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Article ; Online: Observation-based metrics for residential dampness and mold with dose-response relationships to health: A review.

Mendell, M J / Kumagai, K

2017 Volume 27, Issue 3, Page(s) 506–517

Abstract: An important proportion of respiratory illness is considered attributable to residential dampness or mold (D/M). Developing health-protective D/M guidelines has been challenging, in part because unhealthy levels of indoor D/M cannot be defined using ... ...

Abstract	An important proportion of respiratory illness is considered attributable to residential dampness or mold (D/M). Developing health-protective D/M guidelines has been challenging, in part because unhealthy levels of indoor D/M cannot be defined using available microbiological measurements. This review paper explores reported multilevel, observation-based (eg visual or olfactory) D/M metrics for potential in defining unhealthy levels of residential D/M. For many of the 33 multilevel residential D/M metrics identified, health risks generally increased as observed D/M increased. Although some metrics seemed too complex for practical use, simple metrics had among the strongest associations with health outcomes. Available findings suggest the feasibility of setting observation-based D/M thresholds to trigger remedial action, using further improved D/M metrics without microbiological measurements (at least until the actual dampness-related agents that cause illness are better quantified). Additional data would allow setting health-protective D/M thresholds more precisely. Also, metrics could better reflect hidden D/M by more strongly emphasizing mold odor, which has demonstrated strong associations with health effects.
Language	English
Publishing date	2017-05
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1081722-0
ISSN	1600-0668 ; 0905-6947
ISSN (online)	1600-0668
ISSN	0905-6947
DOI	10.1111/ina.12342
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Article ; Online: Measured moisture in buildings and adverse health effects: A review.

Mendell, M J / Macher, J M / Kumagai, K

Indoor air

2018 Volume 28, Issue 4, Page(s) 488–499

Abstract: It has not yet been possible to quantify dose-related health risks attributable to indoor dampness or mold (D/M), to support setting specific health-related limits for D/M. An overlooked target for assessing D/M is moisture in building materials, the ... ...

Abstract	It has not yet been possible to quantify dose-related health risks attributable to indoor dampness or mold (D/M), to support setting specific health-related limits for D/M. An overlooked target for assessing D/M is moisture in building materials, the critical factor allowing microbial growth. A search for studies of quantified building moisture and occupant health effects identified 3 eligible studies. Two studies assessed associations between measured wall moisture content and respiratory health in the UK. Both reported dose-related increases in asthma exacerbation with higher measured moisture, with 1 study reporting an adjusted odds ratio of 7.0 for night-time asthma symptoms with higher bedroom moisture. The third study assessed relationships between infrared camera-determined wall moisture and atopic dermatitis in South Korea, reporting an adjusted odds ratio of 14.5 for water-damaged homes and moderate or severe atopic dermatitis. Measuring building moisture has, despite extremely limited available findings, potential promise for detecting unhealthy D/M in homes and merits more research attention. Further research to validate these findings should include measured "water activity," which directly assesses moisture availability for microbial growth. Ultimately, evidence-based, health-related thresholds for building moisture, across specific materials and measurement devices, could better guide assessment and remediation of D/M in buildings.
MeSH term(s)	Air Microbiology ; Air Pollution, Indoor/adverse effects ; Air Pollution, Indoor/analysis ; Asthma/etiology ; Asthma/microbiology ; Construction Materials/adverse effects ; Construction Materials/analysis ; Disease Progression ; Fungi/isolation & purification ; Humans ; Humidity/adverse effects ; Respiratory Tract Diseases/etiology ; Respiratory Tract Diseases/microbiology
Language	English
Publishing date	2018-05-18
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	1081722-0
ISSN	1600-0668 ; 0905-6947
ISSN (online)	1600-0668
ISSN	0905-6947
DOI	10.1111/ina.12464
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Article: Indoor residential chemical emissions as risk factors for respiratory and allergic effects in children: a review.

