Information
Editors
Rhinitis Associated with Indoor Air Impurities
Essentials
- Indoor air impurities are associated with various upper respiratory symptoms but it has not been possible to show a causative relationship.
- It is difficult to distinguish between upper respiratory tract symptoms associated with indoor air impurities and other types of rhinitis, such as allergic or idiopathic rhinitis.
- If the problem is associated with a certain building, it is essential to find the cause and correct it.
- Investigations into exposure and basic examinations of rhinitis should be performed in primary health care.
- One should not take a stand on the role of a building's indoor air in patient's symptom or illness, without having available a statement on the presence of a significant moisture and mold damage in the building, provided by the health protection authority or by a competent expert that has investigated the building's state and indoor air quality.
General
- Both homes and public premises rather often show moisture damage that unrepaired may lead to microbial growth in the structures, causing adverse health effects in occupants Exposure Assessment in Moisture-Damaged Buildings.
- Storage mites thrive in moistened materials, and occupants of the building may be sensitized to them.
- Other causes of indoor air problems include poorly functioning air conditioning, emissions from building materials, and air pollution from outside or arising as the building is used Indoor Air Pollution.
- Issues associated with problem buildings commonly include symptoms resembling asthma, wheezing, eye irritation, rhinitis, cough and hoarseness. The risk of allergic rhinitis may be increased in problem buildings, but the scientific evidence is still scarce.
- Moisture-damaged buildings should always be repaired without waiting for or requiring occupants to develop symptoms.
- If it is suspected that the rhinitis is associated with moisture damage or another indoor problem and the person with symptoms cannot be part of the decision to repair the building, any causal connection between the symptoms and exposure must be examined.
Diagnostic work-up
- Investigations into exposure and basic examinations of rhinitis should be performed in primary health care.
- If occupational rhinitis is suspected or other legal points of view are involved, the patient should be referred to an otorhinolaryngology clinic. Always attach to the referral the history of exposure.
- Ordinary allergological tests (skin prick and S IgE tests, mould and storage mite challenge tests) are performed in specialized care to diagnose rhinitis associated with indoor air impurities.
- Other disorders with similar symptoms should also be diagnosed in specialized care.
- In current experience, IgE-mediated mould allergy can only rarely be defined as the mechanism behind the symptoms. Rather, the mechanism appears to be irritation of respiratory mucosa and conjunctiva by microbial exposure. There are as yet no research methods in clinical use for showing a causal connection between exposure and irritation symptoms.
References