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OCR for page 425
INDEX
Access to health care, see Utilization of
health care
Adolescents
chlamydia, 180
dampness and asthma, 173,180
fungi, 168, 173
gender factors, 71
prevalence, 30
smoking, 269, 283-284, 290, 401
symptoms, 24, 26-27
Adoptee studies, 79
Adults, 24
allergic vs nonallergic asthma, 33
cat allergens, 108
chlamydia, 179-180
clinical presentation, 24, 26
cockroach allergens, 132
cow and horse allergens, 121
dampness, 308
endotoxins, 152
fungi, 11,166, 170
molds, 11, 308
mortality, 81
nitrogen dioxide, 229, 231, 254
prevalence, 30, 33
respiratory syncytial virus, 177
rhinovirus, 11, 101
sulfur dioxide, 254
tobacco smoking, 7, 9, 268, 269, 270,
279, 280-281
cessation efforts, 282, 284-285
gender factors, 274-275, 276-277,
278-279
pregnant women, 10, 269, 272-
273, 275, 278, 280, 282, 285-286,
290, 401
twin studies, 78-79
volatile organic compounds, 241, 242
see also Occupational asthma;
Pregnant women
African Americans, 1, 30-31, 68, 70, 71-
73,77
children, 71, 73, 77
cockroach allergens, 126,129
tobacco smoke, 283, 286, 290, 401
Age factors, general, 27
CDC study, 29, 30
gender and, 27, 71
"growing out of asthma," 26
mortality, 81
prevalence, 73
see also Adolescents; Adults;
Children; Infants; Preschool
children
Agriculture
cow and horse allergens, 120-121
endotoxins, 151, 155
425
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426
fungi, 163
pesticides, 235, 236
respiratory syncytial virus, 176
Air cleaning, 3, 14-16,124, 253, 327, 328,
360-386, 417
cat allergens, 111-112,113,114,124,
370-371
climate and weather, 381, 382
cost factors, 363, 382-383
electrostatic precipitators, 362, 370-377
heating, ventilation, and air
conditioning systems, 362-363,
364-365, 367, 372-373, 377, 380,
382-383
mites, 380
noise, 363-364, 366, 384
ozone, 252
portable, 363-364, 365, 366, 367, 369,
377-378, 379, 380
research recommendations, 385-386,
404405
standards, 360, 361, 366-367, 369
theoretical considerations, 327-331,
409414
tobacco smoke, 281-282, 289, 369,
370-371, 381
see also High-efficiency particulate air
(HEPA) filters; Ventilation
Air conditioning, see Heating,
ventilation, and air-
conditioning (HVAC) systems
Airway inflammation, 6, 27-28, 31, 34,
87, 89-90, 92-93, 96, 253
endotoxins, 150, 152
tobacco smoke, 271-272, 278
Airway smooth muscle, 89, 96-98
American Home Appliance
Manufacturers, 360
American Lung Association, 378-379
American Society of Heating,
Refrigerating, and Air
Conditioning Engineers
(ASHRAE), 332, 338, 341-342,
356, 361, 366-367, 369
American Thoracic Society, 310
Animal allergens, 3, 4, 6, 7, 11, 105-124,
417
attitudes toward pets, 117,124
birds, domestic, 7, 9,11,121-123
exposure assessment, general, 57, 58-
59
INDEX
prevention and mitigation, general,
13-14, 15, 16
research recommendations, 22,123
124, 136, 150, 394-397
see also Cats; Cows; Dogs; Horses;
Insects; Rodents
Animal models, 41, 416
cockroach allergens, 129
formaldehyde, 245
ozone, 252
pesticides, 237, 400
plasticizers, 250
tobacco smoke, 273
volatile organic compounds, 241
Annual Housing Survey, 303
Antibiotics, 29, 63
Assays, see Bioassays
Attitudes and beliefs
air conditioning, 382-383
dampness, 306
fear of attack, 34
"growing out of asthma," 26
office workers, 319
tobacco smoking, 278-279, 280, 284
286 (passim)
toward pets, 117,124
Australia, 1,116, 228, 323
Bacteria, see Chlamydia; Endotoxins;
Mycoplasma pneumonias
Beliefs, see Attitudes and beliefs
Bioassays, 106, 128
cockroach allergens, 125,126
dust mites, 137,139, 142
ELISA, 125, 142,184, 398
endotoxins, 151-152, 157-158, 397-398
fungi, 160,162,168, 169
pollen, 190
polymerase chain reaction, 106,184,
398
RAST, 80,107,108,126,160,168, 169,
190
volatile organic compounds, 241
Biological markers, other, 53, 57, 60-61
tobacco smoke, 267-268, 269, 272-273
Birds, domestic, 7, 9,11,121-123
Black persons, see African Americans
Breast-feeding, 78
Building Assessment Evaluation Study,
319
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INDEX
Building materials, 4-5, 18, 21, 62
formaldehyde, 243, 245
moisture, 299-301, 303
volatile organic compounds, 239
Buildings, nonresidential, 7, 21,183, 316-
326
cat allergens, 112-113,123-124, 321
dog allergens, 113,114-115,123-124,
321
infectious agents, 183
symptoms, 342, 358, 402403
tobacco smoke, 123-124, 266, 270,
283, 321
