Songklanakarin Journal of Science and Technology SJST R2 Chullasuk

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Journal: Songklanakarin Journal of Science and Technology Manuscript ID SJST-0-00.

1 Songklanakarin Journal of Science and Technology SJST-0-00.R Chullasuk The association between respirable dust exposure and allergic symptoms in the libraries and general offices at Chulalongkorn University, Bangkok, Thailand. Journal: Songklanakarin Journal of Science and Technology Manuscript ID SJST-0-00.R Manuscript Type: Original Article Date Submitted by the Author: -Dec-0 Complete List of Authors: Chullasuk, Pathai; Chulalongkorn University, College of public Health Science; Bureau of Environmental Health, Department of Health Chapman, Robert ; College of Public Health Science, Chulalongkorn University Taneepanichskul, Nutta ; College og Public Health Science, Chulalongkorn University Keyword: PM, Allergic symptoms, Librarians, general officers.

2 Songklanakarin Journal of Science and Technology SJST-0-00.R Chullasuk Page of 0 Original Article The association between respirable dust exposure and allergic symptoms in the libraries and general offices at Chulalongkorn University, Bangkok, Thailand Pathai Chullasuk,, Robert S. Chapman *, Nutta Taneepanichskul ** College of Public Health Science, Chulalongkorn University, Bangkok,, Thailand Bereau of Environmental Health, Department of Health, Nonthaburi Province, 00, Thailand *Corresponding author, address: rschap0@gmail.com ** Corresponding author, address: nutta.taneepanichskul@gmail.com ABSTRACT Background: Nowadays, people face health problems from poor indoor air quality which caused by indoor air pollutants, such as dust. Dust accumulated in several places and libraries are among those. Therefore, library officers are vulnerable to relate symptoms. Method: This study was cross-sectional survey to find the association between respirable dust, PM, exposure and allergic symptoms in librarians compared with general officers. Chi-square and logistic regression were used to identify the prevalence of variables and to analyze the association between PM exposure and allergic symptoms respectively. Result: The study demonstrated that librarians exposed to PM higher than the general officers (p <0.00) and skin rash symptoms was significantly associated with PM exposure (p = 0.0). Conclusion: The librarians had higher risk of PM exposure and associated with allergic symptom of skin rash.

3 Page of Songklanakarin Journal of Science and Technology SJST-0-00.R Chullasuk 0 Other risk factors that related to the symptoms were workplace renovation, daily dust exposure and historical disease. Keywords: PM, Allergic symptoms, Librarians, general officers.. Introduction Nowadays, many people are facing health problems from poor indoor air quality which causes illness and death (WHO, 0). According to the report by WHO in 0,. million of people who live in low and middle income countries are found to have died from household air pollution and the disease which related to poor indoor air pollution. Those commonly found are stroke (%) ischemic Heart disease (%) COPD (%) acute lower respiratory disease (%) and lung cancer (%) (WHO, 0). The South East Asian and Western Pacific regions had the highest occurrences of death from indoor air pollutants with. and. million deaths respectively. The other regions that had the same incidents attributable from household or indoor air pollution were Africa, Eastern Mediterranean and America respectively (WHO, 0). Indoor air pollution caused sick building syndrome among workers who prolonged routine work in the building. This result aligns with WHO report of approximately about % of building in the United States have problems from poor indoor air quality (Research and development U.S.EPA, ) and symptoms that related to poor indoor air quality such as skin, eyes, nose and throat irritation, cough, shortness of breath, headache and dizziness (WCB, 00). Generally, the contaminated pollutants in the building come from airborne dust, painting, and daily activities such as smoking, cosmetics powder and cooking (WCB, 00) or other building components such as chemical from furniture, ventilation system and pesticide (Indoor air division U.S.EPA, ). From the United State of America indoor air report in 00, it showed that

