title: Nasal patency and lavage biomarkers in relation to settled dust and cleaning routines in schools.
abstract: OBJECTIVE
  This study determined the relations between settled dust and cleaning routines in classrooms on one hand, and nasal symptoms, nasal cavity dimensions, and the concentration of selected biomarkers of inflammation in nasal lavage on the other.
  
  
  METHODS
  Measurements of settled dust via standardized vacuum cleaning and an investigation of the cleaning routines were performed in 12 randomly selected primary schools in the municipality of Uppsala. Clinical examinations including acoustic rhinometry and nasal lavage were performed in the school environment among 279 school personnel working in the main buildings of the schools. Eosinophil cationic protein (ECP), myeloperoxidase (MPO), lysozyme, and albumin were analyzed in the lavage fluid. The relationships between the medical and hygienic data were analyzed both bivariately and with a multiple regression model controlling for age, gender, smoking, atopy, room temperature, and urban vicinity of the school.
  
  
  RESULTS
  The amount of settled dust was positively related to subjective nasal obstruction and smaller nasal cavity dimensions measured with acoustic rhinometry. The noses were less patent, and the levels of ECP or lysozyme in the lavage were increased for the subjects in schools with a lower frequency of floor mopping, a lower frequency of desk cleaning, and where wet mopping was used.
  
  
  CONCLUSIONS
  Our results indicate that the actual dust levels in Swedish classrooms can affect the occurrence of nasal obstruction among school personnel. A beneficial effect on the clinical signs of the nasal mucosa was observed for a higher frequency of both floor mopping and desk cleaning, whereas the use of wet mopping seemed disadvantageous in comparison with dry mopping. These findings illustrate the need for adequate cleaning procedures to minimize the environmental effects on the airway mucosa.
authors.affiliation: Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University Hospital, Sweden. robert.walinder@occmed.uu.se
authors.forename: R
authors.initials: R
authors.lastname: Wålinder
authors.forename: D
authors.initials: D
authors.lastname: Norbäck
authors.forename: G
authors.initials: G
authors.lastname: Wieslander
authors.forename: G
authors.initials: G
authors.lastname: Smedje
authors.forename: C
authors.initials: C
authors.lastname: Erwall
authors.forename: P
authors.initials: P
authors.lastname: Venge
mesh_terms: D016902:Air Pollution, Indoor / Q000009:adverse effects / Q000032:analysis*; D015415:Biomarkers; D002648:Child; D003430:Cross-Sectional Studies; D004391:Dust / Q000009:adverse effects / Q000032:analysis*; D004784:Environmental Monitoring / Q000379:methods*; D006796:Household Work / Q000379:methods*; D006801:Humans; D017817:Nasal Lavage Fluid / Q000737:chemistry*; D015508:Nasal Obstruction / Q000175:diagnosis* / Q000209:etiology*; D009299:Nasal Provocation Tests / Q000379:methods*; D020380:Needs Assessment; D016273:Occupational Exposure / Q000032:analysis*; D012044:Regression Analysis; D012220:Rhinitis / Q000175:diagnosis* / Q000209:etiology*; D012307:Risk Factors; D012574:Schools; D013548:Sweden
chemical_list: D015415:Biomarkers; D004391:Dust