see also Heating, ventilation, and air-
conditioning (HVAC) systems;
Occupational asthma; Schools
and daycare centers
Canada, 228
Carbon dioxide, 241, 347, 357
Carbon monoxide, 225, 265
Cats, 3, 6, 9,11, 12, 13-14, 55,106-114,
116, 123, 141, 395
air cleaning, 111-112,113,114,124,
370-371
children, 109,112, 168
dampness and, 309
exposure assessment, 11, 57, 58-59,
106-108, 123-124
immunoglobin, 107, 110
public buildings, 112-113, 123-124,
321
schools, 112,123-124, 321
ventilation, 356
Cell adhesion molecules, 92-95, 394
Census Bureau, 78
Centers for Disease Control and
Prevention, 1, 29-30, 68
Chemical agents, 3, 4, 6, 7-8, 9, 11, 15, 16,
20, 223-262, 323
carbon dioxide, 241, 347, 357
carbon monoxide, 225, 265
fragrances, 3, 9, 11, 247-250
herbicides, 49
see also Formaldehyde; Nitrogen
dioxide and nitrogen oxides;
Pesticides; Plasticizers;
Tobacco smoke, Volatile
organic compounds
427
Children, 24-25, 26, 69-70
adoptee studies, 79
African Americans, 71, 73, 77
air cleaning, 385
allergic vs nonallergic asthma, 33
bird allergens, 122
cat allergens, 109,112,168
chlamydia, 179
cockroach allergens, 130-132
cow and horse allergens, 120
dampness and mold, 308, 309
dog allergens, 116-117
dust mite allergens, 9,136,143-144,
168
endotoxins, 152, 155
fungi, 166-172 (passim)
Hispanics, 73
incidence and prevalence, 20, 27, 30,
33,67-68,69-70,71,73,78,80
nitrogen dioxide, 227-228, 229-230
pesticides, 234-235
pollen, 190-191
respiratory syncytial virus, 176, 177,
178
rhinovirus, 175-176,181, 183
rodent allergens, 119
spirometry, 34
tobacco smoke, 6, 7,11, 20, 263, 267,
268, 269-281, 283, 286-290, 401
volatile organic compounds, 241,
322, 349
see also Infants; Preschool children;
Schools and daycare centers
Chlamydia, 3, 7, 9,11,178-180,181,182
Chronic obstructive pulmonary disease,
27-28, 81-82
Cleaning techniques, see Air cleaning
Climate and weather, 13
air cleaning, 381, 382
cockroaches, 4, 131-132
dust mites, 62,147-148
fungi, 168
tobacco smoke, 281, 286
ventilation, 334, 335, 339, 340-341,
344, 346, 353, 354-355
see also Dampness and moisture;
Heating, ventilation, and air-
conditioning systems;
Temperature factors
Clinical presentation, see Symptoms
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Cockroaches, 3, 4, 6, 9, 11, 13, 109, 124-
136, 417
African Americans, 126, 129
bioassays, 125, 126
children, 130-132
infants, 127, 130-131
preschool, 10,11,130-131, 132
climate, 4, 131-132
dampness, 127
dose-response relationships, 130-131,
132
eosinophils, 128-129
exposure assessment, 57, 58,125-126,
132, 329
genetic factors, 132
hospitalization, 130-131
immunoglobin, 125,126,129, 130-131
immunotherapy, 396
occupational asthma, 126
particulate matter, 126,135
pesticides, 133-134, 237
prevention and mitigation measures,
132-136
race/ethnicity, 129
research recommendations, 13-16,
136, 396
respiratory syncytial virus, 131-132
schools and daycare centers, 126-127
socioeconomic status, 126,128,129
standards, 126
symptoms, 128-129,131-132,149, 150
urban areas, 127,128,129,130,134,140
Commercial and institutional buildings,
see Buildings, nonresidential
Consumer Products Safety Commission,
246
Cosmetics, see Fragrances
Cost and cost-effectiveness factors, 22
air cleaning, 363, 382-383
burden of asthma, 68
heating, ventilation, and air-
conditioning systems, 346-347,
349, 356, 357, 382-383
methodological considerations, 40
moisture remediation, 305
Cows, 9, 11, 120-121,
Dampness and moisture, 4, 7, 14, 18,
298-316, 417
adolescents, 173, 180
INDEX
building materials, 299-301, 303
cockroach allergens, 127
dog allergens, 309
dust mites, 142, 145,147-148, 307,
309, 310, 354-355
endotoxins, 151,155, 156
flooding, 303, 306, 311, 321, 402
fungi, 154,168, 171-173, 302, 303,
306-307, 309, 310
geographic factors, 62; see also
Climate and weather
heating, ventilation, and air-
conditioning systems, 300, 307,
310, 319-320, 340-341, 343, 357-
358, 365
measurement of, 302-304, 307, 308
mold, 302, 303, 308, 309, 322
nonresidential buildings, 316; see also
"moisture" under Heating,
ventilation, and air-
conditioning (HVAC) systems
public education on, 311, 402
research recommendations, 294, 311,
402
schools, 322
standards, 21, 298, 311, 402
types of, 299-300
ventilation, 300, 307, 310, 319-320,
331, 340-341, 343, 352-353, 354-
355, 357-358, 359
volatile organic compounds, 239
Definitional issues, general, viii, 2, 4, 19,
22-24, 406407