Mendell, M J

Indoor air

2007 Volume 17, Issue 4, Page(s) 259–277

Abstract: Unlabelled: Most research into effects of residential exposures on respiratory health has focused on allergens, moisture/mold, endotoxin, or combustion products. A growing body of research from outside the US; however, has associated chemical emissions ... ...

Abstract	Unlabelled: Most research into effects of residential exposures on respiratory health has focused on allergens, moisture/mold, endotoxin, or combustion products. A growing body of research from outside the US; however, has associated chemical emissions from common indoor materials with risk of asthma, allergies, and pulmonary infections. This review summarizes 21 studies in the epidemiologic literature on associations between indoor residential chemical emissions, or emission-related materials or activities, and respiratory health or allergy in infants or children. Associations, some strong, were reported between many risk factors and respiratory or allergic effects. Risk factors identified most frequently included formaldehyde or particleboard, phthalates or plastic materials, and recent painting. Findings for other risk factors, such as aromatic and aliphatic chemical compounds, were limited but suggestive. Elevated risks were also reported for renovation and cleaning activities, new furniture, and carpets or textile wallpaper. Reviewed studies were entirely observational, limited in size, and variable in quality, and specific risk factors identified may only be indicators for correlated, truly causal exposures. Nevertheless, overall evidence suggests a new class of residential risk factors for adverse respiratory effects, ubiquitous in modern residences, and distinct from those currently recognized. It is important to confirm and quantify any risks, to motivate and guide necessary preventive actions. Practical implications: Composite wood materials that emit formaldehyde, flexible plastics that emit plasticizers, and new paint have all been associated with increased risks of respiratory and allergic health effects in children. Although causal links have not been documented, and other correlated indoor-related exposures may ultimately be implicated, these findings nevertheless point to a new class of little recognized indoor risk factors for allergic and respiratory disease, distinct from the current set of indoor risk factors. The available evidence thus raises initial questions about many common residential practices: for instance, using pressed wood furnishings in children's bedrooms, repainting infant nurseries, and encasing mattresses and pillows with vinyl for asthmatic children. The findings summarized here suggest a need for substantially increased research to replicate these findings, identify causal factors, and validate preventive strategies.
MeSH term(s)	Air Pollution, Indoor/adverse effects ; Biocompatible Materials/toxicity ; Child ; Child, Preschool ; Environmental Exposure ; Formaldehyde/toxicity ; Housing ; Humans ; Infant ; Infant, Newborn ; Paint/toxicity ; Phthalic Acids/toxicity ; Plasticizers/toxicity ; Respiratory Hypersensitivity/etiology ; Respiratory Hypersensitivity/immunology ; Respiratory Hypersensitivity/pathology ; Respiratory Tract Infections/etiology ; Respiratory Tract Infections/immunology ; Respiratory Tract Infections/pathology ; Risk Assessment ; Risk Factors
Chemical Substances	Biocompatible Materials ; Phthalic Acids ; Plasticizers ; Formaldehyde (1HG84L3525) ; phthalic acid (6O7F7IX66E)
Language	English
Publishing date	2007-08
Publishing country	England
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S. ; Review
ZDB-ID	1081722-0
ISSN	1600-0668 ; 0905-6947
ISSN (online)	1600-0668
ISSN	0905-6947
DOI	10.1111/j.1600-0668.2007.00478.x
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Article ; Online: Building and environmental factors that influence bacterial and fungal loading on air conditioning cooling coils.

Bakker, A / Siegel, J A / Mendell, M J / Peccia, J

Indoor air

2018

Abstract: We investigated bacterial and fungal concentrations on cooling coils of commercial AC units and quantified associations between microbial loads and AC unit or building operational parameters. A field campaign was conducted to sample 25 AC units in the ... ...