4 Songklanakarin Journal of Science and Technology SJST-0-00.R Chullasuk Page of 0 indoor air pollutants related to household indoor air quality problem mostly came from particulate matter (%), chemical pollutants (0%), humidity (%), carbon dioxide (%), temperature (%) and carbon monoxide (%) respectively (IAQE, 0.) The particulate matter or dust was the major pollutant for indoor air quality problem which caused people health problems especially particulate matter with diameter less than micron such as PM that pass through the lower respiratory track and alveoli and affected to respiratory function and lung disease (U.S.EPA., 0). Those pollutants also affect people who stayed for long period in the area. Not only buildings like houses and general offices, but libraries where there were many books are also likely to expose to high concentration of dust, especially respirable dust (PM ), and fungi. High humidity and appropriate temperature are main contributions for dust to grow and accumulate on bookshelves or the gap between books, and cover them including other objects in the library as dust film (Lloyd, 0). Because workplaces like libraries are sources of high risk of pollutants from dust accumulated that affected librarians and people health as per library users may be contaminated via using of books and materials that lead to health symptoms from dust or fungi. Those symptoms are short-term effects such as eyes, nose and throat irritation, sneezing, running nose (CDC, 0). This study aim to identify the association between PM exposure and allergic symptoms in the staffs both in the library and general offices and to compare the difference of health risk related to dust exposure.. Materials and Methods Questionnaire This study was cross-sectional study to identify the association between respirable dust (PM ) and allergic symptoms by using questionnaire survey. The

5 Page of Songklanakarin Journal of Science and Technology SJST-0-00.R Chullasuk 0 participants in this study were librarians who were defined as exposed group and general office workers who were defined as un-exposed group. The data was collected by using structural questionnaire enquiring socio-demographic and personal information (gender, age, education, respiratory and allergic disease history and smoking habit), risky behavior (type of transportation to work, daily dust exposure and pesticide used in household), characterization of work (work hours, historical of dust and chemical exposure at work), workplace characteristic (workplace characteristic, type of ventilation, workplace cleaning schedule and renovation of workplace) and allergic symptoms occurred in both of the officers. Respirable dust measurement National Institute for Occupational Safety and Health guideline were employed in this study (NIOSH, ). The personal air pump with personal environmental monitor (PEM) and PVC filter continuously collected PM in all participants both exposed and un-exposed group during work (eight hours per day). The PM concentration was calculated by pre-post weight of the filters as following equation. C = (W W ) x 00, mg/m V (L) Details: C = concentration of particulate matter (mg/m ) W = Pre-weight of filter before sampling (mg) W = Post-weight of filter before sampling (mg) V = Air volume as sampled at flow (m ) Personal PM measurements were not obtained from all study participants (the measurement was done in staffs). To enable inclusion of all

6 Songklanakarin Journal of Science and Technology SJST-0-00.R Chullasuk Page of 0 subjects for PM level analysis with symptoms prevalence, the mean of PM measurements in each workplace was calculated. The workplace specific mean PM level was assigned to each participant in that workplace. Data analysis The analysis focused on the relationship between PM exposure and the allergic symptom prevalence from work, which adjusted appropriately for other independent variables. Firstly, normality distribution test was used in choosing the appropriate statistical analysis then T-test was used for comparing the average of PM exposure between exposed and un-exposed group. Also the descriptive statistics was used to describe variable levels with bivariate analysis and examined one independent variable at a time. Moreover, Chi-square and Fisher s Exact test were used for categorical independent variables to compare allergic symptoms prevalence between exposed group and un-exposed group.. Results and Discussion The results of socio-demographic has shown that most of librarians as exposed group, aged between - years old (%) had significant difference with general office workers as un-exposure group, who were - years old (.%) (p < 0.00)..% of librarians were female while general office workers were male and female almost equally (p = 0.00). However, most of librarians and general office workers did not have history of respiratory and allergic disease (.% and.% respectively) (p = 0.). Exposure to daily dust and chemical at work were the factors that can possibly be related to the allergic symptoms. This study has shown that most of librarians were exposed to dust from traveling to work by private car (.%), bus with air condition

