title: Asthma symptoms in relation to measured building dampness in upper concrete floor construction, and 2-ethyl-1-hexanol in indoor air.
abstract: METHODS
  Asthma symptoms in adults in relation to the indoor environment.
  
  
  OBJECTIVE
  To study the relationships between current asthma symptoms (wheeze or attacks of breathlessness) and the indoor environment and dampness in hospitals.
  
  
  METHODS
  A study among personnel (n = 87) in four geriatric hospitals in winter. Indoor air pollutants, dampness in the concrete floor, and allergens in settled dust were measured. Multiple logistic regression analysis was applied, adjusting for age, sex, atopy, and dampness in the participants' own dwellings.
  
  
  RESULTS
  Current asthma symptoms were reported by 17%, and 8% had doctor's diagnosed asthma. Asthma symptoms were more common (adjusted odds ratio = 8.6; 95% confidence interval 1.3-56.7) in two buildings with signs of dampness-related degradation of di(ethylhexyl)-phthalate (DEHP) in polyvinyl chloride (PVC) floor material, detected as presence of 2-ethyl-1-hexanol (2-32 microg/m3) in indoor air (CAS nr 104-76-7). Asthma symptoms were related to higher relative humidity in the upper concrete floor construction, and ammonia in the floor. The newest hospital, built by an anthroposophic society, had low levels of dampness and few asthma symptoms (4%). Cat (Fel d1) and dog allergens (Can f1) were found in dust from all buildings (geometric mean 340 ng/g and 2490 ng/g, respectively). House dust mite allergens (Derp1, Derf1, or Derm1) were found in 75% of all samples (geometric mean 130 ng/g). There was no relationship between allergen levels and asthma symptoms.
  
  
  CONCLUSIONS
  Asthma symptoms may be related to increased humidity in concrete floor constructions and emission of 2-ethyl-1-hexanol, an indicator of dampness-related alkaline degradation of plasticiser DEHP. Moreover, geriatric hospitals can be contaminated by significant amounts of cat, dog and mite allergens.
authors.affiliation: Department of Medical Sciences/Occupational and Environmental Medicine, University Hospital, Uppsala University, Sweden. dan.norback@medsci.uu.se
authors.forename: D
authors.initials: D
authors.lastname: Norbäck
authors.forename: G
authors.initials: G
authors.lastname: Wieslander
authors.forename: K
authors.initials: K
authors.lastname: Nordström
authors.forename: R
authors.initials: R
authors.lastname: Wålinder
mesh_terms: D016902:Air Pollution, Indoor / Q000009:adverse effects*; D000485:Allergens; D001249:Asthma / Q000453:epidemiology / Q000209:etiology*; D003252:Construction Materials; D004051:Diethylhexyl Phthalate / Q000009:adverse effects*; D005260:Female; D000441:Hexanols / Q000009:adverse effects*; D006749:Hospital Design and Construction; D006761:Hospitals; D006801:Humans; D006813:Humidity / Q000009:adverse effects*; D016015:Logistic Models; D008297:Male; D010564:Personnel, Hospital; D013548:Sweden / Q000453:epidemiology
chemical_list: D000485:Allergens; D000441:Hexanols; D004051:Diethylhexyl Phthalate; C034017:2-ethylhexanol