age, female gender, atopy, long-term exposure time and other exposure situations might be the risk factors for prolonged symptoms among mould exposed teachers.

Chlamydia pneumoniae and newly diagnosed asthma: a case-control study in 1 to 6-year-old children.

OBJECTIVE: The aim of the study was to evaluate the association between antibodies to Chlamydia pneumoniae and the onset of asthma in children. METHODOLOGY: In 1996-2000, 122 children aged 1-6 years, who were treated for new asthma as inpatients or outpatients in our hospital, were recruited. For each patient, two controls, matched by age, sex and municipality, were randomly selected from the same population. In 2000, 104 serum samples were available from patients (85%) and 120 from controls (49%) for microimmunofluorescence (MIF) assay for C. pneumoniae and C. trachomatis antibodies, and for enzyme immunoassay (EIA) for C. pneumoniae antibodies. RESULTS: In EIA, the median IgG concentrations were 20 EIU (EIA units) in the patients, and 16 EIU in the controls. IgG was positive (> 30 EIU) in 37 (36%) patients and in 36 (31%) controls. IgA was positive (> 12 EIU) in four (4%) patients and in eight (7%) controls. In MIF, four (4%) patients and seven (6%) controls were IgG positive, and seven were also IgA positive. IgM antibodies were detected in four children by EIA, and in none by MIF. CONCLUSION: IgG antibodies to C. pneumoniae, though common in 1 to 6-year-old children as detected by EIA, did not differ between newly diagnosed asthma patients and controls in this case-control study.

Estimating effects of moisture damage repairs on students' health-a long-term intervention study.

Health symptom questionnaire responses were collected from upper secondary and high school students (n=245) before comprehensive repairs of moisture damage in the school. The questionnaire study was repeated 1 year (n=227), 3 years (n=256), and 5 years (n=233) after the repairs. The data were analyzed both in cross-sectional design including all respondents, and longitudinally including paired observations of those individuals who had responded both before and after the repairs. In addition, the effect of intervention on health symptoms was analyzed using generalized estimating equations (GEEs), taking into account within-subject correlation between repeated measurements. Compared to the situation before the repairs, the situation after the repairs was significantly improved in most of the 20 symptoms studied among the cross-sectional study populations. However, improvement was not so clear in the paired analysis and GEE analysis among the students who responded to three repeated questionnaires. The results indicate that the repairs succeeded in the sense that new cases of symptomatic students were no longer expected. However, the reversibility of symptoms among the group of exposed individuals may need to be considered separately.

Mold-specific immunoglobulin G antibodies in a child population.

The determination of immunoglobulin G (IgG) antibodies to molds has been used as an objective evidence of significant mold exposure. Until present, no data have been published on antibody responses to molds in healthy children living in normal housing conditions. The microbe-specific IgG antibody concentrations of 21 molds and 3 actinobacteria were determined by enzyme-linked immunosorbent assay (ELISA) in 103 1- to 6-year-old children (12.4% of the population of that age), and in 111 7- to 14-year-old school children (12.1%). The international standard sera were available, and the IgG concentrations of the test sera could be expressed in mg/l. On average, IgG concentrations increased in relation to age until the age of 6-7 years. At school age the increase still continued but more slowly. Actinobacteria were the only exceptions; all three tested strains Sreptomyces albus, S. griseus and S. halstedii resulted in rather high concentrations until 3 years of age. If the children lived in a farm, mold-specific IgG concentrations increased at an earlier age than in other children. The results between farmers' children and other children differed significantly before school age for 20 of the 24 microbes tested, the four exceptions being the 3 actinobacteria and the mold Aspergillus versicolor. The reference values must be age related, and separate references are needed for farmers' children before school age.

Maternal sex hormones in early pregnancy and asthma among offspring: a case-control study.