causality, 4547
dose, 55-56
exposure assessment, 12(n.3), 51-54
methodological bias, 4244
prevalence and, 70-71
ventilation, 331
Definition of specific agents
bird allergens, 121
cat allergens, 106-107
cockroach allergens, 125-126
cow and horse allergens, 120
chlamydia, 178
dog allergens, 114
dust mites, 137-138, 149
endotoxins, 150-151
formaldehyde, 243-244
fragrances, 247
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INDEX
fungi, 158-159, 161
mycoplasma, 180-181
nitrogen dioxide, 224
ozone, 251
particulate matter, 253
pesticides, 234
plants, 184
plasticizers, 250
pollen, 184, 186
respiratory syncytial virus, 176
rhinovirus, 175
rodent allergens, 118
sulfur dioxide, 253-354
tobacco smoke, 264-265
volatile organic compounds, 237
Demographic factors, see Educational
attainment; Gender factors;
Genetic factors; Geographic
factors; Migrant population
studies; Race/ethnicity;
Socioeconomic status
Department of Health and Human
Services, 19
see also National Institute for
Occupational Safety and
Health
Diagnosis, see Symptoms
DNA, 98,106, 161
Dogs, 3, 6, 9,11,109,114-117,123-124,
141, 321, 395
children, 112
dampness and, 309
exposure assessment, 57, 59,123-124
immunoglobin, 115, 117
public buildings, 113, 114-115, 123-
124, 321
symptoms, 115, 395
Dose-response relationships, 10, 22, 47,
50
cockroach allergens, 130-131,132
dust mites, 146
tobacco smoke, 278-280
Drugs, see Medication
Dust mites, see Mites
Economic factors, see also Cost and cost-
effectiveness factors;
Socioeconomic status
Education, see Public education
Educational attainment, 21, 285, 286
429
Electrostatic precipitators, 362, 370-377
ELISA, 125, 142,184, 398
Emergency department visits, 30, 33, 70,
80
cat allergens, 109
Employment-related asthma, see
Occupational asthma
Endotoxins, 3, 4, 7, 9, 11, 14, 150-158,
297, 415
agriculture and, 151,155
airway inflammation, 150,152
bioassays, 151-152,157-158, 397-398
children, 152, 155
dampness, 151,155, 156
exposure assessment, 151-152,156
immune system, 153, 154, 157, 158, 397
occupational asthma, 151,155,156
pregnant women, 152
prevention and mitigation, 156-157
research recommendations, 157-158,
397-398
symptoms, 152-156
T lymphocytes, 153, 154, 157,158, 397
urban areas, 155,157
England, 113, 227-228
Environmental Protection Agency
Indoor Air Division, 19, 20
Indoor Environments Division, 20
nitrogen dioxide regulation, 224
Office of Research and Development,
20
outreach strategy, 2
ozone, 252
study at hand, vii, 19, 3940
tobacco smoke, 263, 265
Environmental tobacco smoke, see
Tobacco smoke
Enzyme-linked-immunosorbent assays,
see ELISA
Enzymes, 90,138-139, 159
Eosinophils, 25-26, 89-90, 92, 93, 95
cockroach allergens, 128-129
Ethnicity, see Race/ethnicity
ETS, see Tobacco smoke
European Community Respiratory
Health Survey, 116
Exercise, 28, 32
Exposure assessment, 12,17, 56-62, 63,
77-78, 223, 224, 402, 406407
bird allergens, 121-122
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430
cat allergens, 11, 57, 58-59,106-108,
123-124
cockroach allergens, 57, 58,125-128,
132, 329
cow and horse allergens, 120
definitional issues, 12(n.3), 51-54
dog allergens, 57, 59,114-115,123-124
dust mites, 56-58, 78,139,142-143,
329
endotoxins, 151-152, 156
formaldehyde, 57, 225, 244
fragrances, 247, 249
fungi, 57, 59,158,162-164,169-173,
174-175, 329
microenvironmental model, 54-55
nitrogen dioxide, 57, 61, 77, 224-226
time factors, 226, 231, 234-235, 399
ozone, 251-252
pesticides, 57, 133, 234-235
plants, 57, 399
pollen allergens, 59,187-188, 329
rhinovirus, 175
rodents, 118, 396
time factors, see "exposure" under
Time factors
tobacco smoke, 57, 60-61, 77-78, 263,
265-271, 278-280, 286-287, 288
volatile organic compounds, 57, 61
62, 238-242
time factors, 239, 242, 244, 400
see also Bioassays; Dose-response
relationships; specific allergens
under Prevention and mitigation Gender factors
measures
Exposure mitigation and prevention, see
Prevention and mitigation
measures
Farm animals, see Cows; Horses
Fetuses, see Pregnant women
Filters, 360-363, 364-365, 368, 370-375,
377, 417
see also High-efficiency particulate air
(HEPA) filters
Finland, 116-117, 121
Flooding, 303, 306, 311, 321, 402
Food and Drug Administration, 126
Foreign countries, see International
perspectives; specific countries
INDEX
Formaldehyde, 3, 7, 9,11, 225, 241, 243
247
building materials, 243, 245
