| Summary: | 博士 === 國立臺灣大學 === 公共衛生研究所 === 86 === To evaluate dose-response relationships between work-related
airway inflammation and systemic sysmptoms and dampness
exposure, a cross-sectional study on risk factors was carried
out among 1,237 employees in 19 air-conditioning office
buildings in August and September 1995 in the subtropical Taipei
area. Completed self-reported questionnaires included their
sociodemographic, indoor environmental quality perceptions,
workspace factors, dampness exposure, and occurrence of
allergicdiseases, respiratory diseases and airway inflammation /
systemic symptoms. Dampness exposures included in data analyses
as indexes were combinations of stuffy odor, mold, water
damage and a history of flooding.The most common airway
inflammation and systemic symptoms were headache, lethargy/
fatigue and eye irritation, while the least symptom was
shortness of breath. Alsoallergic rhinitis was the most
prevalent respiratory complain among the respondents. After
controlling for age,sex, job dissatisfaction, ventilationand
atopy, the odds ratio (OR) for eyeirritation for employees was
1.34 when either stuffy odor or mold was presentin the
buildings. The OR increased to 1.72 when both stuffy odor and
mold were present, to 3.14 when sign of water damage was also
present, and to 5.03 when all four dampness exposure
characteristics were noticed in buildings. Indoor dampness is a
very common condition in office buildings in the city, the
presenceof dampness in the building has a dose-response effect
for eye irritation, cough,and lethargy/fatigue among employees.
In addition, indoor bioaerosols (bacteria, fungi, endotoxin,
and beta-1,3-glucan) weredetermined in 8 daycare centers, 8
office buildings, and 8 domesticenvironmentsin the Taipei area.
The associations between indoor dampness, bioaerosols, and
airway inflammation / systemic symptoms were furtherly performed
using a questionnairesurvey. It was demonstrated that the median
contents of indoorbacteria and fungi were the highest for
daycare centers, followed by those for homes and for office
buildings. The similar patterns were observed for endotoxin and
beta-1,3-glucan.Regarding the airway inflammation andsystemic
symptoms, the prevalence rateswere higher for females in office
building than those in daycare centers, and most symptoms were
more prevalent for females than for males. Regarding
bioaerosolexposure in relation to airway inflammation and
systemic symptoms, there was a strongassociation between
beta-1,3-glucan and lethargy/fatigue. In Taiwan, the predominant
perennial allergens are house dust mite (HDM) and fungi.
However, mite allergen levels in these subtropical homes were
always found to be higher than the threshold for sensitization
of HDM allergic responses, therefore, the amounts of mite
allergen might not be the determining factor for allergy
sensitization. Organic dusts and gaseous pollutants are regarded
as potential risk factors for allergic diseases. Furthermore, we
have shown that nonspecific innate immune responses induced by
lipopolysaccharide(LPS) and beta-1,3-D-glucan may influence the
type of antigen-specific immune effector function. In this
study, it was observed that inhaled LPS and beta-1,3-D-glucan
(Grifolan) can abrogate airway inhalation-induced IgE-
specifictolerance and enhance airwayallergen-specific IgE
responses. These results havepotential implications
forunderstanding the development of aerosolized allergen-induced
airway allergicresponses.
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