BACKGROUND: Sex hormones may be associated with the risk of onset of asthma. OBJECTIVE: To study the association between maternal sex hormone concentrations during early pregnancy and the risk of asthma among offspring. METHODS: A case-control study of 129 asthmatic children and 125 control children 5 to 6 years of age. Maternal sera in early pregnancy were obtained from the Finnish Maternal Cohort serum bank. RESULTS: The means of serum progesterone and estradiol and free estradiol in mothers of asthmatic and control children were 81.0 and 82.8 nmol/L (P =.60), 7.87 nmol/L and 7.65 nmol/L (P =.99), and 149.5 pmol/L and 148.0 pmol/L (P =.95), respectively. There were also no differences in the mean concentrations of maternal sex hormones according to the presence of allergic rhinitis or atopic eczema among the children. CONCLUSIONS: The current results do not support an association between maternal sex hormone concentrations during early pregnancy and onset of allergic disease in early childhood.

Mould specific IgG antibodies connected with sinusitis in teachers of mould damaged school: a two-year follow-up study.

OBJECTIVES: The aim of this study was to describe the relationship between mould exposure induced by moisture damage and mould specific immunoglobulin G antibodies to 20 common mould species and their association with respiratory diseases. MATERIALS AND METHODS: Mould specific immunoglobulin G (IgG) antibodies were monitored in teachers in a follow-up after an extensive mould remediation process in school buildings. IgG antibodies to 20 different microbes were determined from the sera of 26 teachers (19 exposed and 7 references) by enzyme-linked immunosorbent assay (ELISA). The serum samples were drawn twice, firstly at the completion of the remediation in the spring of 1997 and secondly, two years later in the spring of 1999. Health data was collected with self-administered questionnaires. RESULTS: No statistical differences were found in the overall concentrations of 20 mould-specific IgG-antibodies between the study and control groups at the beginning of the study. An association between sinusitis and elevated mould-specific IgG-levels forAspergillus fumigatus, Aspergillus versicolor, Aureobasidium pullulans, Chaetomium globosum, Cladosporium cladosporioides, Phialophora bubakii, Rhodotorula glutinis, Sporobolomyces salmonicolor, Stachybotrys atra, and Tritirachium roseum was found in the study group. CONCLUSIONS: In a two-year follow-up the total concentration of the IgG antibodies for Tr. toseum was lower at the end than at the beginning of the follow-up and this remained significant for the group of teachers with sinusitis. The decrease in mould specific IgG to Cl. cladosporioides, Geotrichum candidum, Ph. bubakii and Rhizopus nigricans was associated with bronchitis. According to our knowledge, this is the first study in which the association between elevated mould specific IgG antibodies and sinusitis was found in the school environment.

Effect of building frame and moisture damage on microbiological indoor air quality in school buildings.

The effect of building frame and moisture damage on microbial indoor air quality was characterized in 17 wooden and 15 concrete or brick school buildings. Technical investigations to detect visible moisture and mold damage were performed according to a standardized protocol. Viable airborne microbes were determined by using a six-stage impactor (Andersen 10-800). Mean concentrations of viable airborne fungi were significantly higher in wooden schools than in concrete schools, showing that the frame material was a determinant of concentrations of airborne fungi. Moisture damage of the building did not alter the fungal concentrations in wooden school buildings. In contrast, in concrete schools the effect of moisture damage was clearly seen as higher concentrations compared with the reference schools. Aspergillus versicolor, Stachybotrys, and Acremonium were detected only in samples from moisture damaged buildings, and can be considered marker fungi of such damage in school buildings. In addition, the presence of Oidiodendron as well as elevated concentrations of Cladosporium and actinobacteria were associated with moisture damage in concrete schools.

Nasal symptoms among residents in moldy housing.

OBJECTIVES: The aim of this study was to determine whether mold allergy mediated through immunoglobulin E (IgE) was responsible for the chronic nasal symptoms experienced by residents of moldy dwellings. A secondary aim was to investigate whether nasal mucosal findings were a possible reflection of other pathological mechanisms of chronic rhinitis. METHODS: Sixteen adults living in moldy housing and complaining of chronic rhinitis were compared with sixteen healthy referents without any known mold exposure. All the buildings were surveyed for visible signs of moisture and mold. Microbial measurements were performed in the damp buildings with mold problems and in half of the reference buildings. The clinical study consisted of an otorhinolaryngological examination, nasal cytology, and skin prick tests. In the study cases, nasal provocation tests with fungi cultured from the homes and nasal mucosal biopsy were performed. RESULTS: In the housing with signs of moisture and mold, the concentrations of microorganisms were elevated, but were within the normal range of those of the reference buildings. The only positive skin reaction for molds was detected in one referent. No reactions were elicited in the nasal provocation tests with molds. Squamous metaplasia were detected in four biopsies and three cytograms of the cases but not in the nasal smears of the referents. CONCLUSIONS: In this material, the respiratory symptoms reported by occupants of moldy residences were not caused by mold allergy but were apparently related to nonspecific inflammation following irritation.

