Allergic alveolitis in a school environment.

BACKGROUND A considerable fraction of newly constructed buildings have indoor air problems associated with health effects, usually of the nonspecific sick building syndrome variety. Specific health effects such as asthma, rhinitis, and allergic alveolitis can also occur. CASE On 1 September 1988 a school teacher showed symptoms of an acute respiratory illness, which was first interpreted as pulmonary embolism and then later as atypical sarcoidosis. The illness slowly progressed over six years, at which time the diagnosis was revised to chronic allergic alveolitis, related to her school environment. The school had had indoor-air quality problems off and on for several years. CONCLUSIONS The case illustrates the difficulties of diagnosing cases of chronic allergic alveolitis, especially when it appears in environments where it is not generally encountered. It also raises questions regarding a possible relation between environments associated with the sick building syndrome and the occurrence of building-associated illnesses.

[1]  A. Montanaro,et al.  Building-Related Illness , 1988, Clinical reviews in allergy.

[2]  L. Welch Severity of health effects associated with building-related illness. , 1991, Environmental health perspectives.

[3]  I. Bernstein,et al.  Guidelines for the clinical evaluation of hypersensitivity pneumonitis. Report of the Subcommittee on Hypersensitivity Pneumonitis. , 1989, The Journal of allergy and clinical immunology.

[4]  A. Lundin,et al.  Inhalation fever and respiratory symptoms in the trimming department of Swedish sawmills. , 1994, American journal of industrial medicine.

[5]  G A Letz,et al.  Sick building syndrome: acute illness among office workers--the role of building ventilation, airborne contaminants and work stress. , 1990, Allergy proceedings : the official journal of regional and state allergy societies.

[6]  R. Carter,et al.  Longitudinal course of extrinsic allergic alveolitis in pigeon breeders. , 1989, Thorax.

[7]  W. D. Pitcher Southwestern Internal Medicine Conference: Hypersensitivity Pneumonitis , 1990 .

[8]  K. Kreiss,et al.  The epidemiology of building-related complaints and illness. , 1989, Occupational medicine.

[9]  J. E. Carlson,et al.  Hypersensitivity pneumonitis due to pyrethrum. Report of a case. , 1977, JAMA.

[10]  Emanuel Da,et al.  Farmer's lung disease. , 1983 .

[11]  P. Malmberg,et al.  Exposure to microorganisms associated with allergic alveolitis and febrile reactions to mold dust in farmers. , 1993, Chest.

[12]  J. Salvaggio,et al.  Hypersensitivity pneumonitis; state of the art. , 1979, Chest.

[13]  R. Bauer,et al.  Sick Building Syndrome , 1991, Southern medical journal.

[14]  Hodgson Mj Clinical diagnosis and management of building-related illness and the sick-building syndrome. , 1989 .

[15]  H. Richerson Methods for survey and diagnosis. , 1994, American journal of industrial medicine.

[16]  K Kreiss,et al.  Building-related asthma in Denver office workers. , 1993, American journal of public health.

[17]  L. Belin,et al.  Recognition of allergic alveolitis in the trimming department of a Swedish sawmill. , 1980, European journal of respiratory diseases. Supplement.

[18]  Pertti Pasanen,et al.  Water Condensation Promotes Fungal Growth In Ventilation Ducts , 1993 .

[19]  D. Halpin,et al.  Extrinsic allergic alveolitis and asthma in a sawmill worker: case report and review of the literature. , 1994, Occupational and environmental medicine.

[20]  E. Terho Diagnostic criteria for farmer's lung disease , 1986 .

[21]  W. W. Rhodes,et al.  Pulmonary disease associated with cafeteria flooding. , 1985, Archives of environmental health.

[22]  M J Hodgson,et al.  An outbreak of recurrent acute and chronic hypersensitivity pneumonitis in office workers. , 1987, American journal of epidemiology.

[23]  J. Malo,et al.  Occupational asthma and extrinsic alveolitis due to isocyanates: current status and perspectives. , 1993, British journal of industrial medicine.

[24]  J A Stolwijk Sick-building syndrome. , 1991, Environmental health perspectives.