7 Page of Songklanakarin Journal of Science and Technology SJST-0-00.R Chullasuk 0 (.%), BTS (.0%), bus without air conditioner (.%), motorcycle (.%) and walking (.%) respectively. While, most of general office workers were exposed the same objects from traveling to work by BTS (.%), private car (.0%), bus with air conditioner (.0%), walking (.%), motorcycle (.%) and bus without air conditioner (.%) respectively. According to these results, there were differences between librarians and general office workers about types of transportation including used private car, bus without air conditioner and walk to work (p = 0.00,p = 0.0 and p = 0.00 respectively). There was no differences between the daily dust exposure among librarians and general office workers. By the way, librarians exposed to daily dust from traffic (.%), cleaning house (0.%), cooking (.%), incent smoking (.%) and open burning in their home (.%) respectively. These were similarities in the group of to general office workers who exposed to daily dust from traffic (0.%), cleaning house (.0%), cooking (.%), incent smoking (.%) and open burning in their home (.%), respectively. According to the results, the prevalence of daily dust exposure in librarians came from cooking (p = 0.) and incent smoking (p = 0.) which is higher than the average found in general officers, while general office workers had prevalence of daily dust exposure from traffic (p = 0.0), cleaning house (p = 0.) and open burning at home (p = 0.0) were higher than those found in librarians. Moreover, numbers of librarians used pesticide in household (.%) were higher than general office workers (.%) (p = 0.0) (Table ). From the table, we found that most of libraries had air conditioner (.%) that slightly higher than general offices (.%) (p = 0.0) and mostly of air conditioners in libraries were cleaned up about time per month (.%) when those in

8 Songklanakarin Journal of Science and Technology SJST-0-00.R Chullasuk Page of 0 general offices were cleaned up only - times per year (.%) (p < 0.00). Besides, libraries floors were cleaned every day (.%) which was significantly higher than general offices (.%) (p< 0.00). The workplace of librarians were renovated with polished floor (.%), re-painted (.%), renew floor (.%) and renovated any areas (.%), respectively. This prevalence were higher than general offices that renovated workplaces with polished floor (.%), re-painted (.%), renew floor (.%) and renovated any areas (.%), respectively. Exposure to Particulate matter diameter less than micron (PM ) The mean of PM exposure in librarians were 0. µg/m, range of exposure between. -. µg/m, this was prominently higher than the mean of PM exposure in general office workers with. µg/m, range of exposure between. -. µg/m, (p<0.00). However, the concentration of PM were in acceptable criteria of Occupational Safety and Health Administration (OSHA) that respirable dust concentration should not be exceeding over,000 µg/m in period of work (Table ). The prevalence of allergic symptoms In this study, the prevalence of allergic symptoms that are most found are itchy eyes (.%), headache (.%), running nose (.%), stinging eyes (.%), skin rash (.%), running eyes (.%), redness (.%), watery eyes (.%) and dark circle under eyes (.%) respectively. From the result, we found that the librarians had prevalence of allergic symptoms higher than general office workers including dark cycle under eyes (OR =., %CI = 0.-.), skin rash (OR =., %CI = 0.-.) itchy eyes (OR =., %CI = 0.-.), redness of skin (OR =.,

9 Page of Songklanakarin Journal of Science and Technology SJST-0-00.R Chullasuk 0 %CI = 0.-.), headache (OR =., %CI = 0.-.), stinging eyes (OR =., %CI = 0.-.), watery eyes (OR =., %CI = 0.-.) and running eyes (OR =., %CI = 0.-.) respectively. However, general office workers had more risk to develop running nose symptom compared to librarians (OR = 0., %CI = 0.-.) (Table ). The association between PM exposure and allergic symptoms. PM exposure was found positively associated to skin rash (OR=.00, %CI = ) but it was scarcely associated to running eyes (OR=.00, %CI = ), watery eyes (OR=.0000, %CI = ), itchy eyes (OR=.00, %CI = ), stinging eyes (OR=.000, %CI = ), running nose (OR=.00, %CI = ), redness of skin (OR=.00, %CI = ), dark circle under eyes (OR=0., %CI = ) and headache (OR=.00, %CI = ). In conclusion, PM can be predicted the symptom of skin rash in the workers (Table ). The factors which associate to allergic symptoms In this study, PM was not clearly linked to allergic symptoms but there were other factors which related to allergic symptoms such as gender, work hour per day, history of respiratory and allergic disease, incent smoke exposure, pesticide used in household type of transportation to work and renovation of workplace.. Conclusions The objective of this study was to investigate the association between respiratory dusts, PM, and any allergic symptoms in libraries and to compare to general offices. This research had never been conducted before in Thailand. The results showed that the socio-demographic of the librarians were mostly different from general office workers