Abstract	We investigated bacterial and fungal concentrations on cooling coils of commercial AC units and quantified associations between microbial loads and AC unit or building operational parameters. A field campaign was conducted to sample 25 AC units in the humid, subtropical climate of Southern CT, USA and 15 AC units in the hot-summer Mediterranean climate of Sacramento, CA, USA. Median concentrations (with interquartile range) of bacteria and fungi on the cooling coils were 1.2 × 10
Language	English
Publishing date	2018-05-30
Publishing country	England
Document type	Journal Article
ZDB-ID	1081722-0
ISSN	1600-0668 ; 0905-6947
ISSN (online)	1600-0668
ISSN	0905-6947
DOI	10.1111/ina.12474
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Article ; Online: Development of a method to relate the moisture content of a building material to its water activity.

Macher, J M / Mendell, M J / Chen, W / Kumagai, K

Indoor air

2017 Volume 27, Issue 3, Page(s) 599–608

Abstract: Subjective indicators of building dampness consistently have been linked to health, but they are, at best, semi-quantitative, and objective and quantitative assessments of dampness are also needed to study dampness-related health effects. Investigators ... ...

Abstract	Subjective indicators of building dampness consistently have been linked to health, but they are, at best, semi-quantitative, and objective and quantitative assessments of dampness are also needed to study dampness-related health effects. Investigators can readily and non-destructively measure the "moisture content" (MC) of building materials with hand-held moisture meters. However, MC does not indicate the amount of the water in a material that is available to microorganisms for growth, that is, the "water activity" (A
Language	English
Publishing date	2017-05
Publishing country	England
Document type	Journal Article
ZDB-ID	1081722-0
ISSN	1600-0668 ; 0905-6947
ISSN (online)	1600-0668
ISSN	0905-6947
DOI	10.1111/ina.12346
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Do classroom ventilation rates in California elementary schools influence standardized test scores? Results from a prospective study.

Mendell, M J / Eliseeva, E A / Davies, M M / Lobscheid, A

Indoor air

2016 Volume 26, Issue 4, Page(s) 546–557

Abstract: Limited evidence has associated lower ventilation rates (VRs) in schools with reduced student learning or achievement. We analyzed longitudinal data collected over two school years from 150 classrooms in 28 schools within three California school ... ...

Abstract	Limited evidence has associated lower ventilation rates (VRs) in schools with reduced student learning or achievement. We analyzed longitudinal data collected over two school years from 150 classrooms in 28 schools within three California school districts. We estimated daily classroom VRs from real-time indoor carbon dioxide measured by web-connected sensors. School districts provided individual-level scores on standard tests in Math and English, and classroom-level demographic data. Analyses assessing learning effects used two VR metrics: average VRs for 30 days prior to tests, and proportion of prior daily VRs above specified thresholds during the year. We estimated relationships between scores and VR metrics in multivariate models with generalized estimating equations. All school districts had median school-year VRs below the California VR standard. Most models showed some positive associations of VRs with test scores; however, estimates varied in magnitude and few 95% confidence intervals excluded the null. Combined-district models estimated statistically significant increases of 0.6 points (P = 0.01) on English tests for each 10% increase in prior 30-day VRs. Estimated increases in Math were of similar magnitude but not statistically significant. Findings suggest potential small positive associations between classroom VRs and learning.
Language	English
Publishing date	2016-08
Publishing country	England
Document type	Journal Article
ZDB-ID	1081722-0
ISSN	1600-0668 ; 0905-6947
ISSN (online)	1600-0668
ISSN	0905-6947
DOI	10.1111/ina.12241
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Article ; Online: Indoor thermal factors and symptoms in office workers: findings from the US EPA BASE study.

Mendell, M J / Mirer, A G

Indoor air

2009 Volume 19, Issue 4, Page(s) 291–302

Abstract: Unlabelled: Some prior research in office buildings has associated higher indoor temperatures even within the recommended thermal comfort range with increased worker symptoms. We reexamined this relationship in data from 95 office buildings in the US ... ...

