Nasal and ocular symptoms, tear film stability and biomarkers in nasal lavage, in relation to building-dampness and building design in hospitals

Objectives: To study the relationships between dampness in concrete floors and building design on the one hand, and symptoms and medical signs of the eyes and nose in hospital workers, on the other. Methods: Four hospitals fo r geriatrics were selected to represent buildings with different ages and d esign, irrespective of symptom prevalence. The first building was built in 1925. The second, built in 1985, was known to have dampness in the floor. C onventional building techniques were used in the third building, built in 1 993, and the last building was built in 1994, and was specially designed to include high ceilings, and minimal use of fluorescent lighting and interio r plastic materials. The interior surfaces were painted with water-based be eswax glazing. All staff (n = 95) working day shifts were invited to take p art in a medical examination of the eyes and nose including acoustic rhinom etry and nasal lavage, and a medical questionnaire, and 93% participated. M easurements of temperature, relative air humidity, air flow, illumination, volatile organic compounds (VOCs), molds, and bacteria were carried out in all buildings, together with measurements of formaldehyde, respirable dust, carbon monoxide (CO), carbon dioxide (CO2), nitrogen dioxide (NO2) and ozo ne. Statistical analyses were performed by bivariate analysis, and linear, ordinal, and logistic multiple regressions, adjusting for age, gender, toba cco smoking, atopy, and the perceived psychosocial work environment. Result s: Dampness in the upper concrete floor surface (75-84%), ammonia under the floor [3 parts per million (ppm)], and 2-ethyl-1-hexanol in the air were d etected in the two buildings built in 1985 and 1993. Increased occurrences of ocular and nasal symptoms, an increased concentration of lysozyme in nas al lavage, and decreased tear film stability were found in the subjects wor king in the damp buildings. Those in the specially designed building had fe wer ocular and nasal symptoms, and increased tear film stability. All build ings had low levels of formaldehyde, molds, bacteria, ozone, and NO2. The l owest total concentration of VOCs; and the highest concentration of specifi c VOCs of microbial origin, were found in the building with special design. Conclusion: The study provides new evidence of the role of dampness-relate d alkaline degradation of di-(2-ethylhexyl) phthalate (DEHP) in polyvinyl c hloride (PVC) building material. Emissions related to degradation of DEHP d ue to dampness in the floor, indicated by increased 2-ethyl-1-hexanol in th e air, seem to increase both the secretion of lysozyme from the nasal mucos a and the occurrence of ocular and nasal symptoms. The indoor environment o f the specially designed building with high ceilings and no fluorescent lig hting or interior plastics seemed to have a positive influence on the nasal and ocular mucous membranes.