Respiratory symptoms and fractional exhaled nitric oxide (FeNO) among students in Penang, Malaysia in relation to signs of dampness at school and fungal DNA in school dust

Norbäck, Dan, Hashim, Jamal H., Hashim, Zailina, Cai, Gui-Hong, Sooria, Vinoshini, Ismail, Syazwan A. and Wieslander, Gunilla, (2016). Respiratory symptoms and fractional exhaled nitric oxide (FeNO) among students in Penang, Malaysia in relation to signs of dampness at school and fungal DNA in school dust. Science Of The Total Environment, 577 148-154

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  • Sub-type Journal article
    Author Norbäck, Dan
    Hashim, Jamal H.
    Hashim, Zailina
    Cai, Gui-Hong
    Sooria, Vinoshini
    Ismail, Syazwan A.
    Wieslander, Gunilla
    Title Respiratory symptoms and fractional exhaled nitric oxide (FeNO) among students in Penang, Malaysia in relation to signs of dampness at school and fungal DNA in school dust
    Appearing in Science Of The Total Environment
    Volume 577
    Publication Date 2016-10-29
    Place of Publication London
    Publisher Elsevier B.V.
    Start page 148
    End page 154
    Language eng
    Abstract Few health studies exist on dampness and mould in schools in the tropics. We studied associations between fraction of exhaled nitric oxide (FeNO), respiratory symptoms and airway infections among students and dampness and fungal DNA in schools in Malaysia. A total of 368 randomly selected students from 32 classrooms in 8 secondary schools in Penang, Malaysia, participated (58% participation rate). Information on current respiratory symptoms and the home environment was collected by a standardised questionnaire. FeNO was measured by NIOX MINO (50 ml/min). The classrooms were inspected and dust was collected by vacuuming on special filters and was analysed for five fungal DNA sequences by quantitative PCR. Linear mixed models and 3-level multiple logistic regression (school, classroom, student) were applied adjusting for demographic data and the home environment. Totally 10.3% reported doctor's diagnosed asthma, 15.1% current wheeze, 12.4% current asthma, 37.3% daytime breathlessness, 10.2% nocturnal breathlessness, 38.9% airway infections and 15.5% had pollen or furry pet allergy. The geometric mean of FeNO was 19.9 ppb and 45% had elevated FeNO (> 20 ppb). Boys had higher levels of FeNO. Chinese had less daytime breathlessness than Malay (OR = 0.30: p < 0.001). Indoor carbon dioxide levels were low (380–720 ppm). Dampness was observed in 18% of the classrooms and was associated with respiratory infections (OR = 3.70; 95% CI 1.14–12.1) and FeNO (p = 0.04). Aspergillus versicolor DNA was detected in 67% of the classrooms. Higher numbers of Aspergillus versicolor DNA in classroom dust were associated with wheeze (p = 0.006), current asthma (p = 0.002), respiratory infections (p = 0.005) and elevated FeNO levels (p = 0.02). In conclusion, respiratory symptoms were common among the students and the high FeNO levels indicate ongoing airway inflammation. Building dampness and the mould Aspergillus versicolor in schools in Malaysia can be risk factors for impaired respiratory health among the students.
    UNBIS Thesaurus CHILDREN
    Keyword Fungal DNA
    Building dampness
    School environment
    Asthma
    Mould
    Copyright Holder Elsevier B.V.
    Copyright Year 2016
    Copyright type All rights reserved
    DOI 10.1016/j.scitotenv.2016.10.148
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