Mixed Lung Disease in School Teachers: An Outbreak PDF

The authors describe an outbreak of mixed pulmonary disease in a school with chronic moisture incursion. The field work included a walk-through, bioaerosol sampling; questionnaire survey; and lung function testing before and after work. Antibodies were measured to microorganisms grown in the school among teachers. Two cases of sarcoidosis were identified in the staff (p<.001 by binomial test compared with expected rates). Two thirds of teachers described symptoms consistent with asthma. Teachers with school-related symptoms had greater decrements in forced vital capacity at work than those without (p<0.02). Bioaerosol samples showed the presence of moisture signature fungi but were not, on average, strikingly different from outdoor samples. Differences in antibody titers were not significantly different between symptomatic and asymptomatic teachers. Partial intervention on moisture sources failed to resolve objective evidence for school-related lung disease, as one year later symptomatic teachers still had statistically significantly greater decrements in spirometric indices than did asymptomatic teachers (p<0.05). Teachers with school-related symptoms showed decrements in spirometry as compared with asymptomatic participants. These differences appeared unrelated to measured antibodies against organisms present in the school. Schools and other buildings with chronic moisture damage may contribute to the lung disease burden in the U.S.

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