Agenda

1
Agenda

• Introductions Mary Lou Fleissner, Dr.PH.
• NIOSH Update Terri Pearce, Ph.D.
• UConn Update Eileen Storey, M.D.
• Questions and Answers

2
August 2004 Survey25 Sigourney Street

• Terri A. Pearce, Ph.D. Project Officer
• National Institute for Occupational Safety and
  HealthDivision of Respiratory Disease Studies
• Field Studies Branch
• Morgantown, West Virginia

3
Questions about 25 Sigourney Street

• Has health improved?
• Has the environment improved?
• What happens next?

4
Overall Summary

• There is evidence of improvement in symptoms
  reported in the 12 months prior to the 2004
  survey
• Some occupants of 25 Sigourney Street continue to
  have ongoing respiratory illness
• Previous water damage is likely to have
  contributed to the health complaints
• Ongoing health surveys are required to assess the
  effectiveness of dampness remediation

5
NIOSH Investigation

• Union health hazard evaluation request in
  response to employee reports of
  physician-diagnosed diseases and symptoms
• Became a joint request when management learned of
  the concerns

6
NIOSH 2001 and 2002 Surveys

• September 2001 - Health questionnaire survey
  offered to everyone in the building
• April 2002 Environmental sampling
• June 2002 Offered medical testing to some
  employees

7
2001 and 2002 Findings

• Two to three times the expected number of
  employees with asthma or wheezing
• Persons reporting symptoms or respiratory
  diagnoses frequently had abnormal lung test
  results or asthma medication use
• Mold and endotoxin levels in dust were associated
  with respiratory and skin symptoms

8
Building Repairs

• Exterior repairs to correct balcony drainage,
  brick failure, window leaks, roof replaced
• Interior replacement of water and mold damaged
  sheetrock
• Interior repairs to bathroom core
• Replacement of carpeting on some floors
• Vacuuming of carpets, chairs, and partitions

9
Has the health improved?
10
2004 Post-Repair Survey

• 7-8 months after roof repair
• 3-4 months after post-repair cleaning
• Health Assessment Questionnaires and medical
  testing
• Building Assessment Dust sampling and real-time
  monitoring

11
Participation

• 888 people in 2001 and 771 in 2004
• About 70 for both surveys

2001
2004
12
New Diagnoses from January 2003 to August 2004

• In employees hired 2003-2004
• 1 asthma diagnosis
• In employees hired before 2003
• 6 asthma diagnoses
• 1 hypersensitivity pneumonitis diagnosis
• 1 sarcoidosis diagnosis
• also diagnosed with asthma

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Respiratory Illness - 2004
Condition DRS () DSS ()
Current asthma 13.7 15.5
Hypersensitivity pneumonitis 2.1 0.3
Sarcoidosis 0.4 1.4
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One or more symptoms in the last 12 months - 2004
15
One or more symptoms each week for the last 4
weeks - 2004
16
Non-Respiratory Symptoms - 2004In Last 12 months
and 4 Weeks
17
Summary of 2004 questionnaire survey

• DRS and DSS similar for physician diagnoses and
  respiratory symptoms
• About half of participants reported lower and
  non-respiratory symptoms and 30 reported skin
  symptoms
• More upper than lower respiratory symptoms

18
Has the percent of symptomatic employees changed
between the 2001 and 2004 surveys?

• We compared the results for the 481 employees who
  participated in both surveys

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Asthma-like symptoms in the last 12 months, but
not in the last 4 weeks
2001 Percent 2004 Percent
Wheeze 26 18
Shortness of breath (SOB) 18 13
Chest tightness 20 14
Cough attack 30 15
Awakened by breathing difficulty 10 6
20
Asthma-like symptoms weekly in the last 4 weeks
2001 Percent 2004 Percent
Wheeze 12 17
Shortness of breath (SOB) 15 15
Chest tightness 18 16
Cough attack 22 22
Awakened by breathing difficulty 7 7
21
Have you had symptoms that you think may be
related to the building? Comparison between
2001 and 2004 surveys
22
Summary of comparison2001/2002 to 2004

• There were decreases in the percent of employees
  reporting symptoms in the last 12 months but not
  occurring in the last 4 weeks
• There were no decreases in the percent of
  employees reporting symptoms occurring weekly in
  the last 4 weeks
• Decrease for DRS when asked
• Have you had symptoms that you think may be
  related to the building?

23
Did medical testing results change?

• Lung function test results show similar
  relationships with symptom status in 2002 and
  2004
• Positive allergy skin tests have decreased for
  all symptom groups
• Persons with post-occupancy asthma continue to
  have fewer positive skin allergy tests than
  persons with pre-occupancy asthma

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Abnormal Lung Function Tests 2002 and 2004
Subgroup June 2002 August 2004
Respiratory Case Group 39 (44/114) 36 (26/72)
Fewer Symptoms Group 29 (16/55) 16 (8/50)
Comparison Group 11 (4/37) 18 (5/28)
The participants in the 2002 and 2004 surveys were not all the same people
25
Has the environment improved?
26
Median Dust Levels
27
Median Fungi Levels
28
Median Cat Allergen Levels
29
Have the dust levels changed?

• Amounts of dust in the carpet are somewhat higher
  than measured in 2002
• Amounts of culturable fungi and endotoxin in
  floor dust are also slightly higher than in 2002
• Amounts of cat and dog allergen are lower than in
  2002

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Real-time Monitoring

• Temperature and relative humidity were within the
  recommended ranges
• Some carbon dioxide measurements on 15th floor
  were above the recommended level
• Water activity of some carpets could support
  microbial growth

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Have we answered the questions?

• There were decreases in the percent of employees
  reporting symptoms in the last 12 months but not
  occurring in the last 4 weeks
• There were no decreases in the percent of
  employees reporting symptoms occurring weekly in
  the last 4 weeks
• Dust levels were similar with fungi and endotoxin
  levels being somewhat higher in carpets with cat
  and dog allergen being somewhat lower

32
What happens next?
33
Next Steps

• August health and environmental surveys
• Follow-up for new employees
• Building systems evaluation

34
Overall Summary

• There is evidence of improvement in symptoms
  reported in the 12 months prior to the 2004
  survey
• Some occupants of 25 Sigourney Street continue to
  have ongoing respiratory illness
• Previous water damage is likely to have
  contributed to the health complaints
• Ongoing health surveys are required to assess the
  effectiveness of dampness remediation

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NIOSH - Morgantown

• 1-800-232-2114
• Terri Pearce, Ph.D. Project Officer