University of Oulu

Adams, RI, Leppänen, H, Karvonen, AM, et al. Microbial exposures in moisture-damaged schools and associations with respiratory symptoms in students: A multi-country environmental exposure study. Indoor Air. 2021; 31: 1952– 1966.

Microbial exposures in moisture-damaged schools and associations with respiratory symptoms in students : a multi-country environmental exposure study

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Author: Adams, Rachel I.1; Leppänen, Hanna2; Karvonen, Anne M.2;
Organizations: 1California Department of Public Health, Richmond, CA, USA
2Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Finland
3Institute for Risk Assessment Sciences (IRAS, Utrecht University, Utrecht, The Netherlands
4Barcelona Institute for Global Health (ISGlobal, Barcelona, Spain
5Escola Universitària d'Infermeria, Escoles Universitàries Gimbernat, Universitat Autònoma de Barcelona, Sant Cugat del Vallès, Spain
6Oulu University, Oulu, Finland
7Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
8Department of Public Health, Helsinki University, Helsinki, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.1 MB)
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Language: English
Published: John Wiley & Sons, 2021
Publish Date: 2021-11-11


Moisture-damaged buildings are associated with respiratory symptoms and underlying diseases among building occupants, but the causative agent(s) remain a mystery. We first identified specific fungal and bacterial taxa in classrooms with moisture damage in Finnish and Dutch primary schools. We then investigated associations of the identified moisture damage indicators with respiratory symptoms in more than 2700 students. Finally, we explored whether exposure to specific taxa within the indoor microbiota may explain the association between moisture damage and respiratory health. Schools were assessed for moisture damage through detailed inspections, and the microbial composition of settled dust in electrostatic dustfall collectors was determined using marker-gene analysis. In Finland, there were several positive associations between particular microbial indicators (diversity, richness, individual taxa) and a respiratory symptom score, while in the Netherlands, the associations tended to be mostly inverse and statistically non-significant. In Finland, abundance of the Sphingomonas bacterial genus and endotoxin levels partially explained the associations between moisture damage and symptom score. A few microbial taxa explained part of the associations with health, but overall, the observed associations between damage-associated individual taxa and respiratory health were limited.

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Series: Indoor air
ISSN: 0905-6947
ISSN-E: 1600-0668
ISSN-L: 0905-6947
Volume: 31
Issue: 6
Pages: 1952 - 1966
DOI: 10.1111/ina.12865
Type of Publication: A1 Journal article – refereed
Field of Science: 212 Civil and construction engineering
1183 Plant biology, microbiology, virology
3142 Public health care science, environmental and occupational health
Funding: This work was supported by the European Commission as part of HITEA (Health Effects of Indoor Pollutants: Integrating microbial, toxicological, and epidemiological approaches), Grant agreement no. 211488 under the Seventh Framework Programme, Topic ENV.2007. “Indoor air pollution in Europe: An emerging environmental health issue.” Additional funding was granted to the project by the Finnish Work Environment Fund (grant numbers 115424, 114139), Juho Vainion Säätiö, Yrjö Jahnssonin Säätiö, the Academy of Finland (grant numbers 252718, 339666, 296587), and the California Department of Public Health.
Copyright information: © 2021 The Authors. Indoor Air published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.