exposure assessment, 57, 225, 244
Fragrances, 3, 9, 11, 247-250, 400401
Fungi, 3, 6, 7, 9,14,17,158-175,185
adolescents, 168, 173
adults, 11,166, 170
agricultural, 163
bioassays, 160,162,168, 169
children, 166-172 (passim)
dampness and, 154,168,171-173,
302, 303, 306-307, 309, 310
exposure assessment, 57, 59,158,
162-164, 169-173, 174-175, 329
glucans, 159,161, 162
immunotherapy, 168-169
inflammatory response, 160-161
mycotoxins, 159, 161-162
occupational asthma, 163
plant, 185, 186
prevention and mitigation, 173-174
research recommendations, 22,174
175, 186, 307, 398
schools, 170, 322
standards of exposure, 174
symptoms, 164-173, 174-175
temperature factors, 154,156, 306,
322
T lymphocytes, 161
ventilation, 352, 359
adolescents, 71
age and, 27, 71
CDC study, 29, 30
hospitalizations, 70
mortality, 68
nitrogen dioxide, 399
prevalence, 27, 29, 72, 78
tobacco smoke, 274-275, 276-277, 278
279
twin studies, 78
see also Pregnant women
Genetic factors, 16,17, 23, 28, 32, 63, 67,
80, 98-99, 110
cat allergens, 106,107
cockroach allergens, 132
DNA, 98,106, 161
endotoxins, 157
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INDEX
research recommendations, 99, 394,
396
twin studies, viii, 78-79, 80
Geographic factors, 29-31, 62, 68, 70, 73
dust mites, 147-148
fungal sensitization, 166-167
prevalence, 70, 71, 73, 74-75
rural areas, 120-121, 151, 155, 163,
176, 235, 236
ventilation rates, 335
see also Climate and weather;
Dampness and moisture;
International perspectives;
Urban areas; specific countries
Germany, 80, 143, 239
Glucans, 159, 161, 162
Guidelines for the Diagnosis and
Management of Asthma, 33, 87
Heating, ventilation, and air-
conditioning (HVAC) systems,
3, 14-15, 18, 319-321, 333, 336-
337, 338-347, 353-358, 360
air cleaning, 362-363, 364-365, 367,
372-373, 377, 380, 382-383
beliefs about, 382-383
cost factors, 346-347, 349, 356, 357,
382-383
dust mites, 147, 148
formaldehyde, 244
infectious agents, 183, 299, 343-344,
357-359, 365, 404
moisture, 300, 307, 310, 319-320, 340-
341, 343, 357-358, 365
mold, 321-322
nitrogen dioxide, 225, 231, 233
ozone, 251
preventive measures, 21, 310
schools, 321-322
sulfur dioxide, 254
tobacco smoke, 281, 289
volatile organic compounds, 239, 243
see also Ventilation
High-efficiency particulate air (HEPA)
filters, 124, 362, 365-366, 367,
369, 384, 395, 405
cat allergens, 112, 113, 114, 124, 395
particulate matter (nonbiologic), 253
research recommendations, 385-386
symptoms, effects on, 370-375, 380
431
Hispanics, 71, 73, 129, 283
Historical perspectives
dampness, 303, 305
morbidity and mortality, vii, 3, 29-31,
67-68, 105
nonresidential buildings, 318-319
prevalence, 29-31, 72, 73, 81-82, 105
previous IOM studies, 19-22, 40
risk factor studies, 28-29, 77-78
Horses, 9, 11, 120-121
Hospitalization, 33, 69-70, 81
air cleaning, 374-377
CDC prevalence study, 29-30
cockroach allergens, 130-131
emergency departments, 30, 33, 70,
80, 109
ozone, 252
pollen, 191-192
regional factors, 29-30
socioeconomic status, 79-80
House dust mites, see Mites
Houseplants, see Plants
Humidity and humidifiers, see
Dampness and moisture
HVAC, see Heating, ventilation, and air-
conditioning (HVAC) systems
Immune system, viii, 253, 396
definition of asthma, 22-23
endotoxins, 153, 154, 157, 158, 397
formaldehyde, 245
macrophages, 22, 93, 104, 152-153, 161
see also Inflammatory response; T
lymphocytes
Immunoassays, see Bioassays
Immunoglobin, 31, 34, 57, 88
cat allergens, 107, 110
chlamydia, 180
cockroach allergens, 125, 126, 129,
130-131
dog allergens, 115, 117
dust mites, 137-139, 149
endotoxins, 157
monoclonal antibodies, 125, 142
respiratory syncytial virus, 177, 178
rodent allergens, 119
Immunotherapy, 28, 115, 184
cockroaches, 396
dog allergens, 115
fungi, 168-169
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432
Incidence and prevalence, vii, 1, 21, 22,
29, 67-68, 70-82, 231
adolescents, 30
adults, 30, 33
allergic vs nonallergic asthma, 33
children, 20, 27, 30, 33, 67-68, 69-70,
71,73,78,80
dampness and, 7, 310
definitional issues, 70-71
gender factors, 27, 29, 72, 78
historical perspectives, 29-31, 72, 73,
81-82, 105
international perspectives, 1, 73-74,
76, 77
tobacco smoke, 269, 274-278, 283
Income, see Socioeconomic status
Indoor Allergens: Assessing and Controlling
Adverse Health Effects, 19-21
Infants, 8, 26, 399, 406407
breast-feeding, 78
chlamydia, 179
cockroach allergens, 127,130-131
