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Schools, Mould and Health - An Intervention Study
Principal investigator: Aino Nevalainen, docent, Ph.D. National Public Helath Institute, Laboratory of Environmental Microbiology, e-mail aino.nevalainen@ktl.fi

Moisture and mould problems in school buildings cause exposure to biological indoor air pollutants for the school children, teachers and other personnel, resulting in respiratory symptoms and infections and in some cases, even increased incidence of asthma. A number of occupational diseases caused by biological indoor air pollutants have been recently recognized among teachers and personnel of moisture -damaged schools. Indoor air quality and health problems are common, and the municipalities are putting remarkable resources on the repair measures but little documented data is so far available about the effects of the repair measures on the users health and thus on the cost effectiveness of the repairs. This intervention study is designed to increase our understanding about the effects of the repair measures on the school students health and exposure. The overall aim of the study is to find out whether the moisture and mould repairs of the school buildings have an effect on the exposure to indoor air pollutants, and on the prevalence of respiratory symptoms and diseases of the school students Both the health status and exposure are measured in detail before the repairs are started, and the measurements will be repeated after the completion of the repairs. The study cohort consists of elementary school children and high school students (N=2500). The detailed objectives are:

1. To find out if there is a dose-response effect depending on whether an individual is exposed to mold in school or home or in both,

2. To find out whether the elimination of microbial growth and repair of moisture damage will eliminate the increase of respiratory symptoms and infections among the school students,

3. To find the most relevant methods to characterize the exposure associated with building moisture and mould, and

4. To develop a method to monitor the toxicity and biological activity of the indoor air particulate material.

Microbial exposure is characterized with microbial samples from the indoor air (impactor and filter), surface swab samples, house dust and pieces of damaged materials. Ergosterol concentration and lipid fatty acid profile by GC; acute cell toxicity and other biological activity, see the project of Dr. Hirvonen; concentrations of dog and cat allergens and house dust mites from house dust. The buildings will be inspected for their signs of moisture according to a chekc list and the repair measures will be documented. Health status of the children will be monitored with questionnaires which will be validated with absence analysis and symptom diaries.

This study is linked with the follow-up of the health of the personnel, the technical monitoring of the effectiveness of the repairs, (financed by the Finnish Fund of Occupational Health and Tekes), and several projects of the Consortium studying the exposure to bioaerosols and mechanisms of the health effects. The results will provide tools

for assessing the effectiveness of the repairs in decreasing the symptoms

for understanding which types of damage/exposure produce the highest risk to health

for monitoring the indoor exposure to biological contaminants

for monitoring the indoor air exposure to biological contaminants

for assessing the urgency ranking of the repairs, needed in the community planning

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Development of Methods to Monitor the Success of Repair Measures
National Public Health Institute, Division of Environmental Health,

Laboratory of Environmental Microbiology, e-mail: aino.nevalainen@ktl.fi

Moisture and mould problems have been assessed as a major problem in the modern building stock, and their repair and prevention are one of the most important challenges in the research of building technology. As these problems often lead to health complaints among the users, the prerequisite of a successful repair process is the identification of the ultimate causes of the moisture accumulation and the development of reasonable repair methods. This work must go in parallel with the health-related research including the prevention of diseases and wellbeing of the occupants. Suitable methods for the follow-up of the success of the repairs are urgently needed. The technical criteria of the repair planning may somewhat differ from the health-based criteria. For example, a material previously contaminated with mycotoxins may still be technically usable, but not acceptable for health-based reasons.

The aim of the study is to develop method for monitoring the success of moisture and mould repairs. The strategy is to combine the technical and health-based approach. The material for the study will be collected from large repair projects with an intervention-type studyesign. The exposure and health status of the occupants will be followed throughout the process and the technical repair solutions will be carefully documented.