Abstract	Unlabelled: Some prior research in office buildings has associated higher indoor temperatures even within the recommended thermal comfort range with increased worker symptoms. We reexamined this relationship in data from 95 office buildings in the US Environmental Protection Agency's Building Assessment Survey and Evaluation Study. We investigated relationships between building-related symptoms and thermal metrics constructed from real-time measurements. We estimated odds ratios and 95% confidence intervals in adjusted logistic regression models with general estimating equations, overall and by season. Winter indoor temperatures spanned the recommended winter comfort range; summer temperatures were mostly colder than the recommended summer range. Increasing indoor temperatures, overall, were associated with increases in few symptoms. Higher winter indoor temperatures, however, were associated with increases in all symptoms analyzed. Higher summer temperatures, above 23 degrees C, were associated with decreases in most symptoms. Humidity ratio, a metric of absolute humidity, showed few clear associations. Thus, increased symptoms with higher temperatures within the thermal comfort range were found only in winter. In summer, buildings were overcooled, and only the higher observed temperatures were within the comfort range; these were associated with decreased symptoms. Confirmation of these findings would suggest that thermal management guidelines consider health effects as well as comfort, and that less conditioning of buildings in both winter and summer may have unexpected health benefits. Practical implications: In winter, higher temperatures within the thermal comfort range are common in US office buildings and may be associated with increased symptoms. In summer, temperatures below the thermal comfort range are common and may be associated with increased symptoms. Results from this large study thus suggest that in US office buildings, less winter heating (in buildings that are in heating mode) and less summer cooling may reduce acute symptoms while providing substantial energy conservation benefits, with no expected thermal comfort penalty and, in summer, even thermal comfort benefits. If confirmed, this would be welcome news.
MeSH term(s)	Commerce ; Data Collection ; Humans ; Multivariate Analysis ; Odds Ratio ; Respiratory Insufficiency/epidemiology ; Respiratory Insufficiency/physiopathology ; Risk Management ; Sick Building Syndrome/epidemiology ; Sick Building Syndrome/physiopathology ; Temperature ; United States ; United States Environmental Protection Agency
Language	English
Publishing date	2009-08
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1081722-0
ISSN	1600-0668 ; 0905-6947
ISSN (online)	1600-0668
ISSN	0905-6947
DOI	10.1111/j.1600-0668.2009.00592.x
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Article ; Online: Is health in office buildings related only to psychosocial factors?

Mendell, M J / Fisk, W J

Occupational and environmental medicine

2007 Volume 64, Issue 1, Page(s) 69–70; author reply 69–70

MeSH term(s)	Environment Design ; Humans ; Occupational Diseases/etiology ; Occupational Diseases/psychology ; Occupational Exposure/adverse effects ; Research Design ; Risk Factors ; Sick Building Syndrome/etiology ; Sick Building Syndrome/psychology
Language	English
Publishing date	2007-01
Publishing country	England
Document type	Comment ; Letter
ZDB-ID	1180733-7
ISSN	1470-7926 ; 1351-0711
ISSN (online)	1470-7926
ISSN	1351-0711
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Article: Do indoor pollutants and thermal conditions in schools influence student performance? A critical review of the literature.

Mendell, M J / Heath, G A

Indoor air

2005 Volume 15, Issue 1, Page(s) 27–52

Abstract: Unlabelled: To assess whether school environments can adversely affect academic performance, we review scientific evidence relating indoor pollutants and thermal conditions, in schools or other indoor environments, to human performance or attendance. We ...