dampness and mold, 308
dust mites, 397
nitrogen dioxide, 399
respiratory syncytial virus, 177, 178
rhinovirus, 181
tobacco smoke, 266, 267, 268, 272,
275-278, 286-287, 290
see also Pregnant women
Infectious agents, general, 3, 20, 28, 32,
175-184
heating, ventilation, and air-
conditioning systems, 183, 299,
343-344, 357-359, 365, 404
nitrogen dioxide exposure and, 231-
232
research recommendations, 183-184,
398-399
ventilation systems, 183, 332-333, 356
see also Chlamydia; Dampness and
moisture; Endotoxins; Fungi;
Molds; Mycoplasma pneumonias;
Respiratory syncytial virus;
Rhinovirus
Inflammatory response, viii, 31, 32-33,
253
cat allergens, 107
definition of asthma, 22-23
eosinophilic, 25-26, 89-90, 92, 93, 95,
125-129
INDEX
fungi, 160-161
nitrogen dioxide, 230-231
research recommendations, 23, 34, 394
see also Airway inflammation;
Chronic obstructive
pulmonary disease
Insects, 9,17,124-125, 185
see also Cockroaches; Mites
Institutional and commercial buildings,
see Buildings, nonresidential
Interleukin, 93, 95, 97, 99
endotoxins, 152,153, 154
International Agency for Research on
Cancer, 49
International Classification of Diseases,
30
International perspectives
dampness, 304
dust mites, 136-137, 140,146
fungal sensitization, 166-167
prevalence, 1, 73-74, 76, 77
severity, 77
twin studies, 78-79
see also specific countries
International Study of Asthma and
Allergy in Childhood, 73, 76
Macrophages, 22, 93,104, 152-153,161
Mast cells, 22, 88-89, 90,177
Medication, 23, 33, 96, 371
antibiotics, 29
children, 25
Mexican Americans, 73
Microenvironmental model, 54-55
Migrant population studies, 79
Minority groups, see Race/ethnicity
Mites,3,4,6,7,9,10,11,13,17,29,115-
116, 122, 127, 135, 136-150, 165,
178,254,416
air cleaning, 380
bioassays, 137,139, 142
children, 9,136,143-144, 168
climate conditions, 62,147-148
dampness and, 142,145,147-148,
307, 309, 310, 354-355
dose-response relationships, 146
exposure assessment, 56-58, 78,139,
142-143, 329
geographic factors, 147-148; see also
"climate conditions" supra and
"international perspectives" infra
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INDEX
heating, ventilation, and air-
conditioning (HVAC) systems,
147, 148
immunoglobin, 137-139, 149
infants, 397
international perspectives, 136-137,
140, 146
plants, 185
prevention and mitigation measures,
145-150, 396-397
research recommendations, 22,123,
150, 394-395, 396-397
schools, 322, 323
symptoms, 139-145
temperature factors, 62, 145; see also
"climate conditions" supra
T lymphocytes, 137-138
urban areas, 145,146
ventilation, 147,148, 351-352, 353,
354-355, 359
Mitigation measures, see Prevention and
mitigation measures
Moisture, see Dampness and moisture
Molds, 4, 9, 122, 171-173, 302, 303, 308,
309
schools, 321-322, 323
ventilation, 359
Molecular biology, 3, 87, 96-97, 401
cell adhesion molecules, 92-95, 394
see also Genetic factors
Monoclonal antibodies, 125,142
Morbidity and mortality, 67-70, 75-77,
79-82, 129
EPA outreach strategy, 2, 20
race/ethnicity, 69, 70, 71-73, 77, 79
socioeconomic status, viii, 69, 79-80,
81
trends, vii, 3, 29-31, 67-68,105
see also Symptoms
Mycoplasma pneumonias, 3, 7, 9,11, 180-
181, 182
Mycotoxins, 159, 161-162
National Ambient Air Quality
Standards, 224
National Center for Health Statistics, 29
National Cooperative Inner City
Asthma Study, 119,130,134
National Health and Nutrition
Examination Survey, 70-71
433
National Health Care Survey, 69
National Health Interview Survey, 29,
73,77,79
National Hospital Discharge Survey, 29,
69
National Institute for Occupational
Safety and Health, 317, 318,
319
Netherlands, 118,137, 144
New Zealand, 1, 79,109,116,122,140
Nitrogen dioxide and nitrogen oxides, 3,
6, 9, 11, 224-234, 254, 330
adults, 229, 231, 254
children, 227-228, 229-230
exposure assessment, 57, 61, 77, 224-
226
time factors, 226, 231, 234-235,
399
gender factors, 399
heating, ventilation, and air-
conditioning systems, 225, 231,
233
infants, 399
infectious diseases, 231-232
inflammatory response, 230-231
pollen and, 190,191
prevention and mitigation measures,
233
regulatory interventions, 224
research recommendations, 234, 399
respiratory syncytial virus, 231
schools, 227-228, 322
socioeconomic status, 226, 399
symptoms, 226-233
tobacco smoke, 228
urban areas, 224, 225, 229-230
ventilation, 225, 231, 233, 351, 357