10 Songklanakarin Journal of Science and Technology SJST-0-00.R Chullasuk Page of 0 (p <0.0). Firstly, the librarians who worked in the libraries mostly were woman (.%) with age between - years old (%). This result was different with general office workers who were both male and female and age between - years old (.%). There were similar socio-demographic of respiratory and allergic disease in both of the officers (p =0.) and pesticide used in their household (p =0.0). Moreover, the finding showed that PM exposure was twice higher in librarians than the general office workers (0. and. µg/m respectively), it means the librarians had higher risk than other office workers (p<0.00). PM concentrations was within the range of acceptable values (OSHA standard decided PM concentration should not over than 00 µg/m) that was related to previous study about dust in the libraries which was range between -0 µg/m and not over the acceptable value. There really was no connections to allergic symptoms such as sore eyes, dry throat and breathing difficulties (Righi, 00). Nevertheless, the librarians had prevalence of allergic symptoms with insignificantly higher than those of general office workers accepted skin rash symptoms which associated to PM (p = 0.0). This was related to the finding that other allergic symptoms were highly associated to other factors such as history of respiratory and allergic disease, pesticide used in household, type of transportation to work and air conditioner cleaning schedule (p < 0.0). This consisted of other finding from Italy which showed that any pollutants and poor condition in the library such as indoor microclimate, VOCs and total dust related to users health (Righi, 00; Fantuzzi, ). The future research should find out the association between respiratory and allergic symptoms with other pollutants in the library that possibly affect to people health such as microclimate parameters (related humidity, temperature, wind speed), volatile

11 Page of Songklanakarin Journal of Science and Technology SJST-0-00.R Chullasuk 0 organic compounds (VOCs) from books and microorganisms (bacteria or fungal). The accumulation in indoor air of libraries revealed to previous studied that books in the storeroom are contaminated with many species of fungal and bacteria (Karbowska Berent, 0). The libraries in Thailand should be aware of health issue from indoor air pollutants such as particulate matter, fungi, humidity and temperature in the workplace. Nonetheless the indoor air quality surveillance program is important for all libraries to estimate indoor air quality situation that align to develop program to protect library staff and users. Acknowledgments We thank the Department of Public Health, ministry of Public Health for the scholarship of study at College of Public Health and thank for partially supported by the Ratchadapiseksompoch endowment Fund from Chulalongkorn University. References CDC. 0. Air and Health 0 [updated may 0; cited 0 oct]. Available from: Fantuzzi, C.. Indoor air quality in the university libraries of Modena (Italy). Science of the total environment. (), -. IAQE. 0. Indoor air quality. King mongkut's university of technology Thonburi website [cited 0 January]. Available from: Karbowska-Berent, J. 0. Airborne and dust borne microorganisms in selected Polish libraries and archives. Building and Environment. (), -.

12 Songklanakarin Journal of Science and Technology SJST-0-00.R Chullasuk Page of 0 Lloyd, H. 0. Dust in historic libraries. National trust organization (United Kingdom). Available from: /. NIOSH.. NIOSH Manual of Analytic Methods. Method 00: Particulates not otherwise regulated, respirable. Centers of Disease Control and Prevention. -. Righi, E. 00. Air quality and well-being perception in subjects attending university libraries in Modena (Italy). Science of the total environment. (-), -. The Workers Compensation Board. 00. Indoor air quality, a guide for building owners, managers and occupants. Work Safe British Columbia. ISBN U.S.EPA Research and Development.. Sick Building Syndrome. United State Environmental Protection Agency. Air and Radiation. -. U.S.EPA Indoor air division.. Building air quality; A guide for building owners and facility manager. United State Environmental Protection Agency. Available from: U.S.EPA. 0. Particulate Matter [updated April]. Available from: WHO. 0. Indoor air pollution. The situation of indoor air pollution in Pakistan. Available from: WHO. 0. Household (Indoor) Air pollution. Available from:

13 Page of Songklanakarin Journal of Science and Technology SJST-0-00.R Chullasuk 0 WHO. European Centre for Environmental and Health. 0. WHO guidelines for indoor air quality; selected pollutants. WHO Regional Office for Europe, Copenhagen, Denmark, pp. -.