Microbial exposure and mold-specific serum IgG levels among children with respiratory symptoms in 2 school buildings.

In this study, the authors determined the association between serum mold-specific immunoglobulin G (IgG) levels in primary school children (N = 181) with asthma, wheezing, or cough symptoms and exposure to indoor mold in 2 schools, with and without mold damage. Microbial exposure was determined with environmental sampling. Serum IgG antibody concentrations against 24 microbial strains were determined with enzyme-linked immunosorbent assay. Children's microbe-specific IgG levels were often higher in the reference school. There was an association between elevated serum IgG antibody levels to Penicillium notatum and moisture damage in the school. In addition, moisture damage both in school and at home was associated with Penicillium notatum and Eurotium amstelodami IgG levels. These observations comported with microbial findings in the index school. No other positive associations between IgG antibodies and microbial findings for the school buildings were observed. IgG levels in sera of school children did not provide a specific means for assessing the microbial exposure associated with moisture and microbial problems in the school buildings. Thus, IgG analysis cannot be readily suggested as a routine method for the evaluation of these exposures.

Immunoglobulin G antibodies of children exposed to microorganisms in a water-damaged school.

The aim of this study was to determine whether exposure to fungi (molds and yeasts) among children attending a water-damaged school was reflected by the children's immunoglobulin G (IgG) response to microorganisms typical of water damage and whether the presence of these IgG antibodies was associated with respiratory symptoms and morbidity. The relationships between positive IgG antibodies and atopy, described as elevated allergen-specific immunoglobulin E (IgE) antibodies, were also examined. The study population consisted of a randomly selected group of exposed children attending a water-damaged school and a group of unexposed children of the same age. Serum samples for analyses of IgG and IgE antibodies were drawn from the children. The respiratory morbidity, the number of positive IgG antibodies to nine microorganisms indicating water damage, and IgE sensitization to common environmental allergens (Phadiatop) were studied. The mean number of positive IgG findings was significantly higher among the exposed children. The number of positive IgG antibodies did not correlate with respiratory illnesses or symptoms at the individual level even though the exposed children who had positive IgG antibodies to four or more microorganisms in the total group comparison tended to have higher respiratory morbidity. In the exposed group, a negative correlation was found between the number of positive IgG antibodies and the total value of allergen-specific IgE antibodies. As among adults exposed to microorganisms at work, IgG antibodies in children seem to be a relevant indicator of exposure to microorganisms in a water-damaged school on the group level.

Hypersensitivity symptoms associated with exposure to cellular telephones: no causal link.

The hypothesis that there exist hypersensitive persons who perceive subjective symptoms from radiofrequency (RF) fields emitted by hand held mobile phones (cellular phones) was tested using double blind provocation experiments. We also tested whether sensitive subjects are able to determine whether the phone is on or off by sensing RF fields. The study group consisted of 20 volunteers (13 women and 7 men) who reported themselves as being sensitive to cellular phones. The RF exposure sources were one analogue NMT phone (900 MHz) and two digital GSM phones (900 and 1800 MHz). The duration of a test session was 30 min, and three or four sessions were performed in random order for each subject during 1 day. The subjects were asked to report symptoms or sensations as soon as they perceived any abnormal feelings. In addition, the subjects' blood pressure, heart rate, and breathing frequency were monitored every 5 min. The results of the study indicated that various symptoms were reported, and most of them appeared in the head region. However, the number of reported symptoms was higher during sham exposure than during real exposure conditions. In addition, none of the test persons could distinguish real RF exposure from sham exposure. Hence, we conclude that adverse subjective symptoms or sensations, though unquestionably perceived by the test subjects, were not produced by cellular phones.