Noise, air cleaning equipment, 363-364,
366, 384
Nonresidential indoor environments, see
Buildings, nonresidential
Norway, 78-79,112-113, 322-323
Occupational and Environmental
Disease Surveillance Database,
322
Occupational asthma, 27, 41, 118-119,
142, 316-326
agriculture, 120-121,151,155, 163,
235, 236
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434
cockroach allergens, 126
cows and horses, 120-121
endotoxins, 151,155, 156
fungi, 163
pesticides, 235, 236
plant allergens, 185
plasticizers, 250-251
tobacco smoke, 265-266, 270
see also Schools and daycare centers
Ozone, 3, 77, 241, 251-252, 330, 352
Ozone Generators That Are Sold as Air
Cleaners, 252
Particulate matter, general, 3, 4, 15-16,
32, 77, 95, 225, 252-253, 323
cockroach allergens, 126,135
dog allergens, 117
dose concepts, 55-56
nonresidential buildings, general,
344-345
ventilation, 327-331, 347, 351-352,
356-357, 409-414
see also Air cleaning; Mites; Pollen;
Tobacco smoke
Passive smoking, see Tobacco smoke
Perfumes, see Fragrances
Pesticides, 3, 7,11, 234-237
animal models, 237, 400
children, 234-235
cockroach control, 133-134, 237
exposure assessment, 57,133, 234-235
occupational exposures, 235, 236
research recommendations, 237, 399-
400
socioeconomic status, 235
symptoms, 235-238
urban areas, 235
volatile organic compounds, 239
Pets, see Birds, domestic; Cats; Dogs;
Pharmacological agents, see Medication
Plants, 3, 7, 9,11, 184-186
exposure assessment, 57, 399
fungi, 185, 186
mites, 185
research recommendations, 22,186,
399
see also Pollen
Plasticizers, 3, 11, 250-251, 400
Pollen, 3, 8, 9,11,14,122,184-185,186-193
bioassays, 190
INDEX
children, 190-191
dose concepts, 55-56
exposure assessment, 59,187-188, 329
nitrogen dioxide and, 190,191
sulfur oxides and, 191-192
symptoms, 187,189-192, 193
Polymerase chain reaction, 106,184, 398
Portable air cleaners, 363-364, 365, 366,
367, 369, 377-378, 379, 380
Poverty, see Socioeconomic status
Pregnant women, 27
endotoxins, 152
research recommendations, 17, 21,
22, 290, 399, 401
tobacco smoke, 10, 269, 272-273, 275,
278, 280, 282, 285-286, 290, 401
Preschool children, 6, 9,10, 24-25, 26, 30,
70, 71, 416
cockroach allergens, 10,11,130-131,
132
tobacco smoke, 7, 9,10,11, 25, 266,
270, 276-278, 280, 289
see also Infants
Prevalence, see Incidence and prevalence
Prevention and mitigation measures, vii,
2, 12-18,20,21,22,33,39,40,
49, 87, 224, 253, 406
cat allergens, 111-114, 395
cockroach allergens, 132-136
dampness and moisture, 298, 305,
310-311, 402
dog allergens, 116-117, 395
dust mites, 145-150, 396-397
endotoxins, 156-157
formaldehyde, 246-247
fragrances, 249-250
fungi, 173-174
heating, ventilation, and air-
conditioning systems, 21, 310
infectious agents, 182-183
nitrogen dioxide, 233
pesticides, 237
pollen, 192
rodent allergens, 119-120
schools, 323
socioeconomic status, viii, 285, 290
tobacco smoke, 282-290, 401402
volatile organic compounds, 242-243
see also Air cleaning; Public
education; Regulatory
interventions; Ventilation
OCR for page 435
INDEX
Professional associations
American Home Appliance
Manufacturers, 360
American Lung Association, 378-379
American Society of Heating,
Refrigerating, and Air
Conditioning Engineers
(ASHRAE), 332, 338, 341-342,
356, 361, 366-367, 369
American Thoracic Society, 310
Public buildings, see Buildings,
nonresidential
Public education, 20, 21, 39
dampness, 311, 402
tobacco smoking, 282, 284-285, 286-
288, 289
see also Schools and daycare centers
Puerto Ricans, 129
RAST, 80,107,108,126,160,168, 169,
190
Race/ethnicity, 1, 10
CDC study, 29, 30
cockroach allergens, 129
Hispanics, 71, 73,129, 283
morbidity and mortality, 69, 70, 71-
73,77,79
prevalence, 71
respiratory syncytial virus, 176
smoking, 283, 285, 286, 290, 401
utilization of health care, 79-80
see also African Americans
Radioallergenic absorbent test, see RAST
Regional factors, see Geographic factors
Regulatory interventions, 283
dampness, 21, 311
formaldehyde, 246
nitrogen dioxide, 224
tobacco smoke, 270, 283
ventilation, 318, 332, 338, 341-342, 356
Research recommendations, 2,16-18, 21,
22, 39, 394407
air cleaning, 385-386, 404405
animal allergens, 22,123-124,136,
150, 394-397
cockroach allergens, 13,136, 396
dampness and moisture, 294, 311, 402
dose-response relationships, 22
dust mites, 22,123,150, 394-395, 396-
397
435
endotoxins, 157-158, 397-398
fragrances, 250, 400401
