Validity and recall of information from questionnaires concerning respiratory infections among schoolchildren.

The aim of the study was to assess the reliability of questionnaire information on visits to a physician and the use of antibiotics taken for respiratory infections among schoolchildren attending a water-damaged school and a reference group of schoolchildren attending an undamaged school. Two similar questionnaires on respiratory morbidity in two consecutive years were sent to the parents. The information given on the questionnaires was compared with the patient's records of the local health centre. Although the overall total numbers of ambulatory visits in the patients' records and questionnaires seemed to indicate good reliability, a more detailed individual investigation showed poor recall validity from the questionnaires, including a high percentage of unreported visits to the local health centre from both schools. Underreporting was commoner in the control school than in index school. Recall was best for the children who had no visits to a doctor. Use of antibiotics had a better recall than ambulatory visits in both schools. The study indicates that information on health services in questionnaires is not reliable, at least when occurrences in a period of one year or more are evaluated. The use of patient records as a reference of accuracy is also unreliable, unless all the health care services available to the people in the community are covered.

Increased prevalence of atopy among children exposed to mold in a school building.

BACKGROUND: The purpose of this study was to assess the occurrence of immunoglobulin E sensitization to common environmental allergens (atopy) and new allergic diseases among schoolchildren after starting school in a water-damaged school building. The staff and pupils of a Finnish elementary school with visible water damage and mold complained of respiratory and skin symptoms. The school building was examined and widespread moisture damage was found. A control school with no visible water damage was also examined. No indication of exceptional microbial growth was found in the samples taken from this school. METHODS: History of allergic diseases and the year of diagnosis were established by a questionnaire. IgE antibodies to the common environmental allergens were determined from randomly selcted groups from both schools. RESULTS: Elevated IgE values were significantly more common among the exposed children, as was the occurrence of new allergic diseases after the children started at the school. CONCLUSIONS: The odds ratios for the IgE values of the study groups indicated a possible relationship between exposure to microorganisms and IgE sensitization. Exposure to spores, toxins, and other metabolites of molds may have complex results with unknown immunogenic effects that may act as a nonspecific trigger for allergic sensitization leading to the development of atopy.

Respiratory morbidity among children following renovation of a water-damaged school.

The authors sought to determine whether exposure to molds, resulting from moisture damage in a school, was associated with increased respiratory symptoms and morbidity among schoolchildren and whether the renovation of this building resulted in a decrease in prevalence of respiratory symptoms and morbidity. The study was a follow-up (1-y interval) of children between the ages of 7 and 12 y from two elementary schools in a Finnish suburb. In addition to a questionnaire completed by the parents, the authors assessed the respiratory health of children by examining the health records of a local health center. In the cross-sectional study, the prevalence of symptoms and infections were higher in the exposed group, as were visits to a physician and use of antibiotics. The school was renovated, after which all prevalence decreased and no significant differences remained, except for visits to a physician (according to questionnaire responses). Therefore, moisture damage and exposure to molds increased the indoor air problems of schools and affected the respiratory health of children.

Why do postmenopausal women discontinue hormone replacement therapy?

OBJECTIVES: To study the prevalence and acceptance of hormone replacement therapy (HRT) in the Finnish population and to ascertain the factors leading to premature discontinuation of HRT. METHODS: A questionnaire survey was conducted among all women aged 50-60 selected from the age-sex register, 1065 women were identified and 884 (response rate 84%) agreed to participate. RESULTS: 111 women were premenopausal and 773 postmenopausal; 302 (39%) were current HRT users, 126 (16%) previous users and 345 (45%) non-users. Of the previous users 27% had used oestrogen for less than 6 months and 46% had ceased treatment within 1 year. The main reason for discontinuation was side-effects; 41% of the women had suffered from them. Fear of cancer (16%), recommendation of a physician (12%), inefficiency (4%), and advice of a friend (3%) were other causes of discontinuation. Of the current users, 20% had continuous side-effects from the treatment and 15% had been advised to discontinue the treatment. Eleven percent of current users and 11% of previous users reported not having received any information about HRT. CONCLUSIONS: in this survey, more than half of postmenopausal women had used HRT at menopause. Every third of the women had discontinued the treatment, mainly because of side-effects but also because of fear of cancer and advice of physicians.