title: A longitudinal study of sick building syndrome among pupils in relation to microbial components in dust in schools in China.
abstract: There are few longitudinal studies on sick building syndrome (SBS), which include ocular, nasal, throat, and dermal symptoms, headache, and fatigue. We studied the associations between selected microbial components, fungal DNA, furry pet allergens, and incidence and remission of SBS symptoms in schools in Taiyuan, China. The study was based on a two-year prospective analysis in pupils (N=1143) in a random sample of schools in China. Settled dust in the classrooms was collected by vacuum cleaning and analyzed for lipopolysaccharide (LPS), muramic acid (MuA), and ergosterol (Erg). Airborne dust was collected in Petri dishes and analyzed for cat and dog allergens and fungal DNA. The relationship between the concentration of allergens and microbial compounds and new onset of SBS was analyzed by multi-level logistic regression. The prevalence of mucosal and general symptoms was 33% and 28%, respectively, at baseline, and increased during follow-up. At baseline, 27% reported at least one symptom that improved when away from school (school-related symptoms). New onset of mucosal symptoms was negatively associated with concentration of MuA, total LPS, and shorter lengths of 3-hydroxy fatty acids from LPS, C14, C16, and C18. Onset of general symptoms was negatively associated with C18 LPS. Onset of school-related symptoms was negatively associated with C16 LPS, but positively associated with total fungal DNA. In general, bacterial compounds (LPS and MuA) seem to protect against the development of mucosal and general symptoms, but fungal exposure measured as fungal DNA could increase the incidence of school-related symptoms.
authors.affiliation: Research Center for Environmental Science and Engineering, Shanxi University, 030006 Taiyuan, China. xinzhang0051@sxu.edu.cn
authors.forename: Xin
authors.initials: X
authors.lastname: Zhang
authors.forename: Zhuohui
authors.initials: Z
authors.lastname: Zhao
authors.forename: Tobias
authors.initials: T
authors.lastname: Nordquist
authors.forename: Lennart
authors.initials: L
authors.lastname: Larsson
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Sebastian
authors.forename: Dan
authors.initials: D
authors.lastname: Norback
mesh_terms: D000293:Adolescent; D000485:Allergens / Q000009:adverse effects / Q000032:analysis; D001249:Asthma / Q000453:epidemiology* / Q000276:immunology; D002648:Child; D002681:China / Q000453:epidemiology; D004271:DNA, Fungal / Q000032:analysis; D004391:Dust / Q000032:analysis; D004781:Environmental Exposure / Q000009:adverse effects*; D004875:Ergosterol / Q000009:adverse effects / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D015994:Incidence; D008070:Lipopolysaccharides / Q000009:adverse effects / Q000032:analysis / Q000737:chemistry; D008137:Longitudinal Studies; D008297:Male; D009112:Muramic Acids / Q000009:adverse effects / Q000032:analysis; D015995:Prevalence; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000276:immunology; D012574:Schools; D018877:Sick Building Syndrome / Q000453:epidemiology* / Q000276:immunology
chemical_list: D000485:Allergens; D004271:DNA, Fungal; D004391:Dust; D008070:Lipopolysaccharides; D009112:Muramic Acids; D004875:Ergosterol