Agenda

1. Agenda • Introductions – Mary Lou Fleissner, Dr.PH. • NIOSH Update – Terri Pearce, Ph.D. • UConn Update – Eileen Storey, M.D. • Questions and Answers

2. August 2004 Survey25 Sigourney Street Terri A. Pearce, Ph.D. – Project Officer National Institute for Occupational Safety and HealthDivision of Respiratory Disease Studies Field Studies Branch Morgantown, West Virginia

3. Questions about 25 Sigourney Street • Has health improved? • Has the environment improved? • What happens next?

4. Overall Summary • There is evidence of improvement in symptoms reported in the 12 months prior to the 2004 survey • Some occupants of 25 Sigourney Street continue to have ongoing respiratory illness • Previous water damage is likely to have contributed to the health complaints • Ongoing health surveys are required to assess the effectiveness of dampness remediation

5. NIOSH Investigation • Union health hazard evaluation request in response to employee reports of physician-diagnosed diseases and symptoms • Became a joint request when management learned of the concerns

6. NIOSH 2001 and 2002 Surveys • September 2001 - Health questionnaire survey offered to everyone in the building • April 2002 – Environmental sampling • June 2002 – Offered medical testing to some employees

7. 2001 and 2002 Findings • Two to three times the expected number of employees with asthma or wheezing • Persons reporting symptoms or respiratory diagnoses frequently had abnormal lung test results or asthma medication use • Mold and endotoxin levels in dust were associated with respiratory and skin symptoms

8. Building Repairs • Exterior repairs to correct balcony drainage, brick failure, window leaks, roof replaced • Interior replacement of water and mold damaged sheetrock • Interior repairs to bathroom core • Replacement of carpeting on some floors • Vacuuming of carpets, chairs, and partitions

9. Has the health improved?

10. 2004 Post-Repair Survey • 7-8 months after roof repair • 3-4 months after post-repair cleaning • Health Assessment – Questionnaires and medical testing • Building Assessment – Dust sampling and real-time monitoring

11. Participation • 888 people in 2001 and 771 in 2004 • About 70% for both surveys 2001 2004

12. New Diagnoses from January 2003 to August 2004 • In employees hired 2003-2004 • 1 asthma diagnosis • In employees hired before 2003 • 6 asthma diagnoses • 1 hypersensitivity pneumonitis diagnosis* • 1 sarcoidosis diagnosis * also diagnosed with asthma

13. Respiratory Illness - 2004

14. One or more symptoms in the last 12 months - 2004

15. One or more symptoms each week for the last 4 weeks - 2004

16. Non-Respiratory Symptoms - 2004In Last 12 months and 4 Weeks

17. Summary of 2004 questionnaire survey • DRS and DSS similar for physician diagnoses and respiratory symptoms • About half of participants reported lower and non-respiratory symptoms and 30% reported skin symptoms • More upper than lower respiratory symptoms

18. Has the percent of symptomatic employees changed between the 2001 and 2004 surveys? • We compared the results for the 481 employees who participated in both surveys

19. Asthma-like symptoms in the last 12 months, but not in the last 4 weeks

20. Asthma-like symptoms weekly in the last 4 weeks

21. Have you had symptoms that you think may be related to the building? Comparison between 2001 and 2004 surveys

22. Summary of comparison2001/2002 to 2004 • There were decreases in the percent of employees reporting symptoms in the last 12 months but not occurring in the last 4 weeks • There were no decreases in the percent of employees reporting symptoms occurring weekly in the last 4 weeks • Decrease for DRS when asked: • Have you had symptoms that you think may be related to the building?

23. Did medical testing results change? • Lung function test results show similar relationships with symptom status in 2002 and 2004 • Positive allergy skin tests have decreased for all symptom groups • Persons with post-occupancy asthma continue to have fewer positive skin allergy tests than persons with pre-occupancy asthma

24. Abnormal Lung Function Tests – 2002 and 2004

25. Has the environment improved?

26. Median Dust Levels

27. Median Fungi Levels

28. Median Cat Allergen Levels

29. Have the dust levels changed? • Amounts of dust in the carpet are somewhat higher than measured in 2002 • Amounts of culturable fungi and endotoxin in floor dust are also slightly higher than in 2002 • Amounts of cat and dog allergen are lower than in 2002

30. Real-time Monitoring • Temperature and relative humidity were within the recommended ranges • Some carbon dioxide measurements on 15th floor were above the recommended level • Water activity of some carpets could support microbial growth

31. Have we answered the questions? • There were decreases in the percent of employees reporting symptoms in the last 12 months but not occurring in the last 4 weeks • There were no decreases in the percent of employees reporting symptoms occurring weekly in the last 4 weeks • Dust levels were similar with fungi and endotoxin levels being somewhat higher in carpets with cat and dog allergen being somewhat lower

32. What happens next?

33. Next Steps • August health and environmental surveys • Follow-up for new employees • Building systems evaluation

34. Overall Summary • There is evidence of improvement in symptoms reported in the 12 months prior to the 2004 survey • Some occupants of 25 Sigourney Street continue to have ongoing respiratory illness • Previous water damage is likely to have contributed to the health complaints • Ongoing health surveys are required to assess the effectiveness of dampness remediation

35. NIOSH - Morgantown 1-800-232-2114 Terri Pearce, Ph.D. – Project Officer