title: Upper respiratory symptoms associated with aging of the ventilation system in artificially ventilated offices in São Paulo, Brazil.
abstract: BACKGROUND
  The increase of work-related respiratory complaints in artificially ventilated buildings has multiple causes, and the role of allergen exposure and symptoms is still controversial.
  
  
  OBJECTIVE
  To analyze the risk factors and the association of work-related symptoms with allergen exposure and different conditions of the same air conditioning system in São Paulo, Brazil.
  
  
  METHODS
  Workers were classified according to characteristics of the air conditioning system: the first group (group 1) with ventilation machinery and ducts with > 20 years of use, the second group (group 2) with ventilation machinery with > 20 years of use and ventilation ducts with < 2 years of use, and the third group (group 3) with ventilation machinery and ducts with < 2 years of use. Logistic regression was performed to check the associations between air conditioning groups, allergen exposure (fungi, mites, animal dander, and cockroach), and symptoms.
  
  
  RESULTS
  There was a higher prevalence of building-related worsening of respiratory symptoms (p = 0.004; odds ratio [OR], 8.53) and symptoms of rhinoconjunctivitis (p = 0.01; OR, 8.49) in group 1. There was a lower relative humidity (p = 0.05) and nonsignificant lower temperature in group 1, when compared to the other groups. The viable mold spores totals were higher outdoors than in the indoor samples (n = 45, p = 0.017). There were higher levels of Der p 1 in group 2 (p = 0.032). All allergen levels were considered low.
  
  
  CONCLUSIONS
  There was a strong association of building-related upper-airway symptoms with places having ventilation systems with > 20 years of use.
authors.affiliation: Division of Allergy and Clinical Immunology, Internal Medicine Department, School of Medicine, University of São Paulo, Brazil. gustavog@usp.br
authors.forename: Gustavo S
authors.initials: GS
authors.lastname: Graudenz
authors.forename: Jorge
authors.initials: J
authors.lastname: Kalil
authors.forename: Paulo H
authors.initials: PH
authors.lastname: Saldiva
authors.forename: Walderez
authors.initials: W
authors.lastname: Gambale
authors.forename: Maria do Rosário D O
authors.initials: Mdo R
authors.lastname: Latorre
authors.forename: Fabio F
authors.initials: FF
authors.lastname: Morato-Castro
mesh_terms: D000367:Age Factors; D000389:Air Conditioning / Q000009:adverse effects; D000485:Allergens; D001938:Brazil; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D006813:Humidity; D016015:Logistic Models; D008297:Male; D012140:Respiratory Tract Diseases / Q000209:etiology*; D012307:Risk Factors; D013696:Temperature
chemical_list: D000485:Allergens