fungi, 22,174-175,186, 307, 398
genetics, 99, 394, 396
infectious agents, 183-184, 398-399
inflammatory response, 23, 34, 394
nitrogen dioxide and nitrogen
oxides, 234, 399
nonresidential buildings, 324-325,
359, 402403
pesticides, 237, 399400
plant allergens, 22,186, 399
plasticizers, 251, 400
pollen, 193
pregnant women, 17, 21, 22, 290, 399,
401
previous IOM study, 21-22
rodent allergens, 395-396
synergistic effects, 62-63
tobacco smoke, 290, 401402
ventilation, 359-360, 403404
volatile organic compounds, 243, 400
Respiratory syncytial virus, 3, 7, 9, 10,
11, 176-178, 181, 182
cockroach allergens, 131-132
infants, 177, 178
nitrogen dioxide, 231
socioeconomic status, 176
Rhinovirus, 3, 6, 9,11,175-176,181,183
Risk factors, general, 28-29, 3940, 67
adoptee studies, 79
historical perspectives, 28-29, 77-78
see also Chemical agents; Dampness
and moisture; Demographic
factors; Exposure assessment;
Genetic factors; Infectious
agents, general; Occupational
asthma; Tobacco smoke; other
specific allergens
Rodents, 3, 9,11, 118-120, 396
Rural areas, see Agriculture
Schools and daycare centers, 28, 78, 318,
321-323, 324, 417
cat allergens, 112,123-124, 321
cockroach allergens, 126-127
dampness, 322
days of school missed, 77
dog allergens, 123-124, 321
dust mites, 322, 323
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436
fungi, 170, 322
heating, ventilation, and air-
conditioning (HVAC) systems,
321-322
infectious agents, 183
molds, 321-322, 323
nitrogen dioxide, 227-228, 322
prevention and mitigation measures,
323
rodent allergens, 118
tobacco smoke, 269-270, 283
ventilation, 321-322, 344-345, 349, 358
Sex-based differences, see Gender factors
Smoking, see Tobacco smoke
Socioeconomic status, 1,17, 21
cockroach allergens, 126,128,129
hospitalization, 79-80
infectious agents, 183
methodological issues, 43, 63
morbidity and mortality, general,
viii, 69, 79-80, 81
nitrogen dioxide, 226, 399
pesticides, 235
prevention and mitigation measures,
viii, 285, 290
respiratory syncytial virus, 176
rodent allergens, 395-396
smoking cessation, 285, 290
utilization of health care services, 79-
80
Spirometry, 33-34
Standards
air cleaning, 360, 361, 366-367, 369
American Home Appliance
Manufacturers, 360
American Society of Heating,
Refrigerating, and Air
Conditioning Engineers
(ASHRAE), 332, 338, 341-342,
356, 361, 366-367, 369
cockroach allergens, 126
dampness, 21, 298, 311, 402
fungal exposure assessment, 174
International Classification of
Diseases, 30
nitrogen dioxide regulation, 224
ventilation, 318, 332, 338, 341-342,
356
see also Regulatory interventions
INDEX
Sulfur oxides, 3, 77, 225, 253-254
pollen and, 191-192
Sweden, 114-115,116,121, 241, 245-246,
308, 322, 353
Symptoms, viii, 24-28, 34, 81, 253, 406-
407
adolescents, 24, 26-27
air cleaners, effects on symptoms,
370-377, 378-382
birds, 122, 123
cat allergens, 108-110,111, 395
chlamydia, 179-180
cockroach allergens, 128-129,131-
132, 149, 150
definition of asthma, general, 22, 23,
70-71
dampness-related asthma, 310
dog allergens, 115, 395
dust mites, 139-145
endotoxins, 152-156
formaldehyde, 245-246
fragrances, 247-249, 400401
fungi, 164-173, 174-175
infants, 8
mycoplasma, 181-182, 183-184
nitrogen dioxide, 226-233
nonresidential buildings, 342, 358,
402403
ozone, 252
patients' perception of symptoms, 33
pesticides, 235-238
plants, 185-186
plasticizers, 250-251
pollen allergens, 187,189-192,193
pulmonary function tests, 33-34
respiratory syncytial virus, 177-178
rhinovirus, 175-176
rodent allergens, 118-119
sulfur dioxide, 254
tobacco smoke, 271-278, 279-280, 290
volatile organic compounds, 240-242
Synergistic effects, definition, 62-63; see
also specific exposures (e.g.,
Pollen and" under "Sulfur
oxides")
Temperature factors, 333, 334, 337, 344,
352
fungi, 154,156, 306, 322
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INDEX
mites, 62, 145
moisture, 300, 301-302, 306
mold, 302, 322
schools, 322
volatilized organic compounds, 239,
241, 247, 322
see also Climate and weather;
Dampness and moisture;
Heating, ventilation, and air-
conditioning (HVAC) systems
Time factors, 23-24, 48, 52-53, 54
air cleaning, 367-368
days of school missed, 77
exposure, 1, 52-53, 54, 55, 56, 58, 60,
61, 107, 113, 410411, 413
dampness, 302
endotoxins, 156
formaldehyde, 244, 246
fungi, 170, 173-174
nitrogen dioxide, 226, 231, 234-
235, 399
occupational exposures, 317