14 Songklanakarin Journal of Science and Technology SJST-0-00.R Chullasuk Page of 0 The association between respirable dust exposure and allergic symptoms in the libraries and general offices at Chulalongkorn University, Bangkok, Thailand Characteristics Librarians General office (n= ) workers (n= ) p-value Socio-demographic. Age interval (%) < years - years (.) (.) 0 (.0) (.) - years - years. Gender (%) - Male (.) (.0) (0.) - Female (.). History of respiratory and allergic disease (%) - Yes - No Daily dust and chemical exposure. Type of transportation to work (%) - Motorcycle - Private car - Bus without air conditioner - Bus with air conditioner - BTS - Walk. Source of daily dust exposed (%) - Incent smoke - Cooking - Traffic - Open burning - Cleaning house (.) (.) (.) (.) (.0) (.) (.) (.) (.) (.) (0.) (.) (.) 0.00 (.) (.) 0. (.) (.) (.) (.) 0. (.) 0 (.0) 0.00 (.) 0.0 (.0) 0. (.) (.) (.) (.) (0.) (.) (.0)

15 Page of Songklanakarin Journal of Science and Technology SJST-0-00.R Chullasuk 0 Characteristics Librarians General office (n= ) workers (n= ) p-value. Pesticide used in household (%) Yes (.) (.) - No (.) (.) Table Socio-demographic and daily behaviors between the librarians and general office workers Characteristics Libraries (n= ) General offices (n= ) Workplace characteristic. Ventilation mechanism (%). - Air conditioner - Other : Fan Natural ventilation (.) (.) (.) (.). Cleaned air conditioner (%). - Never - Everyday - time per month - Other: - times per years. Cleaned floor (%) - Everyday - Not more than times/week. Type of renovation workplace (%) - Renovated floor - Renovated some areas - Polished floor - Re-paint (.) (.) (.) (.) (.) (.) (.) (.) (.) (.) (.) (.) (.) (.) (.) (.) (.) (.) (.) (.) Table Workplace characteristics compared between the libraries and general offices p-value 0.0 <0.00 <0.00 <0.00 < <0.00

16 Songklanakarin Journal of Science and Technology SJST-0-00.R Chullasuk Page of 0 Characteristics General office Librarians workers (n= ) (n= ) p-value PM exposure in the workplace: (µg/m ) < Mean - Minimum - Maximum Analyzed with independent sample t-test. Table PM exposure in librarians compared with general office workers Allergic symptoms - Skin rash - Running eyes - Watery eyes - Itchy eyes - Stinging eyes - Running nose - Redness of skin - Dark circle under eyes - Headache Total prevalence (%) (.) (.) (.) (.) (.) (.) (.) (.) (.) Librarians (%) (0.) (.) (.) (.) (.) (.0) (.) General office workers (%) (.) (.) (.) (.) (.) (.) %CI OR p-value (.) (.) (.) (.0) (.) Analyzed with Chi-square test. Table Unadjusted prevalence of allergic symptoms in librarians compared with general office workers

17 Page of Songklanakarin Journal of Science and Technology SJST-0-00.R Chullasuk 0 Allergic symptoms OR p-value % CI - Skin rash - Running eyes - Watery eyes - Itchy eyes - Stinging eyes - Running nose Redness - Dark circles under eyes Analyzed with Logistic regression. Table The association between PM exposure and allergic symptoms

Songklanakarin J. Sci. Technol. 38 (4), , Jul. - Aug Original Article

Songklanakarin J. Sci. Technol. 38 (4), 407-412, Jul. - Aug. 2016 http://www.sjst.psu.ac.th Original Article The association between respirable dust exposure and allergic symptoms in the libraries and