What NIOSH Did

! Conducted questionnaire surveys to assess SCAO employees' respiratory health.

! Examined employees using objective medica tests to assess respiratory health.

! Inspected the heating, ventilating, and air conditioning (HVAC) system.

! Conducted environmental sampling to assess bioaerosol exposure in the building.

What NIOSH Found

! Building-related chest symptoms: wheezing (60% of survey respondents), chest tightness (31%), shortness of breath (24%), and cough for three consecutive months (40%).

! More diversity in fungal flora indoors compared with outdoors, suggesting possible contamination of the building with mold or microbial growth.

! Inappropriate installation and maintenance of the HVAC system, and imbalance of airflow

within occupied spaces.

! Higher exposure to indices of mold, ergosterol and glucan, respectively, associated with asthma and cough in SCAO employees.

SUMMARY

The National Institute for Occupational Safety and Health (NIOSH) received a request for a health hazard evaluation from employees of the Somerset County Assistance Office (SCAO) in November 2000. The request included health complaints (sinus infections, breathing problems, bronchial infections, chronic fatigue, muscle aches, and irritation of throat, nose and eyes) and environmental concerns about water incursion and malfunction of ventilation. At the time of the request, there had been four reported cases of hypersensitivity pneumonitis (HP) and eight reported cases of doctor-diagnosed asthma among a staff of In response to the request, NIOSH investigators conducted an initial walk-through survey in March 2001. The results of sample analyses and the screening questionnaire from the initial survey suggested possible biological contamination of the building and adverse respiratory effects. A second visit was planned and conducted from July 25 through August 15, 2001, to conduct environmental sampling, a heating, ventilating, and air conditioning (HVAC) inspection, medical testing, and a more extensive questionnaire survey. In December 2001, SCAO relocated their employees to a newly constructed building. The objectives of the second visit were to assess potential fungal contamination in the building and exposure levels of occupants, to characterize respiratory symptoms among occupants, to objectively test occupants' pulmonary function, and to examine the association of symptoms and medical test results with environmental exposure. For those aims, we conducted an interviewer-administered questionnaire survey, objective medical tests (spirometry and methacholines challenge tests, carbon monoxide diffusion capacity test, and exhaled nitric oxide measurements), and environmental measurements for microbial contaminants (culturable fungi, spore counts, endotoxin, ergosterol, and (1ˇÂ3)-$-D-glucan), and evaluation of the HVAC system during the survey period.

The participation rate was 93% for the screening questionnaire and 59% for the main questionnaire. There were 62 participants in the screening questionnaire survey and 15% reported asthma, 10% HP, and 36% any chest symptoms (wheeze, chest tightness, or shortness of breath in the past 4 weeks). Workrelatedness was reported by about 61% of the symptomatic people with one or more lower-respiratory symptoms (cough, wheeze, chest tightness, shortness of breath in the past 4 weeks). There were 40 participants in the main questionnaire survey and shortness of breath was reported by 52%, chest tightness by 40%, wheezing by 38%, and coughing for three consecutive months in the past 12 months by 25%. Up to 60% of the symptomatic people with the lower respiratory sympto ms

• fungi: indoor biocontamination -- health symptom
• IAQ - indoor air quality
• IAQ: Health

1. Release of lead-containing particles from a wall enclosure