Abstract	Unlabelled: To assess whether school environments can adversely affect academic performance, we review scientific evidence relating indoor pollutants and thermal conditions, in schools or other indoor environments, to human performance or attendance. We critically review evidence for direct associations between these aspects of indoor environmental quality (IEQ) and performance or attendance. Secondarily, we summarize, without critique, evidence on indirect connections potentially linking IEQ to performance or attendance. Regarding direct associations, little strongly designed research was available. Persuasive evidence links higher indoor concentrations of NO(2) to reduced school attendance, and suggestive evidence links low ventilation rates to reduced performance. Regarding indirect associations, many studies link indoor dampness and microbiologic pollutants (primarily in homes) to asthma exacerbations and respiratory infections, which in turn have been related to reduced performance and attendance. Also, much evidence links poor IEQ (e.g. low ventilation rate, excess moisture, or formaldehyde) with adverse health effects in children and adults and documents dampness problems and inadequate ventilation as common in schools. Overall, evidence suggests that poor IEQ in schools is common and adversely influences the performance and attendance of students, primarily through health effects from indoor pollutants. Evidence is available to justify (i) immediate actions to assess and improve IEQ in schools and (ii) focused research to guide IEQ improvements in schools. Practical implications: There is more justification now for improving IEQ in schools to reduce health risks to students than to reduce performance or attendance risks. However, as IEQ-performance links are likely to operate largely through effects of IEQ on health, IEQ improvements that benefit the health of students are likely to have performance and attendance benefits as well. Immediate actions are warranted in schools to prevent dampness problems, inadequate ventilation, and excess indoor exposures to substances such as NO(2) and formaldehyde. Also, siting of new schools in areas with lower outdoor pollutant levels is preferable.
MeSH term(s)	Absenteeism ; Air Pollution, Indoor/adverse effects ; Asthma/complications ; Asthma/etiology ; Child ; Educational Status ; Fixatives/adverse effects ; Formaldehyde/adverse effects ; Health Status ; Humans ; Schools ; Students ; Temperature ; Ventilation
Chemical Substances	Fixatives ; Formaldehyde (1HG84L3525)
Language	English
Publishing date	2005-02
Publishing country	England
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S. ; Review
ZDB-ID	1081722-0
ISSN	1600-0668 ; 0905-6947
ISSN (online)	1600-0668
ISSN	0905-6947
DOI	10.1111/j.1600-0668.2004.00320.x
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Article ; Online: Quantitative relationship of sick building syndrome symptoms with ventilation rates.

Fisk, W J / Mirer, A G / Mendell, M J

Indoor air

2009 Volume 19, Issue 2, Page(s) 159–165

Abstract: Unlabelled: Data from published studies were combined and analyzed to develop best-fit equations and curves quantifying the change in sick building syndrome (SBS) symptom prevalence in office workers with ventilation rate. For each study, slopes were ... ...

Abstract	Unlabelled: Data from published studies were combined and analyzed to develop best-fit equations and curves quantifying the change in sick building syndrome (SBS) symptom prevalence in office workers with ventilation rate. For each study, slopes were calculated, representing the fractional change in SBS symptom prevalence per unit change in ventilation rate per person. Values of ventilation rate, associated with each value of slope, were also calculated. Linear regression equations were fitted to the resulting data points, after weighting by study size. Integration of the slope-ventilation rate equations yielded curves of relative SBS symptom prevalence vs. ventilation rate. Based on these analyses, as the ventilation rate drops from 10 to 5 l/s-person, relative SBS symptom prevalence increases approximately 23% (12% to 32%), and as ventilation rate increases from 10 to 25 l/s-person, relative prevalence decreases approximately 29% (15% to 42%). Variations in SBS symptom types, building features, and outdoor air quality may cause the relationship of SBS symptom prevalence with ventilation rate in specific situations to differ from the average relationship predicted in this paper. Practical implications: On average, providing more outdoor air ventilation will reduce prevalence rates of sick building syndrome (SBS) symptoms. However, given the costs of energy use, including increased risks of climate change, it is important to balance the benefits and risks of increased ventilation. This paper provides initial estimates of how the incremental health benefits per unit of increased ventilation diminish at higher levels of ventilation.
MeSH term(s)	Air Pollutants, Occupational/analysis ; Air Pollution, Indoor/adverse effects ; Air Pollution, Indoor/analysis ; Humans ; Linear Models ; Models, Theoretical ; Prevalence ; Sick Building Syndrome/epidemiology ; Ventilation/methods
Chemical Substances	Air Pollutants, Occupational
Language	English
Publishing date	2009-04
Publishing country	England
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	1081722-0
ISSN	1600-0668 ; 0905-6947
ISSN (online)	1600-0668
ISSN	0905-6947
DOI	10.1111/j.1600-0668.2008.00575.x
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