pesticides, 133
tobacco smoke, 264-271 (passim),
275
volatile organic compounds, 239,
242, 244, 400
ventilation rates, 334, 338, 340, 341,
348, 352
T lymphocytes, 22, 89, 90-95, 99, 396
cow and horse allergens, 121
dust mites, 137-138
endotoxins, 153,154, 157,158, 397
fungi, 161
Tobacco smoke (ETS), 3, 4, 14-15, 55, 95,
263-297, 328, 415
adolescents, 269, 283-284, 290, 401
adults, 7, 9, 268, 269, 270, 279, 280-
281
cessation efforts, 282, 284-285
gender factors, 274-275, 276-277,
278-279
pregnant women, 10, 269, 272-
273, 275, 278, 280, 282, 285-286,
290, 401
African Americans, 283, 286, 290, 401
air cleaning, 281-282, 289, 369, 370-
371, 381
airway inflammation, 271-272, 278
437
attitudes and beliefs, 278-279, 280,
284-286 (passim)
biological markers, 267-268, 269, 272
273
children, 6, 7,11, 20, 263, 267, 268,
269-281, 283, 286-290, 401
adolescents, 269, 283-284, 290, 401
infants, 266, 267, 268, 272, 275
278, 286-287, 290
preschool, 7, 9,10,11, 25, 266, 270,
276-278, 280, 289
climate and weather, 281, 286
dampness and, 309
dose-response relationships, 278-280
EPA efforts, 263, 265
exposure assessment, 57, 60-61, 77
78, 263, 265-271, 278-280, 286
287, 288
gender factors, 274-275, 276-277, 278
279
heating, ventilation, and air
conditioning systems, 281, 289
infants, 266, 267, 268, 272, 275-278,
286-287, 290
nitrogen dioxide and, 228
nonresidential buildings, 123-124,
266,270,283,321
occupational exposures, 265-266,
270
pregnant women, 10, 269, 272-273,
275, 278, 280, 282, 285-286, 290,
401
prevalence, 269, 274-278, 283
prevention and mitigation measures,
282-290, 401-402
race/ethnicity, 283, 285, 286, 290, 401
regulatory interventions, 270, 283
research recommendations, 290, 401
402
schools, 269-270, 283
socioeconomic status, 285, 290
symptoms, 271-278, 279-280, 290
urban areas, 265-266
ventilation, 281, 289, 347, 356, 369
Treatment, 22, 23-24, 33-34, 87
medication, 23, 25, 29, 33, 96, 371
see also Hospitalization; Prevention
and mitigation measures
Twin studies, viii, 78-79, 90
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438
United Kingdom, 1, 113, 118-119, 227
228, 263, 271
Urban areas, 1, 17, 69
cockroach allergens, 127, 128, 129,
130, 134, 140
dust mites, 145, 146
endotoxins, 155, 157
infectious agents, 183
nitrogen dioxide, 224, 225, 229-230
pesticides, 235
prevalence, 70, 71, 79
rodent allergens, 119
tobacco smoke, 265-266
volatile organic compounds, 239
Utilization of health care, 69-70, 81
socioeconomic status, 79-80
see also Hospitalization
Ventilation, 3, 14-15,18, 327-328, 331
360, 379
air conditioning vs. 382-383
cat allergens, 356
climate conditions, 334, 335, 339, 340
341, 344, 346, 353, 354-355
defined, 331
dust mites, 147, 148, 351-352, 353,
354-355, 359
formaldehyde, 244
fungi, 352, 359
infectious agents, 183, 332-333, 356
moisture, 300, 307, 310, 319-320, 331,
340-341, 343, 352-353, 354-355,
357-358, 359
multifamily apartment buildings,
336-338
nitrogen dioxide, 225, 231, 233, 351,
357
particulate matter, general, 327-331,
347, 351-352, 356-357, 409414
regulatory interventions and
standards, 318, 332, 338, 341
342, 356
research recommendations, 359-360,
403404
schools, 321-322, 344-345, 349, 358
single-family residences, 333-335,
348, 354-355, 359
INDEX
sulfur dioxide, 254
theoretical considerations, 327-331,
409414
time factors, 334, 338, 340, 341, 348,
352
tobacco smoke, 281, 289, 347, 356, 369
volatile organic compounds, 239,
243, 348-349, 351, 357
see also Air cleaning; Heating,
ventilation, and air-
conditioning (HVAC) systems
Viral agents, 328, 330, 415
see also Respiratory syncytial virus;
Rhinovirus
Volatile organic compounds, 3, 7, 11,
225, 237-243
adults, 241, 242
bioassays, 241
building materials, 239
children, 241, 322, 349
dampness, 239
exposure assessment, 57, 61-62, 238
242
time factors, 239, 242, 244, 400
heating, ventilation, and air
conditioning (HVAC) systems,
239, 243
nonresidential buildings, general,
344-345
pesticides, 239
prevention and mitigation measures,
242-243
research recommendations, 243, 400
schools, 322, 349
symptoms, 240-242
temperature factors, 239, 241, 247,
322
tobacco smoke, 264-265, 272
urban areas, 239
ventilation, 239, 243, 348-349, 351,
357
see also Formaldehyde
Water vapor, see Dampness and
moisture
Weather, see Climate and weather
World Health Organization, 263
Representative terms from entire chapter:
nitrogen dioxide
