title: Microbial exposure, symptoms and inflammatory mediators in nasal lavage fluid of kitchen and clerical personnel in schools.
abstract: OBJECTIVE
  The aim of this study was to investigate how the microbial conditions of kitchen facilities differ from those in other school facilities. The health status of the personnel was also studied.
  
  
  METHODS
  The microbial investigations were conducted in six moisture-damaged schools and two reference schools. The symptoms of the kitchen personnel were surveyed with questionnaires and inflammatory responses in nasal lavage (NAL) fluid were measured.
  
  
  RESULTS
  The total concentrations of airborne microbes were lower in kitchens than in other facilities of the schools. However, the occurrence of moisture damage increased the airborne microbial concentrations both in kitchens, and in other facilities. Bacterial concentrations were high on surfaces in the damaged kitchens. Gram-negative bacteria predominated, but also thermophilic bacteria and mycobacteria were detected. Respiratory and general symptoms were prevalent both among kitchen workers and clerical personnel in the moisture-damaged environments. Reported allergies and repeated respiratory infections were connected with high IL-4 concentrations in NAL fluid. Median concentrations of studied inflammatory mediators (NO, IL-4, IL-6 and TNF-alpha) were slightly higher in NAL samples of kitchen workers than among the clerical personnel.
  
  
  CONCLUSIONS
  Kitchen facilites differ from other facilities of the school building for their moisture conditions and microbial contamination. Thus, they represent a specific type of environment that may affect the health status of the personnel.
authors.affiliation: Department of Environmental Health, National Public Health Institute, Kuopio, Finland. ulla.lignell@ktl.fi
authors.forename: Ulla
authors.initials: U
authors.lastname: Lignell
authors.forename: Teija
authors.initials: T
authors.lastname: Meklin
authors.forename: Tuula
authors.initials: T
authors.lastname: Putus
authors.forename: Asko
authors.initials: A
authors.lastname: Vepsäläinen
authors.forename: Marjut
authors.initials: M
authors.lastname: Roponen
authors.forename: Eila
authors.initials: E
authors.lastname: Torvinen
authors.forename: Morten
authors.initials: M
authors.lastname: Reeslev
authors.forename: Sirpa
authors.initials: S
authors.lastname: Pennanen
authors.forename: Maija-Riitta
authors.initials: MR
authors.lastname: Hirvonen
authors.forename: Pentti
authors.initials: P
authors.lastname: Kalliokoski
authors.forename: Aino
authors.initials: A
authors.lastname: Nevalainen
mesh_terms: D000395:Air Pollutants, Occupational / Q000032:analysis*; D016902:Air Pollution, Indoor / Q000032:analysis*; D015169:Colony Count, Microbial; D005387:Finland / Q000453:epidemiology; D005522:Food Services; D006801:Humans; D006813:Humidity / Q000009:adverse effects; D019570:Inhalation Exposure / Q000032:analysis; D015847:Interleukin-4 / Q000032:analysis; D015850:Interleukin-6 / Q000032:analysis; D017817:Nasal Lavage Fluid / Q000382:microbiology*; D016273:Occupational Exposure / Q000032:analysis*; D016272:Occupational Health; D009817:Office Management; D012140:Respiratory Tract Diseases / Q000453:epidemiology / Q000382:microbiology*; D012574:Schools; D011795:Surveys and Questionnaires; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D000078329:Workforce; D017132:Workplace
chemical_list: D000395:Air Pollutants, Occupational; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D015847:Interleukin-4